Tesamorelin vs Ipamorelin
An approved GHRH analog with fat loss trials versus the community's favorite GHRP.
Reviewed by the amino101 editorial team. , first published .
Tesamorelin and ipamorelin are both growth hormone secretagogues, but they sit at opposite ends of the evidence scale. Tesamorelin is a stabilized 44 amino acid GHRH analog approved by the FDA in 2010 as Egrifta for reducing abdominal fat in HIV associated lipodystrophy. Its approval rests on two phase 3 trials with over 800 participants where 2 mg daily cut visceral fat by about 15 to 18 percent over 26 weeks. Ipamorelin is a five amino acid GHRP that completed phase 2 and was dropped; its human data is limited to GH release studies and one surgical recovery trial that missed its endpoint. They act on different receptors, GHRH for tesamorelin and ghrelin for ipamorelin, which is why they are often combined rather than chosen between. The practical differences are cost, since tesamorelin is dosed in milligrams, and purpose: tesamorelin is the one with a documented fat loss effect, ipamorelin is the cheaper general GH pulse. Educational reference only.
| Tesamorelin | Ipamorelin | |
|---|---|---|
| Typical dosage | 1 to 2 mg | 100 to 300 mcg |
| Frequency | once daily | 1 to 3 times daily |
| Route | Subcutaneous | Subcutaneous |
| Half-life | 26 to 38 minutes in plasma | about 2 hours in plasma |
| Cycle | ongoing; reassess at 3 to 6 months with IGF-1 and waist measurements | 8 to 16 weeks |
| Research level | Extensively studied | Well researched |
| Human trials | Approved drug | Randomized trials |
| Status | FDA approved (Egrifta) for HIV-associated lipodystrophy; off-label otherwise | Investigational, not FDA approved (Phase 2 trials completed, not pursued) |
| Effects timeline | IGF-1 rise 2 to 4 weeks, waist and visceral fat change 12 to 26 weeks | deeper sleep 1 to 2 weeks, IGF-1 rise on bloodwork by 4 weeks, recovery and body composition 2 to 3 months |
Key differences
Tesamorelin vs Ipamorelin dosage
Dosage patterns reported in research and community protocols, by goal. Taken from each compound page. Not a prescription.
| Goal | Dosage | Frequency |
|---|---|---|
| Approved dose | 2 mg | once daily |
| Reduced dose for cost or side effects | 1 mg | once daily |
| Stacked with a GHRP | 1 to 2 mg | once daily before bed, with 100 mcg ipamorelin |
| Maintenance after fat loss | 1 mg | once daily, or 2 mg on alternating days |
| Goal | Dosage | Frequency |
|---|---|---|
| Solo nightly dose | 200 to 300 mcg | once daily before bed |
| Stacked with a GHRH analog | 100 mcg | once daily before bed, with 100 mcg Mod GRF 1-29 |
| Three pulse protocol | 100 mcg | 3 times daily, on waking, after training, before bed |
| Recovery focus | 100 to 200 mcg | twice daily, after training and before bed |
Convert any of these to syringe units in the dosage calculator.
Side effects compared
- ▲Injection site redness, itching, bruising, or irritation
- ▲Joint pain and stiffness
- ▲Swelling in the hands and feet, carpal tunnel symptoms
- ▲Elevated blood glucose in susceptible people
- ▲Headache or flushing
- ▲Headache, flushing, or lightheadedness shortly after a dose
- ▲Water retention and puffy hands at higher doses
- ▲Tingling in the fingers when stacked heavily
- ▲Mild appetite increase in some people
- ▲Injection site redness or itching
Which should you choose?
Tesamorelin is the fit for someone whose target is abdominal and visceral fat and who wants a compound with phase 3 trial evidence behind it. It is an approved drug, dosed at 1 to 2 mg daily, with IGF-1 rising within 2 to 4 weeks and waist changes over 12 to 26 weeks. Budget for it: the milligram doses make it the most expensive secretagogue to run. Check fasting glucose periodically, since it can rise.
Ipamorelin is the fit for general GH support on a budget, for sleep quality, or for anyone who wants the cleanest possible GHRP without cortisol or hunger effects. At 100 to 300 mcg nightly a 5 mg vial lasts weeks. It has no fat loss trials of its own, so if that is the goal, treat it as the partner to tesamorelin rather than a substitute.
If visceral fat is the goal, tesamorelin is the only secretagogue with human trial evidence for it, and that settles the choice regardless of price. The effect is moderate, about 15 to 18 percent of visceral fat over 6 months, it reverses when you stop, and it was measured in HIV patients, so the numbers may not transfer exactly to healthy adults. If the goal is general GH support, sleep, or recovery at a budget that allows daily use for months, ipamorelin wins on cost and tolerability. The common move is to use both, since a GHRH analog and a GHRP together produce a larger pulse than either alone; 1 to 2 mg tesamorelin with 100 mcg ipamorelin before bed is the reported pattern and is covered in the tesamorelin and ipamorelin stack. For people on GLP-1 drugs hoping to spare lean mass, no human trial shows that either one does; see GLP-1 muscle loss.
Stacking: Combined before bed on an empty stomach: 1 to 2 mg tesamorelin with 100 mcg ipamorelin is the reported pattern. Tesamorelin replaces Mod GRF 1-29 as the GHRH half of the stack.
Tesamorelin is a stabilized growth hormone releasing hormone analog approved as Egrifta to reduce belly fat in people with HIV-related lipodystrophy. It is the GHRH analog with the strongest human evidence, and people use it off-label for visceral fat loss and general growth hormone support.
Ipamorelin is a pentapeptide that triggers growth hormone release through the ghrelin receptor without the cortisol, prolactin, or hunger spikes seen with older GHRPs. It is the most popular GHRP in the community, usually stacked with a GHRH analog.
Tesamorelin vs Ipamorelin: frequently asked
Which is better for fat loss, tesamorelin or ipamorelin?
Tesamorelin. It has two phase 3 trials showing visceral fat reduction of about 15 to 18 percent over 26 weeks at 2 mg daily. Ipamorelin has no human fat loss data; any effect is inferred from GH release. Neither comes close to the GLP-1 drugs for total weight loss.
Can you take tesamorelin and ipamorelin together?
Yes. They act on different receptors and combining a GHRH analog with a GHRP gives a synergistic GH pulse. The reported pattern is 1 to 2 mg tesamorelin with 100 mcg ipamorelin before bed on an empty stomach, and the details are in the tesamorelin and ipamorelin stack.
Is tesamorelin FDA approved?
Yes, as Egrifta, since 2010, for excess abdominal fat in HIV associated lipodystrophy. Any other use is off label, and the lyophilized vials sold by research suppliers are not the approved product. Ipamorelin has never been approved.
Does tesamorelin work for belly fat in people without HIV?
Probably to some degree, since the mechanism is a GH driven increase in lipolysis that is not specific to HIV, but the fat loss trials were done in HIV lipodystrophy and no large trial in healthy adults exists. A study in older adults looked at cognition, not fat. Expect a moderate effect that reverses after stopping.
Which has more side effects, tesamorelin or ipamorelin?
Tesamorelin, on the trial record: injection site reactions, joint pain, swelling in the hands and feet, carpal tunnel symptoms, and a possible rise in blood glucose. Ipamorelin's reported effects are milder, mostly flushing and headache after a dose, with water retention only at higher doses. Both should be avoided with active cancer.
Related reading
Pulsatile growth hormone release
Visceral fat loss with growth hormone support
Weight loss while limiting muscle loss
One is a GHRP, one is a GHRH analog. Why are they compared, and why are they usually combined?
The two halves of the most popular GH stack. What does each one do, and which CJC-1295 are you actually buying?
Two GHRH analogs with approval histories. Which one still earns the price?
Sources
- Tesamorelin, a growth hormone-releasing factor analog, in HIV-infected patients with excess abdominal fat: pooled analysis of two Phase 3 trials. Journal of Acquired Immune Deficiency Syndromes, 2010
- Effects of tesamorelin on nonalcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. The Lancet HIV, 2019
- Ipamorelin, the first selective growth hormone secretagogue. European Journal of Endocrinology, 1998