Setmelanotide
MC4R Agonist (selective) / Anti-ObesityAlso known as: Imcivree · RM-493
An FDA-approved selective MC4R agonist for rare genetic obesity disorders including POMC, PCSK1, & LEPR deficiency. The most targeted melanocortin anti-obesity drug.
Typical Dose
2–3 mg once daily (FDA-approved dosing)
Route
Subcutaneous injection (once daily)
Cycle
Continuous (approved for ongoing use)
Half-life
~11 hours
Storage
2–8°C. Multi-dose vials: room temp up to 30 days after first use.
Overview
Setmelanotide is a cyclic octapeptide that selectively activates melanocortin 4 receptor (MC4R) in the hypothalamus to restore satiety signaling in patients with specific genetic obesity disorders. It received FDA approval in 2020 for obesity due to POMC, PCSK1, or LEPR deficiency — conditions where the natural MC4R signal pathway is broken.
Unlike Melanotan II (non-selective) or PT-141 (MC3R/MC4R), Setmelanotide's selectivity for MC4R means minimal tanning (low MC1R activity) & sexual side effects. In approved indications, it produces significant & durable weight loss in patients who are otherwise unresponsive to lifestyle or other drug interventions.
Quick Start Guide
FDA-approved for specific genetic diagnoses only. Administered as 2–3 mg SubQ daily via injection pen under physician supervision.
Research Indications
Genetic obesity (POMC/PCSK1/LEPR deficiency)
Most EffectiveFDA approved. Phase III: significant mean weight reduction in patients with defined MC pathway defects.
Research Protocols
FDA-approved therapeutic use
ContinuousDose
2–3 mg once daily
Frequency
Daily SubQ
Route
SubQ abdomen or thigh
Peptide Interactions
Both act on MC4R. Do not combine.
Side Effects & Safety
Common
- Injection site reactions
- Hyperpigmentation (nevi darkening)
- Nausea
- Headache
Uncommon
- Spontaneous penile erections
- Diarrhea
When to Stop
- Signs of allergic reaction
- Suicidal ideation (monitor in pediatric use)
How to Reconstitute
Provided as pre-filled injection cartridge. See prescribing information for administration details.
Dosing math: Commercial product only. Not typically compounded.
Quality Indicators
Good — use as normal
- Clear, colorless solution (commercial product)
Discard immediately
- Discoloration or particulate in commercial vial
What to Expect
Month 1
Appetite suppression begins. Weight loss commences in responsive patients.
Month 3–6
Substantial weight loss in approved genetic indications. Effect plateaus at new set point with continued use.
Community Insights
Self-reported. Reflects user experience, not clinical outcomes.
Research References
New England Journal of Medicine · 2019
Phase III: significant weight loss in 100% of patients with POMC deficiency & 45% of LEPR deficiency patients.
doi:10.1056/NEJMoa1911362 →Verify what you have
Information on this page applies to pharmaceutical-grade peptides. Purity & identity of research-grade products vary. Certipep provides independent ESI-TOF-MS & HPLC analysis with a signed analytical report.
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