Side-by-side · Research reference
HexarelinvsTesamorelin
Side-by-side comparison across mechanism, dosage, evidence, side effects, administration, and stack synergies. Citations on every claim where available.
APhase 1Reviewed19/45 cited
BFDA-ApprovedVerified27/68 cited
Hexarelin
Hexapeptide GHRP · Cardio-tropic
SQ · Multiple sites · 1–3×/day
Tesamorelin
GHRH Analogue · FDA-Approved
SQ · Abdomen · Once Daily
01Mechanism of Action
Parameter
Hexarelin
Tesamorelin
Primary target
Ghrelin receptor (GHS-R1a) + cardiac CD36Smith 1996Ghigo 1997
Hypothalamic GHRH receptorsEGRIFTA® (tesamorelin for inje 2010
Pathway
GHS-R1a → Gαq → Ca²⁺ → GH release. CD36 engagement → direct cardio-tropic actionGhigo 1997
GHRH → Pituitary GH release → Liver IGF-1 synthesisFalutz 2007
Downstream effect
Strong GH pulse + IGF-1 elevation; cardio-protective effects in animal MI modelsGhigo 1997
Increased GH pulsatility, elevated IGF-1, lipolysis of visceral adipose tissueFalutz 2010
Feedback intact?
Yes initially; tachyphylaxis with chronic useGhigo 1997
Yes — physiological pulsatility preserved
Origin
Synthetic hexapeptide His-D-2-Methyl-Trp-Ala-Trp-D-Phe-Lys-NH₂Smith 1996
Synthetic 44-AA GHRH analogue with trans-3-hexenoic-acid modification for stabilityEGRIFTA® (tesamorelin for inje 2010
02Dosage Protocols
Parameter
Hexarelin
Tesamorelin
Standard dose
100–200 mcg per injectionSmith 1996
2 mg / dayEGRIFTA® (tesamorelin for inje 2010
FDA-approved protocol.
Frequency
1–2× per day max (tachyphylaxis with chronic 3× daily)
Once daily (morning or pre-sleep)
Aligns with natural GH pulse.
Lower / starter dose
50 mcg per dose
1 mg / dayFalutz 2010
1 mg still produces significant IGF-1 elevation.
Duration
4–8 weeks on / 4–8 weeks off (tachyphylaxis mitigation)
12–52 weeks
VAT returns within months of stopping.
Reconstitution
Bacteriostatic water
Sterile water per labeling
Preserved at 2–8 °C after reconstitution.
Timing
Pre-sleep + fasted preferred
Empty stomach, pre-sleep preferred
Half-life
~70 minSemenistaya 2010
~26 min (plasma)EGRIFTA® (tesamorelin for inje 2010
Modified vs native GHRH (7 min t½).
03Metabolic / Fat Loss Evidence
Parameter
Hexarelin
Tesamorelin
Primary fat target
—
Visceral adipose tissue (VAT) — abdominal
Effect on lean mass
—
Modest lean mass preservation / slight increase
Effect reversibility
—
VAT returns within months of stopping
Key publication
—
Falutz et al. NEJM 2007 · Falutz JCEM 2010 · FDA approval 2010Falutz 2007Falutz 2010EGRIFTA® (tesamorelin for inje 2010
04Side Effects & Safety
Parameter
Hexarelin
Tesamorelin
Hunger
Strong appetite increase via ghrelin agonism
—
IGF-1 elevation
Strong; monitor with chronic high-dose use
Dose-dependent; supraphysiological levels = discontinue
Cancer risk
Contraindicated in active malignancy (GH/IGF-1 axis)
Contraindicated in active malignancy (GH/IGF-1 axis); theoretical tumour growth riskEGRIFTA® (tesamorelin for inje 2010
Injection site reaction
—
Erythema, pruritus, redness (common)
Fluid retention / Edema
—
Peripheral edema, arthralgia, carpal tunnel (GH-axis effect)
Antibody formation
—
~50% at 26 weeks; non-neutralising in most; rare hypersensitivity (<1%)Sévigny 2018
GI symptoms
—
Nausea, diarrhea (mild, transient)
Absolute Contraindications
Hexarelin
- ·Active malignancy
- ·Pregnancy / breastfeeding
- ·Disrupted hypothalamic-pituitary axis
Tesamorelin
- ·Active malignancy or history of treated cancer
- ·Pregnancy
- ·Hypersensitivity to tesamorelin or mannitol
- ·Disruption of hypothalamic-pituitary axis (trauma, tumour, radiation)
Relative Contraindications
Hexarelin
- ·Untreated diabetes
- ·Severe hyperprolactinemia
Tesamorelin
- ·Untreated diabetes (monitor HbA1c)
- ·Severe carpal tunnel syndrome
- ·Acute critical illness
05Administration Protocol
Parameter
Hexarelin
Tesamorelin
1. Reconstitution
Add 2 mL bacteriostatic water to 5 mg vial → 2.5 mg/mL = 250 mcg per 0.1 mL.
Add 2.1 mL sterile water to 2 mg lyophilised vial. Roll gently — do not shake. Solution should be clear.
2. Injection site
SQ — abdomen or thigh. Rotate sites.
Subcutaneous — abdomen preferred. Rotate sites (avoid same spot within 2 cm). Avoid navel and waistband area.
3. Timing
Pre-sleep + fasted preferred. Cycle on/off to avoid tachyphylaxis.
Once daily. Preferred: evening, 2–3 hrs post-meal, before sleep — aligns with natural GH secretion pulse.
4. Storage
Lyophilised: room temp, light-protected. Reconstituted: refrigerate ≤30 days.
Lyophilised: room temp, light-protected. Reconstituted: refrigerate 2–8 °C, use within 21 days.
5. Needle
29–31G, 4–8 mm insulin syringe.
27–31G, 4–8 mm insulin syringe. Pinch skin, 45° angle for lean individuals.
06Stack Synergy
Hexarelin
+ CJC-1295 (no DAC)
StrongHexarelin (GHRP) + CJC-1295-no-DAC (GHRH analogue) is the higher-amplitude variant of the standard GHRH+GHRP stack. Hexarelin produces a stronger pulse than ipamorelin but with cortisol + prolactin signal — choose this stack for maximum GH amplitude when side-effect tolerance is acceptable. Cycle aggressively.
- Hexarelin
- 100 mcg SQ · pre-sleep
- CJC-1295 (no DAC)
- 100 mcg SQ · same injection
- Primary benefit
- Maximum GH pulse amplitude (with side-effect signal)
Tesamorelin
+ Ipamorelin
StrongTesamorelin (GHRH analogue) and ipamorelin (GHRP / ghrelin mimetic) act on two distinct receptor systems to amplify GH release synergistically — GHRH receptor + ghrelin receptor. This dual-axis stimulation produces a more robust, sustained GH pulse than either alone while maintaining physiological pulsatility. Ipamorelin is highly selective with minimal cortisol or prolactin elevation, making it the preferred GHRP pairing.
- Tesamorelin
- 2 mg SQ · evening
- Ipamorelin
- 200–300 mcg SQ · same injection
- Frequency
- Once daily, pre-sleep
- Primary benefit
- Maximal GH pulsatility, fat loss, recovery, sleep quality