Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Head-to-head comparison of Hexarelin and Tesamorelin — mechanism, dosing, side effects, legal status, and pricing.
Hexarelin (His-D-2MeTrp-Ala-Trp-D-Phe-Lys-NH2) is a synthetic hexapeptide growth hormone secretagogue developed by Mediolanum (Italy) in the 1990s. It is a potent ghrelin-receptor (GHSR-1a) agonist that also binds the CD36 scavenger receptor, giving it a cardioprotective signal distinct from other GHRPs. It is not FDA-approved for any indication and remains a research-only compound; its clinical development for GH deficiency and cardiac indications did not reach approval. A defining feature versus other GHRPs is rapid, pronounced tachyphylaxis with chronic daily dosing.
Tesamorelin (Egrifta / Egrifta SV) is a stabilized analog of human GHRH(1-44) with a trans-3-hexenoic acid moiety at the N-terminus that protects against protease degradation. FDA-approved in November 2010 for the reduction of excess abdominal fat in HIV-infected patients with lipodystrophy, it is the only FDA-approved GHRH analog for this indication. Off-label use for general body composition and visceral fat reduction in non-HIV populations is common but outside the approved label.
Hexarelin
Tesamorelin
Category
Legal Status
Mechanism
Dose Range
Route
COA-verified vendors · trust score ≥70 required · single-vial price — bulk/bundle deals may be lower
Hexarelin
Tesamorelin
COA corpus from Disclosed Labs — independently tested batches only.
Hexarelin
10
COAs
99.4%
Avg purity
4
Labs
Tesamorelin
175
COAs
99.5%
Avg purity
14
Labs
Tesamorelin is among peptides under FDA review for the Category 1 (503A) list; if added, it would require a prescription to be compounded by registered 503A/503B pharmacies — not yet authorized. Hexarelin remains research-only. In April 2026 the FDA removed 12 peptides from Category 2, which does not place them on the Category 1 list or authorize compounding. The FDA's Pharmacy Compounding Advisory Committee is advisory and meets July 23–24, 2026 to review nominations and make recommendations to the FDA.
Ghigo et al. (1994, PMID 8126144, JCEM) characterized hexarelin's GH-releasing activity across IV, SubQ, intranasal, and oral routes in healthy men, establishing it as a potent GH secretagogue. Rahim & Shalet (1998, PMID 10990150, Growth Horm IGF Res) demonstrated that twice-daily SubQ hexarelin in healthy elderly subjects caused ~45% attenuation of the GH AUC over 16 weeks, with partial recovery 4 weeks after discontinuation — the canonical human tachyphylaxis study. Bodart et al. (2002, PMID 11988484, Circulation Research) showed that hexarelin's cardiovascular action in perfused hearts is mediated by CD36 rather than GHSR-1a and is absent in CD36-null animals. Hexarelin has never been FDA-approved; grey-market use for body composition, recovery, or cardiac benefit is not clinically validated.
Key references
FDA approval (NDA 022505) was based on two Phase 3 trials reported by Falutz et al. (NEJM, 2007; PMID 18057338) and the pooled 52-week safety extension, showing ~15-18% reduction in visceral adipose tissue with improved triglycerides in HIV patients with abdominal fat accumulation. Stanley et al. (JAMA, 2014; PMID 25038357) demonstrated concurrent reductions in visceral and liver fat (NAFLD). Baker et al. (Arch Neurol, 2012; PMID 22869065) reported favorable effects on executive function in older adults with and without mild cognitive impairment at 1 mg/day for 20 weeks — note this cognition signal was in MCI / healthy older adults, not specifically APOE4-positive individuals. Current label dose is 1.4 mg SubQ daily (Egrifta SV); legacy Egrifta used 2 mg/day. Off-label use for general body composition in non-HIV populations is common but outside the FDA label.
Key references
Hexarelin (Hormone) and Tesamorelin (Performance) are in different categories and target different biological pathways. This is a common pattern in multi-compound research protocols. Researchers should monitor the biomarkers from both profiles and watch for interactions listed in each compound’s contraindications. Consult a licensed healthcare provider before combining any research compounds.
This platform provides informational tools only, not medical advice. This comparison is for educational purposes only. Consult a licensed provider.
Frequency
Dosing Notes
Half-life
Side Effects
Contraindications
Lab Testing
Disclosed Labs