Tesamorelin / Ipamorelin

Status Tesamorelin alone is FDA-approved for a different indication; this combination is not approved for any useBest evidence E5Sources checked 2026-09-18

Tesamorelin / ipamorelin pairs an FDA-approved GHRH analogue with an unapproved ghrelin-receptor agonist. An FDA warning letter documents one marketed version, 10 mg tesamorelin to 3 mg ipamorelin. The combination has never been tested in a trial, and the tesamorelin dose that circulates for it is the same dose that failed to separate from placebo…

What is in it

Amounts most commonly stated by suppliers. Not standardised.
Component	Stated amount	Share of vial
Tesamorelin	6 to 10 mg	About 67% at 2:1, about 77% at the documented 10:3
Ipamorelin	3 mg	About 33% at 2:1, about 23% at the documented 10:3

This name is not standardised. Different suppliers use it for different combinations and different ratios. A product sold under this name may not match what is described here. Check the actual composition of anything you are looking at.

Evidence below concerns the combination itself. Research on each component is on that component’s own entry.

What it is

Tesamorelin / ipamorelin is a vendor name for two peptides in one vial: tesamorelin, an FDA-approved GHRH analogue sold as Egrifta, and ipamorelin, an unapproved, selective ghrelin-receptor agonist. Unlike CJC-1295 / ipamorelin, one half of this pair is a real drug with a real label. That does not make the blend approved; a fixed combination needs its own dose-ranging and stability data, and none exists for this pair.

What is actually in the vial

Circulating descriptions put the combined vial at roughly 9, 13 or 15 mg total, with tesamorelin to ipamorelin ratios generally in the region of 2:1 to 4:1, tesamorelin-heavy, for example a 9 mg vial described as 6 mg tesamorelin plus 3 mg ipamorelin. That is a different convention from CJC-1295 / ipamorelin, where the dominant split is closer to equal weight.

One instance of this exact product is documented in a primary regulatory source rather than inferred from vendor copy. An FDA warning letter to Royal Peptides LLC, dated 24 August 2026, names a product marketed as BIMORELIN and describes it as “Tesamorelin (10 mg) and Ipamorelin (3 mg),” a ratio of roughly 3.3:1. That is the most concrete composition figure available for this blend, precisely because it comes from an enforcement document rather than a listing.

What one injection delivers, and why that is harder to say here than for other blends

For CJC-1295 / ipamorelin, once the split and the reconstitution volume are known, the milligrams per injection follow from arithmetic. For this blend that same arithmetic runs into a wall: circulating blend material describes the product by combined total peptide weight and does not state how much tesamorelin a single injection is meant to deliver. That is not a gap this entry can fill by calculation, because the vial’s per-dose intent, as distinct from its total content, is not published anywhere reviewed for this entry.

That matters specifically for tesamorelin, because its label requires monitoring against a known dose: glucose status before starting, periodic glucose monitoring during treatment, and IGF-1 monitoring with a stated discontinuation threshold. None of that is structurally possible against a vial where the tesamorelin content of a single dose is not stated.

What has actually been tested

No study of tesamorelin and ipamorelin administered together, in any species, was located for this entry. A ClinicalTrials.gov search for the intervention “tesamorelin AND ipamorelin” returned zero registered trials, and a PubMed search for “tesamorelin ipamorelin combination growth hormone” returned zero results. Each peptide has its own separate human trial record, covered on its own entry, and neither trial record involves the other compound.

Reading tesamorelin’s own dose against the blend

This is the one finding on this page worth sitting with, because it runs the opposite direction from most blends reviewed on this site. Circulating aggregate figures put the tesamorelin component of blended protocols at around 2 mg subcutaneously once daily, but separate circulating material for tesamorelin used on its own, outside a blend, commonly centres closer to 1 mg per day. Set either figure against the approved record and the comparison is unusually direct: EGRIFTA is dosed at 2 mg per day, EGRIFTA SV at 1.4 mg per day and EGRIFTA WR at 1.28 mg per day. A circulating figure of 1 mg per day sits below every approved dose ever marketed for this drug.

It is not simply a low dose. In the phase 2 dose-ranging trial that selected 2 mg per day for the pivotal programme, the 1 mg arm did not separate from placebo on visceral fat or trunk fat, the two measures the drug is approved to treat; only the 2 mg arm reached significance. So where the usual finding on this site is a circulating dose that exceeds anything studied, tesamorelin’s own approved-drug record contains a specific instance of a dose that was tried, in a controlled trial, at roughly the figure that circulates for this component, and it missed its endpoint.

The 1 mg figure is not fabricated or arbitrary either; it was used for 20 weeks in a separate cognition trial, and it was the pre-specified dose-reduction level in a hepatic-fat trial protocol. It is a real dose from the tesamorelin record. It is simply attached, in circulating material, to a use it did not succeed at when it was actually tested at that level.

Regulatory status

Tesamorelin is FDA-approved as Egrifta for HIV-associated lipodystrophy, and its label requirements (glucose and IGF-1 monitoring) apply to that approved product at its approved dose, not to any blend. This blend, as a fixed combination, has no approval of its own. Ipamorelin has no approval anywhere: it was nominated for the 503A compounding list, that nomination was withdrawn, and the Pharmacy Compounding Advisory Committee voted twelve to zero against both the free base and the acetate on 29 October 2024. WADA names ipamorelin directly in section S2.2.4, growth hormone secretagogues, prohibited at all times.

The Royal Peptides LLC warning letter cited above is itself the clearest regulatory fact this entry can offer: a named, marketed product combining these two compounds at a stated ratio was the subject of federal enforcement action in 2026.

What is not known

How much tesamorelin a single injection of this blend is meant to deliver. Circulating material states combined vial weight, not per-dose split, so the actual dose a person injects cannot be determined from the label.

Whether co-administering tesamorelin with ipamorelin produces any effect, favourable or unfavourable, that tesamorelin alone would not. No study of the combination exists in any species.

Whether the two peptides are chemically stable together in one lyophilised cake or in solution over the weeks a reconstituted vial is kept. No stability data for this mixture was located.

Whether the glucose and IGF-1 monitoring tesamorelin’s own label requires is being done by anyone using this blend, given that the tesamorelin dose per injection is not knowable from the product itself.

Whether the 2:1 to 4:1 range, or the 3.3:1 ratio in the one documented warning letter, has any pharmacological basis. No dose-ranging study of the pair exists.

Doses used in published research

No published study has administered this compound to a human being, so no dose appears in the literature and none has been established.

Amounts above record what a named source reported administering in a study. They are not a recommendation, not a protocol, and not instructions.

Converting a vial and a syringe into a draw volume is a separate, mechanical question from what amount to use. The reconstitution calculator does that arithmetic for peptide, HCG, and HGH vials.

What circulates E5

Figures reported online. Not dosing, not verified, not endorsed.
Reported use	Route	Amount reported	Frequency	Reported length
Growth hormone axis stimulation, blend	Subcutaneous	Combined vial dosed by volume; tesamorelin content of a single dose not stated	Once daily, usually in the evening	8 to 12 weeks, then a break
Tesamorelin component, aggregate figure	Subcutaneous	Around 1 to 2 mg	Once daily	8 to 12 weeks
Ipamorelin component	Subcutaneous	A few hundred micrograms	Once daily, usually in the morning	8 to 16 weeks, then a break

The tesamorelin component of this blend is the sharpest comparison on this site between a circulating figure and an approved drug’s own tested record. EGRIFTA is dosed at 2 mg per day, EGRIFTA SV at 1.4 mg and EGRIFTA WR at 1.28 mg. A circulating figure of 1 mg per day, which appears for tesamorelin both alone and as the blend component, sits below every one of those approved doses.

That figure is not simply low, it is a dose that was tried and did not work for the approved indication: in the phase 2 dose-ranging trial that selected 2 mg for the pivotal programme, the 1 mg arm did not separate from placebo on visceral or trunk fat, the two measures the drug treats. Only the 2 mg arm reached significance.

For the ipamorelin component, no human dose comparison is possible at all, because the only dose of ipamorelin ever given to a human in a published trial was intravenous, not subcutaneous, and that trial missed its own endpoint.

None of the circulating material reviewed for this entry states the tesamorelin content of a single injection, which means a person using this blend cannot check their own dose against either the approved record or the failed dose-ranging arm above, because they do not know which one they are closer to.

Recorded as an observation about what is published elsewhere. No figure here is a dose, a protocol, or a recommendation, and nothing in this section is evidence that any amount is safe or effective.