This looksmaxxer's drug & peptide regimen is a medical nightmare

The term “looksmaxxing” is the internet’s hyper-optimized pursuit of physical appearance, taken to an extreme. Diet, skin care, hair restoration, hormones, tanning, weight loss drugs, and experimental peptides can all become part of the project.

Braden Peters, 20, who goes by the alias “Clavicular” online, is a prominent figure in the looksmaxxing world. He recently drew attention for a regimen that reads less like a typical supplement stack and more like a medication reconciliation nightmare.

“We’re not even limiting ourselves to approved medications anymore? … Your cardiovascular system did not consent to the group project. At this point, I don’t even want your peptide stack PDF. I want an EKG to start with. There’s a drug for the physique, a drug for the hair, a drug for the skin, a drug for the erections, a drug for the appetite, a drug affecting the cardiovascular system, then another drug to mitigate something one of the other … drugs might be doing,” said Shantel White, DNP, in an Instagram Reel.

Clavicular's peptide stack provides a useful clinical window into something doctors are increasingly likely to encounter: Patients assembling their own pharmacologic “optimization” protocols from social media, telehealth clinics, peptide vendors, and online "grey market" communities.

Looking closely, this regimen raises three separate questions: What is each drug supposed to do? What are its individual risks? And where might combining them create risks greater than the sum of their parts?

1. Retatrutide

What it is: Retatrutide is not currently an approved prescription drug. It is an investigational triple agonist targeting GIP, GLP-1, and glucagon receptors. In phase 3 studies, it has produced striking weight loss results, which helps explain why it has become the latest obsession in the online peptide world. But it remains under clinical development, and its safety and efficacy are still being evaluated by regulators.^[]

Supposed benefit: Weight loss, improved glycemic control, and metabolic improvement.^[]

Here’s the first major red flag in this regimen: the schedule. Clinical trials have used retatrutide as a once-weekly subcutaneous injection, with participants typically starting at 2 mg and escalating gradually toward target doses such as 4 mg, 6 mg, 9 mg, or 12 mg.^[][]

Clinically, this isn't a classic overdose. There's no approved label defining a maximum safe dose, and dosing every 5 days can't be cleanly converted to a weekly equivalent without pharmacokinetic data. What it does mean: the regimen exceeds the highest dose tested in major phase 3 trials, putting the patient beyond the studied evidence base for a drug whose long-term safety profile is still being established.

In phase 3 data, common adverse effects included nausea, diarrhea, constipation, and vomiting.^[]

For doctors, the other concern is what happens downstream: rapid weight loss, reduced caloric intake, dehydration, loss of lean mass, and nutritional inadequacy may not show up on an influencer’s before-and-after photo.

2. Testosterone

What it is: Testosterone is a sex hormone that drives physical development, reproductive health, and overall physical maintenance.^[] FDA-approved testosterone products are intended for men with low testosterone associated with specific medical conditions.^[]

Supposed benefit: Increased muscle mass, improved bone density, lower body fat, better cognitive function, and improved energy and libido.^[][]

Potential concerns of too much testosterone include mood changes, muscle hypertrophy, testicular atrophy, erythrocytosis, acne, infertility, gynecomastia, and other endocrine effects.^[]

Product labeling also carries warnings involving cardiovascular events, among other risks.^[]

3. Isotretinoin

What it is: Isotretinoin is a retinoid medication that treats severe acne.^[]

Supposed benefit: Suppression of acne.^[]

The recommended daily dosage of Isotretinoin is 0.5 mg to 1 mg per kilogram body weight per day, taken as two divided doses.^[]

Clavicular’s 7.5-mg dose is relatively low compared with conventional daily isotretinoin regimens. For instance, a 170-pound male would take anywhere from 38–77 mg of isotretinoin per day, depending on their specific dosage. But “low dose” does not mean “no monitoring required.” 

4. Melanotan II

What it is: Melanotan II is a largely untested and unlicensed synthetic peptide that mimics natural melanocortin hormones to target specific cell receptors in the body.^[]

Supposed benefit: Tanning, plus possible effects on sexual function.^[]

It is not FDA-approved. The FDA has specifically flagged Melanotan II as a substance that may present significant safety risks, including skin cancer, systemic toxicity, and muscle damage.^[]

5. Tadalafil

What it is: Tadalafil is used to treat erectile dysfunction, and 5 mg once daily is an approved regimen for certain indications.^[] On its own, this is arguably one of the least eyebrow-raising doses on the list.

Supposed benefit: Treating erectile dysfunction, enhancing workout performance,  improving cognitive function, boosting heart health, and preventing Alzheimer’s disease.^[][]

But stacks are about combinations. The two questions here are:

1. Is the patient also using nitrates or other medications that can dangerously lower blood pressure?

2. What happens when tadalafil is combined with oral minoxidil?

Which brings us to another pairing worth watching.

6. Oral minoxidil

What it is: Oral minoxidil is increasingly used off-label for hair loss in patients who do not have androgenetic alopecia. At 2.5 mg, the dose is within the range commonly discussed for low-dose oral therapy.^[]

Supposed benefit: Hair preservation and regrowth.^[]

Minoxidil is a systemic vasodilator.^[] Potential adverse effects include hypertrichosis, edema, tachycardia, and blood pressure–related symptoms.^[]

Oral minoxidil and tadalafil can contribute to vasodilation and lower blood pressure. Some patients may tolerate the combination without obvious symptoms. For others—particularly those with lower baseline blood pressure, dehydration, rapid weight loss, or other vasoactive drugs—it could increase the risk of dizziness, lightheadedness, hypotension, or reflex tachycardia. Now add retatrutide-related nausea, vomiting, or diarrhea into the mix. 

7. Dutasteride

What it is: Dutasteride is primarily used to treat an enlarged prostate.^[] Off-label, it may be used to treat androgenic alopecia.^[]

Supposed benefit: Prevention or treatment of androgenetic hair loss.^[]

At 0.5 mg once a day, the dose is familiar from approved use for benign prostatic hyperplasia, though its use for hair loss varies by market and indication.^[] This may be the clearest example of the internal logic of the stack:

• Use testosterone to support muscle and androgen-related appearance.

• Use dutasteride to reduce one of testosterone’s downstream hair-related consequences.

• Use minoxidil to stimulate hair growth through another pathway.

However, dutasteride can cause sexual adverse effects, and its endocrine effects may complicate interpretation of symptoms and laboratory values.^[]

8. Nebivolol

What it is: Nebivolol is a beta-adrenergic blocker approved for hypertension.^[] At 5 mg once daily, this is a standard starting dose for most patients.

Supposed benefit: Blood pressure control, lower heart rate, and, potentially in the context of this particular regimen, management of stimulant-like cardiovascular effects or elevated blood pressure.^[]

Nebivolol becomes more interesting when you look at what else is in the stack. Unlike a medication taken in isolation, it is being layered on top of tadalafil and oral minoxidil, both of which can affect vascular tone and blood pressure. 

Potential adverse effects of nebivolol include fatigue, headache, bradycardia, and hypotension.^[] Its labeling also warns against abrupt discontinuation.^[]

Nebivolol + tadalafil + oral minoxidil = the expanded blood-pressure stack. This addition makes the hemodynamic cluster more complicated.

Again, this doesn’t mean the combination is automatically dangerous. But it creates a much more plausible scenario for:

• Orthostatic symptoms

• Lightheadedness or syncope

• Symptomatic hypotension

• Bradycardia

• Fatigue that gets blamed on weight loss, dieting, or “being lean”

Another wrinkle: A beta-blocker can blunt tachycardia, meaning the usual compensatory rise in heart rate that might alert a patient—or clinician—to volume depletion or hypotension could be altered.

For doctors, this is the kind of stack where a single in-office blood pressure reading may not tell the whole story. Ask about standing symptoms. Ask about resting heart rate. Ask what happens after injections, workouts, diarrhea, vomiting, fasting, or aggressive calorie restriction.

The medication list is now starting to look less like a series of independent cosmetic interventions and more like a physiology experiment.

9. MSM

What it is: MSM—short for methylsulfonylmethane—is an organosulfur compound sold as a dietary supplement.^[] It is commonly marketed for joint pain and inflammation.

Supposed benefit: Joint support, reduced inflammation, improved exercise recovery, and sometimes healthier skin and nails.^[]

MSM does not appear to have any well-documented direct interactions with the other substances in this stack. But the absence of known interactions isn’t the same as evidence that this exact peptide combination has been studied. MSM interaction research is limited, especially in complex polypharmacy.^[]