# Tesamorelin vs ipamorelin - Canonical: https://residue.info/vs/tesamorelin-vs-ipamorelin/ - Compounds: Tesamorelin (https://residue.info/c/tesamorelin/), Ipamorelin (https://residue.info/c/ipamorelin/) - Updated: 2026-10-19 · Reviewed by: Residue Editorial Team Both raise growth hormone, by different routes. Tesamorelin is a GHRH analog, FDA-approved as Egrifta for excess abdominal fat in HIV lipodystrophy [1]. Ipamorelin is a pentapeptide acting on the ghrelin receptor [2]; it was never approved, its one randomized efficacy trial was negative [3], and FDA lists it in compounding Category 2 [4]. ## Side by side | | Tesamorelin | Ipamorelin | |---|---|---| | Receptor | GHRH receptor (GHRH analog) [5] | Ghrelin / GH-secretagogue receptor [2] | | Size | 44 residues; first 29 match sermorelin [6] | 5 residues (Aib-His-D-2-Nal-D-Phe-Lys-NH2) [2] | | FDA status | Approved: Egrifta (2010), HIV-associated abdominal fat [1] | Never approved; Category 2 for 503B [4] | | Best human data | Two phase 3 trials: visceral fat −15.4% vs placebo at 26 weeks [7] | One RCT in post-operative ileus, no significant benefit [3] | | Dose in trials | 2 mg daily SC [7] | 0.03 mg/kg IV twice daily, up to 7 days [3] | | Reported adverse events | Arthralgia, myalgia, paresthesia, injection-site reactions [8] | FDA cites immunogenicity risk and a reported death with IV use [4] | | Evidence grade | A | C | ## How does each one raise growth hormone? Tesamorelin is a synthetic analog of growth-hormone-releasing hormone given by daily subcutaneous injection; it acts on the pituitary's GHRH receptor [1]. Ipamorelin works through the GH-secretagogue (ghrelin) receptor targeted by GHRP-6: in rat pituitary cells, anesthetized rats and swine it released GH with potency and efficacy similar to GHRP-6, and in swine it did not change FSH, LH, prolactin or TSH [2]. ## What does the human evidence show? **Tesamorelin** has phase 3 data. In two pooled trials in people with HIV and excess abdominal fat, visceral adipose tissue fell 24 cm² versus a 2 cm² rise on placebo at 26 weeks, a treatment effect of −15.4%, without significant change in subcutaneous fat [7]. The effect held at about −18% over 52 weeks but visceral fat reaccumulated after stopping [9]. A randomized trial in people with HIV and fatty liver disease found an absolute 4.1% fall in hepatic fat fraction versus placebo [10]. **Ipamorelin**'s only published randomized efficacy trial tested intravenous dosing in 114 patients after bowel resection; median time to first tolerated meal was 25.3 versus 32.6 hours (p=0.15), with no significant differences on any efficacy analysis [3]. Other data come from rats [11][12]. Neither has published randomized data for anti-aging, bodybuilding or general fat-loss uses in the sources we fetched. ## Are they FDA-approved? Tesamorelin is: Egrifta is approved for the reduction of excess abdominal fat in HIV-infected adults with lipodystrophy, and its label says long-term cardiovascular safety has not been established [1]. Ipamorelin is not: Drugs@FDA returned no application, and FDA placed ipamorelin acetate in Category 2 for 503B outsourcing facilities in 2023 [4]. ## Frequently asked questions **Do tesamorelin and ipamorelin work the same way?** No. Tesamorelin is a GHRH analog [1]; ipamorelin acts like GHRP-6 at the GH-secretagogue (ghrelin) receptor [2]. Both end in pituitary growth hormone release. **Which one has more human evidence?** Tesamorelin, by a wide margin: two phase 3 trials led to its approval [7], and a 2026 meta-analysis pooled five RCTs [8]. Ipamorelin has one published randomized efficacy trial, which missed its endpoints [3]. **Is tesamorelin approved for weight loss?** No. Its label covers excess abdominal fat in adults with HIV lipodystrophy and states it is not indicated for weight-loss management [1]. **Can tesamorelin and ipamorelin be taken together?** No published randomized trial among our sources tested that combination. They act on different receptors [1][2], and ipamorelin is on FDA compounding Category 2 [4]. ## Sources [1] EGRIFTA SV prescribing information: Indications and Usage. FDA-approved labeling via openFDA/DailyMed, version effective 2026-07-29. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3d783378-b02d-4f19-99dd-0fc91a042224 [2] Ipamorelin, the first selective growth hormone secretagogue. Raun K et al. Eur J Endocrinol. 1998. https://pubmed.ncbi.nlm.nih.gov/9849822/ [3] Prospective, randomized, controlled, proof-of-concept study of the Ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients. Beck DE et al. Int J Colorectal Dis. 2014. https://pubmed.ncbi.nlm.nih.gov/25331030/ [4] Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks. U.S. FDA, content current as of 04/22/2026. https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks [5] Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy. Dhillon S Drugs. 2011. https://pubmed.ncbi.nlm.nih.gov/21668043/ [6] PubChem compound record: Tesamorelin. C221H366N72O67S · MW 5136 g/mol. https://pubchem.ncbi.nlm.nih.gov/compound/16137828 [7] Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. Falutz J et al. J Clin Endocrinol Metab. 2010. https://pubmed.ncbi.nlm.nih.gov/20554713/ [8] Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials. Badran AS et al. Obes Res Clin Pract. 2026. https://pubmed.ncbi.nlm.nih.gov/41545261/ [9] Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. Falutz J et al. AIDS. 2008. https://pubmed.ncbi.nlm.nih.gov/18690162/ [10] Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Stanley TL et al. Lancet HIV. 2019. https://pubmed.ncbi.nlm.nih.gov/31611038/ [11] Efficacy of ipamorelin, a novel ghrelin mimetic, in a rodent model of postoperative ileus. Venkova K et al. J Pharmacol Exp Ther. 2009. https://pubmed.ncbi.nlm.nih.gov/19289567/ [12] Ipamorelin, a new growth-hormone-releasing peptide, induces longitudinal bone growth in rats. Johansen PB et al. Growth Horm IGF Res. 1999. https://pubmed.ncbi.nlm.nih.gov/10373343/ --- From Residue. Research and education only; not medical advice. Quote with attribution and a link to the canonical page.