VIP Reconstitution Calculator

No. No VIP formulation is approved for any indication worldwide. Synthetic VIP (aviptadil/RLF-100) holds FDA orphan designations (ARDS 2001; pulmonary arterial hypertension 2005) and received fast-track status for critical COVID-19. In a 196-patient RCT (2:1, IV aviptadil × 3 days), the primary endpoint (alive and free of respiratory failure at day 60) missed significance (OR 1.6; 95% CI 0.86–3.11), but 60-day survival doubled (OR 2.0; CI 1.1–3.9; p=0.035) with no drug-related serious adverse events. All human use is investigational/off-label. (RCT)

Oral dosing is not viable, the peptide is digested (mechanistic). Published human dosing is IV: 3-day inpatient infusions in the RCT, and a 2-hour infusion that dilated cranial arteries and produced delayed headache in 12 healthy volunteers. Inhaled VIP/aviptadil has been explored for post-COVID lung injury. The core delivery problem: native VIP degrades rapidly in vivo, and continuous free-peptide infusion causes dose-limiting hypotension. Micelle and nanoparticle formulations improve tissue delivery at lower doses in animal models. Community users inject SC, commonly 50–100 mcg, 1–2× daily (community protocol); no published human SC pharmacokinetic data exist.

Human trial exposure is short, 3 days IV. Intermittent dosing is mechanistically rational: VIP receptors internalize within ~2 minutes of agonist exposure (80% surface-binding loss in IGR39 melanoma cells). In DSS-colitis mice, alternate-day dosing was effective, and a single micelle-formulated dose reversed colitis. No chronic human safety data exist. Community practice: 4–6 week cycles of 1–2 injections daily, then 2–4 weeks off (community protocol).

Acute effects: hypotension (dose-limiting with continuous free VIP); cranial vasodilation and delayed headache (human volunteer data); flushing and tachycardia (VIP is a classic cutaneous vasodilatory mediator). The COVID RCT reported no drug-related serious adverse events. Caution in hypotension, arrhythmia, and migraine. Pregnancy and lactation: zero human data, avoid (practitioner consensus).

Both, context-dependently. VIP inhibits TNF-α, IL-6, IL-12, and iNOS while enhancing IL-10 and Th2 responses in macrophages and microglia (in-vitro/animal). However, it also drives Th17/IL-17 generation via VPAC1 in some models, and VPAC2-deficient mice develop exacerbated experimental autoimmune encephalomyelitis. Net effect: immunomodulatory, not blanket suppression. Cancer caution: VIP signaling suppresses anti-tumor T-cell responses in pancreatic cancer, and VIP-receptor antagonists synergize with anti-PD-1 (animal), avoid VIP with active malignancy outside a trial.

Probably not. Elevated VIP concentrations have poor positive predictive value for VIPoma (observational). Diagnosis rests on the clinical syndrome, not the level: profuse watery secretory diarrhea, dehydration, hypokalemia, and weight loss, in children, VIP-secreting neuroblastic tumors present this way for months. Biopsy-proven VIP-secreting tumors can occur with serum-negative VIP. Workup pairs fasting VIP (proper sample handling) with cross-sectional imaging (practitioner consensus).

VIP and PACAP are 68% homologous and share VPAC1/VPAC2 receptors; PACAP additionally binds PAC1 with high affinity, whereas VIP needs ~100 nM for PAC1 versus ~1 nM for VPAC receptors (mechanistic). Anti-inflammatory profiles overlap substantially. Vascular differences matter clinically: PACAP27/38 infusions cause pronounced long-lasting cranial vasodilation and headache, while a 2-hour VIP infusion caused dilation with a milder, delayed headache. Choose VIP where VPAC1/VPAC2-mediated gut/immune effects are the goal; PACAP where PAC1-dependent neuroprotection is sought (practitioner consensus).

No published stability data for compounded VIP. Community norms: keep lyophilized vials refrigerated (2–8°C); reconstitute with bacteriostatic water or sterile saline; refrigerate and use within ~2–3 weeks; never refreeze reconstituted peptide. Travel with a cool pack and documentation (community protocol).