Hexarelin

clinical trials

Also known as: Examorelin, EP-23905

**Mechanism of Action** Hexarelin is a synthetic hexapeptide belonging to the growth hormone-releasing peptide (GHRP) family. It acts as a potent agonist at the ghrelin receptor (GHS-R1a), stimulating growth hormone (GH) secretion via the pituitary and hypothalamus. However, its cardioprotective effects are mediated through GH-independent pathways, including direct binding to CD36 (a scavenger receptor) on cardiomyocytes and endothelial cells, which activates anti-apoptotic signaling (e.g., PI3K/Akt) and reduces oxidative stress. This dual mechanism distinguishes Hexarelin from other GHRPs. **Key Research Findings** Clinical trials have demonstrated Hexarelin’s ability to improve cardiac function in patients with chronic heart failure, including increased left ventricular ejection fraction and reduced myocardial ischemia. Preclinical studies show it protects against doxorubicin-induced cardiotoxicity and ischemia-reperfusion injury by attenuating mitochondrial dysfunction and inflammation. Notably, its GH-releasing potency is approximately 10-fold greater than GHRP-6, with a longer half-life (~2 hours) due to resistance to enzymatic degradation. Adverse effects in trials include transient flushing and mild GH-related metabolic changes. **Clinical Relevance** Hexarelin is under investigation for acute and chronic cardiac conditions, particularly where GH-independent cardioprotection is desired. Its potential applications include adjunctive therapy in heart failure, post-myocardial infarction recovery, and prevention of chemotherapy-induced cardiotoxicity. However, its GH-releasing activity limits use in GH-sensitive malignancies. Further phase II/III trials are needed to establish safety and efficacy profiles. For research purposes only — not medical advice.

Key data

Category
Growth Hormone Peptides
Molecular weight
887 g/mol
Molecular formula
C47H58N12O6
CAS number
140703-51-1
Administration
subcutaneous, intranasal
Research status
clinical trials
References
291
Tags
ghrp, ghrelin-mimetic, cardioprotective

Research & studies

Hexarelin promotes the survival of retinal ganglion cells after optic nerve transection
Indian journal of pharmacology · 2026 · PubMed

Single daily doses of 25, 50, and 100 µg/kg hexarelin dose-dependently and significantly increased RGC survival at 7 days after ONT (51.2%, 62.4%, 68.5%, and 74.6% for saline, 25, 50, and 100 µg/kg, respectively).; Twice-daily doses of 100 and 150 µg/kg hexarelin further promoted RGC survival to 91.4% and 109.2%, respectively, compared to 72.9% with saline.; 150 µg/kg hexarelin administered twice daily was optimal for RGC survival after ONT.

Hexarelin alleviates apoptosis on ischemic acute kidney injury via MDM2/p53 pathway
European journal of medical research · 2023 · PubMed

Hexarelin pretreatment reduced tubular necrosis, improved renal function, and inhibited apoptosis in I/R-induced AKI rats.; Hexarelin downregulated pro-apoptotic proteins (Caspase-3, Bax, Bad) and upregulated anti-apoptotic Bcl-2.; Molecular docking showed strong binding affinity between Hexarelin and MDM2, suggesting a mechanism via MDM2/p53 pathway.; Hexarelin suppressed MDM2 and p53 expression in both in vivo and in vitro experiments.

Hexarelin attenuates abdominal aortic aneurysm formation by inhibiting SMC phenotype switch and inflammasome activation
Microvascular research · 2022 · PubMed

Hexarelin decreased infrarenal aorta diameter in elastase-induced AAA mice.; Hexarelin rescued smooth muscle cell contractile phenotype by increasing α-SMA and decreasing MMP2.; Hexarelin inhibited NLRP3 inflammasome activation, IL-18 production, and inflammatory cell infiltration.; Hexarelin suppressed NF-κB signaling pathway, a key initiator of inflammatory response.

Effect of paracellular permeation enhancers on intestinal permeability of two peptide drugs, enalaprilat and hexarelin, in rats
Acta pharmaceutica Sinica. B · 2021 · PubMed

Chitosan and EDTA increased the mucosal permeability of both enalaprilat and hexarelin to a similar extent.; Paracellular enhancers may have greater potential for increasing intestinal absorption of low-molecular-mass hydrophilic peptides than transcellular enhancers.; Mucosal blood-to-lumen flux of 51Cr-EDTA was increased by paracellular enhancers and by luminal hypotonicity.; Luminal hypotonicity did not affect lumen-to-blood transport of enalaprilat or hexarelin, suggesting it primarily affects paracellular transport in the crypt region.

Ghrelin receptor agonist hexarelin attenuates antinociceptive tolerance to morphine in rats
Canadian journal of physiology and pharmacology · 2021 · PubMed

Hexarelin in combination with morphine attenuates analgesic tolerance to morphine.; Co-administration of hexarelin and morphine increases the analgesic effect.; The ghrelin receptor antagonist [d-Lys3]-GHRP-6 has no significant analgesic activity on morphine tolerance.; GHS-R agonist hexarelin with morphine enhances antinociception and attenuates morphine tolerance.

Hexarelin attenuates atherosclerosis via inhibiting LOX-1-NF-κB signaling pathway-mediated macrophage ox-LDL uptake in ApoE(-/-) mice
Peptides · 2019 · PubMed

Hexarelin decreased serum TC, TG and LDL-c and increased serum HDL-c in ApoE-/- mice.; Hexarelin attenuated atherosclerotic plaque and neointima formation compared with the AS group.; Hexarelin decreased aortic CD68 and LOX-1 expression, increased GHSR expression, and suppressed ox-LDL uptake and NF-κB activation in aorta and RAW264.7 macrophages.; The findings support hexarelin as a potential anti-atherosclerosis drug.

Hexarelin protects cardiac H9C2 cells from angiotensin II-induced hypertrophy via the regulation of autophagy
Die Pharmazie · 2019 · PubMed

Hexarelin suppressed angiotensin-II-induced hypertrophy, oxidative stress, and apoptosis in H9C2 cells.; Hexarelin enhanced autophagy in hypertrophic H9C2 cells.; Inhibition of autophagy with 3-methyladenine abolished hexarelin's anti-hypertrophic and protective effects.; Hexarelin's autophagy-dependent protection involves inhibition of mTOR phosphorylation.

Enhanced Pulsatile Growth Hormone Secretion and Altered Metabolic Hormones by in Vivo Hexarelin Treatment in Streptozotocin-Induced Diabetic Rats
International journal of molecular sciences · 2018 · PubMed

STZ-diabetic rats showed significantly reduced total, pulsatile, basal, and per-burst GH secretion, along with increased fasting FFAs and decreased IGF-1 versus controls.; Hexarelin treatment significantly increased total, pulsatile, and basal GH secretion in STZ-rats, but not the mass of GH secreted per burst.; Hexarelin significantly decreased fasting FFAs in STZ-rats, while IGF-1 suppression was maintained.; No significant elevation in GH secretion was observed in the hexarelin-treated control group.

Frequently asked questions

What is Hexarelin?

**Mechanism of Action** Hexarelin is a synthetic hexapeptide belonging to the growth hormone-releasing peptide (GHRP) family. It acts as a potent agonist at the ghrelin receptor (GHS-R1a), stimulating growth hormone (GH) secretion via the pituitary and hypothalamus. However, its cardioprotective effects are mediated th

How does Hexarelin work?

Potent GHRP-family ghrelin receptor agonist with studied cardioprotective effects independent of GH release.

What is the research status of Hexarelin?

Hexarelin is currently classified as clinical trials, with 291 research references on record. This is for research purposes only and is not medical advice.

What is the molecular weight of Hexarelin?

Hexarelin has a molecular weight of approximately 887 g/mol (formula C47H58N12O6).

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