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While older GHRPs like GHRP-6 and GHRP-2 stimulate growth hormone release but also spike cortisol, prolactin, and ACTH levels producing unwanted side effects ipamorelin triggers GH release with minimal impact on other hormones

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J Child Neurol 1995;10:S40-4

They activate the Nuclear Factor Erythroid 2-Related Factor 2(Nrf2) molecule through the extracellular-signal-regulated kinase (ERK) and PI3K/Akt pathways, which in turn regulate various transcription factors