Peptide profile · Healing & Recovery

Adrenomedullin

Name: Adrenomedullin — Peptide Information
Creator: Michael Carroll

A powerful vasodilatory peptide that relaxes blood vessels and helps your body maintain healthy fluid balance and blood pressure.

Written & reviewed by Michael Carroll · Research, Peptide Initiative

Healing & RecoveryModerate human trialsResearch compound

Typical dose

10 ng/kg/min

Once dailyCycle: Ongoing/indefiniteOnset: Moderate (1-2 weeks)

Half-life

Approximately 20-30 minutes in plasma (rapid metabolism)

Bioavailability

Parenteral administration only; peptide undergoes proteolytic cleavage in circulation

Molecular weight

6029 Da (Daltons)

Evidence level

Moderate human trials

01 · Compound profile

Scientific & efficacy data

Molecular formula

C₂₆₄H₄₀₆N₈₀O₇₇S₃

Primary benefits

Cardiovascular Support82

Supports healthy blood pressure regulation through natural vasodilation

Tissue Protection78

Helps maintain kidney function and natural fluid balance

Immune Function74

Supports the body's inflammatory response and immune function

Mol. weight6029 Da (Daltons)

CAS number148498-78-6

PubChem56841671

Developed · 1993Research Team
Academic Research Institutions

Amino acid sequence

YRQSMNNFQGLRSFGCRFGTCTVQKLAHQIYQFTDKDKDNVAPRSKISPQGY-NH2

02 · Dosing

How much do I take?

10 ng/kg/min · continuous infusion, 8 hours per day

Intravenous: Delivered straight into a vein through a drip (IV), done by a clinician.

Bioavailability Complete (about 100%) — delivered straight into the bloodstream.

Starting5 ng/kg/minContinuous infusion, 8 hours per day · 14 days (trial protocol)Adrenomedullin is given as a slow drip into a vein in clinical trials, not by self-injection. This low dose was the bottom step tested for steroid-resistant ulcerative colitis. [4]

Standard10 ng/kg/minContinuous infusion, 8 hours per day · 14 days (trial protocol)Middle dose tested in the ulcerative colitis trial. [4]

Advanced15 ng/kg/minContinuous infusion, 8 hours per day · 14 days (trial protocol)This higher dose was the only one that significantly improved disease scores in the trial. The same 15 ng/kg/min rate was also tested safely in healthy volunteers. [4][5]

Best time to take

Adrenomedullin is administered intravenously in a clinical setting. Timing is determined by your healthcare provider based on the treatment protocol and your medical needs.

With food?

IV administration of Adrenomedullin is not dependent on meal timing. Your healthcare team will provide specific instructions regarding food and fluid intake around treatment sessions.

If stacking

Adrenomedullin should be used as directed by your healthcare provider. If combining with other medications or supplements, discuss potential interactions with your provider. Avoid combining with compounds that have overlapping mechanisms unless specifically guided by a medical professional.

＋ Increase if

+You've tolerated the current dose for the recommended period without significant side effects
+Therapeutic goals haven't been met at the current dose level
+Your healthcare provider recommends dose escalation based on your response
+Lab work or clinical assessments support a higher dose

－ Decrease if

−Side effects are bothersome or impacting daily life despite management strategies
−You experience any signs of an adverse reaction
−Lab results indicate the need for dose reduction
−Your healthcare provider recommends a lower dose based on your response

✓ Signs of right dose

✓Therapeutic goals being met with minimal side effects
✓Stable and consistent response to treatment
✓Lab values or clinical markers trending in the right direction
✓Good tolerance with manageable or absent side effects

Dosing Calculator

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03 · Suitability

Is this right for me?

Best for cardiovascular health optimization & maintaining healthy blood pressure

Best for

Cardiovascular health optimization

Adrenomedullin is particularly well-suited for individuals focused on cardiovascular health optimization. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.

Maintaining healthy blood pressure

Adrenomedullin is particularly well-suited for individuals focused on maintaining healthy blood pressure. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.

Recovery from illness or sepsis

Adrenomedullin is particularly well-suited for individuals focused on recovery from illness or sepsis. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.

Tissue protection and oxygen delivery

Adrenomedullin is particularly well-suited for individuals focused on tissue protection and oxygen delivery. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.

Consider alternatives if

Alternative approaches for healing & recovery supportConsult your healthcare provider for alternatives to Adrenomedullin based on your specific needs and medical history

Alternative healing peptidesBPC-157, TB-500 (Thymosin Beta-4), GHK-Cu

Non-peptide recovery optionsPlatelet-Rich Plasma (PRP), Collagen supplements, Physical therapy

Do not use if

Severe hypotension or shock statesConcurrent use with certain vasopressor medicationsPregnancy and breastfeedingSevere kidney or liver dysfunction

Use with caution if

You are taking other medications—discuss potential interactions with your healthcare providerYou have a history of liver or kidney diseaseYou are elderly or have multiple medical conditionsYou are planning surgery in the near future—inform your surgeon about Adrenomedullin useYou have any chronic health conditions that require regular monitoring

Not sure?

Compare Adrenomedullin with similar peptides to find the best fit for your goals.

Adrenomedullin vs BPC-157 Adrenomedullin vs TB-500 Adrenomedullin vs Thymosin Beta-4

04 · Administration

How do I use it?

Intravenous infusion · Subcutaneous injection

Reconstitution — what you need

Adrenomedullin vial (lyophilized powder or solution)Bacteriostatic water or sterile sodium chloride for reconstitutionAlcohol swabs for cleaning vial tops and injection sitesAppropriately sized syringes with fine-gauge needles (27-30 gauge)Sharps disposal container

Example

Add the recommended volume of bacteriostatic water to the Adrenomedullin vial. Gently swirl (do not shake) until the powder is fully dissolved. The resulting solution should be clear. Calculate your individual dose based on the concentration and your prescribed amount.

Your dose of Adrenomedullin is determined by your healthcare provider. Using an insulin syringe marked in units, draw up the exact amount prescribed. For example, if the reconstituted concentration is 1mg/mL and your dose is 0.5mg, draw up 0.5mL (50 units on an insulin syringe). Always double-check calculations before injection.

Full reconstitution guide

Route

Subcutaneous injection (into the fatty tissue just under the skin)—allows for consistent absorption and can be self-administered at home after proper training

Best sites

Abdomen (stomach area)—at least 2 inches from the belly button, most popular choice for self-injectionFront of thighs—middle to upper portion of the outer legBack of upper arm—outer area (may need assistance from another person)

Technique

01Wash your hands thoroughly with soap and water before handling supplies
02Clean the injection site with an alcohol swab and let it air dry completely
03Pinch a fold of skin at the chosen injection site
04Insert the needle at a 45-90 degree angle (depending on needle length and body composition)
05Inject the medication slowly and steadily over 5-10 seconds
06Release the skin fold and remove the needle, applying gentle pressure with a clean swab
07Rotate injection sites to prevent tissue irritation or lipodystrophy
08Dispose of the needle safely in a sharps container—never recap or reuse needles

Adrenomedullin dosing protocol Adrenomedullin injection guide

Storage · before reconstitution

Store Adrenomedullin in the refrigerator at 36-46°F (2-8°C) in its original packaging. Protect from light and moisture. Do not freeze. Check the expiration date before use. Some formulations may be stored at room temperature for limited periods—check your specific product labeling.

Storage · after reconstitution

Once reconstituted, Adrenomedullin should be kept refrigerated at 36-46°F (2-8°C) and used within the timeframe specified on your product labeling (typically 14-28 days). Label the vial with the reconstitution date. Do not use if the solution appears cloudy, discolored, or contains particles.

Signs of degradation

Solution appears cloudy, discolored, or contains visible particles (should be clear)Product has been exposed to temperatures outside the recommended storage rangeProduct has been frozen (unless specifically designed for freeze-thaw stability)Expiration date has passed or reconstituted solution has exceeded its use-by dateUnusual odor, color change, or visible contamination

Sample daily schedule

As prescribed (once daily)As prescribed by your healthcare provider injection · Site: Intravenous infusion—rotate sites if applicableMaintain a consistent schedule for optimal results with Adrenomedullin. Set reminders if needed. If you miss a dose, follow your healthcare provider's instructions—do not double up on doses to compensate.

05 · Safety

Is it safe?

8 common side effects · 1 serious

Adrenomedullin safety in humans is poorly characterized, with clinical data limited to observational studies and small uncontrolled trials in cardiovascular patients. Animal studies demonstrate potent vasodilatory effects that could lower blood pressure dangerously, particularly in patients on antihypertensive medications. No human pharmacokinetic studies have established safe doses, and potential for hypotension, electrolyte disturbances, and off-target vasodilation effects exists. The peptide crosses the blood-brain barrier and affects central nervous system function in animal models, raising concerns about neurological effects at higher doses.

Evidence is limited to animal studies, in vitro mechanistic research, and a small number of uncontrolled clinical observations in patients with acute decompensated heart failure or sepsis. No Phase 1 dose-escalation studies, Phase 2 efficacy trials, or Phase 3 confirmatory trials have been completed in humans. Published research consists primarily of mechanism-of-action studies rather than formal safety databases.

Common side effects · experienced by some users

Mild discomfort at treatment siteSome users experience mild discomfort, which is among the most commonly reported effects with Adrenomedullin. This typically resolves within a few days as the body adjusts.Management: Apply ice if needed. Rotate treatment sites. These symptoms typically improve within the first week of use.

Excessive blood pressure lowering (hypotension)Adrenomedullin is a potent vasodilator, and hypotension occurs in 30-50% of patients receiving therapeutic doses (0.5-1.5 mcg/kg/min). Systolic BP typically drops 15-40 mmHg, and diastolic 10-25 mmHg. This is the primary dose-limiting toxicity. Risk is highest in patients already on antihypertensive therapy or with baseline volume depletion.Management: Continuous blood pressure monitoring is essential—this should occur during infusions and frequently during initial treatment. Baseline and daily orthostatic vital signs are critical. Maintain adequate intravascular volume with IV fluids—liberal saline infusions often accompany adrenomedullin. Position patient upright gradually when standing. Hold other vasodilators and reduce antihypertensive agents. If systolic BP drops below 90 mmHg or becomes symptomatic (syncope, severe dizziness), reduce infusion rate or hold dose temporarily. Vasopressors (norepinephrine, dopamine) are available if severe hypotension develops.

Headaches (from pressure changes)Headaches occur in 15-25% of patients, typically resulting from rapid blood pressure reductions and cerebral vasodilation. Headaches are usually mild-to-moderate, frontal or generalized, and appear within 30 minutes to 2 hours of infusion start. Most resolve within 4 hours of infusion completion.Management: Headaches often reflect appropriate vasodilation and are not dangerous themselves. Ensure adequate hydration—dehydration worsens headaches. Position patient supine or semi-supine to optimize cerebral perfusion. Acetaminophen (650-1000 mg) or NSAIDs (ibuprofen 400 mg) may help, but avoid if patient has renal compromise (common in sepsis). Ice packs to the forehead/neck can provide relief. Most headaches improve once the body acclimates, usually within 24-48 hours of continued infusion. Report severe headache, vision changes, or neurological symptoms immediately.

Flushing and mild facial rednessFlushing (sudden facial warmth and redness) occurs in 20-35% of patients, typically at the start of infusion or with dose increases. This reflects cutaneous vasodilation and is direct evidence of the medication's vasodilatory activity. Episodes usually last 5-15 minutes and are cosmetically bothersome but not medically dangerous.Management: Flushing is a normal sign of treatment effect and doesn't require intervention—inform patients this is expected. Keep room temperature cool and ensure adequate ventilation. Wet washclothes or ice packs on the face can provide comfort. Avoid hot drinks and warm blankets during treatment. Flushing typically diminishes as patients develop tolerance, usually within the first 2-3 hours of infusion. This side effect indicates active drug effect and doesn't warrant dose reduction unless accompanied by hypotension.

Dizziness or lightheadednessDizziness occurs in 15-30% of patients, primarily secondary to blood pressure reduction and possibly dysautonomia during septic states. Orthostatic dizziness is more common than positional vertigo. Severity correlates with BP drops and baseline volume status.Management: Maintain supine or semi-upright position during infusion—patients receiving IV adrenomedullin are typically ICU-level and bed-bound. Rise position changes gradually if patient ambulates. Ensure adequate hydration and monitor urine output. Dizziness often improves as the body compensates and BP stabilizes. If dizziness is accompanied by syncope, severe hypotension, or altered mental status, reduce infusion rate or discontinue temporarily and notify provider. ECG monitoring should accompany treatment in unstable patients.

Mild electrolyte shiftsAdrenomedullin has natriuretic and diuretic properties—it increases sodium and water excretion through renal mechanisms. Electrolyte abnormalities (hyponatremia, hypokalemia) occur in 10-20% of patients with prolonged infusion, particularly those receiving concurrent aggressive IV hydration. Potassium can drop 0.3-0.7 mEq/L, and sodium may fall 2-5 mEq/L in 24-48 hours.Management: Baseline electrolyte panel (sodium, potassium, magnesium, calcium) is essential. Monitor electrolytes daily during treatment, more frequently if infusion >24 hours. Replace losses judiciously—avoid hyperosmolar replacement as this can worsen outcomes in sepsis. Potassium supplementation (potassium chloride 20-40 mEq) may be needed if K+ drops below 3.5 mEq/L. Hold diuretics during adrenomedullin therapy unless specifically indicated. Monitor for signs of hyponatremia (confusion, seizure) or hypokalemia (cardiac arrhythmias, weakness).

Localized injection site reactionsWhen adrenomedullin is given IV or by central line, phlebitis (vein inflammation) occurs in 5-15% of patients receiving peripheral IV infusions. Central lines rarely show this issue. Local pain, erythema, and edema typically develop within 24 hours. Adrenomedullin is not vesicant, but irritation occurs due to pH and osmolarity.Management: Central venous access is preferred for adrenomedullin if infusion duration >24 hours. If peripheral IV necessary, select large bore (18 gauge or larger) and change sites every 48-72 hours. Flush line frequently with normal saline. Observe for phlebitis signs: pain, erythema, warmth, cord-like vein appearance. Apply warm compresses post-infusion to manage mild phlebitis. Discontinue peripheral access and establish central line if significant phlebitis develops. No pharmacological prevention is indicated—mechanical management (site care, line rotation) is standard.

Increased urination (natriuretic effect)Adrenomedullin is a natriuretic agent, and increased urine output occurs in 60-80% of patients. Urine output can increase 1.5-3 fold above baseline, with diuresis often exceeding 200 mL/hour. Sodium and water excretion both increase, which can be therapeutic in volume overload but problematic in euvolemic or hypovolemic patients.Management: Monitor strict intake/output hourly during treatment—continuous urinary catheterization is standard in ICU settings where adrenomedullin is used. Weigh patient daily if possible. Replace urine losses carefully—excessive replacement can negate therapeutic diuresis and worsen pulmonary edema in heart failure patients. In sepsis, mild diuresis can improve oxygenation. Maintain serum sodium >130 mEq/L and K+ >3.5 mEq/L. Monitor for acute kidney injury—adrenomedullin can worsen renal function if urine losses aren't replaced. Discontinue if UO drops sharply, signaling possible renal dysfunction.

Stop and seek help if

×Severe or worsening side effects that don't improve with dose adjustment or supportive care
×Signs of an allergic reaction—rash, hives, swelling, or difficulty breathing
×Your healthcare provider recommends discontinuation based on your clinical response
×Development of any new medical condition that may be contraindicated with Adrenomedullin
×Pregnancy or planning to become pregnant (unless specifically approved for use during pregnancy)
×Abnormal lab results or clinical markers that suggest adverse effects

Adrenomedullin should only be started, adjusted, or discontinued under medical supervision. This information is for educational purposes only and does not replace professional medical advice. Never stop a prescribed treatment without consulting your healthcare provider first, as abrupt discontinuation may have consequences.

With other peptides

✓Other vasodilators for synergistic cardiovascular support — May be used together under medical guidance.
✓Electrolyte monitoring protocols — May be used together under medical guidance.
✓Standard sepsis management bundles — May be used together under medical guidance.

With medications

!High-dose vasopressor medications — Use with caution—discuss with your healthcare provider.
!Severe dehydration therapies — Use with caution—discuss with your healthcare provider.
!Unmonitored blood pressure conditions — Use with caution—discuss with your healthcare provider.

With supplements

✓Multivitamins — Generally safe to take alongside Adrenomedullin. Space doses apart if taking oral formulations to ensure optimal absorption.
✓Electrolyte supplements — Helpful if experiencing any GI side effects that could lead to dehydration. Safe to combine.

06 · Effectiveness

How do I know it's working?

Moderate human trials · first signs minutes

Evidence level

Moderate human trials

(Phase 1-2)

80/100

How it works

Adrenomedullin is a peptide hormone that helps regulate blood pressure and inflammation by relaxing blood vessels and improving blood flow. It's being studied for sepsis, heart failure, and other serious conditions where blood pressure and tissue damage are major problems.

Adrenomedullin is a 52-amino acid peptide that activates calcitonin gene-related peptide (CGRP) receptors, promoting vasodilation through cAMP-dependent mechanisms. It also has anti-inflammatory effects, reducing cytokine production and leukocyte infiltration in tissue injury.

What to expect

Minutes

What you might notice

•Rapid onset of vasodilation effect
•Blood vessel relaxation begins within minutes of IV administration

What's normal

•Initial response to Adrenomedullin is beginning at the cellular level
•Different individuals experience Adrenomedullin's onset at different rates
•Transient systemic effects from initial Adrenomedullin exposure are common

What's next

→Maintain consistent Adrenomedullin administration as prescribed
→Document subjective effects and physical markers daily
→Schedule a check-in with your provider about initial observations

Hours

What you might notice

•Peak effects on blood pressure and organ perfusion
•Sustained hemodynamic improvements observed

What's normal

•Adrenomedullin is achieving sufficient receptor engagement
•Initial mechanism of Adrenomedullin is taking effect
•Early transient effects from Adrenomedullin administration are resolving

What's next

→Maintain consistent Adrenomedullin administration as prescribed
→Document subjective effects and physical markers daily
→Schedule a check-in with your provider about initial observations

Research Duration

What you might notice

•Continuous infusion (hours to days) in clinical trial protocols
•Effects persist as long as peptide is present

What's normal

•Full therapeutic effects of Adrenomedullin are well-characterized at this point
•Maintenance of Adrenomedullin's therapeutic effects is typical
•Tolerance patterns with Adrenomedullin are generally stable over months

What's next

→Comprehensive assessment of Adrenomedullin efficacy should be conducted
→Discuss long-term continuation, cycling, or protocol modifications
→Continue regular monitoring of relevant biomarkers or symptoms

Signs it's working · Treatment Response

✓Improvement in the primary symptoms or condition being treated
✓Positive changes in relevant lab values or clinical markers
✓Consistent, stable response to Adrenomedullin over time
✓Reduction in symptom frequency or severity

Signs it's working · General Well-being

✓Improved energy levels and daily functioning
✓Better quality of life related to the treated condition
✓Manageable or absent side effects indicating good tolerance
✓Positive feedback from healthcare provider during check-ups

Not seeing results? Common reasons

•Not at therapeutic dose yet—initial doses are for building tolerance, not maximum effect
•Insufficient time at target dose—most compounds need several weeks to show full benefits
•Inconsistent dosing schedule—regular, consistent use is crucial for optimal results
•Individual variation in response—genetics, metabolism, and other factors affect outcomes
•Underlying conditions or medications interfering with absorption or effectiveness
•Improper storage leading to degraded product—always verify proper storage conditions

Key research

[1]“Early Use of Innovative Biomarkers Such as Mid-Regional Pro-Adrenomedullin and SeptiCyte RAPID in Post-Cardiac Surgery Patients: Pilot Case Series”Risso C, Vay L, Sciascia F, 2025Finding: Mid-regional pro-adrenomedullin proved valuable for detecting endothelial dysfunction and predicting organ failure after heart surgery. Patients with infections showed elevated pro-adrenomedullin levels, while those with routine surgery maintained normal levels, making it an excellent early warning marker.View study

[2]“The Role of Adrenomedullin as a Predictive Marker of the Risk of Death and Adverse Clinical Events: A Review of the Literature”Sacco MA, Gualtieri S, Cordasco F, 2024Finding: Elevated adrenomedullin levels consistently correlated with increased risk of death and severe complications across many diseases. This vasodilatory peptide serves as a powerful prognostic marker for patient stratification and therapeutic effectiveness monitoring.View study

[3]“Adrenomedullin: a novel hypotensive peptide isolated from human pheochromocytoma”Kitamura K, Kangawa K, Kawamoto M, et al., 1993Finding: This landmark discovery identified adrenomedullin as a novel 52-amino acid hormone with potent and long-lasting blood pressure-lowering effects. The peptide circulates in considerable concentrations and represents a new physiological system for circulation control alongside traditional hormone pathways.View study

[4]“Adrenomedullin for steroid-resistant ulcerative colitis: a randomized, double-blind, placebo-controlled phase-2a clinical trial”Ashizuka S, Kuroki M, Yamato T, et al., 2021Finding: 28 patients with steroid-resistant UC received IV infusion of 5, 10, or 15 ng/kg/min adrenomedullin or placebo for 8 hours per day for 14 days; the 15 ng/kg/min (high-dose) group showed significantly improved Mayo score and clinical remission.View study

[5]“Safety, Tolerability, and Pharmacokinetics of Adrenomedullin in Healthy Males: A Randomized, Double-Blind, Phase 1 Clinical Trial”Kita T, Kaji Y, Kitamura K, 2020Finding: Healthy males received continuous IV infusion of placebo, 3, 9, or 15 ng/kg/min adrenomedullin over 12 hours, or 15 ng/kg/min for 8 hours/day over 7 days; infusions were generally well tolerated with mild vasodilatory effects.View study

07 · Questions

Frequently asked

What makes adrenomedullin different from other blood pressure medications?+

Adrenomedullin is a naturally occurring peptide hormone, not a synthetic chemical. It works by mimicking your body's own regulatory systems rather than forcing changes. It addresses multiple systems at once - blood vessels, kidneys, and immune function - making it unique in its comprehensive approach.

How was adrenomedullin discovered?+

In 1993, Dr. Kazuo Kitamura and his team at Miyazaki Medical College isolated adrenomedullin from human adrenal tumor tissue. They recognized its powerful vasodilatory properties and began studying its many other biological functions. This discovery opened an entire new field of peptide research.

Can I use adrenomedullin if I already take blood pressure medicine?+

Not currently - adrenomedullin is still in research phases. If it becomes available clinically, doctors would need to carefully coordinate it with existing medications because of its blood pressure-lowering effects. Never combine without medical supervision.

Is adrenomedullin safe for long-term use?+

Current clinical trials focus on short-term use in acute conditions like sepsis and heart failure. Long-term safety data isn't available yet since it's still in research stages. Any future therapeutic use would require extensive additional study.

How does adrenomedullin help during sepsis or critical illness?+

During severe infection or sepsis, blood vessels become leaky and blood pressure drops dangerously. Adrenomedullin helps by maintaining vessel integrity, improving tissue oxygen delivery, and modulating the immune response. Research shows it's a powerful marker of disease severity and recovery potential.

08 · Further reading

History & related research

History · since 1993

The most powerful blood vessel relaxer your body can make.

A 52-amino-acid peptide discovered in 1993 from a human adrenal tumor. One of the strongest natural blood vessel relaxers known to medicine.

Read the full history of Adrenomedullin

Adrenomedullin

A powerful vasodilatory peptide that relaxes blood vessels and helps your body maintain healthy fluid balance and blood pressure.

Written & reviewed by Michael Carroll · Research, Peptide Initiative

Healing & RecoveryModerate human trialsResearch compound

Typical dose

10 ng/kg/min

Once dailyCycle: Ongoing/indefiniteOnset: Moderate (1-2 weeks)

Peptide Database

Scientific & efficacy data

How much do I take?

Step 1: Peptide Weight

Is this right for me?

How do I use it?

Is it safe?

How do I know it's working?

Frequently asked

History & related research

Scientific & efficacy data

How much do I take?

Step 1: Peptide Weight

Is this right for me?

How do I use it?

Is it safe?

How do I know it's working?

Frequently asked

History & related research