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CJC-1295 ipamorelin vs tesamorelin: the approved one and the other two

Tesamorelin is what CJC-1295 was meant to become. Both are GHRH analogues, both were aimed at the same visceral fat in the same HIV patients in the same years, and one of them finished. Comparing them is less a matter of chemistry than of evidence: a 412-patient NEJM trial and an approval on one side, two small studies in healthy volunteers on the other, and ipamorelin standing apart with a receptor of its own.

Published September 21, 2026Updated September 21, 202610 sources, DOIs verified
Two glass specimen jars, one tall and one short, beside a folded white cloth

Same target, same years

In the mid-2000s two Montreal companies were chasing the same clinical prize with two versions of the same hormone. Theratechnologies had tesamorelin, the full 44-residue GHRH with a protective hexenoyl group on its N-terminus; ConjuChem had CJC-1295, the 1-29 fragment with four substitutions and an albumin-binding tail. Both registered phase 2 trials in HIV patients whose antiretroviral therapy had left them with visceral fat, a population in which the GH axis is blunted and the cardiovascular risk of that fat is well documented.

ConjuChem's trial, 120 planned patients over 12 weeks, started in December 2005 and was terminated in September 2006 without posting results [ConjuChem, 2005]. Theratechnologies' programme ran to two phase 3 trials, a NEJM paper in 2007 and an FDA approval on November 10, 2010 [U.S. et al., 2010]. Searches for "tesamorelin vs cjc 1295" run to about 880 a month and "tesamorelin ipamorelin" to 4,400, so the question is being asked; the record answers it clearly.

What tesamorelin was shown to do

Falutz and colleagues randomised 412 HIV patients with abdominal fat accumulation, 86 % men, to 2 mg of tesamorelin or placebo injected subcutaneously once a day for 26 weeks. Visceral adipose tissue, measured by CT, fell 15.2 % on tesamorelin and rose 5.0 % on placebo. Triglycerides fell 50 mg/dl against a 9 mg/dl rise; the ratio of total to HDL cholesterol fell 0.31 against a 0.21 rise; IGF-1 rose 81.0 % against a 5.0 % fall, all with P < 0.001. Adverse events did not differ significantly between groups, but more patients on tesamorelin withdrew because of one, and glycaemic measures did not differ [Falutz et al., 2007].

Seven years later, Stanley and colleagues at Massachusetts General Hospital looked at the liver. Fifty antiretroviral-treated patients received 2 mg of tesamorelin or placebo daily for 6 months. Visceral adipose tissue changed by −34 cm² against +8 cm² (treatment effect −42 cm², P = .005); liver fat, as lipid-to-water percentage, changed by −2.0 % against +0.9 % (P = .003). Fasting glucose rose 9 mg/dl at 2 weeks on tesamorelin against 2 mg/dl on placebo (P = .03), a difference that had disappeared by 6 months [Stanley et al., 2014]. That early glucose signal is the one adverse effect specific to raising the GH axis that has been quantified for any molecule on this site.

What CJC-1295 was shown to do

CJC-1295's human record is two trials in healthy adults, both published in 2006. After a single subcutaneous dose, mean GH rose 2 to 10-fold for 6 days or more and IGF-1 1.5 to 3-fold for 9 to 11 days; the half-life was 5.8 to 8.1 days and no serious adverse reactions were reported [Teichman et al., 2006].

One week after a single 60 or 90 µg/kg dose, trough GH was 7.5-fold higher, mean GH 46 % higher and IGF-1 45 % higher, with the pulses unchanged [Ionescu et al., 2006]. Those are pharmacodynamic endpoints, not clinical ones: no CJC-1295 trial measured fat, lipids or liver, because the trial that would have did not finish. The peptide's full account is in CJC-1295 peptide.

Where ipamorelin fits, and why "tesamorelin ipamorelin" exists

Ipamorelin is not a GHRH analogue. It is a five-residue agonist of the ghrelin receptor, designed at Novo Nordisk to release GH without cortisol or prolactin [Raun et al., 1998], with a 2-hour half-life in men [Gobburu et al., 1999], whose clinical development was two phase 2 trials in postoperative ileus that measured no GH endpoint [Beck et al., 2014]. Pairing it with a GHRH analogue rests on the two-receptor logic explained in what is CJC-1295 ipamorelin. Clinics that offer "tesamorelin ipamorelin" are applying that logic to the approved GHRH analogue instead of the unapproved one. No trial has tested either pairing; tesamorelin's approval covers tesamorelin alone, in one indication.

Side by side

Swipe sideways to see the whole table.

ItemTesamorelinCJC-1295Ipamorelin
StructureGHRH(1-44) with N-terminal hexenoyl groupGHRH(1-29), 4 substitutions, albumin linkerpentapeptide, Aib-His-D-2-Nal-D-Phe-Lys-NH2
ReceptorGHRH receptorGHRH receptorghrelin receptor (GHS-R1a)
Largest human trial412 patients, 26 weeks [Falutz et al., 2007]healthy adults, 28 and 49 days [Teichman et al., 2006]320 patients, results unpublished
Clinical endpoint measuredvisceral fat −15.2 %, liver fat −2.0 %, IGF-1 +81 %none (GH, IGF-1 only)time to first meal, not significant
Glucose signal+9 mg/dl at 2 weeks, not significant at 6 months [Stanley et al., 2014]not reportednot measured
Regulatory statusFDA-approved November 2010 [U.S. et al., 2010]phase 2 terminated 2006phase 2, not pursued
WADAprohibited, S2prohibited, S2prohibited, S2 [World, 2026]

What the comparison means

It does not mean tesamorelin is a stronger GH secretagogue than CJC-1295; no study compared them, and CJC-1295's week-long half-life is a pharmacological feature tesamorelin lacks. It means that one molecule was carried through the trials that turn a mechanism into a measured outcome, and the other was not. When a page describes what "CJC-1295 ipamorelin" does to body fat, the numbers it has in mind, if it has any, are tesamorelin's, borrowed across a receptor that both share and a clinical programme that only one completed.

Reading the tesamorelin trials is the best available way to see what a GHRH analogue can do in people; reading the CJC-1295 trials is the only way to see what CJC-1295 did. The two comparisons this site draws with its nearer relative are in sermorelin versus CJC-1295 ipamorelin.

Sources

Each DOI below returned HTTP 200 on api.crossref.org and each NCT number on clinicaltrials.gov when this page was last updated. Nothing is cited from memory.

  1. Falutz J, Allas S, Blot K, et al. (2007). Metabolic effects of a growth hormone-releasing factor in patients with HIV. New England Journal of Medicine 357(23):2359-2370. doi:10.1056/NEJMoa072375CrossRef 200 NCT00123253CT.gov 200
    412 HIV patients with abdominal fat accumulation, 2 mg tesamorelin or placebo daily for 26 weeks. Visceral adipose tissue down 15.2 % versus up 5.0 %; IGF-1 up 81 %; more withdrawals for adverse events on tesamorelin.
  2. Stanley TL, Feldpausch MN, Oh J, Branch KL, Lee H, Torriani M, Grinspoon SK (2014). Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA 312(4):380-389. doi:10.1001/jama.2014.8334CrossRef 200 NCT01263717CT.gov 200
    50 patients, 2 mg tesamorelin or placebo daily for 6 months. Visceral fat −34 cm² versus +8 cm²; liver fat −2.0 % versus +0.9 %; fasting glucose up 9 mg/dl at 2 weeks, not significant at 6 months.
  3. Teichman SL, Neale A, Lawrence B, Gagnon C, Castaigne JP, Frohman LA (2006). Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults. Journal of Clinical Endocrinology & Metabolism 91(3):799-805. doi:10.1210/jc.2005-1536CrossRef 200
    Two randomized, placebo-controlled, double-blind ascending-dose trials (28 and 49 days) in healthy adults aged 21 to 61. Four ascending single doses in the first study (30 and 60 µg/kg named as the best tolerated); two or three weekly or biweekly doses in the second. Half-life 5.8 to 8.1 days.
  4. Ionescu M, Frohman LA (2006). Pulsatile secretion of growth hormone (GH) persists during continuous stimulation by CJC-1295, a long-acting GH-releasing hormone analog. Journal of Clinical Endocrinology & Metabolism 91(12):4792-4797. doi:10.1210/jc.2006-1702CrossRef 200
    Overnight 12-hour sampling every 20 minutes in healthy men aged 20 to 40, before and one week after a single 60 or 90 µg/kg injection. Trough GH up 7.5-fold, mean GH up 46 %, IGF-1 up 45 %, pulse frequency and amplitude unchanged.
  5. ConjuChem Inc. (2005). A multicenter, randomized, placebo-controlled, double-blind, phase 2 study to evaluate the efficacy and safety of CJC 1295 administered for 12 weeks in HIV infected patients with HIV associated visceral obesity. ClinicalTrials.gov registry entry. NCT00267527CT.gov 200
    Planned 120 patients, low dose, high dose or placebo, 12 weeks of treatment and 6 weeks of follow-up. Started December 2005, terminated September 2006. No results posted.
  6. U.S. Food and Drug Administration, Drugs@FDA (2010). EGRIFTA (tesamorelin acetate), application 022505, approval history. Drugs@FDA. www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=over…
    Approval date 11/10/2010 for tesamorelin acetate, the only GHRH analogue discussed on this site that reached approval.
  7. Raun K, Hansen BS, Johansen NL, Thøgersen H, Madsen K, Ankersen M, Andersen PH (1998). Ipamorelin, the first selective growth hormone secretagogue. European Journal of Endocrinology 139(5):552-561. doi:10.1530/eje.0.1390552CrossRef 200
    The Novo Nordisk paper that describes ipamorelin (Aib-His-D-2-Nal-D-Phe-Lys-NH2). EC50 1.3 nmol/l in rat pituitary cells, ED50 2.3 nmol/kg in swine, no ACTH or cortisol release at more than 200 times the GH ED50, no effect on FSH, LH, PRL or TSH.
  8. Gobburu JV, Agersø H, Jusko WJ, Ynddal L (1999). Pharmacokinetic-pharmacodynamic modeling of ipamorelin, a growth hormone releasing peptide, in human volunteers. Pharmaceutical Research 16(9):1412-1416. doi:10.1023/A:1018955126402CrossRef 200
    Five intravenous infusion rates (4.21 to 140.45 nmol/kg over 15 minutes) in eight healthy men per dose level. Terminal half-life 2 hours, clearance 0.078 l/h/kg, one GH episode peaking at 0.67 hours, SC50 214 nmol/l.
  9. Beck DE, Sweeney WB, McCarter MD, Ipamorelin 201 Study Group (2014). Prospective, randomized, controlled, proof-of-concept study of the ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients. International Journal of Colorectal Disease 29(12):1527-1534. doi:10.1007/s00384-014-2030-8CrossRef 200 NCT00672074CT.gov 200
    Phase 2, multicentre, double-blind, placebo-controlled. 117 enrolled, 114 analysed. Intravenous 0.03 mg/kg twice daily for up to 7 days. Adverse events in 87.5 % (ipamorelin) versus 94.8 % (placebo). Median time to first tolerated meal 25.3 versus 32.6 hours, p = 0.15.
  10. World Anti-Doping Agency (2026). The Prohibited List, class S2 (peptide hormones, growth factors, related substances and mimetics). WADA. www.wada-ama.org/en/prohibited-list…
    GHRH analogues (CJC-1295, sermorelin, tesamorelin) and growth hormone secretagogues (ipamorelin and the GHRPs) are listed by name as prohibited at all times.

Questions readers ask

What is the difference between tesamorelin and CJC-1295?

Both are GHRH analogues acting on the same receptor. Tesamorelin is the full 44-residue GHRH with a trans-3-hexenoic acid group at the N-terminus; CJC-1295 is the 1-29 fragment with four substitutions and an albumin-binding linker. Tesamorelin completed a 412-patient phase 3 trial and was approved by the FDA in 2010 for HIV-associated abdominal fat; CJC-1295's phase 2 in the same indication was terminated in 2006.

What did tesamorelin do in its trials?

In 412 HIV patients, 2 mg daily for 26 weeks reduced visceral adipose tissue by 15.2 % against a 5.0 % increase on placebo, cut triglycerides by 50 mg/dl and raised IGF-1 by 81 %. In a later 50-patient trial, 6 months of tesamorelin cut visceral fat by 34 cm² and liver fat by 2.0 percentage points, with a transient rise in fasting glucose at 2 weeks.

Does tesamorelin combine with ipamorelin?

Not in any published trial. The 'tesamorelin ipamorelin' pairing sold by some clinics follows the same GHRH-plus-GHRP logic as CJC-1295 ipamorelin, but no human study has tested it, and tesamorelin's approval covers tesamorelin alone in one indication.

Which is more studied, tesamorelin or CJC-1295 ipamorelin?

Tesamorelin, by an order of magnitude: two phase 3 trials, an FDA approval and a decade of post-approval studies. CJC-1295 has two small trials in healthy adults, ipamorelin has one pharmacokinetic study and two ileus trials, and the pair has none.

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