What ipamorelin is
Ipamorelin is a synthetic pentapeptide agonist at the growth hormone secretagogue receptor GHS-R1a, the same receptor ghrelin acts on. Two of its five residues are non-natural (α-aminoisobutyric acid at position 1, D-2-naphthylalanine at position 3), one more is a D-amino acid, and the C-terminus is amidated. Those modifications are what give a five-residue peptide enough metabolic stability to be useful.
Mechanistically it sits on the opposite side of the GH axis from the GHRH analogs: CJC-1295, sermorelin and tesamorelin act at the GHRH receptor, ipamorelin at the ghrelin receptor. That is why the two classes are studied together, and why they are sold together.

