Cardiovascular · Investigational
Adrenomedullin
No lawful US pathway
01 · Overview
Adrenomedullin is a 52-amino acid peptide produced by vascular endothelial and smooth muscle cells with potent blood-pressure-lowering activity. It signals through the calcitonin receptor-like receptor paired with receptor activity-modifying protein 2, raising cyclic AMP in human endothelial and smooth muscle cells (PMID 10217420).
It also influences vascular permeability and the integrity of blood and lymphatic vessels (PMID 18097473).
02 · Research summary & key findings
Circulating adrenomedullin and its precursor fragments are prognostic markers: a meta-analysis of 25 studies and 13,915 heart failure patients found pro-adrenomedullin predicted mortality and the combined endpoint of mortality or hospitalization (PMID 41262231). In sepsis, the therapeutic approach taken furthest is not adrenomedullin itself but adrecizumab, a non-neutralizing antibody against it; in the randomized phase 2a AdrenOSS-2 trial of 301 septic shock patients it was well tolerated but did not improve the primary safety-efficacy index (PMID 34605947). No adrenomedullin-based therapy is approved.
03 · Regulatory status
Adrenomedullin is in the investigational stage. While preclinical and early-phase data exist, it has not received regulatory approval for clinical use in the United States.
No lawful pathway today
Adrenomedullin is not FDA-approved and does not currently have a lawful prescription or compounding pathway in the United States, so we do not sell it and will not book a consultation for it. That can change: in 2026 FDA began reviewing several peptides for compounding.
See the 4 FDA-approved compounds in Cardiovascular
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04 · Administration routes
- Intravenous
References
- [1]The RAMP2/CRLR complex is a functional adrenomedullin receptor in human endothelial and vascular smooth muscle cells FEBS Lett, 1999. PMID 10217420
- [2]The GPCR modulator protein RAMP2 is essential for angiogenesis and vascular integrity J Clin Invest, 2008. PMID 18097473
- [3]Safety and tolerability of non-neutralizing adrenomedullin antibody adrecizumab (HAM8101) in septic shock patients: the AdrenOSS-2 phase 2a biomarker-guided trial Intensive Care Med, 2021. PMID 34605947
- [4]Pro-adrenomedullin as a prognostic biomarker in patients with heart failure: A systematic review and meta-analysis JRSM Cardiovasc Dis, 2025. PMID 41262231
Primary literature
- PubMed: "Adrenomedullin"
Peer-reviewed literature indexed by the National Library of Medicine.
- ClinicalTrials.gov: "Adrenomedullin"
Registered interventional and observational studies, including status and phase.
- PubChem: "Adrenomedullin"
Chemical structure, molecular properties, and bioactivity data.
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