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Mechanism of Action Ipamorelin activates the ghrelin receptor (GHS-R1a) on anterior pituitary somatotrophs, stimulating GH release in a pulsatile pattern that closely mirrors endogenous GH secretion

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In the pivotal tesamorelin trial, IGF-1 rose by roughly 81% relative to placebo a clear pharmacodynamic signal that the peptide was engaging its target and driving the GHIGF-1 axis

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GH peptides, by contrast, work upstream: they enhance the pituitary's own response to GHRH or ghrelin signals, preserving the pulse structure