Combination evidence
Tesamorelin + Ipamorelin
Also called Tesa/Ipa, Tesamorelin + Ipamorelin stack
This pairing combines tesamorelin, an FDA-approved GHRH analog labelled for excess abdominal fat in HIV-associated lipodystrophy 1, with ipamorelin, an unapproved ghrelin-receptor agonist. No human study of the combination was found, and the tesamorelin label does not address co-use with GH secretagogues.
Not studied together in humans
Components
What has been studied
- No human study of tesamorelin given with ipamorelin (or with any GH-releasing peptide) was found. Searched: PubMed (tesamorelin AND (ipamorelin OR GHRP OR ghrelin OR secretagogue)) and ClinicalTrials.gov (tesamorelin AND ipamorelin), October 2026. Hits were reviews.
Why the pairing is discussed
Mechanistic reasoning drawn from studies of each component. Theoretical unless a study above tested the pair.
- Theoretical: tesamorelin stimulates GH secretion via GHRH receptors and raises IGF-1, per its label 1; ipamorelin releases GH through a GHRP-like receptor 2. Human work with other molecules showed GHRH and a GH-releasing peptide together released GH synergistically 3, which is the basis for discussing the pair.
Concerns and unknowns
- The tesamorelin label warns of glucose intolerance or diabetes (HbA1c of at least 6.5% at week 26 in 5% versus 1% with placebo), fluid retention, IGF-1 elevation, and contraindicates use in active malignancy because it induces release of GH, a known growth factor 1. Adding a second GH secretagogue could plausibly increase these exposures; this has not been studied.
- The tesamorelin label states it is not indicated for weight loss management and that long-term cardiovascular safety has not been established 1.
- FDA lists ipamorelin acetate among compounding substances that may present significant safety risks, citing possible immunogenicity 4.
- WADA's 2026 Prohibited List names tesamorelin (as a GHRH analogue) and ipamorelin in section S2.2.4 (growth hormone releasing factors and secretagogues), prohibited at all times 5.
Status of each component
| Compound | Regulatory status | Evidence | Half-life |
|---|---|---|---|
| Tesamorelin | FDA-approved | A | Mean elimination half-life about 11 minutes after |
| Ipamorelin | Not approved — research use only | B | Terminal half-life of about 2 hours in healthy mal |
Frequently asked questions
Is tesamorelin + ipamorelin approved?
No. Tesamorelin alone is FDA-approved for a specific HIV-related indication 1; ipamorelin is not approved anywhere, and the combination has no approval or study.
Has the combination been studied?
No human study was found.
Why would they be paired?
What label warnings matter here?
The tesamorelin label warns of glucose intolerance, fluid retention and IGF-1 elevation 1. How a second secretagogue changes these risks is unknown.
Is it allowed in sport?
References
- EGRIFTA WR (tesamorelin) for injection, prescribing information (revised 03/2025) FDA label (DailyMed). 2025
- Ipamorelin, the first selective growth hormone secretagogue Eur J Endocrinol. 1998
- Growth hormone (GH)-releasing peptide stimulates GH release in normal men and acts synergistically with GH-releasing hormone J Clin Endocrinol Metab. 1990
- Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks (content current as of 04/22/2026) FDA. 2026
- International Standard: Prohibited List 2026 World Anti-Doping Agency. 2026