Aviptadil
Synthetic form of vasoactive intestinal peptide (VIP). Not FDA-approved; investigational.
What it is
Aviptadil (RLF-100, Zyesami) is a synthetic version of vasoactive intestinal peptide (VIP), a 28-amino-acid peptide neurotransmitter and hormone involved in smooth muscle relaxation, vasodilation, and immune signaling. The compound has been studied for various pulmonary and cardiovascular conditions. Aviptadil is not FDA-approved for any use in the United States.
Aviptadil received attention during the COVID-19 pandemic for respiratory failure, with NeuroRx (now NRx Pharmaceuticals) advancing trials for severe COVID. Results were mixed and the compound did not receive emergency authorization in the US for COVID. It has been used in some compassionate use protocols.
Mechanism of action
Proposed mechanisms come from laboratory and animal research. VIP receptor activation has been reported to produce:
- Pulmonary smooth muscle relaxation and bronchodilation
- Vasodilation
- Anti-inflammatory effects in experimental models
- Possible effects on Type II alveolar cell function
Clinical evidence
Trials in COVID respiratory failure showed mixed results. Earlier research in pulmonary arterial hypertension and acute lung injury has been ongoing for years without producing clear clinical applications. Well-controlled human trials establishing the effectiveness and safety of aviptadil are lacking.
Why we don’t prescribe it at The Tide
The Tide does not prescribe aviptadil. It is an experimental cardiopulmonary drug, and acute respiratory and cardiovascular emergencies require hospital-level care.
Side effects and contraindications
Reported effects include hypotension, flushing, and GI effects. Human safety has not been established in well-controlled trials, and long-term effects are unknown.