Melanotan 2 Overdose: What to Do
Melanotan 2 overdose: emergency signs, Poison Control, and what a published case of 6 mg actually caused - rhabdomyolysis, sympathomimetic toxicity, ICU care.
The short version
A published case report describes a man who injected 6 mg of Melanotan II at once, about six times his usual dose. He developed sympathomimetic toxicity and rhabdomyolysis and spent three days in intensive care. Other published cases describe priapism lasting weeks and a kidney (renal) infarction after repeated dosing over months. For a suspected overdose, call 911 for severe symptoms, or Poison Control at 1-800-222-1222 (verify that number yourself).
- A published case of a single 6 mg injection caused rhabdomyolysis, kidney injury and an ICU admission.
- Call 911 for chest pain, severe muscle pain, dark urine, an erection lasting over 4 hours, or fainting; call Poison Control at 1-800-222-1222 otherwise.
- Separate published cases describe priapism not resolved at 4-week follow-up, and a renal infarction after repeated dosing over 6 months.
- An unlabelled research vial has no verified concentration, so the amount taken is often unknown. Tell a clinician that.
US legal status - Research use only
Melanotan II has no FDA-approved product and no approved or reviewed overdose threshold. It was nominated to, then withdrawn from, FDA’s Category 2 bulk-substance safety-risk review.
AU legal status - Not on the ARTG
Not on the Australian Register of Therapeutic Goods, so the TGA has not assessed it for safety, quality or effectiveness. Goods that are not on the ARTG cannot lawfully be supplied or advertised in Australia except through a specific pathway - the Special Access Scheme, an Authorised Prescriber, a clinical trial, or personal importation.
Regulators reach their own conclusions on their own timelines. Where these two disagree, the difference is the point - not an error.
For what Melanotan is and its wider safety record, see the main Melanotan guide. For the one published dosing study, see Melanotan 2 dosage. This page covers what to do about a suspected overdose and what published cases of high or repeated exposure show.
What to tell a clinician or Poison Control
- The product name and any label or lot information on the vial or packaging.
- The amount you believe was injected, in mg, and roughly when.
- That the source is an unregulated research or grey-market product, if that is the case. It has no verified concentration or purity.
- Anything else taken around the same time.
- The specific symptoms, and when each one started.
If the amount is unknown, say so rather than guessing a number. An unlabelled vial gives nobody a reliable way to know what was injected.
A published case of overdose: 6 mg, single injection
A case report Nelson 2012 - Nelson ME, Bryant SM, Aks SE. Melanotan II injection resulting in systemic toxicity and rhabdomyolysis. Clin Toxicol (Phila). 2012;50(10):1169-73., in the references below describes a 39-year-old man who bought Melanotan II online and injected 6 mg subcutaneously in a single dose. He reported this as about six times his usual starting dose. Within two hours he had tachycardia peaking at 146 bpm, tremors, sweating and anxiety, with blood pressure 151/85.
His creatine kinase, a blood marker of muscle breakdown, was 1,760 IU/L on arrival and rose to 17,773 IU/L twelve hours later. That is rhabdomyolysis, and acute kidney injury came with it (creatinine 2.25 mg/dL). He was treated with benzodiazepines, admitted to intensive care, and given IV fluids with sodium bicarbonate. By discharge three days later his CPK had fallen to 2,622 IU/L and his creatinine to 1.23 mg/dL.
What the only published human dosing study used, for comparison
Outside case reports, the entire published human dosing record for Melanotan II is a single 1996 pilot trial in 3 men Dorr 1996 - Dorr RT, Lines R, Levine N et al. Evaluation of melanotan-II, a superpotent cyclic melanotropic peptide in a pilot phase-I clinical study. Life Sci. 1996;58(20):1777-84., in the references below. They had subcutaneous injections starting at 0.01 mg/kg, escalated in 0.005 mg/kg steps to 0.025-0.03 mg/kg, given daily on weekdays for two weeks. For a person weighing 80 kg, 0.03 mg/kg works out to 2.4 mg, well below the 6 mg single dose in the toxicity case above.
The trial reported mild nausea, Grade II somnolence at the top dose in one of two subjects, and spontaneous erections lasting 1-5 hours. It reported no event resembling the case above, at its much lower doses.
Small or uncontrolled human studies. Too little to settle the question either way. One small pilot trial (3 men, escalating low doses) and a handful of published case reports describe human exposure to Melanotan II. No published study has systematically tested a toxic or overdose range.
Other published harms from Melanotan use
- Priapism. A published case describes a man who developed acute, low-flow priapism after subcutaneous melanotan injection. He was treated in the emergency department with cavernosal aspiration, irrigation and phenylephrine Dreyer 2019 - Dreyer BA, Amer T, Fraser M. Melanotan-induced priapism: a hard-earned tan. BMJ Case Rep. 2019;12(2)., in the references below. He avoided surgery but had not recovered erectile function at 4-week follow-up. The authors call this an under-reported, potentially life-altering complication.
- Renal infarction. A separate case describes a man who self-administered 27 mg of Melanotan II in total over 6 months (including 10 mg doses twice and a 7 mg dose). He then developed right-sided abdominal pain, vomiting and fever Peters 2020 - Peters B, Hadimeri H, Wahlberg R et al. Melanotan II: a possible cause of renal infarction: review of the literature and case report. CEN Case Rep. 2020;9(2):159-161., in the references below. Imaging showed a renal infarction affecting about half of one kidney, with normal renal arteries. The authors name direct toxic vasoconstriction, not a blood clot, as the likely mechanism. Kidney function was still mildly reduced, and blood pressure elevated, at 2-month follow-up.
Who should not use it
No FDA-reviewed contraindication list exists, because Melanotan II has never gone through that review. Nothing on this page is a safety clearance for any group. It reports what the small published record contains.
Related
- Melanotan: what the published cases show
- Melanotan 2 dosage: what the one published trial used
- Dosage calculator
- Are peptides safe?
Common questions
What should I do if I think someone has overdosed on Melanotan 2?
Call 911 (in the US) for chest pain, severe muscle pain, or dark or tea-coloured urine. Call also for an erection lasting more than 4 hours, fainting, or any severe or rapidly worsening symptom. For a suspected overdose that is not causing those signs, call Poison Control at 1-800-222-1222, free, confidential and available around the clock. Bring or photograph the vial or packaging.
What does a Melanotan 2 overdose actually look like?
A published case report describes a 39-year-old man who injected 6 mg at once, about six times his own usual starting dose. Within two hours he had a racing heart (up to 146 bpm), tremors, sweating and anxiety. His creatine kinase, a marker of muscle breakdown, rose to 17,773 IU/L over the next 12 hours. That is rhabdomyolysis, and acute kidney injury came with it. He went to intensive care and needed three days of IV fluids and bicarbonate before discharge.
Are there other reported harms beyond that one case?
Yes. A separate published case describes a man who developed priapism (a prolonged, painful erection) after injecting melanotan. He was treated with aspiration and medication in the emergency department and had not recovered erectile function at 4-week follow-up. Another case describes a man who injected 27 mg in total over 6 months. He developed a renal infarction, a blocked blood supply to part of a kidney. He had abdominal pain, vomiting and fever.
What symptoms mean I should get emergency care right now?
Call 911 for any of these. Chest pain. A racing or irregular heartbeat. Severe muscle pain, weakness or dark/tea-coloured urine (possible rhabdomyolysis). An erection lasting more than 4 hours (priapism, a urological emergency). One-sided abdominal or flank pain with fever (possible kidney involvement). Fainting. Any symptom that feels dangerous or is getting rapidly worse.
What should I tell a clinician or Poison Control?
Give the product name and any label or lot information on the vial. Give the amount you believe was injected, in mg, and roughly when. If the source is an unregulated research or grey-market product with no verified concentration, say so. Add any other substances taken around the same time, and the specific symptoms with when each started. If the amount is unknown, say that: it is useful information and should not be guessed.
Is there a known safe upper limit for Melanotan 2?
No regulator has reviewed or approved any dose of Melanotan II. The only published human dosing study used 0.01-0.03 mg per kg of body weight in three men, far below the 6 mg single-injection case that caused toxicity. No published study shows where, between those two points, harm reliably begins. This page reports both ends of the published record rather than invent a threshold.
References (6 sources)
Bibliographic detail is fetched from PubMed, not written by me - so a citation here cannot drift from the paper it names. Study design comes from PubMed's own tags rather than my judgement.
- 1.Dorr RT, Lines R, Levine N et al. Evaluation of melanotan-II, a superpotent cyclic melanotropic peptide in a pilot phase-I clinical study. Life Sci. 1996;58(20):1777-84.Clinical trialPMID 8637402
- 2.Nelson ME, Bryant SM, Aks SE. Melanotan II injection resulting in systemic toxicity and rhabdomyolysis. Clin Toxicol (Phila). 2012;50(10):1169-73.Case reportPMID 23121206
- 3.Dreyer BA, Amer T, Fraser M. Melanotan-induced priapism: a hard-earned tan. BMJ Case Rep. 2019;12(2).ReviewPMID 30796078full text
- 4.Peters B, Hadimeri H, Wahlberg R et al. Melanotan II: a possible cause of renal infarction: review of the literature and case report. CEN Case Rep. 2020;9(2):159-161.ReviewPMID 31953620full text
- 5.FDA - Certain Bulk Drug Substances for Use in Compounding That May Present Significant Safety Risks (Category 2 list and the withdrawn-nominations table, which includes Melanotan II).- US Food and Drug Administrationregulatory
- 6.America's Poison Centers - confirms 1-800-222-1222 as the national Poison Control number, free, expert and confidential.- America's Poison Centersother