Anamorelin

Also called Adlumiz, anamorelin hydrochloride and ONO-7643^{2, 5}

Anamorelin is a pill, not a peptide, that switches on the ghrelin receptor. Ghrelin is the hunger hormone, so the drug raises appetite and growth hormone.² It was built for cancer cachexia, the weight and muscle loss of advanced cancer. In four phase 3 trials with about 1,600 patients, it added about 1 to 2 kg over 12 weeks. Handgrip strength didn't improve.^{4, 6, 7} Japan approved it in 2021.² European regulators refused it in 2017, citing marginal gains and poor safety records.¹ It is not approved in the US, and the only US sources we found are "research use only" vendors.

Related: macimorelin, lenomorelin (ghrelin itself), MK-677 and ipamorelin act on the same receptor. See every peptide's status in the regulatory tracker.

At a glance

Where to get it

MoveWell sells nothing and earns nothing from this page. There is no legal way to buy anamorelin in the US. Why

Molecular structure

A small molecule, not a chain of amino acids. One end comes from the amino acids aminoisobutyric acid and tryptophan. The other end is a benzyl-piperidine ring with a trimethyl hydrazide, which no protein contains.

The benzyl-piperidine hydrazide end, the non-peptide part

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Type

Small molecule, taken by mouth

Formula

C31H42N6O3

Weight

546.7 g/mol

Salt sold

Anamorelin hydrochloride

PubChem

CID 9828911

Target

Ghrelin receptor (growth hormone secretagogue receptor)

Drawn from the PubChem structure, with both chiral centres in the R form. Formula and weight are for the free base.¹⁵

What it is

Anamorelin is a man-made drug that copies the action of ghrelin, the stomach hormone that signals hunger and triggers growth hormone release. Ono calls it a "ghrelin receptor agonist."² It is taken as a tablet.

It was developed for cancer cachexia: loss of weight, muscle and appetite in advanced cancer that eating more doesn't fix. Helsinn ran the global trials, and Ono holds the rights in Japan, South Korea and Taiwan.² The idea was that a ghrelin-like drug could restore appetite and rebuild muscle.

It is sometimes sold online next to MK-677 and peptides. Like MK-677, it is not a peptide. Lenomorelin is ghrelin itself, and macimorelin is a related pill used only as a one-time diagnostic test.

How it works

• Ghrelin receptor. It switches on the same receptor as ghrelin, which raises appetite and growth hormone.²
• Weight and lean mass. In trials, patients gained body weight and lean body mass compared with placebo.^{4, 5}
• Sodium channels. It also blocks sodium channels in the heart, which can slow electrical conduction. That's why Japan bars it in people with serious heart conduction problems.³
• Liver enzyme. It is broken down by the liver enzyme CYP3A4, so strong blockers of that enzyme are ruled out.³

Evidence map

Each claimed use is graded separately. A grade measures how much evidence exists, not whether the result was good news.

Scale: 5 FDA-approved, 4 strong human, 3 limited human, 2 animal or lab only, 1 anecdotal

Key studies

All of these trials were in people with advanced cancer. None tested anamorelin in healthy people, athletes or for bodybuilding.

By goal

Pick your goal to see what the evidence supports.

Sources: Temel 2016,⁴ SCALA,⁶ Taniguchi 2023.⁷

How it's used

Anamorelin has no approved dose in the US, and we don't give one.

In Japan the label dose is 100 mg once a day, taken on an empty stomach with no food for an hour after.^{2, 3} It is for patients who meet set criteria, including at least 5% weight loss with poor appetite within 6 months. Doctors check the response after about 3 weeks and usually stop it if weight and appetite haven't improved. Heart rhythm, blood sugar and liver tests are checked during treatment.³ We report this as information, not instruction.

Side effects and who should avoid it

• High blood sugar. The most common severe side effect in the phase 3 trials, though rare at about 1%.⁴ In 6,016 Japanese patients, 4.8% had high blood sugar or related problems.⁸
• Heart conduction. It blocks sodium channels and can worsen heart conduction problems and cause arrhythmias. Conduction problems were seen in 1.1% of Japanese patients.^{3, 8}
• Liver. Liver problems were reported in 1.2% of Japanese patients. Liver tests are checked during treatment.^{3, 8}
• Nausea. Reported in 2.6% of Japanese patients.⁸
• Who can't take it in Japan. People with heart failure, a past heart attack, angina, serious heart block, moderate or severe liver disease, or a bowel blockage, and anyone on strong CYP3A4 blockers such as clarithromycin, itraconazole or ritonavir.³
• Poor safety records. EU regulators couldn't fully judge the risks because, after inspecting trial sites, they found safety data "had not been recorded adequately."¹
• Online products. Research-grade anamorelin isn't made or checked to drug standards, and none of the trial safety monitoring comes with it.

Compared with

Sources: Ono,² FDA 503A rules,¹¹ WADA 2026 list,¹³ Macrilen label,¹⁸ COSCIENS.¹⁹ See our guides to macimorelin, MK-677, lenomorelin (ghrelin) and ipamorelin.

Stacks

No combination with anamorelin has been tested in healthy people. Stacking it with MK-677 or ipamorelin would act on the same receptor twice, and we found no study of any such stack. Anamorelin alone can raise blood sugar.⁸

Myths vs evidence

All options

MoveWell sells nothing and has no commercial link on this page. Checked November 1, 2026

Research use only products

We don't list sellers. "Research use only" anamorelin is sold outside FDA's drug rules, with no check on purity or dose. In August 2026 FDA warned five peptide sellers that the label doesn't excuse products clearly meant for people.¹⁴

Legal status history

Newest first.

1. Current statusNov 1, 2026Not FDA-approved. Can't be compounded in the US. Not covered by the HHS peptide policy. Approved in Japan. Banned in sport.^{2, 11, 12, 13}
2. Next · no dateNo US filing found. SCALA-1 and SCALA-2 haven't appeared as a full paper that we could find.^{6, 17}
3. Oct 28, 2026HHS enforcement discretion policy covers six peptides. Anamorelin is not one of them.¹²
4. Nov 17, 2025Results posted for a US pancreatic cancer trial that closed early with 4 patients.⁹
5. Oct 2023SCALA-1 and SCALA-2 presented: weight gain, no change in appetite symptom scores.⁶
6. Jan 22, 2021Approved in Japan as Adlumiz for cancer cachexia in four cancers.²
7. Nov 16, 2017EU refusal becomes final. CHMP had confirmed it on re-examination on Sep 14, 2017.¹
8. May 18, 2017EU drug committee recommends refusal.¹
9. 2016ROMANA 1 and 2 published.⁴

FAQ

Related guides

References