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Options for managing tolerance include a brief dose reduction for 4 to 8 weeks ("drug holiday" at a lower dose, not complete cessation), lifestyle optimization to maximize the medication effect, evaluation for other contributing factors (thyroid function, cortisol, sleep quality, medication interactions), and consideration of adding a complementary compound to address specific aspects of the plateau

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Some clinicians also combine a low dose of GHRP-2 (50-75 mcg) with a GHRH analog such as CJC-1295 (without DAC) to achieve a synergistic GH release, then switch to Ipamorelin once GH levels normalize

Sermorelin operates as a synthetic growth hormone-releasing hormone (GHRH) analogue, mimicking the natural hormone produced by the hypothalamus

Impact of tranilast on restenosis after coronary angioplasty: tranilast restenosis following angioplasty trial (TREAT)

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