Anamorelin

Orally active, selective ghrelin (GHSR1a) receptor agonist developed for cancer anorexia-cachexia; approved in Japan for cachexia in several cancers.

Overview

Anamorelin is a small-molecule mimetic of the gut hormone ghrelin, the endogenous ligand of the growth-hormone secretagogue receptor (GHSR1a). By activating this receptor centrally and peripherally it stimulates appetite, drives a modest rise in growth hormone and IGF-1, and promotes an anabolic state that counteracts the muscle and weight loss of cancer cachexia.

In the pivotal ROMANA 1 and ROMANA 2 phase 3 trials in advanced non-small-cell lung cancer, anamorelin 100 mg once daily significantly increased lean body mass and improved anorexia-cachexia symptoms compared with placebo over 12 weeks, although the co-primary endpoint of handgrip strength was not met. The ROMANA 3 safety extension confirmed durable benefits and good tolerability out to 24 weeks.

The most common drug-related adverse effect is hyperglycaemia, reflecting ghrelin's role in glucose metabolism. Anamorelin remains investigational in the United States and Europe but is an approved therapy in Japan.

Mechanism of Action

Ghrelin receptor activation couples through Gq signalling in hypothalamic neurons to increase food intake and through the pituitary to release growth hormone, raising circulating IGF-1. The combined orexigenic and anabolic actions increase lean body mass and body weight. Because ghrelin also influences insulin secretion and glucose handling, hyperglycaemia is the principal metabolic side effect.

Reconstitution Calculator

Reconstitution Calculator

Calculate your peptide dosing

Draw Volume
0.100mL
Syringe Units
10units
Concentration
2,500mcg/mL
Doses / Vial
20doses
Vial Total
5mg
Waste / Vial
0mcg
Syringe Cap.
100units · 1mL
How to reconstitute
Gather & prepare
1/6Gather & prepare

Set up a clean workspace with all supplies ready.

1.Wash hands thoroughly, put on disposable gloves
2.Your 5mg peptide vial (lyophilized powder)
3.Bacteriostatic water (you'll need 2mL)
4.A 3–5mL syringe with 21–25 gauge needle for reconstitution
5.Alcohol swabs (70% isopropyl)
Use bacteriostatic water (0.9% benzyl alcohol) for multi-dose vials. Sterile water is only safe for single-use.
Supply Planner

7x / week for weeks

·
40%
2vials
28 doses20 days/vial12 leftover
Cost Breakdown
Vial price
$0.00per dose
$0.00 /week$0 /month
Store 2-8°C30 day shelf lifeSwirl gentlyFor research purposes only

This calculator is provided for informational and educational purposes only. It is not intended as medical advice, diagnosis, or treatment guidance. Always consult a qualified healthcare professional before preparing or administering any substance. PepGuide assumes no liability for decisions made based on these calculations.

References (2)

  1. [1]
    Temel JS, Abernethy AP, Currow DC, et al. Anamorelin in patients with non-small-cell lung cancer and cachexia (ROMANA 1 and ROMANA 2): results from two randomised, double-blind, phase 3 trials The Lancet Oncology (2016)

    Anamorelin 100 mg once daily significantly increased lean body mass versus placebo over 12 weeks in advanced NSCLC patients with cachexia, though handgrip strength did not improve.

  2. [2]
    Currow D, Temel JS, Abernethy A, et al. ROMANA 3: a phase 3 safety extension study of anamorelin in advanced non-small-cell lung cancer (NSCLC) patients with cachexia Annals of Oncology (2017)

    Extended dosing to 24 weeks was well tolerated and maintained body-weight and anorexia-cachexia symptom benefits, with hyperglycaemia the most common drug-related adverse event.

Updated 2026-07-07Reviewed by ai-enrich-2026-07-contentSources: https://pubmed.ncbi.nlm.nih.gov/26906526/, https://pubmed.ncbi.nlm.nih.gov/28472437/

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