Tesamorelin vs Ipamorelin

Tesamorelin

A stabilised GHRH analogue with an FDA approval for HIV-associated lipodystrophy — the only growth-hormone-axis secretagogue with a genuine regulatory signal. Famous for selectively shrinking visceral fat.

Best for

Best when you want the approved GHRH with visceral-fat data raising the overall GH signal.

Ipamorelin

A selective ghrelin-receptor agonist that triggers a GH pulse without raising cortisol or prolactin — the property that made it the default GHRP and pushed the older, dirtier GHRPs to the margins.

Best for

Best when you want a clean ghrelin-receptor pulse with no cortisol, prolactin, or hunger.

Tesamorelin

FDA-approved (2010) as Egrifta for HIV-associated lipodystrophy on the strength of two phase-3 trials demonstrating 15–20% visceral adipose tissue reduction at 26 weeks. Long-term extension data out to 52 weeks confirms maintained benefit with continued dosing. Off-label use in non-HIV populations is supported by mechanistic plausibility but has not been subjected to a dedicated phase-3 trial; the safety profile is borrowed from the HIV cohort.

Ipamorelin

Original pharmacology work by Raun and colleagues (1998) established the GH-selectivity profile — the absence of cortisol and prolactin lift is what differentiates this peptide from the older GHRPs and the data on that point is reproducible. Long-term outcome trials in healthy adults are not the literature's strong suit. The pulse pharmacology is tight; the chronic body-recomp evidence is anecdotal-plus-mechanism rather than RCT-based.