Side-by-side · Research reference

TesamorelinvsTesofensine

Side-by-side comparison across mechanism, dosage, evidence, side effects, administration, and stack synergies. Citations on every claim where available.

AFDA-ApprovedVerified27/68 cited

BPhase 3Draft10/40 cited

Tesamorelin

GHRH Analogue · FDA-Approved

2 mgDaily doseEGRIFTA® (tesamorelin for inje 2010

15–20%VAT reductionFalutz 2010

~26 minHalf-lifeEGRIFTA® (tesamorelin for inje 2010

SQ · Abdomen · Once Daily

Tesofensine

SNDRI · Phase 3 obesity candidate

0.25–0.5 mgDaily doseAstrup 2008

9.2 kgWeight ↓ (24 wk)Astrup 2008

Phase 3Evidence levelAstrup 2008

Oral · Once daily morning

01Mechanism of Action

Parameter

Tesamorelin

Tesofensine

Primary target

Hypothalamic GHRH receptorsEGRIFTA® (tesamorelin for inje 2010

Serotonin / norepinephrine / dopamine transporters (SERT / NET / DAT)Astrup 2008

Pathway

GHRH → Pituitary GH release → Liver IGF-1 synthesisFalutz 2007

Triple monoamine reuptake inhibition → ↑synaptic 5-HT, NE, DA → appetite suppression + thermogenesisAstrup 2008

Downstream effect

Increased GH pulsatility, elevated IGF-1, lipolysis of visceral adipose tissueFalutz 2010

Strong appetite suppression, mild thermogenic effect, weight lossAstrup 2008

Feedback intact?

Yes — physiological pulsatility preserved

—

Origin

Synthetic 44-AA GHRH analogue with trans-3-hexenoic-acid modification for stabilityEGRIFTA® (tesamorelin for inje 2010

Small molecule developed by NeuroSearch (Denmark) for CNS indications, repurposed for obesityAstrup 2008

Antibody development

~50% after 26 wks (non-neutralising in most)Sévigny 2018

—

02Dosage Protocols

Parameter

Tesamorelin

Tesofensine

Standard dose

2 mg / dayEGRIFTA® (tesamorelin for inje 2010

FDA-approved protocol.

0.25–0.5 mg / dayAstrup 2008

Frequency

Once daily (morning or pre-sleep)

Aligns with natural GH pulse.

Once daily, morning

Lower / starter dose

1 mg / dayFalutz 2010

1 mg still produces significant IGF-1 elevation.

0.125 mg / day

Evidence basis

RCT / FDA-approvedFalutz 2007 Falutz 2010

Phase 2b + ongoing Phase 3Astrup 2008

Duration

12–52 weeks

VAT returns within months of stopping.

24 weeks per studied cycle

Reconstitution

Sterile water per labeling

Preserved at 2–8 °C after reconstitution.

—

Timing

Empty stomach, pre-sleep preferred

Morning to avoid sleep disruption

Half-life

~26 min (plasma)EGRIFTA® (tesamorelin for inje 2010

Modified vs native GHRH (7 min t½).

~9 days (very long)

Form

—

Oral capsule

03Metabolic / Fat Loss Evidence

Parameter

Tesamorelin

Tesofensine

Primary fat target

Visceral adipose tissue (VAT) — abdominal

—

Quantified reduction

15–20% VAT ↓Falutz 2010

By CT at 26 weeks (Falutz et al., NEJM).

—

IGF-1 impact

+66 ng/mL (2 mg dose) · +81% mean elevationFalutz 2007

—

Effect on lean mass

Modest lean mass preservation / slight increase

—

Insulin sensitivity

Neutral to slight impairment (monitor HbA1c)Clarke 2018

—

Triglycerides

Significant TG reduction noted in Phase 3Falutz 2010

—

Glucose metabolism

Generally neutral; 4.5% HbA1c elevation riskClarke 2018

—

Effect reversibility

VAT returns within months of stopping

—

Key publication

Falutz et al. NEJM 2007 · Falutz JCEM 2010 · FDA approval 2010Falutz 2007 Falutz 2010 EGRIFTA® (tesamorelin for inje 2010

—

04Side Effects & Safety

Parameter

Tesamorelin

Tesofensine

Injection site reaction

Erythema, pruritus, redness (common)

—

Fluid retention / Edema

Peripheral edema, arthralgia, carpal tunnel (GH-axis effect)

—

Glucose intolerance

HbA1c ↑ in 4.5% vs 1.3% placebo; HbA1c ≥6.5% hazard OR 3.3Clarke 2018

—

IGF-1 elevation

Dose-dependent; supraphysiological levels = discontinue

—

Cancer risk

Contraindicated in active malignancy (GH/IGF-1 axis); theoretical tumour growth riskEGRIFTA® (tesamorelin for inje 2010

—

Antibody formation

~50% at 26 weeks; non-neutralising in most; rare hypersensitivity (<1%)Sévigny 2018

—

GI symptoms

Nausea, diarrhea (mild, transient)

—

Pregnancy / OB

ContraindicatedEGRIFTA® (tesamorelin for inje 2010

Contraindicated

Heart rate / BP

—

Dose-dependent ↑ HR + BPAstrup 2008

Insomnia

—

Dose-related; mitigate with morning timing

Dry mouth

—

Common

Nausea

—

Common

Mood changes

—

Anxiety / agitation possible

Cardiovascular events

—

Phase 3 trial monitoring; not yet FDA-cleared

Absolute Contraindications

Tesamorelin

·Active malignancy or history of treated cancer
·Pregnancy
·Hypersensitivity to tesamorelin or mannitol
·Disruption of hypothalamic-pituitary axis (trauma, tumour, radiation)

Tesofensine

·Pregnancy / breastfeeding
·Severe cardiovascular disease
·Concurrent MAOI use

Relative Contraindications

Tesamorelin

·Untreated diabetes (monitor HbA1c)
·Severe carpal tunnel syndrome
·Acute critical illness

Tesofensine

·Hypertension
·Anxiety disorder
·Insomnia

05Administration Protocol

Parameter

Tesamorelin

Tesofensine

1. Reconstitution

Add 2.1 mL sterile water to 2 mg lyophilised vial. Roll gently — do not shake. Solution should be clear.

Oral capsule (investigational; not commercial).

2. Injection site

Subcutaneous — abdomen preferred. Rotate sites (avoid same spot within 2 cm). Avoid navel and waistband area.

Swallow whole with water, morning only.

3. Timing

Once daily. Preferred: evening, 2–3 hrs post-meal, before sleep — aligns with natural GH secretion pulse.

Morning to mitigate insomnia. Do not dose evening.

4. Storage

Lyophilised: room temp, light-protected. Reconstituted: refrigerate 2–8 °C, use within 21 days.

Room temp ≤25 °C, dry place.

5. Needle

27–31G, 4–8 mm insulin syringe. Pinch skin, 45° angle for lean individuals.

Monitor BP + HR + mood. Avoid stimulants + MAOIs.

06Stack Synergy

Tesamorelin

+ Ipamorelin

Strong

View Ipamorelin →

Tesamorelin (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

Raun 1998

Tesofensine

— no documented stacks