CJC-1295 vs Tesamorelin: Head-to-Head Comparison

Both CJC-1295 and tesamorelin activate the same GHRH receptor on pituitary somatotroph cells, but their structural modifications produce different pharmacokinetic profiles.

CJC-1295: Engineered for Duration

CJC-1295 modifies the GHRH (1–29) sequence at four amino acid positions (Ala2, Asn8, Ala15, Leu27) to resist DPP-IV degradation. The DAC (Drug Affinity Complex) version adds a maleimidopropionic acid linker that covalently binds serum albumin after injection, extending the half-life from approximately 30 minutes to 6–8 days.^[1]

• Without DAC: Enhanced but still pulsatile GH release with a half-life of approximately 30 minutes.
• With DAC: Sustained GH and IGF-1 elevation for days following a single injection, with mean GH levels increasing 2–10 fold for 6+ days.^[1]

Tesamorelin: Engineered for Stability

Tesamorelin retains the full 44-amino-acid GHRH sequence but adds a trans-3-hexenoic acid group at the N-terminus, which protects against enzymatic degradation and enhances binding affinity without dramatically altering the half-life.^[2]

• Pulsatile GH release: Like sermorelin, tesamorelin produces acute GH pulses that closely mimic physiological GHRH signaling.
• Visceral fat targeting: Clinical trials have specifically demonstrated tesamorelin’s ability to reduce visceral adipose tissue, likely through GH-mediated lipolysis in visceral fat depots.^[3]

The evidence gap between tesamorelin and CJC-1295 is substantial and represents the most important distinction in this comparison.

Tesamorelin Clinical Evidence

Tesamorelin has the strongest clinical evidence base of any GHRH analog currently available:^[2]

• Phase III trials: Multiple large randomized controlled trials demonstrated tesamorelin 2 mg daily significantly reduced visceral adipose tissue (VAT) compared to placebo in HIV-infected patients with lipodystrophy. VAT reductions of 15–18% were observed over 26 weeks.^[3]
• Body composition: Beyond VAT reduction, tesamorelin improved trunk fat, waist circumference, and patient-reported body image scores.
• Hepatic effects: Meta-analysis data suggest tesamorelin may reduce hepatic fat content and improve liver function markers.
• IGF-1 increase: Clinical trials confirmed significant and sustained IGF-1 elevation during treatment.
• Reversibility: VAT reduction reversed upon cessation of therapy, indicating that continued administration is needed for sustained effects.

CJC-1295 Clinical Evidence

CJC-1295’s evidence base is far more limited:^[1]

• Single-dose pharmacology: One published human trial demonstrated dose-dependent GH and IGF-1 elevation for 6–11 days after a single CJC-1295 DAC injection.
• Pulsatility preservation: Research confirmed GH pulsatility is preserved during CJC-1295 DAC stimulation.
• Development halted: Clinical development was suspended following a participant death during trials, limiting further human data collection.

Tesamorelin’s FDA-approved status with Phase III data, post-marketing surveillance, and meta-analyses puts it in an entirely different evidentiary category than CJC-1295.

The dosing strategies reflect each compound’s different regulatory and availability contexts.

Tesamorelin Dosing

• FDA-approved dose: 2 mg subcutaneous injection once daily, administered in the abdomen.
• No dose titration: Unlike GLP-1 agonists, tesamorelin does not require gradual dose escalation.
• Prescription required: Available as Egrifta SV, requiring a prescription and currently indicated only for HIV-associated lipodystrophy.
• Cost: As a branded pharmaceutical, tesamorelin is significantly more expensive than research-grade CJC-1295 (often $1,000+ per month at retail).

CJC-1295 Dosing

• Without DAC: 100–300 mcg subcutaneous, 1–3 times daily, typically combined with ipamorelin.
• With DAC: 1–2 mg subcutaneous once or twice weekly.
• Research compound: Available from peptide research suppliers without prescription, at a fraction of tesamorelin’s cost.

The practical choice often comes down to access: tesamorelin requires a prescription and is FDA-approved only for HIV lipodystrophy, while CJC-1295 is available as a research compound but lacks clinical-grade manufacturing standards and regulatory oversight.

Tesamorelin’s extensive safety monitoring through the FDA approval process and post-marketing surveillance provides a much more complete safety picture than CJC-1295.

Tesamorelin Safety

• Clinical trial safety: Generally well-tolerated across Phase III trials. Common adverse events included injection site reactions (erythema, pruritus, pain), arthralgia, and myalgia.^[2]
• IGF-1 monitoring: Tesamorelin raises IGF-1 levels, and prescribing guidelines recommend monitoring IGF-1 during treatment. Elevated IGF-1 warrants dose adjustment or discontinuation.
• Contraindications: Tesamorelin is contraindicated in pregnancy and should be used with caution in patients with active malignancy.
• Long-term data: Post-marketing safety data spanning over a decade of clinical use are available.

CJC-1295 Safety

• Limited data: No FDA-reviewed safety evaluation. Available safety data comes from one small human trial and anecdotal reports.
• Reported effects: Injection site reactions, flushing, headache, and water retention are commonly reported. The DAC version may cause more sustained effects.
• Safety signal: The participant death during CJC-1295 DAC trials, while not definitively attributed to the compound, represents an unresolved safety concern.^[1]

The choice between CJC-1295 and tesamorelin involves navigating different trade-offs around evidence, access, and cost.

Tesamorelin May Be Preferred For:

• Clinical-grade evidence requirements: Tesamorelin is the only GHRH analog with Phase III data, FDA approval, and post-marketing surveillance.
• Visceral fat reduction: The specific clinical indication and supporting data for VAT reduction make tesamorelin the evidence-based choice for this application.
• Physician-supervised protocols: Available through standard prescription channels with established dosing and monitoring guidelines.

CJC-1295 May Be Preferred For:

• Cost-sensitive research: CJC-1295 is available at a fraction of tesamorelin’s cost from peptide research suppliers.
• Combination protocols: CJC-1295 without DAC is the most commonly used GHRH component in combination with ipamorelin.
• Extended-duration protocols (DAC version): Weekly dosing convenience may be preferred for certain research designs.
• Broader GH optimization research: CJC-1295 is available for general research without the prescription and indication requirements of tesamorelin.