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BPC-157 Dosing in Hepatic Impairment: Evidence, Risks, and Clinical Guidance At a glance No FDA-approved formulation / BPC-157 is available only through 503A compounding pharmacies Zero published human RCTs evaluating BPC-157 in hepatic impairment populations Animal models show hepatoprotective effects against NSAID, alcohol, and toxin-induced liver damage Standard compounded dose range is 200-500 mcg/day subcutaneously or intramuscularly Suggested starting dose in hepatic impairment is 200-250 mcg/day subcutaneously Peptides are cleared primarily by proteolytic degradation, not hepatic CYP450 metabolism Liver enzyme monitoring (ALT, AST, bilirubin) recommended at baseline and every 2-4 weeks BPC-157 has shown cytoprotective effects on gastric and intestinal mucosa in over 20 animal studies The FDA has not established hepatic dosing adjustments for BPC-157 Cycle length in liver-compromised patients: 4-6 weeks with reassessment before continuation What Is BPC-157 and How Does It Work