Tesamorelin vs CJC-1295: differences, evidence and safety
Answer first
Tesamorelin and CJC-1295 without DAC both copy the brain hormone that releases growth hormone. Tesamorelin is the full 44-building-block chain, approved in the United States for belly fat in adults with HIV and tested in large trials. CJC-1295 without DAC is a reworked 29-building-block fragment for which no study could be found. No study comparing them could be found.
At a glance
How they work
Both substances are laboratory-made versions of growth hormone-releasing hormone, the brain signal that tells the pituitary gland to release growth hormone. Neither is growth hormone itself. Both are meant to prompt the body to release its own.
Tesamorelin
- It copies all 44 building blocks (amino acids) of the natural hormone. A small six-carbon chain, called a hexenoyl group, sits at the front end and slows its breakdown [1], [2].
- It binds the pituitary gland's docking points for this hormone about as strongly as the natural hormone does in laboratory tests [1].
- The gland then releases growth hormone in its normal pulses. In patients, IGF-1, a messenger made mainly in the liver, rose together with its carrier protein IGFBP-3 [1].
CJC-1295 without DAC
- It copies only the first 29 building blocks of the hormone, with four of them swapped. Sellers call it Mod GRF 1-29 [3], [4].
- The swaps were designed for durability rather than strength. They shield the chain from a blood enzyme and remove a site that degrades in storage. They also take out an easily oxidised building block [4], [5], [6].
- It should bind the same receptor and so raise growth hormone and then IGF-1. No binding study with this molecule could be found, so this is inferred from related substances [3].
The target is therefore the same. The difference lies in how each molecule was protected against breakdown. Tesamorelin keeps the natural sequence and adds one group at its front end instead of swapping amino acids [2]. CJC-1295 without DAC swaps four amino acids inside a shortened chain [4].
A third molecule shares the name. The DAC form carries a 30th building block, a chemical hook that latches onto a blood protein. The scientific literature has used the name CJC-1295 for that hooked form since 2005 [5], [3].
How long each lasts differs as well. Tesamorelin has a half-life of about 11 minutes in healthy adults. It reaches its peak level after a median, or middle value, of 0.15 hours [1].
For CJC-1295 without DAC, no measured half-life could be found, and the often-quoted figure of around 30 minutes has no published basis [3]. The one swap tested in people, in ten men, lengthened the parent sequence's half-life from 4.3 to 6.7 minutes [6]. The DAC form, by contrast, has an estimated half-life of 5.8 to 8.1 days [7].
What the studies show
No study that compares tesamorelin and CJC-1295 directly could be found in the published record reviewed for this page.
Laboratory method only The two appear side by side only in anti-doping laboratory work. A 2021 study analysed sermorelin, tesamorelin, CJC-1295 and the DAC form in urine to build detection tests. It identified 19 breakdown products, and it measured no effect on the body [8].
What follows are the separate studies of each substance.
Tesamorelin: deep belly fat in people with HIV
Phase 3 RCT The first approval trial randomised 412 adults with HIV and lipodystrophy, a condition in which body fat is redistributed in an unusual way. After 26 weeks the deep fat around the organs had fallen by 15.2 per cent on treatment and risen by 5.0 per cent on placebo (p < 0.001) [9].
The official label reports the same result as a difference of 31 square centimetres, or 20 per cent [1].
Phase 3 RCT The second trial followed 404 adults for six months. The deep fat fell by 10.9 per cent on treatment, against 0.6 per cent on placebo (p < 0.0001). Fat on the arms and legs did not change, and neither did the fat just under the skin of the belly [10].
Meta-analysis Pooling five randomised trials, the difference against placebo averaged 27.71 square centimetres of visceral fat. Body mass index did not change significantly [11].
Body weight did not move either. It changed by −0.4 kg in the first approval trial and +0.5 kg in the second, neither different from placebo. The label states that the drug is not indicated for weight loss [1].
Tesamorelin: liver fat and thinking
RCT A trial enrolled 61 people with HIV whose liver fat was at least 5 per cent. Twelve months of treatment lowered that fraction by 4.1 percentage points more than placebo (95 per cent confidence interval −7.6 to −0.7; p = 0.018) [12].
After a year, 35 per cent of the treated group were below the 5 per cent threshold, against 4 per cent on placebo [12].
Phase 2 RCT An academic trial treated 152 adults aged 55 to 87, average age 68, for 20 weeks. It found a favourable overall effect on thinking tests (p = 0.03), mainly in planning and mental flexibility. No regulator has approved the drug for anything to do with memory [13].
Tesamorelin: missed goals and what happens after stopping
Phase 2 RCT A trial in 73 people with HIV and abdominal obesity found no cognitive advantage over the comparison group (p = 0.673). It was open-label, with no dummy injection, and its authors call it underpowered [14].
Phase 2 RCT In 53 adults with type 2 diabetes, twelve weeks of treatment changed nothing measurable. The insulin response, fasting glucose and long-term blood sugar all stayed the same [15].
Phase 3 RCT In the extension phase, 263 participants were randomised again for a further 26 weeks. Those who stayed on treatment held the reduction at 18 per cent below their starting point at 52 weeks. Those switched to placebo regained the deep fat [16].
CJC-1295 without DAC: no studies found
No evidence No published study of this substance in people, in animals or in cells could be found, and the public trial register lists none [3], [17]. A 2026 review places it in its lowest evidence grade, D, defined as having no peer-reviewed human studies [3].
The public trial register shows the gap plainly. A search for tesamorelin returned 24 registered studies. A search for Mod GRF 1-29 or modified GRF returned none [17].
Scoping review A 2026 review searched for CJC-1295 alongside bone, muscle, tendon and cartilage. Across the peptides it covered, 67 per cent of what it found was animal work. It concluded that the claimed benefits remain unsubstantiated by current human trials [18].
What was measured in the DAC form
Phase 1 Two randomised, placebo-controlled studies of the DAC form ran over 28 and 49 days. A single injection raised average growth hormone two- to tenfold for six days or longer. IGF-1 rose 1.5- to 3-fold for nine to eleven days [7].
None of these figures transfers to the DAC-free form. They depend on the blood-protein hook, which the form sold as Mod GRF 1-29 lacks [3].
Phase 2 (terminated) The only trial found in the register under the name CJC-1295 used the DAC form. It targeted the very group tesamorelin was later approved for: adults with HIV-associated abdominal fat [17].
It planned 120 participants for 12 weeks and ran from December 2005 to September 2006. The register records no reason for the stop, and no results were filed or published [17].
The company's own statement names the reason. A participant died of a heart attack on 13 July 2006, and the company halted the trial. Whether the substance played any part is neither proven nor ruled out [19].
Tesamorelin's first approval trial in the same group ran from June 2005 to April 2007, and its results were published [9], [20].
These results come from different molecules, populations, endpoints and study lengths. The tesamorelin figures and the DAC-form figures cannot be set against each other, and neither describes CJC-1295 without DAC.
Safety
The two safety records differ mainly in how much is known. Tesamorelin has an official label drawn from its approval trials. For CJC-1295 without DAC, no study that gave it to people under observation could be found, so nothing has ever been counted [3].
Tesamorelin, from the American label:
- Injection-site reactions in 17 per cent against 6 per cent on placebo over the first 26 weeks, including redness, itching, pain and swelling [1].
- Joint pain in 13 per cent against 11 per cent. Muscle pain affected 6 per cent against 2 per cent, and swelling of the ankles and feet 6 per cent against 2 per cent [1].
- Allergic reactions in 4 per cent of those treated, including itching, flushing, hives and rash [1].
- Higher blood sugar. The odds of developing diabetes were raised (odds ratio 3.3; 1.4 to 9.6) [1].
- Raised IGF-1. At 26 weeks, 47 per cent of participants were more than two standard deviations above normal. The label calls the long-term consequences unknown [1].
- Antibodies in about half of those treated, 50 per cent at 26 weeks, without a visible change in how well the drug worked [1].
- Situations that rule it out entirely: an active cancer, a disrupted link between the hypothalamus and the pituitary gland, a known allergy, and pregnancy [1].
CJC-1295 without DAC, from what is on record:
- The American regulator names serious adverse events, raised heart rate and a body-wide widening of blood vessels. It does not say which form of CJC-1295 was involved [21].
- The same entry warns of immune reactions by certain routes, and of difficulties with impurities and with characterising the active ingredient [21].
- Class effects are borrowed from neighbours. Reviewers list injection-site pain, brief flushing, nausea, dizziness, headache and a temporary rise in prolactin. These come from sermorelin and tesamorelin data [3].
- A theoretical concern attaches to the class. Higher IGF-1 tracks with cancer risk in population studies. Reviewers call this theoretical and note no established clinical signal [3].
- Grey-market quality is a documented problem. Seized products carried altered structures, and such products are often mislabelled or contaminated [22], [23].
No safety ranking is possible. No comparison of the two could be found, and for one of them no safety data of its own could be found.
Why this page lists no doses. Tesamorelin is a prescription medicine, and choosing an amount is a matter for a doctor and the official product information. For CJC-1295 without DAC, no study could be found that would allow a dose to be reported. This page therefore reports what was measured without repeating any amounts [3].
Legal status
Tesamorelin has been approved and prescription-only in the United States since 10 November 2010. The approval covers only excess belly fat in adults with HIV and lipodystrophy [24]. The European application was withdrawn on 21 June 2012, and the Canadian product has been cancelled since 30 September 2022 [25], [26]. CJC-1295 is approved nowhere. An American compounding nomination was withdrawn, and the regulator's risk assessment remains published [21]. Australia lists CJC-1295 in Schedule 4 and bans possession without authority [27]. Both are banned in sport at all times under section S2.2.4 of the 2026 Prohibited List [28]. The monographs reflect the position on 7 September 2026.
Used together?
The blend directory lists a three-part product, "Tesamorelin + Ipamorelin + CJC-1295 (No DAC)", abbreviated TIC, under blends. Its entry describes two growth hormone-releasing hormone analogues combined with a selective growth hormone secretagogue. It notes that the mixture holds no approval.
No study of tesamorelin and CJC-1295 given together could be found in the tesamorelin or CJC-1295 monographs or in their sources. The same holds for the three-part mixture.
Ipamorelin, the third component, works through a different receptor, the ghrelin receptor [3]. Its pairing with CJC-1295 appears in forum-derived reports, which a 2026 review labels as behavioural data rather than clinical recommendations. No interaction, kinetics or safety study of that pair could be found [3].
What is sold under these names adds a further unknown. A preparation seized in 2009 held a 29-building-block peptide matching what is marketed as CJC-1295. Other seized material carried an extra building block, apparently designed to defeat laboratory tests [29], [22].
Frequently asked questions
Which is better, tesamorelin or CJC-1295?
Neither can be ranked, because no study comparing them could be found. In adults with HIV and lipodystrophy, tesamorelin reduced deep belly fat by 15.2 per cent over 26 weeks, while it rose by 5.0 per cent on placebo. For CJC-1295 without DAC, no measurement of any kind could be found, in people, animals or cells. A comparison would set a phase 3 result against an empty record.
Is tesamorelin or CJC-1295 safer?
No study comparing their safety could be found, so no ranking is possible. Tesamorelin has an official label with measured frequencies, for example injection-site reactions in 17 per cent against 6 per cent on placebo. For CJC-1295 without DAC nothing has ever been counted. That is an absence of data, not a clean safety record.
What is the difference between tesamorelin and CJC-1295?
Both copy growth hormone-releasing hormone and should act on the same receptor. Tesamorelin keeps all 44 building blocks and adds one small group at the front end. CJC-1295 without DAC keeps the first 29 and swaps four of them. Tesamorelin is an approved medicine in the United States, while CJC-1295 is approved nowhere.
Can tesamorelin and CJC-1295 be taken together?
No study of the two given together could be found, so nothing is known about the effect or the safety of the combination. The blend directory lists a three-part product, TIC, that contains tesamorelin, ipamorelin and CJC-1295 without DAC. Its entry notes that the mixture holds no approval.
How does tesamorelin compare with CJC-1295 and ipamorelin?
No study comparing tesamorelin with the pairing of CJC-1295 and ipamorelin could be found. Ipamorelin works through a different receptor, the ghrelin receptor. Its combination with CJC-1295 appears in forum-derived reports, and no interaction, kinetics or safety study of that pair could be found. Tesamorelin's approval, by contrast, rests on randomised trials in one patient group.
Is CJC-1295 with DAC the same as CJC-1295 without DAC?
No. The DAC form carries a 30th building block, a chemical hook that binds a blood protein and keeps it circulating for days. The form sold as Mod GRF 1-29 has 29 building blocks and no hook. The published human studies under the name CJC-1295 all concern the DAC form.
How long do tesamorelin and CJC-1295 last in the body?
Tesamorelin has a half-life of about 11 minutes in healthy adults. For CJC-1295 without DAC, no half-life measured in a person could be found. The often-quoted figure of around 30 minutes has no published basis. The multi-day half-life found in studies belongs to the DAC form.
Are tesamorelin and CJC-1295 approved medicines?
Tesamorelin has been approved in the United States since 10 November 2010. The approval covers only excess belly fat in adults with HIV and lipodystrophy, and no other country has one. CJC-1295 is approved in no country and for no condition, and Australia bans its possession without authority.
Are tesamorelin and CJC-1295 banned in sport?
Yes, both at all times, in competition and out of it. The 2026 Prohibited List names them together in section S2.2.4, among the growth hormone-releasing hormone analogues. The wording does not separate the forms with and without DAC.
Sources
- Tesamorelin for injection — US Prescribing Information. Theratechnologies Inc., revision 03/2025. DailyMed setid 839334d3-8c1d-4c26-9036-2ab524a6ea75. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=839334d3-8c1d-4c26-9036-2ab524a6ea75
- PubChem. Compound CID 16137828, tesamorelin. C221H366N72O67S, 5,136 g/mol. A 44-residue chain stabilised by an N-terminal trans-3-hexenoyl group rather than by amino-acid substitutions. Retrieved 7 September 2026. https://pubchem.ncbi.nlm.nih.gov/compound/16137828
- Dominikowski A, Rękoś Z, Olejarz M, Szczepanek-Parulska E, Domin R, Ruchała M (2026). The emerging landscape of performance-enhancing peptides modulating GH-IGF1 axis: bridging the gap between clinical evidence and patient self-administration. Frontiers in Endocrinology 17:1822475. PMID 42395176. DOI 10.3389/fendo.2026.1822475. Treats CJC-1295 with and without DAC as separate substances and grades the DAC-free form tier D, "no peer-reviewed human studies". Table 1 records "t½ not reported in human studies" and no reported route of administration; table 2 is labelled as behavioural rather than clinical data. Retrieved 7 September 2026.
- PubChem. Compound CID 56841945, the DAC-free form. C152H252N44O42, 3,367.9 g/mol, InChIKey XOZMWINMZMMOBR-HRDSVTNWSA-N, CAS 863288-34-0. The stored structure and IUPAC name describe 29 residues with a C-terminal arginine amide and no maleimide group. Retrieved 7 September 2026. https://pubchem.ncbi.nlm.nih.gov/compound/56841945
- Jetté L, Léger R, Thibaudeau K, Benquet C, Robitaille M, Pellerin I, Paradis V, van Wyk P et al. (2005). Human growth hormone-releasing factor (hGRF)1-29-albumin bioconjugates activate the GRF receptor on the anterior pituitary in rats: identification of CJC-1295 as a long-lasting GRF analog. Endocrinology 146(7):3052-3058. PMID 15817669. DOI 10.1210/en.2004-1286. First description, and the source of the definition "CJC-1295, a tetrasubstituted form of hGRF(1-29) with an added N epsilon-3-maleimidopropionamide derivative of lysine at the C terminus". Cultured rat pituitary cells and Sprague-Dawley rats.
- Soule S, King JA, Millar RP (1994). Incorporation of D-Ala2 in growth hormone-releasing hormone-(1-29)-NH2 increases the half-life and decreases metabolic clearance in normal men. Journal of Clinical Endocrinology and Metabolism 79(4):1208-1211. PMID 7962295. DOI 10.1210/jcem.79.4.7962295. Ten healthy men, constant intravenous infusion. The disappearance half-life rose from 4.3 ± 1.4 to 6.7 ± 0.5 minutes. The only direct human evidence for any of the four substitutions.
- 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 and Metabolism 91(3):799-805. PMID 16352683. DOI 10.1210/jc.2005-1536. Concerns the DAC form only. Two randomised, placebo-controlled, double-blind dose-escalation studies over 28 and 49 days in healthy adults aged 21 to 61. Estimated half-life 5.8 to 8.1 days.
- Memdouh S, Gavrilović I, Ng K, Cowan D, Abbate V (2021). Advances in the detection of growth hormone releasing hormone synthetic analogs. Drug Testing and Analysis 13(11-12):1871-1887. PMID 34665524. DOI 10.1002/dta.3183. Studies "sermorelin, tesamorelin, CJC-1295, and CJC-1295 with drug affinity complex" in fortified urine, distinguishing the bare sequence from the conjugate. Nineteen major metabolites identified, synthesised and characterised as reference material.
- 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. PMID 18057338. DOI 10.1056/NEJMoa072375
- Falutz J, Potvin D, Mamputu JC et al. (2010). Effects of tesamorelin in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. Journal of Acquired Immune Deficiency Syndromes 53(3):311-322. PMID 20101189. DOI 10.1097/QAI.0b013e3181cbdaff
- Badran AS, Helal A, Shata KS et al. (2026). Body composition, hepatic fat, metabolic, and safety outcomes of tesamorelin in HIV-associated lipodystrophy: a meta-analysis of randomized controlled trials. Obesity Research and Clinical Practice 20(1):2-12. PMID 41545261. DOI 10.1016/j.orcp.2026.01.002
- Stanley TL, Fourman LT, Feldpausch MN et al. (2019). Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV 6(12):e821-e830. PMID 31611038. DOI 10.1016/S2352-3018(19)30338-8
- Baker LD, Barsness SM, Borson S et al. (2012). Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults. Archives of Neurology 69(11):1420-1429. PMID 22869065. DOI 10.1001/archneurol.2012.1970
- Ellis RJ, Vaida F, Hu K et al. (2025). Effects of tesamorelin on neurocognitive impairment in persons with HIV and abdominal obesity. Journal of Infectious Diseases 231(5):1230-1238. PMID 39813152. DOI 10.1093/infdis/jiaf012
- Clemmons DR, Miller S, Mamputu JC (2017). Safety and metabolic effects of tesamorelin in patients with type 2 diabetes: a randomized, placebo-controlled trial. PLoS One 12(6):e0179538. PMID 28617838. DOI 10.1371/journal.pone.0179538
- Falutz J, Allas S, Mamputu JC et al. (2008). Long-term safety and effects of tesamorelin in HIV patients with abdominal fat accumulation. AIDS 22(14):1719-1728. PMID 18690162. DOI 10.1097/QAD.0b013e32830a5058
- ClinicalTrials.gov, API v2. Full-text searches for "CJC-1295" (one study, NCT00267527, the DAC form), "CJC-1293", "modified GRF" and "Mod GRF 1-29" (no study of this substance class), and the control search "tesamorelin" (24 studies). NCT00267527: phase 2, randomised, double-blind, placebo-controlled, 120 planned participants with HIV-associated visceral obesity, sponsor ConjuChem, December 2005 to September 2006, status terminated with no reason recorded, no results posted. Retrieved 6 and 7 September 2026. https://clinicaltrials.gov/study/NCT00267527
- Tewari K, Liu TP, Im C, Hamad C, Petrigliano F, Cheung EC, Kremen TJ (2026). Peptide supplements and their therapeutic applications in sports medicine. American Journal of Sports Medicine. PMID 42578445. DOI 10.1177/03635465261464420. PRISMA-oriented scoping review covering six peptides including CJC-1295, searched against musculoskeletal terms. 67 per cent of the retrieved publications were preclinical animal models.
- ConjuChem Biotechnologies Inc. (2006). ConjuChem provides findings of DAC(TM):GRF HIV Lipodystrophy trial investigation. Company statement, Montréal, 8 August 2006; original page offline, read in the Internet Archive copy of 30 June 2017 on natap.org. Retrieved 7 September 2026.
- ClinicalTrials.gov, NCT00123253 — TH9507 in patients with HIV-associated lipodystrophy. Phase 3, n = 412, June 2005 to April 2007. https://clinicaltrials.gov/study/NCT00123253
- US Food and Drug Administration. "Certain Bulk Drug Substances for Use in Compounding that May Present Significant Safety Risks", page content current as of 22 April 2026, checked 7 September 2026. CJC-1295 appears in the table "Bulk drug substances nominated but withdrawn". The risk entry names immunogenicity for certain routes, complexities with peptide-related impurities and API characterisation, and serious adverse events including increased heart rate and systemic vasodilatory reaction. No form is specified. https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks
- Gajda PM, Holm NB, Hoej LJ, Rasmussen BS, Dalsgaard PW, Reitzel LA, Linnet K (2019). Glycine-modified growth hormone secretagogues identified in seized doping material. Drug Testing and Analysis 11(2):350-354. PMID 30136411. DOI 10.1002/dta.2489. Powders seized by Danish customs contained analogues of GHRP-2, GHRP-6, ipamorelin and "modified growth hormone releasing factor (modified GRF 1-29)", each carrying an additional glycine at the N-terminus.
- Coutinho LFD, de Oliveira Neves LF, Camilo RP (2026). A new era of doping? Use of peptide and peptide-analog drugs in recreational and professional sport and bodybuilding: a critical review. Journal of Sports Medicine and Physical Fitness 66:880-885. PMID 41880199. DOI 10.23736/S0022-4707.26.17773-1
- Drugs@FDA / openFDA, application 022505, approval and supplement history. Retrieved 7 September 2026. https://api.fda.gov/drug/drugsfda.json?search=openfda.generic_name:%22tesamorelin%22
- European Medicines Agency. Withdrawn application: tesamorelin. Withdrawal 21 June 2012, applicant Ferrer Internacional S.A. https://www.ema.europa.eu/en/medicines/human/withdrawn-applications/egrifta
- Health Canada, Drug Product Database, DIN 02438712. Status "Cancelled Post Market" since 30 September 2022. https://health-products.canada.ca/dpd-bdpp/info?lang=eng&code=92311
- Therapeutic Goods (Poisons Standard—June 2026) Instrument 2026, F2026L00633, registered 28 May 2026, Australia. Schedule 4 carries the entry "CJC-1295 (CAS No. 863288-34-0)." Appendix D clause 5 is headed "Poisons for which possession without authority is illegal"; CJC-1295 is item 7. https://www.legislation.gov.au/F2026L00633
- World Anti-Doping Agency. The 2026 Prohibited List, in force from 1 January 2026, section S2.2.4: "Growth hormone releasing factors, including, but not limited to: growth hormone-releasing hormone (GHRH) and its analogues (e.g. CJC-1293, CJC-1295, sermorelin and tesamorelin) ...". Category S2, prohibited at all times, non-specified substance. https://www.wada-ama.org/en/prohibited-list
- Henninge J, Pepaj M, Hullstein I, Hemmersbach P (2010). Identification of CJC-1295, a growth-hormone-releasing peptide, in an unknown pharmaceutical preparation. Drug Testing and Analysis 2(11-12):647-650. PMID 21204297. DOI 10.1002/dta.233. Examined for Norwegian police and customs in 2009: "The preparation was found to contain a 29 amino acid peptide with a C-terminal amide function ... The sequence is consistent with a peptide currently marketed under the name CJC-1295."