VIP (vasoactive intestinal peptide)

A natural body peptide sold as a nose spray. It is not approved. A big US study found it did not help very sick COVID patients.

AI illustration of a spray bottle labeled VIP — AI illustration

FDA statusNot approved

Not approved in the US. On the FDA Category 1 list while it is reviewed for pharmacies.

Proof it works in people for breathing problems and long illnessTested: no clear benefit

The biggest trial found no benefit. Nose spray is untested.

Safety data in peopleLimited

Hundreds of hospital patients in a vein. Nose spray is untested.

Three separate grades: the law (not approved, still under FDA pharmacy review), proof (no benefit in its biggest trial), and safety data (only from hospital use). None of the studies used a nose spray.

By the Peptide Science Desk Editorial TeamFact-checked against FDA and official sources · Oct 28, 2026Not yet reviewed by a licensed clinician. How we check facts

What is it?

VIP (vasoactive intestinal peptide) is a 28-building-block signal your body makes in the gut, lungs and brain. It was first found in the gut, which is how it got its name. It relaxes blood vessels and airways. The lab-made medicine version is called aviptadil.

Why do people use it?

Online, VIP nose spray is sold for breathing problems and for long illness after mold exposure. Doctors have tested aviptadil in a vein for COVID, as a mist for lung diseases, and as a shot for erection problems.

Does it really work?

No for COVID, unclear for anything else. In 461 very sick COVID patients, IV aviptadil did not help recovery. An earlier 196-person trial missed its main goal. Small lung studies saw short-term effects. We found no trial of VIP nose spray.

Studies in people

We found 8 studies in people. They used VIP in a vein, as an inhaled mist, or as a shot. None used the nose spray sold online.

Study design	People	What they measured	What they found	Year	Journal	PubMed
Randomized, placebo (TESICO), in a vein	461 very sick COVID patients	Recovery by day 90	No better than placebo. 86 vs 83 people died.	2023	Lancet Respir Med	PMID 37348524
Randomized, placebo, in a vein	196 people with COVID lung failure	Alive and off breathing support at day 60	Missed its main goal. Some later measures looked better.	2022	Crit Care Med	PMID 36044317
Randomized, placebo, inhaled	80 people in hospital with COVID	Days to go home	Went home a bit sooner: 7.8 vs 10 days.	2025	Med Princ Pract	PMID 39870064
Small study, one inhaled dose	20 people with high lung blood pressure	Lung blood flow	Small, short opening of lung blood vessels. No side effects.	2008	Eur Respir J	PMID 18978135
Small open study, inhaled, 4 weeks	20 people with sarcoidosis	Lung immune cells	Safe. Calmed some immune signals in lung fluid.	2010	Am J Respir Crit Care Med	PMID 20442436
Randomized, placebo, shot	24 men with erection problems	Erection	Some swelling, but no erection firm enough for sex on VIP alone.	1990	J Urol	PMID 2405186
Look-back study, shot mixed with phentolamine	308 men with erection problems	Ability to have sex	Worked for 59%. Face flushing in 22.5%.	2025	J Sex Med	PMID 40192471
Randomized, placebo, crossover, in a vein	12 people with migraine	Whether it starts a migraine	No migraines. A mild short headache.	2008	Cephalalgia	PMID 18254893

We read each of these 8 papers on PubMed on October 28, 2026.

The numbers in a chart

Two big trials where the peptide did not help

% of very sick hospital patients who died, peptide vs placebo

Thymosin alpha-1 for sepsisTESTS · 1,106 adults · deaths by day 28

23.4%

24.1%

VIP (aviptadil) for severe COVID-19TESICO · 461 adults · deaths by day 90

38%

36%

Almost the same in both groups: no clear benefit.

Show the numbers as a table

Two big trials where the peptide did not help: % of very sick hospital patients who died, peptide vs placebo
Trial	Peptide	Placebo
Thymosin alpha-1 for sepsis TESTS · 1,106 adults · deaths by day 28	23.4%	24.1%
VIP (aviptadil) for severe COVID-19 TESICO · 461 adults · deaths by day 90	38%	36%

Two different trials and diseases. Different trials, different people: not a head-to-head comparison. Sources: Wu et al., BMJ 2025 (TESTS) (PMID 39814420); Brown et al., Lancet Respir Med 2023 (TESICO) (PMID 37348524).

More charts: Peptides by the numbers

Is it safe? Side effects

It opens blood vessels. In one study, it widened head arteries a lot.
Given in a vein to people with migraine, it caused a mild headache, but not a migraine.
In a 308-man study of a shot mixed with another drug, 22.5% had face flushing.
The nose spray sold online has no safety studies.

Is it legal in the US?

VIP is not an FDA-approved medicine.

It is on the FDA’s "Category 1" list.
That means the FDA is still checking whether regular pharmacies may mix it. No final decision has been made.

What this means for VIP

Category 1 is not approval. It means the FDA has not decided yet. (FDA)
Sprays sold "for research" are not medicine. The FDA has warned sellers of such products. (FDA)
Bringing it into the US for yourself is, in most cases, illegal, the FDA says. (FDA)

Banned in sports? Drug tests

Not named, but may be banned.

VIP is not named on WADA's list. But WADA says its list is not complete. It also bans any drug that is not approved for people by any government anywhere (section S0). From Jan 1, 2027, that rule names "peptides" too. Ask USADA before you use it.

Check work, NCAA, and military rules for VIP

Talk to your doctor

If you have breathing problems or illness you think came from mold, ask a lung or allergy doctor for testing. Bring any VIP spray you use, because it opens blood vessels. We never share doses or tell you where to buy. Print our doctor questions sheet.

Check any peptide in 1 secondFree FDA Status Checker: approved, being tested, or not proven.

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Not medical advice. Medical disclaimer.