Peptide

Setmelanotide

Also known as

Imcivree · IMCIVREE · RM-493 · RM493 · Setmelanotide acetate · setmelanotide SC

Community talk. May contain inaccuracies. Not medical advice. Not a protocol. Not for human or animal use.

What it is

Imcivree / RM-493	A daily SubQ peptide acting at MC4R in the brain's hunger pathway, used for specified rare obesity conditions rather than general obesity.
Distinct melanocortin	It differs from Melanotan II and PT-141. Their tanning, sexual-effect and dose stories cannot stand in for Setmelanotide accounts.

Notes

A signal in the brain's hunger pathway. It activates the melanocortin-4 receptor (MC4R) in the brain's hunger pathway. The daily under-skin injection Imcivree treats specified conditions: Bardet-Biedl syndrome (BBS), POMC, PCSK1 or LEPR deficiency, and acquired hypothalamic obesity (HO). General obesity is excluded. IMCIVREE US prescribing information, revised March 2026 (Official context · Accessed 2026-09-30)

Setmelanotide, also called Imcivree or RM-493, is a peptide discussed for persistent, extreme hunger in specific rare forms of obesity. People describe a quieter relationship with food, but also nausea, darker skin and mood effects. Those experiences do not establish a general fat-loss or tanning treatment.

The melanocortin names are easy to mix up. Peptide threads compare it with Melanotan II and PT-141. These are different compounds. A post about tanning or sexual arousal does not establish Setmelanotide's appetite response, amount or formulation. Setmelanotide HA (IMCIVREE) (Community discussion · Accessed 2026-09-30) · Pt-141 for PSSD — comment specifically describing setmelanotide (Personal report · Accessed 2026-09-30)

Source context — IMCIVREE US prescribing information, revised March 2026: Approved product clinical context; not measured community kinetics, general-obesity eligibility or research-powder equivalence. Selected schedules below are incomplete orientation, not a personal regimen.

Source context — Setmelanotide HA (IMCIVREE): Interest and secondhand comparison, not a use log. MT-II appetite experience is not setmelanotide experience; no usable dosage or outcome supplied.

Source context — Pt-141 for PSSD — comment specifically describing setmelanotide: Anonymous early nonclinical account; identity and purity unverified, dose/route/duration unspecified. Comment conflates melanotan and PT-141; no claim that all its pharmacology is accurate.

What people notice

Less relentless hunger	An adult with hypothalamic obesity describes less obsessive eating. A caregiver describes fewer repeated food requests.
Weight change	That adult reports 25 kg lost over five months after earlier GLP-1 intolerance; this is one diagnosis-specific account, not an expected general fat-loss result.
Pigment and tolerability vary	One caregiver describes early fatigue/migraine, then darker skin and freckles. Another user stops for dark spots and reports nausea without libido improvement; a different user reports no tanning.

Notes

Less relentless attention to food. The French hypothalamic-obesity author described relief from obsessive eating. Caregiver discussion similarly emphasizes fewer repeated food requests. This matters beyond the scale: feeling full can change everyday meals and family routines. Un traitement anti-obésité est en train de me changer la vie (Personal report · Accessed 2026-09-30)

Weight change, with a diagnosis-specific context. That author reported losing 25 kg over five months after earlier GLP-1 intolerance. It is one unusually detailed account, not an expected result for someone without the same underlying condition. Un traitement anti-obésité est en train de me changer la vie (Personal report · Accessed 2026-09-30)

Pigmentation ranges from none to a reason to stop. The lipedema commenter said they stayed pale. The sexual-health commenter reported new dark spots despite sunscreen, nausea and no libido improvement. Their product identity is unverified; the report still cautions against treating sexual side effects as a promised benefit. Does anyone take Imcivree? (Community discussion · Accessed 2026-09-30) · Pt-141 for PSSD — comment specifically describing setmelanotide (Personal report · Accessed 2026-09-30)

Early fatigue can accompany better food control. Maël's caregiver reported two days of fatigue/migraine, then darker skin and freckles after escalation. These unwanted effects accompanied less food-seeking. Médicament IMCIVREE — Maël caregiver update (Personal report · Accessed 2026-09-30)

Source context — Un traitement anti-obésité est en train de me changer la vie: One French-language self-report of hypothalamic obesity after childhood brain surgery. Diagnosis, product, adherence and weight are unverified; dose is only 33% of the author's described maximum. Replies include inaccurate medical claims; these are not adopted.

Source context — Does anyone take Imcivree?: Mixed prospective question and anonymous experience; no numerical dose or validated genotype. Permanent effectiveness, LES mechanism and quoted prices are unsupported claims, not established facts. Absence of tanning is not absence of efficacy.

Source context — Médicament IMCIVREE — Maël caregiver update: One caregiver report, translated from French; no numerical dose supplied. The text dates its update at 1.5 months despite publication occurring about two months after the stated start; retain reported interval rather than calculate a new onset.

Doses people talk about

Community amount gap	One person reports a daily morning injection at 33% of a stated maximum, without milligrams. That proportion cannot establish an actual dose.
Prescription figures	0.5–3 mg once daily is retained prescription-summary wording, not a self-experiment range. Indication, age and kidney function change the schedule.
Separate SubQ label schedules	For BBS/pathway deficiency at age 12+, the saved US label starts 2 mg daily for two weeks, then 3 mg if tolerated. Acquired HO at age 6+ uses 0.5/1/2/3 mg stages; younger/renal schedules differ.

Notes

One daily morning injection; 33% of a stated maximum. The French author reports this frequency and relative amount but never supplies milligrams. The proportion cannot be converted into a verified dose. Another peptide commenter explicitly says they do not know the amount. Un traitement anti-obésité est en train de me changer la vie (Personal report · Accessed 2026-09-30) · fat loss stack? — setmelanotide suggestion (Community opinion · Accessed 2026-09-30)

Prescription milligrams: 0.5–3 mg once daily in the retained discussion. That old community wording summarizes prescription figures, not a measured self-experiment range. It must not be read as one interchangeable start-to-maximum schedule; indication, age and kidney function change the official schedule.

Official schedules are distinct. For BBS/pathway deficiency at age 12+, the US label describes 2 mg SC daily for two weeks, then 3 mg if tolerated. Ages 6–11 start at 1 mg, ages 2–5 at 0.5 mg. Acquired HO at age 6+ steps 0.5, 1, 2, then 3 mg daily over two-week stages. Renal/younger maintenance differs. IMCIVREE US prescribing information, revised March 2026 (Official context · Accessed 2026-09-30)

Source context — fat loss stack? — setmelanotide suggestion: Unsubstantiated suggestion. Claim that setmelanotide isolates appetite effects is contradicted by pigment and sexual adverse reports. AOD success further down is not setmelanotide success.

Half-life, onset & duration

Felt onset	One caregiver describes less food-seeking by about 1.5 months after starting low and increasing. That update interval is not a guaranteed onset.
Felt duration	One adult notices more hunger the same day after a missed morning injection; no precise hours-of-benefit window is established.
Half-life	About 11 hours effective half-life in adult normal-renal clinical modeling. The community sources do not measure clearance.
Blood peak	Median about eight hours for the clinical SubQ product; steady state within roughly two days. These values differ from hunger-response timing.

Notes

Around 1.5 months in one caregiver's update. Maël's caregiver described reduced food-seeking by that point after starting low and increasing the dose. The post supplies no hourly onset and no mg amount. Its reporting interval is not a guaranteed response time. Médicament IMCIVREE — Maël caregiver update (Personal report · Accessed 2026-09-30)

Same-day hunger difference after a missed morning. The French author noticed the difference on days an injection was forgotten. This suggests benefit depended on continued treatment for that person; it does not establish a precise number of hours of appetite control. Un traitement anti-obésité est en train de me changer la vie (Personal report · Accessed 2026-09-30)

No numerical community estimate in these sources. A bodybuilding-forum debate calls it short-lived without giving a Setmelanotide number. Its nearby 21-day figure is MariTide's. The clinical estimate is identified separately below; subjective hunger cannot measure clearance. Stimulants as weight loss drugs — tolerance and titration debate (Community discussion · Accessed 2026-09-30)

About 11 hours is clinical pharmacokinetics. Adult normal-renal modeling: approximately 11-hour effective half-life, eight-hour median blood peak, steady state within two days. Clinical SC-product values differ from felt duration. IMCIVREE US prescribing information, revised March 2026 (Official context · Accessed 2026-09-30)

Source context — Stimulants as weight loss drugs — tolerance and titration debate: Mechanistic debate, no personal setmelanotide treatment log. The 21-day half-life and three-month accumulation argument concern MariTide, not setmelanotide.

Cycles people discuss

Ongoing daily treatment	Accounts describe continuing daily therapy and medical/access interruptions, with little documented bodybuilding cycle practice.
Stopping for unwanted effects	One commenter stops because pigmentation becomes unacceptable. No scheduled off-week, safe restart or guaranteed permanent effect follows.

Notes

Ongoing daily treatment, rather than a defined cutting cycle. The retained community record describes interruptions for medical or access reasons and little documented bodybuilding cycle practice. The French account views treatment as continuing; a lipedema poster worries about committing to daily injections indefinitely. Un traitement anti-obésité est en train de me changer la vie (Personal report · Accessed 2026-09-30) · Does anyone take Imcivree? (Community discussion · Accessed 2026-09-30)

Stopping for unwanted effects also appears. The Setmelanotide commenter in a sexual-health thread stopped because pigmentation became unacceptable. That is a reason to discontinue, not evidence for a scheduled off-week or a safe restart routine. Pt-141 for PSSD — comment specifically describing setmelanotide (Personal report · Accessed 2026-09-30)

No-tolerance claims outrun the accounts. A Reddit reply claims permanent effectiveness; a MESO-Rx debate claims no titration. Neither supplies long-term outcome measurements. The official product does use titration. Does anyone take Imcivree? (Community discussion · Accessed 2026-09-30) · Stimulants as weight loss drugs — tolerance and titration debate (Community discussion · Accessed 2026-09-30)

Stacks

Specialist treatment context	The original record describes specialist monotherapy plus lifestyle support. One detailed account also involved other hormone treatments.
Incretin combination talk	MC4-plus-GLP-1 reasoning and prior/concomitant GLP-1 discussion exist, but these records establish no fixed ratio or reliable community combination outcome.
Comparisons stay separate	Metreleptin and MT-II appear as comparisons. Adding a tanning peptide is not established appetite support.

Notes

Usually monotherapy: Specialist rare-obesity care frames setmelanotide alone plus lifestyle support — not BPC/TB/GHK “healing stack” culture. [community]

Support alongside treatment: Diet, activity and behavioral support appear alongside treatment in the clinical discussion. Their contribution and the underlying hunger disorder complicate attribution of weight changes to the drug alone. [trial]

Original Nico_Fr post; author replies on previous GLP-1 intolerance, daily morning injection, same-day difference after missed mornings, hospital-pharmacy follow-up and concomitant hormone treatments. Body lines 21–32, 65–71, 292–322, 385–417 and 931–938 in inspected extraction. Un traitement anti-obésité est en train de me changer la vie (Personal report · Accessed 2026-09-30)

GLP-1 concurrent talk: Forums and some trial analyses discuss prior or concomitant GLP-1 receptor agonists; TRANSCEND-type HO work allowed prior GLP-1 and small concomitant subsets — not a fixed dual protocol. [trial]

MC4 + GLP-1 rationale: Mechanistic speculation is complementary pathways (hypothalamic MC4 vs gut-incretin); human cookbook ratios do not exist for setmelanotide + semaglutide/tirzepatide. [community]

Comparisons are not combination recipes. The original record distinguishes specialist monotherapy from healing-stack culture and retains discussions of incretin combinations, metreleptin and MT-II. Complementary-pathway reasoning supplies no fixed ratio, reliable co-use result or evidence that adding a tanning peptide helps appetite.

Watch for

Skin, sexual and mood changes	Warnings include changing moles, depression/suicidality, unwanted sexual arousal and serious allergy. An erection over four hours requires emergency care.
Hypothalamic-obesity risks	The label flags acute adrenal insufficiency with secondary adrenal insufficiency, and sodium imbalance with central diabetes insipidus. Kidney function affects dosing.
Research-product uncertainty	Unregulated powder is not verified Imcivree. Approval does not identify a vial's contents, purity or strength.

Notes

Skin, sexual and mood changes need attention. Warnings include depression/suicidality, unwanted sexual arousal, changing moles and serious allergy. An erection over four hours requires emergency care. IMCIVREE US prescribing information, revised March 2026 (Official context · Accessed 2026-09-30)

Hypothalamic-obesity care has additional risks. Warnings include acute adrenal insufficiency with secondary adrenal insufficiency, and sodium imbalance with central diabetes insipidus. Kidney function affects dosing. IMCIVREE US prescribing information, revised March 2026 (Official context · Accessed 2026-09-30)

Research powder is not verified Imcivree. The older record notes cost-driven interest in unregulated products. A pharmaceutical approval does not identify a research vial's contents, purity or strength; combining melanocortins adds uncertainty rather than establishing a useful stack.

Full notes

What Setmelanotide does

A signal in the brain's hunger pathway. It activates the melanocortin-4 receptor (MC4R) in the brain's hunger pathway. The daily under-skin injection Imcivree treats specified conditions: Bardet-Biedl syndrome (BBS), POMC, PCSK1 or LEPR deficiency, and acquired hypothalamic obesity (HO). General obesity is excluded. Official context
The melanocortin names are easy to mix up. Peptide threads compare it with Melanotan II and PT-141. These are different compounds. A post about tanning or sexual arousal does not establish Setmelanotide's appetite response, amount or formulation. Reddit · r/Peptides Personal report Community

Changes people seek

Less relentless attention to food. The French hypothalamic-obesity author described relief from obsessive eating. Caregiver discussion similarly emphasizes fewer repeated food requests. This matters beyond the scale: feeling full can change everyday meals and family routines. Personal report Community
Weight change, with a diagnosis-specific context. That author reported losing 25 kg over five months after earlier GLP-1 intolerance. It is one unusually detailed account, not an expected result for someone without the same underlying condition. Personal report
A different pathway after other appetite drugs disappoint. A fat-loss thread suggests Setmelanotide, yet gives no dose or personal outcome. The older record also contains MC4-plus-incretin speculation. Neither establishes that adding it to semaglutide or tirzepatide solves a plateau. Reddit · r/Peptides Community

Doses people discuss

Prescription milligrams: 0.5–3 mg once daily in the retained discussion. That old community wording summarizes prescription figures, not a measured self-experiment range. It must not be read as one interchangeable start-to-maximum schedule; indication, age and kidney function change the official schedule. Community
One daily morning injection; 33% of a stated maximum. The French author reports this frequency and relative amount but never supplies milligrams. The proportion cannot be converted into a verified dose. Another peptide commenter explicitly says they do not know the amount. Personal report Reddit · r/Peptides

Half-life

No numerical community estimate in these sources. A bodybuilding-forum debate calls it short-lived without giving a Setmelanotide number. Its nearby 21-day figure is MariTide's. The clinical estimate is identified separately below; subjective hunger cannot measure clearance. MESO-Rx Forum

Onset: when a change is noticed

Around 1.5 months in one caregiver's update. Maël's caregiver described reduced food-seeking by that point after starting low and increasing the dose. The post supplies no hourly onset and no mg amount. Its reporting interval is not a guaranteed response time. Personal report

Duration: how long a change lasts

Same-day hunger difference after a missed morning. The French author noticed the difference on days an injection was forgotten. This suggests benefit depended on continued treatment for that person; it does not establish a precise number of hours of appetite control. Personal report
A couple of days of early yawning or stretching. A commenter described these sensations fading and hiccups with larger amounts. This is an adverse-experience timeline, not appetite-benefit duration. Reddit · r/lipedema

Cycles and time off

Ongoing daily treatment, rather than a defined cutting cycle. The retained community record describes interruptions for medical or access reasons and little documented bodybuilding cycle practice. The French account views treatment as continuing; a lipedema poster worries about committing to daily injections indefinitely. Community Personal report Reddit · r/lipedema
Stopping for unwanted effects also appears. The Setmelanotide commenter in a sexual-health thread stopped because pigmentation became unacceptable. That is a reason to discontinue, not evidence for a scheduled off-week or a safe restart routine. Personal report

Good to know

Skin, sexual and mood changes need attention. Warnings include depression/suicidality, unwanted sexual arousal, changing moles and serious allergy. An erection over four hours requires emergency care. Official context
Hypothalamic-obesity care has additional risks. Warnings include acute adrenal insufficiency with secondary adrenal insufficiency, and sodium imbalance with central diabetes insipidus. Kidney function affects dosing. Official context
Research powder is not verified Imcivree. The older record notes cost-driven interest in unregulated products. A pharmaceutical approval does not identify a research vial's contents, purity or strength; combining melanocortins adds uncertainty rather than establishing a useful stack. Community

What people describe in practice

Pigmentation ranges from none to a reason to stop. The lipedema commenter said they stayed pale. The sexual-health commenter reported new dark spots despite sunscreen, nausea and no libido improvement. Their product identity is unverified; the report still cautions against treating sexual side effects as a promised benefit. Reddit · r/lipedema Personal report
Early fatigue can accompany better food control. Maël's caregiver reported two days of fatigue/migraine, then darker skin and freckles after escalation. These unwanted effects accompanied less food-seeking. Personal report
Coverage and daily treatment are practical concerns. The BBS Foundation reports insurance and Medicaid difficulties. A lipedema poster feared losing coverage after starting, while questioning a hunger-focused treatment because they did not experience constant hunger. A gene-test result alone does not describe someone's lived symptoms. Community guide Reddit · r/lipedema
No-tolerance claims outrun the accounts. A Reddit reply claims permanent effectiveness; a MESO-Rx debate claims no titration. Neither supplies long-term outcome measurements. The official product does use titration. Reddit · r/lipedema MESO-Rx Forum
Comparisons are not combination recipes. The original record distinguishes specialist monotherapy from healing-stack culture and retains discussions of incretin combinations, metreleptin and MT-II. Complementary-pathway reasoning supplies no fixed ratio, reliable co-use result or evidence that adding a tanning peptide helps appetite. Community

Clinical context behind the numbers

Official schedules are distinct. For BBS/pathway deficiency at age 12+, the US label describes 2 mg SC daily for two weeks, then 3 mg if tolerated. Ages 6–11 start at 1 mg, ages 2–5 at 0.5 mg. Acquired HO at age 6+ steps 0.5, 1, 2, then 3 mg daily over two-week stages. Renal/younger maintenance differs. Official context
About 11 hours is clinical pharmacokinetics. Adult normal-renal modeling: approximately 11-hour effective half-life, eight-hour median blood peak, steady state within two days. Clinical SC-product values differ from felt duration. Official context