Agonist
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MetabolicSubcutaneous

Setmelanotide

Also known as: Imcivree · RM-493 · BIM-22493

Selective MC4R agonist. FDA-approved for genetic obesity caused by POMC, PCSK1, LEPR, or Bardet-Biedl syndrome deficiencies. Activates the melanocortin satiety pathway downstream of the leptin-POMC defect.

At a glance

Half-life
11 hours
Common route
Subcutaneous
Typical dose range
1,000–3,000mcg
Stability (reconstituted)
14days refrigerated

Best timing

Once daily, same time each day. Dose-titrated over weeks. Most weight-loss effect is seen in monogenic obesity populations — not general weight-loss agent in normal physiology.

Contraindications

  • Personal or family history of melanoma
  • Pregnancy
  • Severe renal impairment
  • Concurrent MAO inhibitor use

Watch symptoms

  • Skin hyperpigmentation
  • Injection site reactions (very common)
  • Spontaneous erections
  • Nausea, vomiting
  • Mood changes — depression and suicidal ideation reported in trials

Citations

The primary literature.

  1. 01Setmelanotide for POMC, PCSK1, or LEPR deficiency obesity (Phase 3)PubMed
  2. 02Setmelanotide for Bardet-Biedl syndrome and Alström syndromePubMed
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