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According to the MHRA SmPC, no dose adjustment is required for patients with renal or hepatic impairment , though closer clinical monitoring is advised in severe renal impairment due to potential dehydration risk from gastrointestinal side effects

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References Translational Andrology and Urology (PMC) Beyond the androgen receptor: the role of growth hormone secretagogues in the modern management of body composition in hypogonadal males (2020 review) European Journal of Endocrinology (PubMed) Ipamorelin, the first selective growth hormone secretagogue (1998 preclinical pharmacology study) European Journal of Anatomy Chronic in vivo Ipamorelin treatment stimulates body weight gain and growth hormone (GH) release in vitro in young female rats (2002 animal study on chronic dosing) Pharmaceutical Research (PubMed) Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers (1999 Phase I clinical pharmacology study) European Journal of Anatomy Three-week chronic in vivo ipamorelin treatment: no desensitization of GH release mechanisms (2002 animal study) International Journal of Colorectal Disease (PubMed) Prospective, randomized, controlled, proof-of-concept study of the ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients (2014 Phase II clinical trial) Johns Hopkins Arthritis Center How to Give a Subcutaneous Injection (patient educational resource) NCBI Bookshelf Best practices for injection: asepsis, preparation, and administration techniques Pharmacologic Considerations (PMC) Subcutaneous drug injection: review of pharmacologic considerations and site rotation practices NIBSC (National Institute for Biological Standards) Peptide Handling, Dissolution & Storage Guidelines (peptide storage recommendations) Bachem (Peptide Manufacturer) Handling and Storage Guidelines for Peptides (technical best-practices) Creative Peptides How Long Do Peptides Last