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Tesamorelin vs ipamorelin

A Tesamorelin GHRH (growth-hormone-releasing factor) analog FDA-approved — Egrifta (2010) C Ipamorelin Ghrelin-receptor (GH-secretagogue receptor) agonist Not FDA-approved · FDA compounding Category 2 (503B)

Residue Editorial Team · updated

In brief

Both raise growth hormone, by different routes. Tesamorelin is a GHRH analog, FDA-approved as Egrifta for excess abdominal fat in HIV lipodystrophy1FDAEGRIFTA SV prescribing information: Indications and Usage. FDA-approved labeling via openFDA/DailyMed, version effective 2026-07-29.. Ipamorelin is a pentapeptide acting on the ghrelin receptor2PubMedIpamorelin, the first selective growth hormone secretagogue. Raun K et al. Eur J Endocrinol. 1998.; it was never approved, its one randomized efficacy trial was negative3PubMedProspective, 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., and FDA lists it in compounding Category 24FDACertain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks. U.S. FDA, content current as of 04/22/2026..

How do Tesamorelin and Ipamorelin compare at a glance?

Table 1. Tesamorelin and Ipamorelin on the dimensions that matter most; every entry is cited.
DimensionTesamorelinIpamorelin
ReceptorGHRH receptor (GHRH analog)5PubMedTesamorelin: a review of its use in the management of HIV-associated lipodystrophy. Dhillon S Drugs. 2011.Ghrelin / GH-secretagogue receptor2
Size44 residues; first 29 match sermorelin6PubChemPubChem compound record: Tesamorelin. C221H366N72O67S · MW 5136 g/mol.5 residues (Aib-His-D-2-Nal-D-Phe-Lys-NH2)2
FDA statusApproved: Egrifta (2010), HIV-associated abdominal fat1Never approved; Category 2 for 503B4
Best human dataTwo phase 3 trials: visceral fat −15.4% vs placebo at 26 weeks7PubMedEffects 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.One RCT in post-operative ileus, no significant benefit3
Dose in trials2 mg daily SC70.03 mg/kg IV twice daily, up to 7 days3
Reported adverse eventsArthralgia, myalgia, paresthesia, injection-site reactions8PubMedBody 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.FDA cites immunogenicity risk and a reported death with IV use4
Evidence gradeAC

Written by Residue Editorial Team

Reviewed by Residue Editorial Team · source-by-source check,

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Registry data · How we grade · Markdown + sources

Figure 1. Size of the research record, from PubMed and ClinicalTrials.gov at the data edition. Bars are scaled to the larger value in each row; volume is not quality.
PubMed records 105 51
Trial publications 24 2
Registered studies 24 3
Phase 3 studies 2 0

Tesamorelin Ipamorelin

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 receptor1. 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 TSH2.

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 fat7. The effect held at about −18% over 52 weeks but visceral fat reaccumulated after stopping9PubMedLong-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.. A randomized trial in people with HIV and fatty liver disease found an absolute 4.1% fall in hepatic fat fraction versus placebo10PubMedEffects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Stanley TL et al. Lancet HIV. 2019..

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 analysis3. Other data come from rats11PubMedEfficacy of ipamorelin, a novel ghrelin mimetic, in a rodent model of postoperative ileus. Venkova K et al. J Pharmacol Exp Ther. 2009.,12PubMedIpamorelin, a new growth-hormone-releasing peptide, induces longitudinal bone growth in rats. Johansen PB et al. Growth Horm IGF Res. 1999..

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 established1. Ipamorelin is not: Drugs@FDA returned no application, and FDA placed ipamorelin acetate in Category 2 for 503B outsourcing facilities in 20234.

Two identical glass beakers, one holding pale amber liquid and one clear, standing either side of a brass balance

Why do they get these evidence grades?

A Tesamorelin
FDA-approved (Egrifta) for excess abdominal fat in HIV-associated lipodystrophy, based on two phase 3 trials. Other uses are graded separately. Grade A: Approved / regulatory-grade.
C Ipamorelin
One small randomized proof-of-concept trial (postoperative ileus) showed no significant benefit; the rest of the record is animal and pharmacology work. Grade C: Limited / early human data.

Questions readers ask

Do tesamorelin and ipamorelin work the same way?

No. Tesamorelin is a GHRH analog1; ipamorelin acts like GHRP-6 at the GH-secretagogue (ghrelin) receptor2. 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 approval7, and a 2026 meta-analysis pooled five RCTs8. Ipamorelin has one published randomized efficacy trial, which missed its endpoints3.

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 management1.

Can tesamorelin and ipamorelin be taken together?

No published randomized trial among our sources tested that combination. They act on different receptors1,2, and ipamorelin is on FDA compounding Category 24.

References

Every source below was retrieved from its official API or page and cached on the data-edition date. Numbers match the margin notes.

  1. 1 FDA EGRIFTA SV prescribing information: Indications and Usage. FDA-approved labeling via openFDA/DailyMed, version effective 2026-07-29.
  2. 2 PubMed Raun K, Hansen BS, Johansen NL, et al. Ipamorelin, the first selective growth hormone secretagogue. Eur J Endocrinol 1998. PMID 9849822; doi:10.1530/eje.0.1390552.
  3. 3 PubMed Beck DE, Sweeney WB, McCarter MD, et al. Prospective, randomized, controlled, proof-of-concept study of the Ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients. Int J Colorectal Dis 2014. PMID 25331030; doi:10.1007/s00384-014-2030-8.
  4. 4 FDA Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks. U.S. FDA, content current as of 04/22/2026.
  5. 5 PubMed Dhillon S. Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy. Drugs 2011. PMID 21668043; doi:10.2165/11202240-000000000-00000.
  6. 6 PubChem PubChem compound record: Tesamorelin. C221H366N72O67S · MW 5136 g/mol.
  7. 7 PubMed Falutz J, Mamputu JC, Potvin D, et al. 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. J Clin Endocrinol Metab 2010. PMID 20554713; doi:10.1210/jc.2010-0490.
  8. 8 PubMed Badran AS, Helal A, Shata KS, et al. Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials. Obes Res Clin Pract 2026. PMID 41545261; doi:10.1016/j.orcp.2026.01.002.
  9. 9 PubMed Falutz J, Allas S, Mamputu JC, et al. Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS 2008. PMID 18690162; doi:10.1097/QAD.0b013e32830a5058.
  10. 10 PubMed Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV 2019. PMID 31611038; doi:10.1016/S2352-3018(19)30338-8.
  11. 11 PubMed Venkova K, Mann W, Nelson R, et al. Efficacy of ipamorelin, a novel ghrelin mimetic, in a rodent model of postoperative ileus. J Pharmacol Exp Ther 2009. PMID 19289567; doi:10.1124/jpet.108.149211.
  12. 12 PubMed Johansen PB, Nowak J, Skjaerbaek C, et al. Ipamorelin, a new growth-hormone-releasing peptide, induces longitudinal bone growth in rats. Growth Horm IGF Res 1999. PMID 10373343; doi:10.1054/ghir.1999.9998.