Tesamorelin and ipamorelin blend (10 mg)
This blend pairs an approved drug with an unapproved one. Tesamorelin is the only GHRH analogue with an FDA approval, for one specific use, backed by large trials; ipamorelin is a research peptide whose one efficacy trial missed. Putting them in one vial does not carry the first one's approval over to the mix.
As sold, one vial: Tesamorelin 5 mg, Ipamorelin 5 mg. Statuses as of October 3, 2026. Reviewed by the Grey Peptides Editorial Board. Nothing here is a recommendation or a dose, and no seller is named or linked.
Each component at a glance
From our encyclopedia and FDA's July 2026 Pharmacy Compounding Advisory Committee record. Evidence grades follow the rubric on our methodology page.
| Component | Evidence | FDA status | PCAC, July 2026 | WADA 2026 | WADA 2027 | Interactions |
|---|---|---|---|---|---|---|
| Tesamorelin | High | FDA Approved | Not voted on | Prohibited (S2.2.4) | Prohibited (S2.2.4) | Fully reviewed |
| Ipamorelin | Medium | Discontinued | Not voted on | Prohibited (S2.2.4) | Prohibited (S2.2.4) | Partly reviewed |
What one vial contains: the ratio arithmetic
The vial holds 10 mg in total. Whatever volume of water is added and however much is drawn, every draw carries the components in the same proportions. The table expresses each as a share of the vial, as a multiple of the smallest component (Tesamorelin), and as a concentration if the whole vial were dissolved in 2 mL or 3 mL of water. These are arithmetic illustrations of what is in the vial, not suggested volumes or doses.
| Component | In the vial | Share | × Tesamorelin | In 2 mL | In 3 mL |
|---|---|---|---|---|---|
| Tesamorelin | 5 mg | 50.0% | 1 | 2.5 mg/mL | 1.67 mg/mL |
| Ipamorelin | 5 mg | 50.0% | 1 | 2.5 mg/mL | 1.67 mg/mL |
The Blend & Stack Calculator runs the same arithmetic for any volume and draw, with this composition as a preset (Tesamorelin and ipamorelin, 10 mg (5/5)).
Tesamorelin on its own
Tesamorelin is a stabilised analogue of GHRH, the hypothalamic hormone that tells the pituitary to release growth hormone. Its FDA label approves it for one thing: the reduction of excess abdominal fat in adults with HIV and lipodystrophy. The label adds that it is not indicated for weight loss management because it is weight neutral, and that its long-term cardiovascular safety has not been established1.
Its evidence is substantial for that use. In 806 people with HIV and excess abdominal fat, 26 weeks of daily tesamorelin reduced visceral fat by 24 cm², against a 2 cm² rise on placebo2, and people who stayed on it kept the reduction through 52 weeks3. In a one-year trial in people with HIV and fatty liver, it lowered liver fat by 4.1 percentage points more than placebo4. In 53 people with type 2 diabetes, 12 weeks did not worsen glucose control5. None of these trials involved ipamorelin, and none studied people without HIV for fat loss.
Ipamorelin on its own
Ipamorelin is a synthetic agonist of the ghrelin receptor, the second route by which the pituitary is told to release growth hormone. In pigs it did so without raising ACTH or cortisol6; in healthy men each intravenous dose produced one short growth hormone pulse, with a half-life of about two hours7. Its only efficacy trial, in 114 adults after bowel surgery, found it well tolerated but did not significantly shorten time to a first meal8. It is not approved.
Why the pair has never been tested
The reasoning for the blend is the same as for other GHRH-plus-ghrelin-agonist pairs: two accelerators may release more growth hormone than one. Older class studies support that for GHRH with GHRP-6 or GHRP-2 in short tests, as our CJC-1295 and ipamorelin page explains. We found no study, in people or animals, of tesamorelin with ipamorelin, so nothing is known about whether adding ipamorelin changes tesamorelin's effect on visceral or liver fat, its side effects, or its effect on glucose.
There is also a mismatch of purpose. Tesamorelin's benefit was shown on visceral fat in people with HIV. The blend is sold for general fat loss, muscle and recovery, uses the tesamorelin trials did not test and its label specifically sets aside for weight loss.
Equal parts: what the ratio means here
With 5 mg of each, every draw holds equal milligrams of each, as the table above shows. Equal milligrams of two peptides with different potencies, half-lives and receptors do not make a balanced dose of either. A blend also removes the ability to adjust or stop one peptide separately, and a reaction cannot be traced to one of them. Our Blend Calculator shows what each draw contains; it cannot say what amount is appropriate in people.
Interactions on the tesamorelin label
The EGRIFTA WR label lists two interaction areas: because growth hormone can alter the clearance of drugs metabolised by liver cytochrome P450 enzymes, patients on such drugs should be monitored, and people on glucocorticoid replacement for adrenal insufficiency may need higher maintenance or stress doses after starting it1. Adding a second growth hormone secretagogue is not addressed by the label, because it was never studied.
Regulatory status in the United States
Tesamorelin is approved only as the labelled product, prescribed for its labelled use. A vial of tesamorelin mixed with ipamorelin is not that product and is not approved. FDA's page on bulk drug substances that may present significant safety risks in compounding, current as of April 22, 2026, places ipamorelin acetate in the category outsourcing facilities should not use, citing possible immunogenicity, its unnatural amino acids, and serious adverse events including death in a published study of intravenous use9.
For tested athletes
Both are prohibited at all times under S2.2.4 of the World Anti-Doping Code, growth hormone releasing factors, which names tesamorelin among the GHRH analogues and ipamorelin among the secretagogues10. Approval for HIV lipodystrophy does not exempt an athlete; use would need a therapeutic use exemption. The 2027 List keeps both statuses10.
What to check before anything else
If the goal is abdominal fat in someone with HIV, the approved tesamorelin product exists and a doctor can prescribe it. For other goals, ask what the tesamorelin trials actually showed, whether the certificate of analysis names and quantifies both peptides with purity for each, and whether a 'research use only' label means the vial was never made for people. Our Approved-Alternative Finder shows the tesamorelin label's indication, and our tesamorelin and visceral fat guide covers the trials in detail.
Sources
- Theratechnologies. EGRIFTA WR (tesamorelin) for injection, US prescribing information, sections 1 and 7. DailyMed version 2, effective July 29, 2026; read October 1, 2026.
- Falutz, J., et al. (2010). 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, 95. PubMed 20554713 ↗
- Falutz, J., et al. (2008). Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS, 22. PubMed 18690162 ↗
- Stanley, T. L., et al. (2019). Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV, 6. PubMed 31611038 ↗
- Clemmons, D. R., et al. (2017). Safety and metabolic effects of tesamorelin, a growth hormone-releasing factor analogue, in patients with type 2 diabetes: A randomized, placebo-controlled trial. PLoS One, 12. PubMed 28617838 ↗
- Raun, K., et al. (1998). Ipamorelin, the first selective growth hormone secretagogue. Eur J Endocrinol, 139. PubMed 9849822 ↗
- Gobburu, J. V., et al. (1999). Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers. Pharm Res, 16. PubMed 10496658 ↗
- Beck, D. E., et al. (2014). 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, 29. PubMed 25331030 ↗
- U.S. Food and Drug Administration. Certain bulk drug substances for use in compounding that may present significant safety risks (entry for ipamorelin acetate). Page current as of April 22, 2026; read October 1, 2026. Source ↗
- World Anti-Doping Agency. The 2026 Prohibited List (S2.2.4 growth hormone releasing factors), in force January 1 to December 31, 2026; the 2027 List keeps the same wording. Source ↗
Related: the blends and stacks hub, the Name Decoder, the COA Decoder and the Interaction Matrix. Last updated October 3, 2026.