Tesamorelin / Ipamorelin

Educational overview

Tesamorelin / Ipamorelin is listed in the ezGLP knowledgebase under Blends. Evidence and regulatory status can vary by formulation, route, and jurisdiction.

Tesamorelin / Ipamorelin is a fixed-ratio compounded blend pairing a growth hormone-releasing hormone (GHRH) analogue with a ghrelin-receptor agonist. Tesamorelin is a stabilised full-length GHRH analogue that acts on pituitary GHRH receptors and is the active ingredient of the FDA-approved product Egrifta. Ipamorelin is a synthetic pentapeptide agonist of the ghrelin receptor GHS-R1a described in 1998 as a selective growth hormone secretagogue with little effect on cortisol or prolactin. The two mechanisms converge on growth hormone release, and combined GHRH and ghrelin-receptor stimulation is known to produce a larger GH pulse than either agent alone.

The evidence is entirely component-level. Tesamorelin has phase III randomised trial data in more than eight hundred HIV-infected adults with abdominal lipohypertrophy, published by Falutz and colleagues in 2010, and a 2017 randomised safety trial in type 2 diabetes by Clemmons and colleagues. Ipamorelin has a 1998 preclinical characterisation, a 1999 pharmacokinetic study in healthy volunteers by Gobburu and colleagues, and a 2014 randomised proof-of-concept trial in postoperative ileus by Beck and colleagues that did not progress to approval. No published clinical trial has evaluated the fixed-ratio tesamorelin / ipamorelin product, so claims about additive effects on body composition, sleep, or recovery are extrapolations rather than findings.

The blend itself has no marketing approval anywhere. Tesamorelin is FDA-approved only as Egrifta for reducing excess abdominal fat in HIV-infected adults with lipodystrophy, and it is not authorised in the European Union after the applicant withdrew in 2012; ipamorelin has never been approved and was placed by the FDA in category 2 of bulk substances nominated for compounding in 2023, the category for substances that may present significant safety risks. A compounded blend containing both is therefore an unapproved drug product regardless of tesamorelin's own approval. Both peptides are named on the World Anti-Doping Agency Prohibited List under section S2.2.4, banned at all times.

Compounded blends are supplied as a single lyophilised vial containing both peptides in a set mass ratio, reconstituted with bacteriostatic water for subcutaneous injection. Neither the Egrifta label nor any published study addresses the stability of tesamorelin and ipamorelin sharing one solution, so the compounding pharmacy's beyond-use dating is the only formal reference for storage and handling. Because the two components cannot be tracked separately once dissolved, an inventory record for the blend generally captures total peptide mass per vial, the stated component split, lot number, reconstitution date, resulting concentration, and storage temperature, along with start and stop dates given that tesamorelin's effect on visceral fat reverses after discontinuation.

Category

Blends

Routes represented

Subcutaneous (SubQ)

Storage context

Follow the dispensed product or pharmacy label; storage and beyond-use time vary by formulation.