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VIP

Nasal spray for mold illness

Vasoactive intestinal peptide; aviptadil

Match every finding to its exact substance, formulation, route and study population. A related molecule or approved medicine does not validate a catalog vial.

Human / product-specific records · Animal / laboratory evidence · Mechanistic / indirect records
Explore the evidenceWhy people take it
Compare this compoundRead original sources Community reports
Schematic illustration · View structure evidence

Simplified drawing of a chain of 28 amino acids

At a glance

Why people take it. And what backs it up.

  1. Recover from mold illness

    Small uncontrolled studies

    Its main use: a prescription nasal spray, often four times a day, as the final step of the Shoemaker mold-illness protocol.

    Sources (5)

  2. Ease long COVID

    People report it, not studied

    Some with long COVID use the spray, often with thymosin alpha-1, hoping to ease lingering brain fog and other symptoms.

    Sources (3)

  3. Ease joint pain and arthritis

    People report it, not studied

    A few inject research-vial VIP hoping to calm joint pain and rheumatoid arthritis.

    Sources (2)

  4. Treat erectile dysfunction

    Approved in parts of Europe, with phentolamine

    Combined with phentolamine as Invicorp, a penile injection, it is approved in several European countries for erectile dysfunction; VIP alone is not.

    Sources (4)

Evidence briefing

Sources checked

What the sources support.

VIP is a native 28-amino-acid neuropeptide; aviptadil is its synthetic form. The European product record is for aviptadil combined with phentolamine (Invicorp and country-specific names), an intracavernosal erectile-dysfunction medicine in some European markets. This is not approval of VIP alone, nasal VIP, or research vials. A US randomized trial of IV aviptadil for COVID-19 hypoxemic respiratory failure did not significantly improve its primary clinical outcome.

Keep in mind

The approved combination, route and erectile-dysfunction indication cannot be generalized to standalone VIP or proposed CIRS, lung or COVID uses; the US COVID trial result was negative on its primary endpoint.

Identity and research status reviewRead the original sources

The research. What’s been studied.

  • Animal & lab studies

    Blood-vessel and airway signaling

    VIP can relax smooth muscle in experimental physiology; this does not establish treatment benefit for lung or vascular disease.

  • Early human studies

    Anti-inflammatory research

    Effects on immune signaling have been studied in laboratory and clinical research, but no general anti-inflammatory treatment benefit is established.

  • Human evidence

    Erectile dysfunction product

    Aviptadil combined with phentolamine is authorized in some European markets for intracavernosal treatment of erectile dysfunction. The approval is for the combination product, not VIP alone.

  • Early human studies

    COVID-19 research

    A randomized US trial of IV aviptadil did not significantly improve its primary clinical outcome in patients with COVID-19 respiratory failure.

What do these labels mean?
  • Human evidence: approved-drug data or larger human studies, within the populations and uses studied.
  • Early human studies: small, preliminary or limited human studies.
  • Animal & lab studies: animal or laboratory findings that do not establish effects in people.
  • Unverified: a proposed use or claim without verified supporting clinical evidence.
How each claim was reviewed (4)

Reported effects and evidence.

A citation may support, qualify or correct a claim. Read the study scope; a laboratory result is not an established benefit in people. Each review covers a claim as it was first collected; the tiles above show the collection’s current wording.

  1. Small human airway study; broader physiology requires sources

    Review of “Relaxes airways and blood vessels”

    Small human VIP experiments examined airway responsiveness. Do not imply a general airway-opening treatment from physiology alone.

    Limitations and applicability. Six-person asthma study found no baseline bronchodilation but altered histamine responsiveness; route and endpoint matter.

    Original collected claim and review history

    Original title: Relaxes airways and blood vessels

    Widens blood vessels and airways by relaxing smooth muscle.

    Original label: early. Preserved for traceability; the reviewed wording above qualifies this record.

    Record vip:benefit:1 · Annotated 2026-10-01 · Review method

  2. Preclinical mouse immune experiment

    Review of “Anti-inflammatory”

    VIP altered regulatory T-cell and inflammatory responses in experimental mouse arthritis.

    Limitations and applicability. Mouse arthritis/T-regulatory-cell finding does not establish broad human anti-inflammatory efficacy.

    Original collected claim and review history

    Original title: Anti-inflammatory

    Dampens inflammatory immune signals.

    Original label: animal. Preserved for traceability; the reviewed wording above qualifies this record.

    Record vip:benefit:2 · Annotated 2026-10-01 · Review method

  3. Verified Swedish approved-combination label

    Review of “Erectile dysfunction treatment”

    Swedish Invicorp product information specifies treatment of erectile dysfunction in adult men with the aviptadil–phentolamine combination.

    Limitations and applicability. Regulatory indication belongs to Invicorp, an aviptadil–phentolamine combination. It cannot validate nasal VIP or CIRS uses.

    Original collected claim and review history

    Original title: Erectile dysfunction treatment

    Combined with phentolamine, approved for ED in some European countries.

    Original label: proven. Preserved for traceability; the reviewed wording above qualifies this record.

    Record vip:benefit:3 · Annotated 2026-10-01 · Review method

  4. Small uncontrolled observational treatment report

    Review of “Mold-related illness (CIRS)”

    A small uncontrolled report studied nasal VIP in a selected CIRS cohort; efficacy remains uncertain.

    Limitations and applicability. Open-label, selected 20-patient report cannot establish causation, general mold-illness treatment or comparative efficacy.

    Original collected claim and review history

    Original title: Mold-related illness (CIRS)

    Used as a nasal spray by some practitioners for chronic inflammatory response syndrome, based on small uncontrolled studies.

    Original label: early. Preserved for traceability; the reviewed wording above qualifies this record.

    Record vip:benefit:4 · Annotated 2026-10-01 · Review method

The research in detail

Evidence category

Human trials, not approved

Aviptadil has been studied for respiratory and inflammatory conditions, including COVID-19. A large US randomized trial in COVID-19-associated hypoxemic respiratory failure did not significantly improve the primary clinical outcome. VIP nasal spray use for CIRS is not supported by adequate controlled evidence.

Evidence is assessed claim by claim above. Regulatory approval, study design, findings and relevance are separate questions; there is no single evidence score.

Risks and unknowns. What to know first.

Collected cautions follow. These are not an exhaustive or independently validated safety assessment; claim references do not automatically support every caution.

  • Flushing, low blood pressure, fast heart rate and diarrhea.
  • Rare tumors that overproduce VIP cause severe watery diarrhea, which shows what too much can do.

What people report

Show all 6 cautionsShow fewer cautions

Read this first: what “research use only” means

Published dosing records. What the label abroad says.

Historical label and trial records for the named product, route, population and indication. These records are not a personal schedule or a validated regimen for a catalog vial. Source attribution does not establish applicability.

Invicorp

Erectile dysfunction in adult men (Swedish label; also approved in other European countries)

As neededLabel abroad

Source: Invicorp summary of product characteristics (Swedish Medical Products Agency, revised 2026-07-09)

Each injection
25 mcg
How
Injection into the penis (into the erectile tissue, near the base)
How often
As needed, no more than once a day or 3 times a week
How long
As needed, with regular check-ups

Limit. No more than once a day, and no more than 3 times a week.

  • The approved product is not VIP alone: each 0.35 mL ampoule combines 25 mcg of aviptadil (VIP) with 2 mg of phentolamine, and it is injected into the penis.
  • The first injections must be given by health care staff. After training, men may inject at home, with regular check-ups (for example every 3 months).
  • The label says the erection should be firm enough for sex and should not last more than 1 hour. It tells patients to contact a doctor at once if an erection lasts a long time, for example 4 hours or more.
  • Aviptadil alone, given into a vein, was tested for COVID-19 lung failure; a trial in 461 hospital patients found no significant benefit (TESICO, Lancet Respiratory Medicine, 2023), and that use is not approved.

This schedule comes from the cited national product label. Authorization and availability can change: check the current local status and exact formulation. A research vial is not the labeled product.

Community protocols. Reported online. Not clinically validated.

Community reports Collection date: 30 Sep 2026

Most commonly the Shoemaker CIRS (mold illness) protocol: a compounded nasal spray of 50 mcg per spray, one spray four times a day, stepping up to two sprays four times a day (or 4–8 or more sprays a day) if symptoms remain, for months (users say about 6 months on average), then tapering off.

More about this

Outside CIRS, a minority inject research-vial VIP (about 100 mcg once or twice a day) or make homemade nasal sprays.

Not testedFrequently encountered in reviewed sources

Shoemaker CIRS nasal spray (starting dose)

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
50 mcg per spray
How often
1 spray four times a day, alternating nostrils
Route
Nasal spray
Timing
Spread through the day (for example on waking, lunch, supper and bedtime); exact 6-hour spacing is not needed
How long
Months; users report about 6 months on average
Cycle
Taper once well: 50 mcg twice a day for 30 days, then once a day for 30 days, then stop; recheck at 6 months
Ramp
First dose given in the clinic, with blood tests before and 15 minutes after
Mixing
Pharmacy-made spray at 500 mcg per mL (for example 6 mg in 12 mL); each 0.1 mL spray gives 50 mcg; a 12 mL bottle lasts about 30 days at 4 sprays a day; kept refrigerated
  • Used only as the last (12th) step, after leaving the moldy building, binders, and clearing nasal MARCoNS, with normal lipase and a passed visual contrast test.
  • Protocol rule: stop VIP if belly pain develops and lipase rises above range.
  • Pharmacy leaflets list flushing, warmth, headache, dizziness, nasal irritation and stomach upset; Wells Pharmacy says it is not for people with low blood pressure.
Sources (4)

Not testedCommon

CIRS step-up / higher dose

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
100 mcg per dose (2 sprays), or 4–8 or more sprays a day (200–400+ mcg a day)
How often
2 sprays four times a day
Route
Nasal spray
How long
From month 2 onward, for months
Ramp
Month 1: 1 spray four times a day; month 2: 2 sprays four times a day if symptoms have not resolved
  • Shoemaker’s 2017 study had 13 patients on more than 7 doses a day for up to 6 months.
  • Patients report ramping up the number of sprays over weeks; one CIRS patient reported that moving from 300 mcg to a ‘500mcg full-dose’ made them worse (see cautions).
Sources (4)
Show all 7 protocolsShow fewer protocols

Not testedSometimes seen

Long high-dose course for brain shrinkage / early dementia

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
300–600 mcg a day
How often
Several sprays through the day
Route
Nasal spray
How long
6–9 months
  • From Shoemaker’s site, based on a 2017 study that used 600 mcg a day and on unpublished practice.
Sources (1)

Not testedSometimes seen

General wellness or brain use (outside CIRS)

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
25–100 mcg a day (Ben Greenfield) to 200–400 mcg a day (one pharmacy)
How often
Once a day, or divided through the day
Route
Nasal spray
  • Sources disagree about fourfold.
  • One user said a couple of sprays of a research spray (13.3 mcg per spray) once or twice a day helped during COVID infections.
Sources (3)

Not testedSometimes seen

Research-vial injection under the skin

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
About 100 mcg per shot (few reports)
How often
Twice a day (morning or afternoon, and night); some once at bedtime
Route
Injection under the skin
Timing
Some take it at bedtime to sleep through headaches and flushing
  • Used for joint pain, rheumatoid arthritis, gut problems and mold illness, mostly by people without a prescription spray.
  • Users report flushing, headaches and a racing heart (see cautions).
Sources (3)

Not testedSometimes seen

Homemade nasal spray from research vials

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
About 13–100 mcg per spray; users settle around 50 mcg per dose
How often
Up to 4 times a day (one user found 4 times a day too much)
Route
Nasal spray
Mixing
10 mg vial dissolved in 1 mL water, then topped up to 10 mL in a spray bottle (about 100 mcg per spray)
  • Some research vendors sell ready-made sprays (one bottle stated 13.3 mcg per spray).
  • Users say it must be refrigerated and degrades within 60–90 days.
Sources (3)

Not testedFringe

Escalating spray strength (some CIRS clinics)

Collected report · exact form and route are only as reported below. Source date and reporter identity are not separately verified. Collection checked 30 Sep 2026; presentation annotated 2026-10-01.

Frequency labels describe this collection, not a measured population. Contradictory records remain available.

Details and sourcesHide details
Dose
50 mcg up to 2,000 mcg per spray
How often
1–16 sprays a day
Route
Nasal spray
How long
30 days to indefinitely
  • Quoted on Jay Campbell’s site from an unnamed CIRS source; the original source was not found.
Sources (2)

Where the numbers come from

Dr. Ritchie Shoemaker’s CIRS (mold illness) program. His open-label studies set the doses: 2013, 20 patients using 50 mcg as a nasal spray four times a day; 2017, one spray four times a day for a month, then two sprays four times a day, with some patients on more than 7 doses a day. Hopkinton Drug and other compounding pharmacies make the 500 mcg per mL spray (50 mcg per 0.1 mL). Approved aviptadil products (injections with phentolamine for erectile dysfunction) and aviptadil trials given into a vein or inhaled are not the source of community dosing. Research-vial injection doses have no clear origin.

Home-made sprays and serums

Home-made nasal spray. Community recipes. Not tested.

Original source recordsHide

VIP nasal spray is a clinic treatment in Dr. Ritchie Shoemaker’s mould-illness (CIRS) protocol: a compounded spray, 50 mcg four times a day, kept in the fridge. Some users also make or buy their own. Evidence is one open-label trial and case reports, plus pharmacy listings.

Best evidence: Open-label trial of 20 patients (Shoemaker et al., Health 2013: 50 mcg four times a day by nasal spray for at least 18 months) and a 2016 case report; clinic instructions (2011); compounding pharmacy listing (Tailor Made, 500 mcg per mL, 12 mL). A 2024 review says VIP is available only from compounding pharmacies.

Not testedNasal sprayFrequently encountered in reviewed sources

Clinic protocol: compounded VIP nasal spray, 50 mcg four times a day

Original source-specific report. Collection checked 30 Sep 2026; presentation annotated 2026-10-01. Source date and reporter identity are not separately verified. Exact form and route are limited to the source’s description.

Batch: 12 mL (pharmacy listing)

Ingredients and methodHide the recipe

Ingredients

IngredientAmountRole
VIP (aviptadil)500 mcg per mL (Tailor Made listing); 50 mcg per dose in the trialActive

Method

  1. Blow your nose first to clear dust and mucus.
  2. Spray once into either nostril; doses need not be exactly 6 hours apart (e.g. at teeth brushing, lunch, supper and bedtime).
How it’s used
One spray four times a day (clinic letter); 50 mcg four times a day (trial and case report). Clinic pages later mention 300–600 mcg a day for 6–9 months for other uses.
Per dose
50 mcg per dose (trial). The pharmacy listing gives 500 mcg per mL but not the spray volume.
Storage
Refrigerated, with the bottle kept upright (the spray adapter did not always seal).
Keeps for
Keep it fresh: ‘older than one month loses some of its efficacy’ (clinic letter).
  • Before starting, the clinic required a normal visual contrast test, a low mould index in the home (ERMI) and a nasal culture free of biofilm-forming staph (MARCoNS).
  • Shoemaker’s site says over 1,000 doctors had prescribed VIP nasal spray to over 10,000 patients from at least five pharmacies.

Not stated: preservative.

Sources (12)

Not testedNasal spraySometimes seen

Ready-made vendor VIP spray: 13.3 mcg per spray

Original source-specific report. Collection checked 30 Sep 2026; presentation annotated 2026-10-01. Source date and reporter identity are not separately verified. Exact form and route are limited to the source’s description.

Ingredients and methodHide the recipe

Ingredients

IngredientAmountRole
VIPnot statedActive
How it’s used
The buyer had read ‘50 mcg/4x/day’; one reply suggested a couple of sprays once or twice a day.
Per dose
13.3 mcg per spray (stated on the bottle).
Storage
Fridge (reply).
  • It arrived unrefrigerated.
Sources (2)

Not testedNasal sprayFringe

Home-made VIP spray in 60/40 bacteriostatic water/saline

Original source-specific report. Collection checked 30 Sep 2026; presentation annotated 2026-10-01. Source date and reporter identity are not separately verified. Exact form and route are limited to the source’s description.

Ingredients and methodHide the recipe

Ingredients

IngredientAmountRole
VIPnot statedActive
Bacteriostatic water60% of the liquidLiquid / preservative
Saline40% of the liquidLiquid
Preservative
Bacteriostatic water, diluted with saline to reduce sting.

Not stated: how it’s used and the amount per dose.

Sources (1)

How the method was put together, step by step with its sources

Editorial synthesis and reported strength comparison

This synthesized method combines source records. It has not been validated for preparation, sterility, compatibility, absorption or storage. Select a reported strength to inspect the arithmetic; no strength is selected for you.

Not testedNasal spray

No amounts were found in the reviewed recipe records for this one. What was found is under “Original source records”.

The general method for home-made nasal sprays, with its sources

Good to know

  • Bacteriostatic water contains 0.9–1.1% benzyl alcohol as a preservative. Its label covers mixing injections, not nasal use; EU labels warn of allergic reactions.
  • Some use store-bought saline nasal spray for its preservatives: often benzalkonium chloride, which can irritate the nose with long use, and sometimes benzyl alcohol.
  • Never tap water: it is not sterile, and CDC researchers warn against it for nasal rinsing.
What people report
Research notes

1) Concentration errors: Tailor Made Compounding’s dosing chart (‘12mL at 50mcg/mL’) and Jodie Dashore’s CIRS protocol PDF (‘50 mcg/mL, 1 spray 4 times a day’) say 50 mcg per mL, but the standard spray is 500 mcg per mL giving 50 mcg per 0.1 mL spray (TMC’s own fact sheet, Shoemaker 2017, Park Compounding). ‘50 mcg/mL’ looks like a typo for 50 mcg per spray. 2) ‘Full dose’ is ambiguous on forums (‘500mcg’ may mean a 500 mcg per mL strength or 500 mcg a day). 3) Regulatory: FDA lists vasoactive intestinal peptide in 503A Category 1 (under evaluation; list updated May 14, 2026), which lets 503A pharmacies compound it under FDA’s interim policy. Surviving Mold’s undated ‘Save VIP’ page says FDA once announced plans to remove it; that did not happen as of May 2026. VIP is not FDA-approved; aviptadil with phentolamine is approved for erectile dysfunction in some European countries, and those doses are not community protocols. 4) Kent Holtorf, a peptide practitioner, argues VIP suppresses Th1 immunity and may raise long-term cancer risk and leaves it out of his CIRS protocol (per a patient blog’s summary of his talk); this is opinion, not a study finding. 5) The ‘up to 2,000 mcg per spray, 1–16 sprays a day’ range on Jay Campbell’s site is quoted from an unnamed source that could not be traced. 6) Shoemaker protocols require passing earlier steps (mold removal, MARCoNS clearance, normal lipase) first; many forum users start VIP without them. 7) Tailor Made Compounding, one dose source here, pleaded guilty in 2020 to distributing unapproved new drugs (VIP was not named in the plea list).

Nasal spray

The trial and most clinic material come from Dr. Shoemaker’s own practice. The FDA decision is reported by his site, not taken from an FDA document in this search. Current US availability of compounded VIP was not confirmed.

Measurement basics and calculator

Explore vial arithmetic

What it is. In plain English.

A native neuropeptide with human trials; a European erectile-dysfunction medicine combines its synthetic form with phentolamine.

A 28-amino-acid neuropeptide found in several tissues. Aviptadil is synthetic VIP. Some European countries authorize aviptadil only as part of an intracavernosal combination product with phentolamine for erectile dysfunction; that product status does not apply to VIP alone, nasal sprays or research vials.

It relaxes smooth muscle (widening blood vessels and airways), drives water secretion in the gut and dampens inflammatory signals.

Reviewed 2026-10-01.

Structure. What it really looks like.

Experimental

Cryo-EM structure of VIP (orange) bound to the human VPAC1 receptor (gray).

Vasoactive intestinal peptide (VIP, orange) bound to the human VPAC1 receptor (gray). All 28 amino acids are resolved. Also part of the experiment, but not drawn: a G protein and an antibody fragment.

8E3Z, Piper et al., 2022. Rendered with Mol* (Sehnal et al., 2021) from RCSB PDB data (Berman et al., 2000).

Specs. The facts at a glance.

Length
28 amino acids
Sold as
  • VIP 10 mg
Regulatory status
Aviptadil plus phentolamine is a nationally authorized intracavernosal erectile-dysfunction product in some European countries. This is not approval of VIP alone or wellness-clinic/research-vial products; VIP/aviptadil is not FDA-approved.
Also known as
Vasoactive intestinal peptide; aviptadil

Sources. What this page rests on.

Every source behind this page, with what it says and when it was checked, is in the Source library.

VIP in the Source library

Original overview and research notes · annotated 2026-10-01

Historical collection text. Read alongside the claim corrections above; identity or evidence qualifications may supersede this wording.

Calms inflammation and relaxes blood vessels

A natural neuropeptide that relaxes blood vessels and calms immune responses.

A 28-amino-acid peptide found throughout the gut, lungs, brain and immune system.

It relaxes smooth muscle (widening blood vessels and airways), drives water secretion in the gut and dampens inflammatory signals.

As aviptadil, it was studied inhaled and IV for lung injury; COVID-19 trials didn’t show a clear benefit. Some practitioners use VIP nasal spray for mold-related illness (CIRS), based on small uncontrolled studies.

Original status record: Aviptadil plus phentolamine is approved for erectile dysfunction in some European countries. Not FDA-approved.

More in Immune system.

Glossary

Cryo-EM

Cryo-electron microscopy. Molecules are frozen in a thin layer of ice and photographed thousands of times with an electron microscope; the images are combined into a 3D map.

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Glossary

Resolution

How sharp a structure is, measured in ångströms (Å; a ten-billionth of a meter). Smaller is sharper.

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Glossary

Protein Data Bank (PDB)

The free worldwide archive of 3D structures of proteins and other molecules measured in experiments. Each entry has a four-character code, like 7KI0.

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