Tesamorelin vs ipamorelin

Tesamorelin (Egrifta) is a GHRH analogue approved in the US to reduce belly fat in adults with HIV-related lipodystrophy, with many more studies in people. Ipamorelin releases growth hormone through the ghrelin receptor and is not approved, and both are banned in sport. This page compares their results.

Best randomized result by outcome

For each outcome that two or more peptides have results for: the best result of a single randomized trial, on the same measure (the same kind of number, the same unit). When a trial has several dose arms, the cell shows the highest dose arm. The trials differ in people, length and dose, so a gap between two cells is not proof that one peptide works better.

No outcome has a randomized-trial result on the same measure for two or more of these peptides yet.

Outcomes with a randomized result for one peptide only (4 outcomes)

The other peptides have no randomized result on the same measure, so these results cannot be set side by side.

Outcomes with a randomized result for one peptide only: Tesamorelin, Ipamorelin
Outcome	Tesamorelin	Ipamorelin
Growth hormone and IGF-1Endocrine and hormonesCompared as: difference from placebo, in μg/liter	92 μg/liter Treatment effect on IGF-I Dose studied: 2 mg12 monthsn = 602012	No randomized trial result 29 results from other study designs.
Body weightMetabolic and weightCompared as: difference from placebo, in cm2	−42 cm2 Treatment effect Dose studied: 2 mg6 monthsn = 482014	No randomized trial result 9 results from other study designs.
Glycemic controlMetabolic and weightCompared as: difference from placebo, in mg/dl	7 mg/dL Treatment effect Dose studied: 2 mg6 monthsn = 482014	No randomized trial result 2 results from other study designs.
Adverse eventsWhole bodyCompared as: value in the arm that got the peptide, in %	No comparable result 16 randomized-trial results measure it in another way or another unit.	87.5% Any treatment-emergent adverse event Placebo: 94.8% Dose studied: 0.03-mg/kg twice dailypostoperative day 1 to 7 or hospital dischargen = 1142014

Growth hormone and IGF-1Endocrine and hormonesCompared as: difference from placebo, in μg/liter
- Tesamorelin
  92 μg/liter
  Treatment effect on IGF-I
  Dose studied: 2 mg12 monthsn = 602012
- Ipamorelin
  No randomized trial result
  29 results from other study designs.
Body weightMetabolic and weightCompared as: difference from placebo, in cm2
- Tesamorelin
  −42 cm2
  Treatment effect
  Dose studied: 2 mg6 monthsn = 482014
- Ipamorelin
  No randomized trial result
  9 results from other study designs.
Glycemic controlMetabolic and weightCompared as: difference from placebo, in mg/dl
- Tesamorelin
  7 mg/dL
  Treatment effect
  Dose studied: 2 mg6 monthsn = 482014
- Ipamorelin
  No randomized trial result
  2 results from other study designs.
Adverse eventsWhole bodyCompared as: value in the arm that got the peptide, in %
- Tesamorelin
  No comparable result
  16 randomized-trial results measure it in another way or another unit.
- Ipamorelin
  87.5%
  Any treatment-emergent adverse event
  Placebo: 94.8%
  Dose studied: 0.03-mg/kg twice dailypostoperative day 1 to 7 or hospital dischargen = 1142014

Comparing 2 peptides · Data version 308560

Only differences

Swipe sideways to see every peptide.

Comparison of Tesamorelin, Ipamorelin
Peptide	Modified form Tesamorelin	Synthetic analog Ipamorelin
Identity
Kind	Modified form	Synthetic analog
Area	Growth hormone axis	Growth hormone axis
Evidence
Amount of evidence	288	110
Evidence level	Has results from studies in people	Has results from studies in people
Safety
Safety results	43 (34 in people)	1 (1 in people)
Status
Approval
Sport (WADA)
Registered trials	23 · 3 active1 more mentions it but does not test it	21 more mentions it but does not test it

Shared outcomes

Body weight48
Growth hormone and IGF-151
Glycemic control30
Adverse events30
Pharmacokinetics31
Exercise and physical function4

Approval and sport status

From the regulatory data of each peptide.

Tesamorelin
The FDA label for Egrifta says: “Reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy” No central EU authorisation (EMA).
Ipamorelin
Its most advanced trial is in phase 2. The FDA, the EMA and the other sources we use show no approval (as of 9 Oct 2026).

Amount of evidence by outcome

Outcome groups with study results for at least two of these peptides. Counts include only results from studies that gave the peptide. Bar length is the number of results, on one scale. The bars show how much was studied, not how large an effect was. A peptide with more studies can look stronger here without being stronger. For results, see the randomized results above.

Study results per shared outcome group and evidence class
Outcome group	Tesamorelin	Ipamorelin
Body weightMetabolic and weight	39354	99
Growth hormone and IGF-1Endocrine and hormones	22193	293242
Glycemic controlMetabolic and weight	28253	22
Adverse eventsWhole body	29236	11
PharmacokineticsPharmacology	18792	1376
Exercise and physical functionWhole body	33	11

Sequence alignment

Each analog against its native parent, residue by residue. Substitutions, non-standard residues and modifications are marked. Calculated from the two sequences.

Against Somatorelin, human GHRH(1-44)Tesamorelin

Tesamorelin is the same as Somatorelin, human GHRH(1-44) residues 1 to 44, with 2 added groups.

Top row: Somatorelin, human GHRH(1-44) (parent)
Bottom row: Tesamorelin

ADAIFTNSY

RKVLGQLSAR

KLLQDIMSRQ

QGESNQERGA

RAR

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end

What is different

1Position 1: Tyr carries an added group: other modification.
2Position 44: Leu carries an added group: C-terminal amide.

Against Ghrelin (human), ghrelin-28Ipamorelin

Ipamorelin differs from Ghrelin (human), ghrelin-28 at 5 positions.

Top row: Ghrelin (human), ghrelin-28 (parent)
Bottom row: Ipamorelin

Same as parent
Substituted
Non-canonical or D-form
Modified side chain or end
Parent context

What is different

1Position 1: Gly is replaced by Aib, an amino acid that is not one of the standard 20.
2Position 2: Ser is replaced by His.
3Position 3: Xaa is replaced by D-2-Nal, an amino acid that is not one of the standard 20.
4Position 4: Phe is replaced by its mirror-image form, D-Phe.
5Position 5: Leu is replaced by Lys.

Trials side by side

Registered trials, ranked by phase (late phases first), then posted results and enrollment. Status is the registry status. Study results come from published studies. Results posted at ClinicalTrials.gov are shown on each trial page.

Tesamorelin23 registered trials

Top 3 of 23 trials, ranked by phase, then posted results and enrollment: 2 completed · 1 stopped early · 2 with posted results · source ClinicalTrials.gov (opens in a new tab)

CompletedPhase 3Results postedNCT00608023