Tesamorelin
Hormonal and Signaling
ABOUT
Tesamorelin is a growth-hormone-releasing hormone analogue. U.S. Egrifta labelling describes a specific indication for reduction of excess abdominal fat in people with HIV-associated lipodystrophy; it is not labelled as general weight-loss treatment.
EVIDENCE OVERVIEW
Supported by controlled human trials
WHAT THIS MEANS
Established. Review the research and limitations before relying on this record.
IDENTITY
HALF-LIFE
HOW IT IS THOUGHT TO WORK
Tesamorelin is a synthetic analogue of human growth-hormone-releasing hormone, a 44-amino-acid peptide with a trans-3-hexenoyl group on the N-terminal tyrosine that resists DPP-4 degradation. It binds pituitary GHRH receptors and stimulates endogenous growth hormone synthesis and release, raising IGF-1. It reduces visceral adipose tissue specifically, which is the basis of its narrow indication.
PHARMACOKINETICS
11 minutes after a single subcutaneous dose of EGRIFTA WR 1.28 mg in healthy subjects. The short half-life is why once-daily dosing produces a pulse rather than sustained GH elevation.
REVIEW
PUBLISHED PAIR RECORDS
with Ipamorelin
Growth-hormone axis: documented synergistic releaseTesamorelin acts at the GHRH receptor while Ipamorelin acts at the ghrelin/GH-secretagogue receptor. In healthy men, submaximal doses of a GH-releasing peptide combined with GHRH stimulated GH release synergistically rather than additively, and the combined area-under-curve response exceeded the arithmetic sum of each given alone. Combining these two classes therefore produces a larger GH and downstream IGF-1 response than either alone. Ipamorelin is the more receptor-selective secretagogue in this group and has comparatively little effect on prolactin, ACTH and cortisol. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with GHRP-2
Growth-hormone axis: documented synergistic releaseTesamorelin acts at the GHRH receptor while GHRP-2 acts at the ghrelin/GH-secretagogue receptor. In healthy men, submaximal doses of a GH-releasing peptide combined with GHRH stimulated GH release synergistically rather than additively, and the combined area-under-curve response exceeded the arithmetic sum of each given alone. Combining these two classes therefore produces a larger GH and downstream IGF-1 response than either alone. GHRP-2 also raises prolactin, ACTH and cortisol; in a head-to-head human comparison the ACTH/cortisol-releasing activity of GHRP-2 and hexarelin was similar to that of CRH, while prolactin release was lower than that of TRH. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with GHRP-6
Growth-hormone axis: documented synergistic releaseTesamorelin acts at the GHRH receptor while GHRP-6 acts at the ghrelin/GH-secretagogue receptor. In healthy men, submaximal doses of a GH-releasing peptide combined with GHRH stimulated GH release synergistically rather than additively, and the combined area-under-curve response exceeded the arithmetic sum of each given alone. Combining these two classes therefore produces a larger GH and downstream IGF-1 response than either alone. GHRP-6 also raises prolactin, ACTH and cortisol; in a head-to-head human comparison the ACTH/cortisol-releasing activity of GHRP-2 and hexarelin was similar to that of CRH, while prolactin release was lower than that of TRH. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Hexarelin
Growth-hormone axis: documented synergistic releaseTesamorelin acts at the GHRH receptor while Hexarelin acts at the ghrelin/GH-secretagogue receptor. In healthy men, submaximal doses of a GH-releasing peptide combined with GHRH stimulated GH release synergistically rather than additively, and the combined area-under-curve response exceeded the arithmetic sum of each given alone. Combining these two classes therefore produces a larger GH and downstream IGF-1 response than either alone. Hexarelin also raises prolactin, ACTH and cortisol; in a head-to-head human comparison the ACTH/cortisol-releasing activity of GHRP-2 and hexarelin was similar to that of CRH, while prolactin release was lower than that of TRH. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with MK-677
Growth-hormone axis: documented synergistic releaseTesamorelin acts at the GHRH receptor while MK-677 acts at the ghrelin/GH-secretagogue receptor. In healthy men, submaximal doses of a GH-releasing peptide combined with GHRH stimulated GH release synergistically rather than additively, and the combined area-under-curve response exceeded the arithmetic sum of each given alone. Combining these two classes therefore produces a larger GH and downstream IGF-1 response than either alone. MK-677 is an orally active, long-acting ghrelin-receptor agonist, so the combined effect on the GH/IGF-1 axis is sustained rather than pulsatile, and trials of MK-677 report deterioration of glucose tolerance. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with CJC-1295 (without DAC)
Same receptor class: overlapping GHRH-receptor activityCJC-1295 (without DAC) and Tesamorelin are both growth-hormone-releasing-hormone receptor agonists, so they act on the same pituitary receptor population rather than on complementary pathways. Published human work characterises GHRH-receptor and ghrelin-receptor stimulation as the two distinct routes to GH release; two agents from the same route do not provide that documented synergy, and their effects on the GH/IGF-1 axis overlap. Duration differs across this class - DAC-modified and depot-style analogues sustain exposure far longer than short-acting ones. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with CJC-1295 with DAC
Same receptor class: overlapping GHRH-receptor activityCJC-1295 with DAC and Tesamorelin are both growth-hormone-releasing-hormone receptor agonists, so they act on the same pituitary receptor population rather than on complementary pathways. Published human work characterises GHRH-receptor and ghrelin-receptor stimulation as the two distinct routes to GH release; two agents from the same route do not provide that documented synergy, and their effects on the GH/IGF-1 axis overlap. Duration differs across this class - DAC-modified and depot-style analogues sustain exposure far longer than short-acting ones. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Sermorelin
Same receptor class: overlapping GHRH-receptor activitySermorelin and Tesamorelin are both growth-hormone-releasing-hormone receptor agonists, so they act on the same pituitary receptor population rather than on complementary pathways. Published human work characterises GHRH-receptor and ghrelin-receptor stimulation as the two distinct routes to GH release; two agents from the same route do not provide that documented synergy, and their effects on the GH/IGF-1 axis overlap. Duration differs across this class - DAC-modified and depot-style analogues sustain exposure far longer than short-acting ones. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with IGF-1 LR3
Additive IGF-1 receptor signallingTesamorelin raises IGF-1 indirectly by stimulating growth-hormone release, while IGF-1 LR3 is an IGF-1 analogue that acts directly at the IGF-1 receptor. The two therefore converge on the same downstream signalling. Regulatory labelling for recombinant IGF-1 records that the IGF-1 receptor is homologous to the insulin receptor, that IGF-1 has insulin-like hypoglycaemic effects, and that hypoglycaemia is among its most common adverse effects; doses of insulin or other hypoglycaemic products may need reducing. Growth hormone itself moves blood glucose in the opposite direction, so the net glycaemic effect of the pair is not predictable from either agent alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with IGF-1 DES
Additive IGF-1 receptor signallingTesamorelin raises IGF-1 indirectly by stimulating growth-hormone release, while IGF-1 DES is an IGF-1 analogue that acts directly at the IGF-1 receptor. The two therefore converge on the same downstream signalling. Regulatory labelling for recombinant IGF-1 records that the IGF-1 receptor is homologous to the insulin receptor, that IGF-1 has insulin-like hypoglycaemic effects, and that hypoglycaemia is among its most common adverse effects; doses of insulin or other hypoglycaemic products may need reducing. Growth hormone itself moves blood glucose in the opposite direction, so the net glycaemic effect of the pair is not predictable from either agent alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Semaglutide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Semaglutide acts in the opposite direction on glycaemic control. Trials of the oral secretagogue MK-677 specifically report raised fasting glucose and impaired glucose tolerance. The combined effect on blood glucose is therefore not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Tirzepatide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Tirzepatide acts in the opposite direction on glycaemic control. Trials of the oral secretagogue MK-677 specifically report raised fasting glucose and impaired glucose tolerance. The combined effect on blood glucose is therefore not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Retatrutide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Retatrutide acts in the opposite direction on glycaemic control. Trials of the oral secretagogue MK-677 specifically report raised fasting glucose and impaired glucose tolerance. The combined effect on blood glucose is therefore not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Survodutide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Survodutide acts in the opposite direction on glycaemic control. Trials of the oral secretagogue MK-677 specifically report raised fasting glucose and impaired glucose tolerance. The combined effect on blood glucose is therefore not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Mazdutide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Mazdutide acts in the opposite direction on glycaemic control. Trials of the oral secretagogue MK-677 specifically report raised fasting glucose and impaired glucose tolerance. The combined effect on blood glucose is therefore not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Cagrilintide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Cagrilintide acts in the opposite direction on glycaemic control. Trials of the oral secretagogue MK-677 specifically report raised fasting glucose and impaired glucose tolerance. The combined effect on blood glucose is therefore not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Native GIP
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Native GIP acts in the opposite direction on glycaemic control. Trials of the oral secretagogue MK-677 specifically report raised fasting glucose and impaired glucose tolerance. The combined effect on blood glucose is therefore not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 19 Aug 2026with Liraglutide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Liraglutide acts in the opposite direction on glycaemic control. The combined effect on blood glucose is not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Exenatide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Exenatide acts in the opposite direction on glycaemic control. The combined effect on blood glucose is not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Dulaglutide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Dulaglutide acts in the opposite direction on glycaemic control. The combined effect on blood glucose is not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Pramlintide
Opposing effects on glucose regulationTesamorelin raises growth-hormone exposure, and growth hormone is a counter-regulatory hormone: controlled human studies show GH administration impairs insulin-stimulated glucose uptake and deteriorates glucose tolerance through increased lipolysis, with chronic GH excess producing insulin resistance. Pramlintide acts in the opposite direction on glycaemic control. Pramlintide is the sharper case: its labelling carries a boxed warning for severe hypoglycaemia in the insulin-treated setting, so an agent pushing glucose the other way makes the net effect harder to anticipate rather than conveniently cancelling out. The combined effect on blood glucose is not predictable from either agent alone and warrants monitoring rather than assumption. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with follistatin-344
Converging on muscle growth from two different directionsFollistatin-344 antagonises myostatin and activin A, removing a brake on skeletal-muscle growth through the SMAD2/3 pathway. Tesamorelin pushes the accelerator instead, raising growth-hormone exposure and downstream IGF-1. These are genuinely distinct pathways converging on the same tissue outcome, which is why the combination is attractive in principle and why its size cannot be predicted from either alone. The evidence does not support treating it as characterised: human follistatin data comes from AAV-delivered gene therapy in open-label muscular-dystrophy trials of a handful of patients, not from injected follistatin protein, and a case series reported central serous chorioretinopathy in bodybuilders using subcutaneous FS-344. Growth factors affecting muscle regeneration are prohibited at all times in sport. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with AOD-9604
Growth-hormone fragment that does not act through the growth-hormone receptorAOD-9604 is the C-terminal fragment of human growth hormone (residues 177-191), and it is commonly scheduled alongside growth-hormone secretagogues on the assumption that it adds to the same axis. It does not: the fragment was designed to reproduce the lipolytic action of growth hormone without its diabetogenic effects, and published work shows its lipolytic action is not mediated directly through the growth hormone receptor. Tesamorelin raises endogenous growth hormone and downstream IGF-1; AOD-9604 does not add to that signal. The more relevant fact is efficacy: FDA's review describes a 502-person obesity trial in which AOD-9604 showed no significant difference from placebo on its primary endpoint, and development did not proceed to approval. AOD-9604 is prohibited by the World Anti-Doping Agency. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with CJC-1295 / Ipamorelin blend
Inherited from a component of this blendCJC-1295 / Ipamorelin blend contains Ipamorelin and CJC-1295 (without DAC), and the catalogue holds a curated pair record between those components and Tesamorelin: Ipamorelin (growth-hormone axis: documented synergistic release); CJC-1295 (without DAC) (same receptor class: overlapping ghrh-receptor activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CJC-1295 with DAC / Ipamorelin blend
Inherited from a component of this blendCJC-1295 with DAC / Ipamorelin blend contains Ipamorelin and CJC-1295 with DAC, and the catalogue holds a curated pair record between those components and Tesamorelin: Ipamorelin (growth-hormone axis: documented synergistic release); CJC-1295 with DAC (same receptor class: overlapping ghrh-receptor activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Sermorelin / Ipamorelin blend
Inherited from a component of this blendSermorelin / Ipamorelin blend contains Ipamorelin and Sermorelin, and the catalogue holds a curated pair record between those components and Tesamorelin: Ipamorelin (growth-hormone axis: documented synergistic release); Sermorelin (same receptor class: overlapping ghrh-receptor activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CJC-1295 / GHRP-2 blend
Inherited from a component of this blendCJC-1295 / GHRP-2 blend contains GHRP-2 and CJC-1295 (without DAC), and the catalogue holds a curated pair record between those components and Tesamorelin: GHRP-2 (growth-hormone axis: documented synergistic release); CJC-1295 (without DAC) (same receptor class: overlapping ghrh-receptor activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CJC-1295 / GHRP-6 blend
Inherited from a component of this blendCJC-1295 / GHRP-6 blend contains GHRP-6 and CJC-1295 (without DAC), and the catalogue holds a curated pair record between those components and Tesamorelin: GHRP-6 (growth-hormone axis: documented synergistic release); CJC-1295 (without DAC) (same receptor class: overlapping ghrh-receptor activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CJC-1295 / Hexarelin blend
Inherited from a component of this blendCJC-1295 / Hexarelin blend contains Hexarelin and CJC-1295 (without DAC), and the catalogue holds a curated pair record between those components and Tesamorelin: Hexarelin (growth-hormone axis: documented synergistic release); CJC-1295 (without DAC) (same receptor class: overlapping ghrh-receptor activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Kyinsu
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Tesamorelin: Semaglutide (opposing effects on glucose regulation). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CagriSema
Inherited from a component of this blendCagriSema contains Semaglutide and Cagrilintide, and the catalogue holds a curated pair record between those components and Tesamorelin: Semaglutide (opposing effects on glucose regulation); Cagrilintide (opposing effects on glucose regulation). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026HUMAN EVIDENCE
FDA-approved for reduction of excess abdominal fat in people with HIV-associated lipodystrophy, established in two randomised placebo-controlled phase 3 trials. The label explicitly limits this: it is not indicated for weight loss management, and the effect of continued treatment beyond one year on cardiovascular risk has not been established.
REPORTED EFFECTS
Labelled adverse reactions include arthralgia, injection-site erythema and pruritus, pain in extremity, peripheral oedema and myalgia - characteristic growth-hormone-axis effects. Labelled warnings cover increased IGF-1 with a theoretical neoplasia risk, glucose intolerance and diabetes, fluid retention, and hypersensitivity. It is contraindicated in disruption of the hypothalamic-pituitary axis, active malignancy, and pregnancy.
RESEARCH LIMITATIONS
This is a label-based summary, not a recommendation. Formulations, indications, warnings, contraindications, and availability can differ by product and jurisdiction; check the current official label and consult a qualified clinician.
CURATED SOURCES · 2