How Sermorelin Is Injected: Route, Timing and Units

"How to inject sermorelin" is a question about a medicine whose label has gone. Sermorelin was approved in the US as Geref, studied and sold as a once-daily injection under the skin, and later discontinued; what survives is the trial record, a 1999 review, and the instructions compounding pharmacies publish for the version they now make. This page sets out what each source states about the route, the timing and the site, then turns the circulating amounts into syringe units. It describes; it recommends no amount, site or schedule.

The dose figures themselves, with their sources, are on the sermorelin dosage page; the water and concentration arithmetic for 5 mg and 10 mg vials is on the sermorelin reconstitution page. The compound is covered in Medibact's Sermorelin guide.

What the record holds, by source

The first two rows are the evidence base; the last is a practice description. They agree on the route and the bedtime timing. Only the pharmacy names sites, and it names the three that subcutaneous injections are generally given into rather than anything specific to sermorelin.

The approved product, and why it left

Drugs@FDA lists NDA 020443 (Geref 0.5 mg and 1 mg vials) and NDA 019863 (the 0.05 mg diagnostic ampule) as discontinued, both held by EMD Serono (openFDA, read 2026-10-15). The FDA's 2013 Federal Register determination, recorded on this site's dosage page, states the products were not withdrawn for reasons of safety or effectiveness; the pharmacy page read today gives "business reasons". That determination is what lets the molecule be compounded. It also means the one document that would answer "where is sermorelin injected" in a regulator's words, the label, is no longer served by DailyMed or Drugs@FDA.

Route and timing in the trial

The supporting trial gave GHRH(1-29), sermorelin's active sequence, at 30 mcg/kg under the skin once daily at bedtime to 110 previously untreated prepubertal children with growth hormone deficiency, for up to a year (Thorner et al., Journal of Clinical Endocrinology and Metabolism 1996, PMID 8772599). Height velocity rose from 4.1 to 8.0 cm a year at six months. The review two years after approval adds that the same 30 mcg/kg given as a continuous infusion or as three divided doses produced smaller height-velocity gains than once-daily subcutaneous somatropin (Prakash and Goa, BioDrugs 1999, PMID 18031173). The once-at-bedtime pattern is therefore the one regimen with outcome data behind it; no trial read for this page compared bedtime with morning injection.

The compounding page explains the bedtime timing by the night-time peak of the body's own growth-hormone release. That is a mechanism statement by the pharmacy, reported here as theirs.

The site, as the compounders state it

The pharmacy page describes the injection as going "into the fatty subcutaneous tissue (often in the abdomen, thigh, or upper arm)", then narrows it: the lower abdomen at least 2 inches away from the navel, the front of the thigh, or the outer upper arm, with sites rotated daily "to prevent lipoatrophy or irritation". The 2-inch figure matches the distance the current tesamorelin labels give for their abdominal site, as set out on where tesamorelin is injected; tesamorelin is the GHRH analogue that does still have a label, and its label names the abdomen only. The general description of a subcutaneous peptide injection is on how peptides are injected.

What happens at the site

The 1999 review lists pain at the injection site, with transient facial flushing, as the most commonly reported adverse events for both the intravenous test dose and repeated once-daily subcutaneous doses. It reports no rate in the abstract. The pharmacy's rotation advice addresses lipoatrophy, a loss of fat under the skin at repeatedly used sites; no sermorelin trial read for this page reports it, so it stands as the pharmacy's precaution, not a measured effect.

The amounts, as syringe units

Units on a U-100 syringe = amount ÷ concentration × 100. The amounts in circulation are 200 to 500 mcg once daily (clinic and pharmacy pages, as recorded on this site's sermorelin dosage page, 2026-09-18; the pharmacy read today cites 0.2 to 0.3 mg). Research vials are labelled 5 mg and 10 mg.

Where the concentrations come from: 2.5 mg/mL is a 5 mg vial with 2 mL of water; 3.33 mg/mL a 10 mg vial with 3 mL; 5 mg/mL a 5 mg vial with 1 mL or a 10 mg vial with 2 mL; 10 mg/mL a 10 mg vial with 1 mL. Every amount is a small volume, between 0.02 and 0.2 mL, which is why the more dilute rows exist: at 10 mg/mL, 200 mcg is two marks on a 0.3 mL barrel. The trial's weight-based 30 mcg/kg is a different scale altogether, 0.6 mg for a 20 kg child, and is not converted here. The sermorelin calculator works any vial and volume, and mcg to units gives the method for any microgram amount.

Status that bears on the injection

Sermorelin is not on the FDA's list of bulk substances that may present significant safety risks in compounding (content current 2026-04-22, read 2026-10-15). The 2026 World Anti-Doping Agency Prohibited List names it in section S2.2.4, among growth-hormone-releasing-hormone analogues, alongside CJC-1295 and tesamorelin (Tractatenblad 2026 no. 25, read 2026-10-15), and anti-doping laboratories have published methods that detect it in plasma, including a metabolite found after a subcutaneous dose in a volunteer (Knoop et al., 2016, PMID 26879649), and in urine at low picogram-per-millilitre levels (Coppieters et al., 2022, PMID 35298973). A European customs and laboratory survey of seized injectables in 2014 reported sermorelin among the falsified products found (Venhuis et al., Drug Testing and Analysis 2016, PMID 26456392).

What is not established

No current label, so no regulator's statement of the site. No trial comparing injection sites, or bedtime with daytime timing. No trial of the adult 200 to 500 mcg figures; the outcome trial is paediatric and weight-based. No rate for injection-site reactions in an abstract read for this page. Decisions about whether and how to use sermorelin belong with a prescriber.

Sources and dates

Opened 2026-10-15: Drugs@FDA through openFDA for sermorelin (NDA 020443 and NDA 019863); PubMed abstracts through NCBI E-utilities for PMIDs 8772599, 18031173, 26879649, 35298973 and 26456392, and a PubMed count for sermorelin with subcutaneous or injection (8 records); the ClinicalTrials.gov v2 search for sermorelin (42 records); Empower Pharmacy's sermorelin acetate injection page; the FDA page on bulk drug substances that may present significant safety risks (content current 2026-04-22); the 2026 Prohibited List text in Tractatenblad 2026 no. 25. The Federal Register determination 2013-04827 is as read on this site's sermorelin dosage page (2026-09-18). Unit arithmetic by this site. Corrections go to the contact page.