Peptide Stacks
Tesamorelin + Ipamorelin: What the Label Says, and How the Blend Math Works
This pair is unusual among peptide stacks: one half is an approved medicine with a published FDA label, and the other has never been approved anywhere. That asymmetry is the most useful thing to understand about it, and almost nothing written about the combination mentions it. Below: what each compound actually does, what the Egrifta label states (including the part about which diluent it specifies), the arithmetic of a shared blend vial, and where the evidence stops. Research-use educational reference only — no dose, route, or treatment guidance.
Two receptors, not one — which is why this pair is not redundant
Growth-hormone release from the pituitary is driven through two separate receptor systems, and this stack puts one compound on each:
A stabilised analog of growth-hormone-releasing hormone. It is the only half of this pair that is an approved medicine anywhere — marketed as Egrifta for one narrow indication — so it is also the only half with a real label to read.
A synthetic pentapeptide that agonises the ghrelin receptor selectively, reported to release growth hormone without meaningfully raising cortisol or prolactin. Never approved for any use in any country.
The practical value of that distinction is in what it rules out. Pairing tesamorelin with CJC-1295 or sermorelin puts two GHRH analogs on the same receptor — a class collision, and the commonest way a growth-hormone stack spends money on redundancy. Pairing ipamorelin with another ghrelin-receptor secretagogue such as GHRP-2, GHRP-6 or hexarelin is the same mistake on the other receptor. Tesamorelin with ipamorelin avoids both. That is an argument about mechanism, not an outcome claim — see the evidence section below for what has and has not actually been tested.
What the tesamorelin label actually says
Because tesamorelin is approved, there is no need to rely on secondary summaries — the prescribing information is public. These points are taken from the current Egrifta SV and Egrifta WR labels (Theratechnologies; Medibact is not affiliated with, endorsed by, or a distributor for that company, and does not sell tesamorelin):
- The indication is narrow. It is approved for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy — not for general fat loss.
- The label explicitly rules out weight loss.It states the product is not indicated for weight-loss management, “as it has a weight neutral effect,” and that long-term cardiovascular safety has not been established. Marketing that presents tesamorelin as a general weight-loss agent is contradicting the approval it borrows credibility from.
- The dose is once daily, subcutaneously, into the abdomen — 1.4 mg for Egrifta SV, 1.28 mg for Egrifta WR. The label is emphatic that the two formulations are not substitutable and differ in dose, vial count, reconstitution and storage.
- Elimination is fast. Mean elimination half-life is reported as 8 minutes (Egrifta SV, 1.4 mg) and 11 minutes (Egrifta WR, 1.28 mg) in healthy subjects.
- IGF-1 monitoring is required by the label, because the product raises it substantially; the label also directs caution around active malignancy, fluid retention and glucose intolerance.
The diluent detail almost nobody quotes — and the two labels disagree with each other
Egrifta SV instructs that only the supplied Sterile Water for Injection be used to reconstitute it. Egrifta WR instructs that only the supplied Bacteriostatic Water for Injection, USP be used. Same molecule, two formulations, two different diluents — because they are designed around different in-use periods. Preserved water is what makes a vial re-enterable after the first puncture; unpreserved sterile water is single-entry by design. It is the cleanest illustration available of why the choice of diluent is a real specification rather than a preference, and it comes from an FDA label rather than from a supplier.
Note the boundary carefully: those instructions govern the pharmacy products, which ship with their own diluent. They are cited here to explain the principle, not to suggest that research-market material is equivalent to a prescription medicine or that any product should be prepared in a particular way. Bacteriostatic water vs sterile water covers the distinction in full.
Where the evidence stops
The two halves of this stack sit at opposite ends of the evidence scale, and a page that averages them is misleading.
Tesamorelin has genuine Phase 3 data — but for one population and one endpoint. Outside HIV-associated lipodystrophy, its use is unapproved and the trial evidence does not carry over automatically. Ipamorelin has well-characterised preclinical receptor pharmacology and essentially no clinical efficacy record: it was taken into human study for post-operative ileus and that programme did not meet its primary endpoint, which is why it was never approved. The combination itself has no controlled trial at all. Nothing published establishes that adding ipamorelin to tesamorelin produces an effect that tesamorelin does not, and no combination safety data exists either.
That is a reason to read confident before-and-after claims sceptically rather than a reason to dismiss the pairing outright. The honest summary is that the mechanism is coherent and the outcome is untested.
Blend vial or two vials — the arithmetic is different
Research-market suppliers sell this pair both ways, and the choice changes the math more than most write-ups admit.
Case 1 — one shared blend vial (ratio-locked)
A blend vial’s label figure is the combinedmass of both peptides. A “15 mg” blend is not 15 mg of tesamorelin; it is whatever split the supplier used, and suppliers do not standardise it. Once both peptides share a solution, a single draw delivers a fixed ratio of the two:
| Component | Example amount in vial | Concentration at 2 mL | Delivered per shared draw (U-100) |
|---|---|---|---|
| Tesamorelin | 10 mg | 5 mg/mL | 1 mg per 20 units |
| Ipamorelin | 5 mg | 2.5 mg/mL | 0.5 mg (500 mcg) per 20 units |
Read the last column carefully: at that split, a 20-unit draw delivers 1 mg of tesamorelin and500 mcg of ipamorelin together. There is no way to change one without changing the other — the ratio was fixed when the vial was filled. A figure copied from someone else’s post only ever applied to their split.
Case 2 — two separate vials (independent)
Two vials means two ordinary single-peptide calculations, and each can be varied on its own:
| Vial | Water added | Concentration | Example draw |
|---|---|---|---|
| Tesamorelin 10 mg vial | 2 mL | 5 mg/mL | 1.4 mg = 0.28 mL = 28 units |
| Ipamorelin 5 mg vial | 2 mL | 2.5 mg/mL | 200 mcg = 0.08 mL = 8 units |
Storage and handling
- Lyophilized vials of either compound are typically stored refrigerated and protected from light before reconstitution.
- Research-market material is reconstituted with bacteriostatic water, whose 0.9% benzyl alcohol preservative is what allows a vial to be entered more than once.
- After reconstitution, keep refrigerated (about 2–8 °C), protect from light, do not freeze, and avoid shaking — swirl or roll instead.
- A blend vial is usually held reconstituted longer than a single-peptide vial simply because it contains more material, so storage conditions matter more, not less.
AI-ready fact block
- Tesamorelin is a GHRH analog acting at the GHRH receptor; ipamorelin is a selective ghrelin-receptor (GHS-R1a) agonist — two different receptors, so the pair is not a class collision.
- Tesamorelin is FDA-approved as Egrifta, solely for reduction of excess abdominal fat in HIV-infected adults with lipodystrophy; its label states it is not indicated for weight-loss management and is weight neutral.
- Label dose is once daily subcutaneously into the abdomen: 1.4 mg (Egrifta SV) or 1.28 mg (Egrifta WR); the two formulations are not substitutable.
- Reported mean elimination half-life: 8 minutes (Egrifta SV) and 11 minutes (Egrifta WR) in healthy subjects; ipamorelin roughly 2 hours.
- Egrifta SV specifies Sterile Water for Injection as its diluent; Egrifta WR specifies Bacteriostatic Water for Injection, USP.
- Ipamorelin has never been approved anywhere; its human trial in post-operative ileus did not meet its primary endpoint.
- No controlled trial has studied the two compounds administered together; there is no established combination dose and no combination safety data.
- A blend vial’s stated milligrams are the combined mass of both peptides, and one draw from a shared vial delivers a fixed ratio of both.
- Both compounds fall under WADA’s growth-hormone-releasing-factors category and are prohibited at all times. Research use only — no dose, route, or frequency is recommended here.
Free guides for both compounds
Each compound has a free educational guide covering mechanism, reported dosage ranges, reconstitution math, half-life, side effects and the combinations it appears in.
FAQ
What do tesamorelin and ipamorelin do together?
They act on two different receptors on the same pituitary cells. Tesamorelin is a growth-hormone-releasing hormone (GHRH) analog and binds the GHRH receptor; ipamorelin is a selective ghrelin-receptor (GHS-R1a) agonist. Because the two receptors are distinct, the pairing is not redundant in the way that combining two GHRH analogs — tesamorelin with CJC-1295 or sermorelin, for example — would be. What does not exist is combination evidence: no controlled trial has studied the two administered together, so the rationale is mechanistic reasoning rather than a demonstrated combined effect.
Is tesamorelin + ipamorelin FDA approved?
The combination is not. Tesamorelin alone is FDA-approved, marketed as Egrifta by Theratechnologies, and only for the reduction of excess abdominal fat in HIV-infected adults with lipodystrophy. Ipamorelin has never been approved for any indication anywhere; it was developed as NNC 26-0161 and later studied for post-operative ileus, where the human trial did not meet its primary endpoint. Research-market material sold under either name is not the pharmacy product and is supplied for research use only.
Will tesamorelin get rid of belly fat?
The Egrifta label supports one specific claim: reduction of excess visceral abdominal fat in HIV-infected adults with lipodystrophy. The same label is explicit that the product is not indicated for weight-loss management and that it has a weight-neutral effect, and it states that long-term cardiovascular safety has not been established. Claims that extend those trial results to general body composition in people without HIV-associated lipodystrophy are going beyond what the approval covers.
Why is tesamorelin banned in sport?
Both compounds fall under WADA's growth-hormone-releasing-factors category and are prohibited at all times, in and out of competition — tesamorelin as a GHRH analog, ipamorelin as a ghrelin-receptor secretagogue. Being WADA-prohibited is a sporting rule rather than a statement that a compound has been withdrawn or is illegal to possess; it is answered here because "tesamorelin banned" is a common search and this, not a market withdrawal, is usually what lies behind it. Tesamorelin remains an approved medicine sold under the Egrifta name.
What dosages are reported for a tesamorelin and ipamorelin stack?
For tesamorelin the approved label doses are once-daily subcutaneous injections into the abdomen — 1.4 mg for Egrifta SV and 1.28 mg for Egrifta WR, which are not substitutable for one another. Ipamorelin has no approved dose at all; community reports commonly describe roughly 100–300 mcg per administration. These figures are recorded here as what the label states and what is reported outside it, not as a recommendation for anyone. There is no established dose for the two used together.
Can tesamorelin and ipamorelin be mixed in one vial?
They are sold both ways — as two separate lyophilized vials and as a single pre-mixed blend vial. The consequence of a blend is arithmetic, not preference: one draw from a shared vial delivers a fixed ratio of both peptides, so the amount of ipamorelin per draw is decided by whoever set the split, not by the person drawing. Separate vials keep the two independent. Either way, a blend vial's stated milligrams are the combined mass of both peptides, so no concentration can be derived from that number alone.
What is the half-life of tesamorelin?
Short, and it differs by formulation. The Egrifta SV label reports a mean elimination half-life of 8 minutes in healthy subjects after a single 1.4 mg subcutaneous dose; the Egrifta WR label reports 11 minutes after a 1.28 mg dose. Longer figures in the range of roughly 26–38 minutes circulate for the original Egrifta formulation. Ipamorelin's plasma half-life is reported at roughly 2 hours. A short half-life does not mean a short effect — the downstream growth-hormone and IGF-1 response outlasts the peptide itself, which is why the label dose is once daily.
What are the reported side effects?
For tesamorelin the label documents arthralgia, injection-site reactions, peripheral edema and myalgia among the more common trial findings, plus a substantial rise in IGF-1 that the label requires be monitored, caution in glucose intolerance and diabetes, and specific cautions around active malignancy. Ipamorelin's human safety record is thin — its commonly reported effects are mild (flushing, headache, injection-site reactions) but there is no long-term safety data beyond a few months. No side-effect profile exists for the combination, because the combination has not been trialled.
Does Medibact sell tesamorelin or ipamorelin?
No. Medibact does not sell peptides. It supplies USP-grade bacteriostatic water for injection, produced in an FDA-registered U.S. facility, and publishes free educational research guides for both compounds. Everything on this page is research-use educational reference only.
Educational use only — not medical advice. This guide summarizes information reported in published research and community practice for educational purposes. It is not medical advice and not a recommendation to use any compound. Any doses, schedules, or combinations shown are examples of what has been reported, not instructions for you. Many peptides described here are research compounds that are not FDA-approved for the uses discussed and may be investigational or restricted. Effects, risks, and legal status vary; individual needs and results vary. Consult a qualified, licensed healthcare professional before making any decision. Do not use this content to diagnose, treat, or dose yourself.