Setmelanotide (Imcivree)_
Also known as Imcivree, RM-493
An approved daily shot for rare genetic forms of obesity.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is Setmelanotide (Imcivree)?
Plain language first. The technical label stays, but it never stands alone.Overview
Setmelanotide is an MC4R agonist that switches on the brain's melanocortin-4 receptor, a master control for hunger. In plain terms: for people with rare genetic defects in this exact hunger pathway, it restores the missing 'I'm full' signal. It is FDA-approved only for those specific conditions.
What it's used for
An approved daily shot for rare genetic forms of obesity. It flips a fullness switch in the brain to cut relentless hunger, but it is only for specific diagnosed conditions.
How does Setmelanotide (Imcivree) work?
What it does in the body, and where.Setmelanotide is the clearest example of a drug built for a specific broken mechanism rather than for a symptom.
- 01It switches on MC4R in the brainThe melanocortin-4 receptor, the master switch for hunger, sitting at the end of a signalling chain.
- 02It replaces a signal that never arrivesIn people with rare genetic faults upstream of MC4R, the fullness message is never sent. This supplies it directly at the receptor.
- 03Approved only for those genetic conditionsPOMC, PCSK1, and LEPR deficiency, and Bardet-Biedl syndrome. In people without those faults the pathway is already working, and the drug has little to add.
Where this compound is thought to act.
What else is it used for?
Each use below carries its own evidence level. Approved means regulators have cleared it for that purpose. Investigational means it is in trials. Early research means it is being studied and is not established.
- Severe obesity and constant hunger caused by certain rare genetic conditions (POMC, PCSK1 and LEPR deficiency, and Bardet-Biedl syndrome)FDA-approved
- Obesity caused by injury or damage to the hypothalamus, the part of the brain that controls hunger, approved in March 2026FDA-approved
How much, and do you cycle it?
The range, and whether you take breaks.2 up to 3 mg per day (start low, increase slowly), daily. Not cycledFDA label
Taken continuously for as long as it is working. Neither the label nor clinical practice describes an on/off schedule.
How do I dose and price it?
Enter your vial and your dose. Pick a mix. We show the draw and the cost.The vial holds a fixed amount of drug. Adding more water does not make more drug, it just spreads it thinner, so you draw a bigger number on the syringe for the same dose.
Choose your mix
Measuring the water1 mL = one full 100-unit syringe.
Your draw
40 / 100 unitsHow do you store it?
Before mixing, and after.Dry powder in the freezer or fridge. Once mixed, fridge, and use within about a month.
Unmixed lyophilized Setmelanotide (Imcivree) keeps for a long time cold. Once you add water the clock starts: most reconstituted vials hold up for roughly 28 to 30 days at fridge temperature. Keep it out of light, and do not freeze it after mixing.
What are the side effects and cautions?
Known cautions and warnings for this compound.Who should avoid it
- Pregnancy
- Only appropriate for specific diagnosed conditions, so it is not a general weight-loss option
Stop and get help
- A mole that changes in size, shape, or colour
- Signs of an allergic reaction
- A prolonged erection
Common effects
- Darkening of skin and moles, which is expected
- Injection-site reactions
- Nausea
- Spontaneous erections in men
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is Setmelanotide (Imcivree) approved?
And where the numbers on this page come from.Yes. FDA-approved.
A regulator reviewed the evidence and cleared it for specific uses.
- DoseFrom the drug label. The manufacturer tested this range and a regulator reviewed it.
- Vial sizeFrom what vendors typically list; not a recommendation.
- Sources
- Reviewed22 July 2026
What else is like Setmelanotide (Imcivree)?
Others in Weight loss and metabolic, side by side.If you're weighing Setmelanotide (Imcivree), it's worth reading Semaglutide, Tirzepatide, and Retatrutide in the same class.
An approved daily shot for rare genetic forms of obesity.
- Dose
- 2 up to 3 mg per day (start low, increase slowly)
- How often
- Daily
The drug in Ozempic and Wegovy: a weekly shot that curbs hunger for steady weight loss.
- Dose
- 0.25 up to 2.4 mg per week (start low, increase slowly)
- How often
- Weekly
The drug in Mounjaro and Zepbound: a weekly shot for major weight loss and blood sugar.
- Dose
- 2.5 up to 15 mg per week (start low, increase slowly)
- How often
- Weekly
An experimental weekly shot with some of the biggest weight-loss numbers yet in trials.
- Dose
- 1 up to 12 mg per dose (start low, increase slowly)
- How often
- Weekly
10What these words mean
Show glossary +
What these words mean
- Titrate
- Starting at a low dose and increasing it slowly over time so your body adjusts and side effects stay mild.
- Subcutaneous
- An injection just under the skin, into the fat layer, usually with a short, thin insulin needle.
- Intramuscular (IM)
- An injection into a muscle, using a longer needle.
- Reconstitution
- Mixing a powdered peptide with liquid (bacteriostatic water) so it can be drawn into a syringe.
- Bacteriostatic water
- Sterile water with a tiny amount of preservative, used to mix powdered peptides.
- Concentration
- How strong the mixed peptide is, in milligrams per milliliter (mg/mL). More water makes it weaker; less water makes it stronger.
- Units (on the syringe)
- The marks on an insulin syringe. 100 units equals 1 mL. They measure how much liquid you draw, not the dose in milligrams.
- mcg and mg
- Units of dose. 1 milligram (mg) equals 1,000 micrograms (mcg).
- GLP-1
- A natural gut hormone that lowers appetite and blood sugar. Drugs that copy it, like semaglutide, are used for weight loss.
- Growth hormone secretagogue
- A compound that nudges your body to release more of its own growth hormone, rather than injecting the hormone itself.
- Half-life
- How long a compound stays active in your body. A longer half-life means you inject less often.
- Peptide vs small molecule
- A peptide is a short chain of amino acids. A few items here (like MK-677 or methylene blue) are small molecules, not true peptides, but people use them the same way.
- Research only
- No approved dose or use in people. Sold for research and not reviewed by the FDA for safety or quality.
- Investigational
- Still being tested in clinical trials and not yet approved or legally sold for general use.
- Banned in drug-tested sport
- Prohibited by the World Anti-Doping Agency (WADA); using it can disqualify a competing athlete.
Sources
- FDA, first approval for rare genetic obesity(2020)First FDA approval for obesity caused by specific rare genetic conditions.
- Rhythm Pharmaceuticals, hypothalamic obesity approval (Mar 2026)(2026)FDA approval for acquired hypothalamic obesity.
Last reviewed 22 July 2026