Carl read the papersWhat it actually is
Tesofensine is a small-molecule drug, not a peptide. It blocks the reuptake of three brain chemicals: noradrenaline, dopamine and serotonin. It was first tested in Parkinson's and Alzheimer's disease, then for obesity.
Saniona licenses it to Medix for Mexico and Argentina. Mexico's regulator did not approve it in November 2024; Medix resubmitted in February 2025 and we found no approval since. Meanwhile it is sold online as capsules and tablets, often next to peptides.
How it’s thought to work
- Triple reuptake inhibition — Keeps noradrenaline, dopamine and serotonin active for longer in the brain. WADA classes it as a stimulant.
- Appetite suppression — Raises fullness. In one trial the effect faded as weight came off and returned when the drug was restarted.
- Heart rate — Raises it: +7.4 beats per minute on 0.5 mg in the main trial.
- Long half-life — Clears slowly. In a 2026 anti-doping study, one dose of about 0.5 mg could still be detected in urine for up to 500 hours (about 3 weeks).
What the research says
One headline trial carries most of the weight. In a 24-week Danish phase 2 trial (203 people on a diet), weight fell 4.5%, 9.2% and 10.6% on 0.25, 0.5 and 1.0 mg daily, against 2.0% on placebo. In 2013 The Lancet attached an expression of concern to that paper, and the authors published a letter titled 'Under-reporting of adverse effects of tesofensine'. Medix's Mexican phase 3 programme (372 people) reported about 10% weight loss over 24 weeks according to Saniona, but we found no peer-reviewed paper on it.
- Phase 2 (n=203, 24 wks): -4.5%, -9.2%, -10.6% on 0.25, 0.5, 1.0 mg vs -2.0% placebo.
- Heart rate +7.4 bpm on 0.5 mg; dry mouth, nausea, constipation, diarrhoea and insomnia were the common side effects.
- The Lancet issued an expression of concern on that trial in 2013.
- Abuse study in 52 recreational stimulant users: abuse potential no greater than bupropion or atomoxetine.
Reported protocols
These are the doses the peptide community actually reports running (Reddit & forums), alongside published research — logged for education, not as a recommendation to use.
| Parameter | Commonly reported range |
|---|---|
| Trial doses | 0.25, 0.5 or 1.0 mg once daily by mouth; 0.5 mg was the dose the researchers singled out, and the dose used in Tesomet |
| Community dose | Forum users report 125 to 500 mcg in the morning, often by quartering or halving 500 mcg tablets; some take 125 to 250 mcg every other day, and some found 250 mcg strongly stimulating |
| Frequency | Once daily, usually morning (some users every other day) |
| Route | Oral (tablet or capsule) |
| Cycle | Trials ran 24 weeks; the fullness effect weakened over that time |
| Community tip | The recurring complaints are insomnia, irritability and anxiety. One forum thread is entirely about irritability on it. Several users cut the dose or spaced it out to cope. |
Common use cases
| Goal | Community protocol notes |
|---|---|
| Appetite and food noise | the main reason people take it; 0.25 to 0.5 mg in trials |
| Alongside a GLP-1 | forum pattern, untested |
| Hypothalamic obesity | studied as Tesomet with metoprolol in a small trial |
Mixing it (reconstitution)
Freeze-dried peptides must be reconstituted with bacteriostatic water before they can be measured. Carl’s calculator turns “mg in the vial + ml of water + target dose” into “units on the syringe” — and tells you how long the vial lasts.
→ Open the Reconstitution Calculator
Injection & handling
No injection. Tesofensine is taken by mouth, and forum users take it in the morning because of insomnia. Many cut 500 mcg tablets into halves or quarters to start at 125 to 250 mcg, and some only take it every other day. Because it clears slowly, levels build up with daily dosing and fall slowly after stopping, so a dose that feels fine on day one can feel different a week later.
Stacks it appears in
- With a weekly GLP-1 — A common forum pattern, often with retatrutide: tesofensine for daytime food noise on top of a weekly injection. No trial has tested it.
- Tesomet (with metoprolol) — Saniona paired it with the beta-blocker metoprolol to blunt the heart-rate rise. In 21 adults with hypothalamic obesity, Tesomet added 6.3% weight loss over placebo with no heart-rate change.
Sources
- Phase 2 trial, Lancet 2008 (PMID 18950853)
- Lancet 2013 expression of concern (PMID 23561987)
- Astrup et al, 'Under-reporting of adverse effects of tesofensine', Lancet 2013 (PMID 23849924)
- Appetite sensations, Obesity 2012 (PMID 21720440)
- Abuse potential in recreational stimulant users, Clin Pharmacol Ther 2010 (PMID 20520602)
- Urinary metabolism and detection, Drug Test Anal 2026 (PMID 42320973)
- Tesomet in hypothalamic obesity, Eur J Endocrinol 2022 (PMID 35294397)
- Long half-life DDI model, Clin Pharmacokinet 2010 (PMID 20000889)
- Saniona: Mexican application not yet approved (6 Nov 2024)
- Saniona: Medix resubmitted to COFEPRIS (20 Feb 2025)
- ClinicalTrials.gov: NS 2330 in early Parkinson's (NCT00148486) and Alzheimer's (NCT00153010)
- GLP-1 Forum, 'Tesofensine' thread
- GLP-1 Forum, 'Teso is awesome (update: for a while...)'
- GLP-1 Forum, 'Anger issues with Tesofensine'
- Anabolic Steroid Forums, 'Tesofensine Experiment/Experience'
- SAHPRA, Peptide Products: Public Information (published 26 May 2026)
- WADA 2026 Prohibited List (S0 non-approved substances; S6.B specified stimulants)
