Peptide profile · Healing & Recovery
Ularitide
A synthetic natriuretic peptide designed to help your heart pump better and remove excess fluid when you need it most.
Written & reviewed by Michael Carroll · Research, Peptide Initiative
Typical dose
15 ng/kg/min
Half-life
6-7 minutes (in circulation)
Bioavailability
100% (intravenous administration)
Molecular weight
3505.9
Evidence level
Strong human trials
01 · Compound profile
Scientific & efficacy data
Molecular formula
C145H234N52O44S3
Primary benefits
Directly improves heart function and blood flow by relaxing vessels and reducing cardiac workload during emergencies.
Naturally increases water and sodium excretion while maintaining critical electrolyte levels for heart health.
Supports kidney function during heart stress rather than damaging it, unlike some other emergency heart treatments.
Noscira (Spanish biotech)
Amino acid sequence
SLRPGGA(32 amino acids total - Urodilatin structure)02 · Dosing
How much do I take?
15 ng/kg/min · continuous infusion
Intravenous infusion: Delivered straight into a vein through a drip (IV), done by a clinician.
Bioavailability Complete (about 100%) — delivered straight into the bloodstream.
Best time to take
Ularitide 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 Ularitide is not dependent on meal timing. Your healthcare team will provide specific instructions regarding food and fluid intake around treatment sessions.
If stacking
Ularitide 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 managing acute heart failure symptoms and fluid overload & improving oxygen delivery when your heart can't pump efficiently
Best for
Managing acute heart failure symptoms and fluid overload
Ularitide is particularly well-suited for individuals focused on managing acute heart failure symptoms and fluid overload. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Improving oxygen delivery when your heart can't pump efficiently
Ularitide is particularly well-suited for individuals focused on improving oxygen delivery when your heart can't pump efficiently. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Protecting kidney function in critical heart patients
Ularitide is particularly well-suited for individuals focused on protecting kidney function in critical heart patients. Research and clinical experience suggest meaningful benefits in this area when used as part of a comprehensive treatment approach.
Consider alternatives if
Do not use if
Use with caution if
Not sure?
Compare Ularitide with similar peptides to find the best fit for your goals.
04 · Administration
How do I use it?
Intravenous infusion
Reconstitution — what you need
Example
Add the recommended volume of bacteriostatic water to the Ularitide 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 Ularitide 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.
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
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
Storage · before reconstitution
Store Ularitide 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, Ularitide 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
Sample daily schedule
05 · Safety
Is it safe?
4 common side effects · 1 serious
Ularitide is a recombinant B-type natriuretic peptide approved in Europe for acute heart failure with safety data from Phase 3 trials showing favorable tolerability compared to placebo and nesiritide. Hypotension is the primary dose-limiting adverse effect, requiring baseline blood pressure assessment and careful hemodynamic monitoring during IV infusion. Natriuretic peptide class risks include worsening renal function in some patients and hypokalemia (electrolyte abnormalities from enhanced diuresis), necessitating electrolyte monitoring during acute phase therapy.
Phase 3 PROTECT trial and European post-market surveillance provide moderate safety evidence in acute decompensated heart failure populations. Not approved in the United States, but used extensively in Europe since 2007. Long-term chronic heart failure safety data beyond acute infusion phase are limited; mechanism of action (natriuretic/vasodilatory) suggests favorable renal and hemodynamic profile compared to inotropes, but clinical outcomes data remain incomplete.
Common side effects · experienced by some users
Less common
These typically resolve with continued use or dose adjustment.
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 Ularitide
- ×Pregnancy or planning to become pregnant (unless specifically approved for use during pregnancy)
- ×Abnormal lab results or clinical markers that suggest adverse effects
Ularitide 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
- ✓ACE Inhibitors — Both work to relax blood vessels and reduce heart workload; complementary long-term therapy
- ✓Diuretics — Synergistic fluid removal; ularitide naturally enhances diuretic effects
- ✓Beta-Blockers — Reduce heart rate and force while ularitide improves blood flow; balanced approach to heart recovery
With medications
- !Vasoconstrictors — Directly oppose ularitide's mechanism; could cause dangerous blood pressure swings
- !NSAIDs — Can reduce natriuretic peptide effectiveness and increase kidney injury risk
- !Certain Antiarrhythmics — May increase hypotension risk when combined with ularitide
With supplements
- ✓Multivitamins — Generally safe to take alongside Ularitide. 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?
Strong human trials · first signs 1988
Evidence level
Strong human trials
(Phase 3 or FDA approved)
How it works
Ularitide is an intravenous peptide for acute decompensated heart failure. It activates natriuretic peptide receptors to widen blood vessels, reduce fluid retention, and improve heart function in critically ill patients.
Ularitide is a natriuretic peptide that activates NPR-A receptors, increasing cGMP and promoting vasodilation, natriuresis, and reduced aldosterone secretion.
What to expect
1988
What you might notice
- •Urodilatin discovered in human urine by Wolf-Georg Forssmann's research group
- •First identification of this natural kidney hormone
What's normal
- •Full integration of Ularitide into physiological systems is established
- •Long-term Ularitide response remains personalized to your physiology
- •Ularitide tolerance is well-maintained with consistent dosing
What's next
- →Maintain your established Ularitide protocol for sustained benefits
- →Continue periodic monitoring to confirm Ularitide efficacy
- →Review comprehensive Ularitide response with your provider
2000
What you might notice
- •Early clinical studies of ularitide (synthetic urodilatin) begin in Europe
- •Transition from research to human testing
What's normal
- •Ularitide has achieved stable, long-term homeostatic integration
- •Sustained efficacy of Ularitide remains consistent
- •Chronic Ularitide effects remain stable and predictable
What's next
- →Maintain your established Ularitide protocol for sustained benefits
- →Continue periodic monitoring to confirm Ularitide efficacy
- →Review comprehensive Ularitide response with your provider
2012
What you might notice
- •Major Phase 3 trial (ULARITIDE-AHEF) launched with 2,157 patients
- •Largest clinical test of ularitide for acute heart failure treatment
What's normal
- •Ularitide has achieved stable, long-term homeostatic integration
- •Sustained efficacy of Ularitide remains consistent
- •Chronic Ularitide effects remain stable and predictable
What's next
- →Maintain your established Ularitide protocol for sustained benefits
- →Continue periodic monitoring to confirm Ularitide efficacy
- →Review comprehensive Ularitide response with your provider
2015
What you might notice
- •Cardiorentis announces positive Phase 3 results for acute decompensated heart failure
- •Demonstrates safety and efficacy in large patient population
What's normal
- •Ularitide has achieved stable, long-term homeostatic integration
- •Sustained efficacy of Ularitide remains consistent
- •Chronic Ularitide effects remain stable and predictable
What's next
- →Maintain your established Ularitide protocol for sustained benefits
- →Continue periodic monitoring to confirm Ularitide efficacy
- →Review comprehensive Ularitide response with your provider
2016
What you might notice
- •Phase 3 trial completed;
- •FDA grants Fast Track designation
- •Recognition of therapeutic potential;
- •expedited review pathway
What's normal
- •Ularitide has achieved stable, long-term homeostatic integration
- •Sustained efficacy of Ularitide remains consistent
- •Chronic Ularitide effects remain stable and predictable
What's next
- →Maintain your established Ularitide protocol for sustained benefits
- →Continue periodic monitoring to confirm Ularitide efficacy
- →Review comprehensive Ularitide response with your provider
2018
What you might notice
- •Comprehensive meta-analysis published comparing ularitide to other emergency heart treatments
- •Scientific validation of ularitide's role in acute heart failure management
What's normal
- •Full therapeutic effects of Ularitide are well-characterized at this point
- •Maintenance of Ularitide's therapeutic effects is typical
- •Tolerance patterns with Ularitide are generally stable over months
What's next
- →Comprehensive assessment of Ularitide 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 Ularitide 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
07 · Questions
Frequently asked
What makes ularitide different from other emergency heart failure drugs?+
Ularitide is unique because it mimics a natural hormone your kidneys produce. Unlike older drugs that can damage your kidneys, ularitide actually protects kidney function while treating heart failure. It works by natural mechanisms your body already understands, making it gentler with fewer dangerous side effects.
How quickly does ularitide start working?+
Ularitide works fast—within minutes of starting the IV infusion, patients typically begin breathing easier and feel better as excess fluid starts draining. The peak effects usually happen within 30-60 minutes, making it ideal for emergency heart failure situations.
Can I take ularitide at home?+
No, ularitide must be given as an intravenous infusion in a hospital or clinical setting. This allows doctors to carefully monitor your blood pressure, kidney function, and heart rhythm while receiving treatment. This is why it's used for acute (sudden, serious) heart failure rather than long-term home care.
Is ularitide approved by the FDA yet?+
As of now, ularitide is not FDA-approved in the United States, though it has received Fast Track designation for expedited review. It has been studied extensively in large clinical trials and shows promise, but it requires final regulatory approval before becoming available as a standard treatment. It may be available in other countries.
What should I expect if I receive ularitide?+
You'll receive ularitide through an IV line in a hospital setting. You'll be monitored continuously with heart monitors and blood pressure cuffs. Most patients experience improvement in breathing within the first hour. Common side effects like dizziness or mild headaches may occur but are usually manageable. Treatment typically lasts 24-72 hours depending on your condition.
How does ularitide protect the kidneys?+
This is one of ularitide's biggest advantages. While it increases water and sodium excretion (which is what you want), it also increases blood flow to the kidneys and doesn't have the toxic effects on kidney cells that some other emergency heart drugs do. This means your kidneys stay healthier while being treated for heart failure.
08 · Further reading
History & related research
History · since 1988
The kidney's own healing protein, made in a lab to rescue failing hearts.
Ularitide is a man-made copy of urodilatin, a special protein that your kidneys naturally make. Your kidneys use urodilatin to control water, salt, and blood pressure.
Read the full history of Ularitide