Tesamorelin and hexarelin are both sold as growth-hormone-releasing peptides, and they are searched against each other as if they were two strengths of one thing. The records behind them are of different kinds. Tesamorelin is an approved medicine with a label, a fixed daily dose and a 412-person trial. Hexarelin is a 1990s research compound with a run of small per-kilogram studies and no approval anywhere. This page sets the two records side by side and converts both sets of figures to syringe units.
Each compound's full record is on tesamorelin dosage and hexarelin dosage. Hexarelin against the secretagogue it is most often swapped for is on hexarelin vs ipamorelin.
Side by side
| Tesamorelin | Hexarelin | |
|---|---|---|
| What it is | 44-amino-acid human GRF sequence with a hexenoyl group; MW 5,135 as free base (label) | Six-residue growth hormone secretagogue, also called examorelin; MW 887.0 (PubChem CID 6918297, as recorded on this site 2026-10-11) |
| Approval | FDA-approved since 2010 (EGRIFTA; EGRIFTA SV and EGRIFTA WR on DailyMed today) | None anywhere |
| Labelled dose | 1.28 mg once daily (WR); 1.4 mg once daily (SV) | None |
| Registry records (ClinicalTrials.gov, 2026-11-11) | 24 | 0 |
| PubMed records (2026-11-11) | 123 | 316 |
| Longest dosed study | 26 weeks, 2 mg daily, 412 adults | 16 weeks, 1.5 mcg/kg twice daily |
| IGF-1 in that study | +81.0% | No significant change |
| Half-life | 11 minutes after a single dose in healthy subjects (label) | Not stated in the sources opened for this page |
Hexarelin has more than twice as many indexed papers as tesamorelin. Most are short stimulation studies from the 1990s, in which one dose was given and growth hormone was measured over the next few hours. A larger paper count is not a larger dosing record.
What the long studies measured
The comparison that matters is what happened when each was given for months.
Tesamorelin's pivotal trial assigned 412 adults with HIV and abdominal fat accumulation to 2 mg a day or placebo for 26 weeks. Visceral fat fell 15.2% on tesamorelin and rose 5.0% on placebo; IGF-1 rose 81.0% against a 5.0% fall (Falutz et al., 2007). The rise in IGF-1 held to the end of the trial.
Hexarelin's longest study gave 1.5 mcg/kg under the skin twice daily for 16 weeks. The growth-hormone response to a test dose fell from an area of 19.1 to 10.5 microgram-hours per litre, about 45% lower, and returned to 19.4 four weeks after the last dose. IGF-1, body fat, lean mass and bone density did not change significantly (Rahim et al., 1998; figures as recorded on this site's hexarelin page).
So the one compound has a sustained IGF-1 rise on record and the other has a fading response with no IGF-1 change. These are not matched trials: one enrolled adults with HIV-associated fat accumulation, the other a group of adults the abstract does not describe further, at different doses and in different decades. The contrast describes the two records. It is not a head-to-head result, and none exists.
The doses by mass
| Compound | Source | Daily amount | Per week |
|---|---|---|---|
| Tesamorelin | EGRIFTA WR label | 1.28 mg | 8.96 mg |
| Tesamorelin | EGRIFTA SV label | 1.4 mg | 9.8 mg |
| Tesamorelin | Original label and pivotal trial | 2 mg | 14 mg |
| Hexarelin | 16-week study, 1.5 mcg/kg twice daily, at 70 kg | 0.21 mg | 1.47 mg |
| Hexarelin | Online figures recorded by the 2026 review, 100–200 mcg once or twice daily | 0.1–0.4 mg | 0.7–2.8 mg |
The labelled tesamorelin dose is about 6 times the hexarelin study dose by mass, and the original 2 mg dose about 9.5 times. Tesamorelin is also nearly six times the molecular weight (5,135 against 887), so in molecules the two daily amounts are close: 1.28 mg of tesamorelin is about 0.25 micromoles and 0.21 mg of hexarelin about 0.24 micromoles. That is this site's arithmetic on the two molecular weights, and it says nothing about equivalence — the compounds act on different receptors.
Both in syringe units
On a U-100 syringe, units = amount ÷ concentration × 100.
| Vial and water | Concentration | Amount | Units |
|---|---|---|---|
| Tesamorelin 10 mg + 2 mL | 5 mg/mL | 1.28 mg | 25.6 |
| Tesamorelin 10 mg + 2 mL | 5 mg/mL | 1.4 mg | 28 |
| Tesamorelin 10 mg + 2 mL | 5 mg/mL | 2 mg | 40 |
| Hexarelin 2 mg + 2 mL | 1,000 mcg/mL | 70 mcg (1 mcg/kg at 70 kg) | 7 |
| Hexarelin 2 mg + 2 mL | 1,000 mcg/mL | 105 mcg (1.5 mcg/kg) | 10.5 |
| Hexarelin 2 mg + 2 mL | 1,000 mcg/mL | 210 mcg (3 mcg/kg) | 21 |
The labelled products are not drawn this way. EGRIFTA WR is an 11.6 mg vial reconstituted with 1.3 mL of bacteriostatic water to 8 mg/mL, and its 1.28 mg dose is 0.16 mL, which would be 16 units; research-market vials of 5 and 10 mg are not that product. The tesamorelin calculator works any other vial and water volume, and the mcg to units page gives the formula.
What each label or study warns about
The EGRIFTA WR label is indicated only for reducing excess abdominal fat in HIV-infected adults with lipodystrophy. It states the product is not indicated for weight-loss management, describing its effect on weight as neutral, and it carries warnings on glucose intolerance and on raised IGF-1, which it says needs periodic monitoring.
Hexarelin has no label to carry warnings. The studies recorded that it raised cortisol and prolactin as well as growth hormone (Massoud et al., 1996, as recorded on this site's hexarelin page), and the 2026 review lists prolactin and cortisol elevations among the adverse effects reported for the secretagogue class.
What is not established
No study compares tesamorelin with hexarelin or combines them. Tesamorelin's trials are in HIV-associated abdominal fat, not in healthy adults using it for body composition. Hexarelin has no body-composition trial, no approved product and no published dosing beyond 16 weeks; the online figure of 100 to 200 mcg comes from no study. Whether a research-market vial of either contains what its label names is shown only by analysis. Nothing on this page is a dose or a suggestion to use either; Medibact's tesamorelin guide covers that molecule and its evidence in full.
Sources and dates
Opened 2026-11-11: the EGRIFTA WR label on DailyMed (published 2026-08-03, revised 03/2025), sections 1, 2, 5, 11 and 12; ClinicalTrials.gov v2 API searches for tesamorelin (24), hexarelin (0), examorelin (0) and tirzepatide as a control (334); PubMed searches for tesamorelin (123), hexarelin or examorelin (316) and both together (1); the PubMed abstracts of Falutz et al., NEJM 2007 (PMID 18057338), Rahim et al., JCEM 1998 (PMID 9589671), Imbimbo et al., 1994 (PMID 7957536) and Dominikowski et al., 2026 (PMID 42395176). The EGRIFTA SV dose, the 16-week response figures, the cortisol and prolactin finding and hexarelin's molecular weight are as recorded on this site's tesamorelin and hexarelin pages (2026-09-18 and 2026-10-11). Weekly totals, ratios, micromoles and units are arithmetic by this site. Corrections go to the contact page.