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ForumsOther Peptides & Research CompoundsIpamorelin vs Tesamorelin — anyone have experience?

Ipamorelin vs Tesamorelin — anyone have experience?

PedsEndoPhilly Wed, Sep 11, 2024 at 3:05 PM 46 replies 2,741 viewsPage 1 of 10
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PedsEndoPhilly
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Sep 11, 2024 at 3:05 PM#1

Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience both.

The bit I cannot resolve on my own is which effects tachyphylax and which persist, because the answer explains why tolerability improves while the appetite effect keeps working.

Practical detail welcome, however dull — the duller the better.

44 14sarah_TO, wendy_avl, jason_paloalto and 41 others
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Dr.MetabolicMD
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Sep 11, 2024 at 3:21 PM#2
PedsEndoPhilly said:
Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…

PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing. Semaglutide:

  • Tmax: 24-72 hours post-injection
  • T½: ~168 hours (7 days) — enables weekly dosing
  • Steady state: reached at 4-5 weeks
  • Bioavailability (SubQ): ~89%
  • Volume of distribution: ~12.5L (primarily plasma)

The albumin binding (>99%) is the key pharmacological innovation — creating a sustained-release effect from a single injection. Previous GLP-1 agonists (exenatide) required BID dosing due to rapid clearance.

Last edited: Sep 11, 2024 at 5:21 PM
43 13PedsEndoPhilly, SleepDoc_PDX, RegAffairsDC and 40 others
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MASHdoc_SA
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Sep 11, 2024 at 3:37 PM#3
Dr.MetabolicMD said:
PK/PD modeling for the pharmacology: understanding the pharmacokinetics helps optimize dosing.

No disagreement with Dr.MetabolicMD. One condition attached. The mechanism is more central than most summaries suggest. Receptor agonism in the arcuate nucleus activates POMC neurons and inhibits AgRP/NPY signalling, and the downstream MC4R pathway is the same one disrupted in monogenic obesity — convergent genetic evidence that the target is the right one. Peripherally there is glucose-dependent insulin secretion, glucagon suppression and delayed gastric emptying, but the gastric component largely adapts over months while the central effect persists, which is why the durable effect is appetite rather than fullness.

42 12JennaRN, LabKate, kate.chem and 39 others
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maya_sedona
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Sep 11, 2024 at 3:53 PM#4
PedsEndoPhilly said:
Reading about receptor desensitisation and trying to work out which of the effects adapt over time and which do not, because people clearly experience…

Same experience, arrived at from the opposite direction. Posting only so the count is not one.

Last edited: Sep 11, 2024 at 7:53 PM
41 11MikeKY_noInsulin, Dr.RaviCardio, jennifer_SEA and 38 others
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Dr.EndoIndy
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Sep 11, 2024 at 5:15 PM#5

Clinical perspective, offered as context rather than as advice.

Receptor pharmacology relevant to the pharmacology: semaglutide is a GLP-1R agonist with a C-18 fatty acid chain that enables albumin binding (>99%), creating a depot effect with a ~168-hour half-life enabling weekly dosing[1].

Tirzepatide is a dual GIP/GLP-1R agonist with higher GIP affinity (5:1 GIP:GLP-1 potency ratio). The GIP component may enhance beta-cell function and adipocyte lipid metabolism beyond what GLP-1 alone achieves.

For the pharmacology, the pharmacology explains the clinical differences between these agents.

References:
[1] Lau J, et al. J Med Chem. 2015;58(18):7370-7380.
40 10SandraNC_45, Dr.EndoIndy, tom_AK and 37 others
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