GH Secretagogues Compared: Tesamorelin, Ipamorelin, CJC-1295, MK-677

Comparing 4 compounds by evidence grade, FDA status, mechanism, and key safety considerations: Tesamorelin, Ipamorelin, CJC-1295, MK-677.

	Tesamorelin	Ipamorelin	CJC-1295	MK-677
Evidence grade	Grade A: Approved and proven	Grade C: Preliminary or limited human evidence	Grade B: Human evidence, not approved for this use	Grade B: Human evidence, not approved for this use
FDA status	FDA approved FDA-approved (Egrifta; Egrifta WR approved 2025) for reduction of excess abdominal fat in HIV-infected patients with lipodystrophy; not approved for any other indication.	Not FDA approved Not FDA-approved for any indication; banned from both 503A and 503B compounding as of April 2026.	Not FDA approved Not FDA-approved for any indication; removed from Category 2 compounding restriction April 2026, pending formal PCAC review and rulemaking for potential Category 1 placement.	Not FDA approved Not FDA-approved for any indication; FDA has specifically cited a congestive heart failure safety signal from a stopped clinical trial.
Mechanism	Synthetic analogue of endogenous growth hormone-releasing hormone (GHRH) that binds pituitary GHRH receptors, stimulating pulsatile GH secretion and downstream IGF-1 production, which reduces visceral adiposity.	Ipamorelin binds selectively to the growth hormone secretagogue receptor (GHSR-1a), stimulating pulsatile GH release from the pituitary without substantially affecting cortisol or prolactin at tested doses.	CJC-1295 binds and activates the GHRH receptor on pituitary somatotroph cells, stimulating pulsatile GH secretion; albumin binding via the DAC modification extends the half-life to approximately 8 days, producing sustained GH and downstream IGF-1 elevation.	MK-677 acts as a non-peptide agonist at the ghrelin receptor (GHSR-1a), stimulating pulsatile GH release from the pituitary and subsequently elevating circulating IGF-1.
Key safety	Tesamorelin is contraindicated in patients with active malignancy; any preexisting malignancy must be inactive and treatment complete before initiating therapy,...	Human safety data for ipamorelin is limited; the available studies were not designed primarily to characterize safety. GH secretagogues as a class elevate insul...	Long-term human safety data for CJC-1295 do not exist; the single published human RCT was short-duration and enrolled healthy volunteers only. Sustained, pharma...	MK-677 carries a documented serious safety signal that must be prominently disclosed: a phase IIb clinical trial was stopped early after a higher rate of conges...