Most entries in this catalogue have to start by saying the compound is not a peptide. This one does not: vasoactive intestinal peptide is a 28-amino-acid peptide the body makes for itself, and its synthetic form, aviptadil, has been through a large randomised trial run by the National Institutes of Health.
The dose record is correspondingly good. It is also almost unusable as a vial figure, for a reason worth setting out precisely.
The figures, as the protocols state them
| Study | Route | Regimen as registered |
|---|---|---|
| ACTIV-3b/TESICO (NCT04843761 / NCT06729606) | Intravenous | 12 h/day for 3 days: 50 → 100 → 150 pmol/kg/hr |
| SAMICARE expanded access (NCT04453839) | Intravenous | Same escalation, "on 3 or more successive days" |
| ZYESAMI inhaled (NCT04360096, NCT05137795) | Nebulized | 100 µg three times daily |
| I-SPY COVID-19 platform (NCT04488081) | Nebulized | 100 µg three times daily, max 14 days |
| Leuppi inhaled study (NCT04536350) | Nebulized | 67 µg three times daily, 10 days |
The intravenous arm of every serious programme is a rate, in picomoles of peptide per kilogram of body weight per hour. Not a quantity. A figure in those units is not yet a dose: it needs a body weight, a duration and a molecular weight before it becomes a mass, which is exactly the gap the dosing-claim guide is built around, and the same failure the kisspeptin record produces in nanomoles.
Converting it, and what the conversion shows
Aviptadil's molecular weight is 3,326.8 g/mol (PubChem CID 16132300, C147H237N43O43S). For a 70 kg adult:
| Day | Rate | Per hour | Over the 12-hour infusion |
|---|---|---|---|
| 1 | 50 pmol/kg/hr | 11.6 µg | 139.7 µg |
| 2 | 100 pmol/kg/hr | 23.3 µg | 279.5 µg |
| 3 | 150 pmol/kg/hr | 34.9 µg | 419.2 µg |
| Whole course | ≈ 838 µg |
That derivation is performed here; the trial states rates and leaves the mass implicit. It varies with body weight, so it illustrates a scale rather than fixing a dose.
The scale is the finding. An entire escalating three-day intensive-care course of this compound comes to roughly eight hundred and thirty-eight micrograms — under a milligram, spread across thirty-six hours of infusion. A single vial in most of this market is measured in multiples of that.
The inhaled arithmetic runs the other way and must not be read across. 100 µg three times daily for 14 days is 4,200 µg, about five times the mass of the complete IV course. Almost none of that difference is systemic exposure: deposition in the airway, particle size and the fraction swallowed all sit between a nebulizer and the bloodstream. The two records coexist; neither converts into the other.
The result
The trial has posted results, and they are worth reporting plainly because this is the best evidence the compound has.
234 participants started aviptadil plus standard of care. 237 started placebo plus standard of care. Deaths through day 90: 86 on aviptadil, 83 on placebo.
Numerically slightly worse on the drug, which at that margin means no detectable effect rather than harm. Alongside it, one inhaled phase 2/3 programme was terminated by sponsor decision at 144 participants, one phase 3 was withdrawn with nobody enrolled, and a Swiss inhaled trial was terminated for want of eligible patients once hospitalisations fell.
Two pulmonary arterial hypertension programmes using the long-acting analogue pemziviptadil, NCT03556020 and NCT04433546, are also registered as terminated.
The effect nobody selling it mentions
VIP is used in human experimental medicine to provoke headache.
Two registered studies say so in their titles — NCT00255320, "Experimental Headache Induced by Vasoactive Intestinal Polypeptide", and NCT00272896, "Hemodynamic and Headache-Inducing Effect of Intravenous Vasoactive Intestinal Peptide" — both in healthy volunteers, with further registered work on long-lasting VIP infusions in migraine.
This is not an adverse-event footnote discovered after the fact. It is a reproducible pharmacological action in healthy people, established on purpose, at research infusion rates. A compound used as a provoking agent in headache models has a documented effect profile that any account of it should carry.
Where the material is registered
FDA's published Drug Master File list holds two files for vasoactive intestinal peptide, both inactive: Peninsula Labs in January 1991, Bachem Americas in August 1997. The analogue aviptadil has one active Type II file, MSN Life Sciences, June 2021.
A Drug Master File is not an approval and is not required by statute, so this records who has registered manufacturing information rather than who may make the compound — the distinction is set out in full on the sources page. What it does show is that the natural peptide currently has no live US drug-substance filing under its own name.
What the record does not contain
No approved label anywhere. No oral, subcutaneous or intranasal figure in any registered protocol. No dose-finding study establishing what the escalation in the NIH trial was escalating toward — the 50/100/150 ladder appears in the protocols as a given.
So the honest summary of this compound's dose record is that it is real, it is large by this catalogue's standards, it sits almost entirely in a hospital intravenous setting expressed in units that need three further values to become a quantity, and the trial it was built for returned 86 deaths against 83.
Every figure above is reported from a registered protocol or a posted result, with its identifier. None of them is offered as a figure to use, and decisions about administering anything to a person belong with a clinician.