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The combination essentially mimics the way the hypothalamus naturally orchestrates peak GH release during deep sleep: a GHRH surge (replicated by CJC-1295 or Mod GRF 1-29) coincides with falling somatostatin and rising ghrelin (replicated by ipamorelin), producing the large nocturnal GH pulse that drives overnight tissue repair and metabolic housekeeping

Friedenberg FK, Palit A, Parkman HP, Hanlon A, Nelson DB (2008) Botulinum toxin A for the treatment of delayed gastric emptying

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Some tingling is normal with active ingredients, but burning or stinging isn't