Half-lifeVery long, about 10 days (234 hours in human data); its main breakdown product lasts even longer, so it takes weeks to build up and to clear
Vial sizes—
The simple version
What it does
It cuts appetite by keeping three brain chemicals active longer.
How people take it
0.25–1 mg as a pill by mouth, once a day in the morning.
Know this
It raises heart rate in most people, so skip it if you have heart problems.
What it is
Tesofensine isn't a peptide; it's a pill that changes brain chemistry, a bit like an antidepressant or a stimulant diet pill. It was first tested for Parkinson's and Alzheimer's, where it didn't help, but people in those trials lost weight, so it was then studied for obesity. It isn't approved in the US or Europe, and a request for approval in Mexico hadn't been approved as of the last public update.
How it works
It keeps three brain messengers (noradrenaline, dopamine and serotonin) active for longer. That turns down hunger and helps you feel full sooner. The same boost to noradrenaline also speeds up your heart, which is the main safety trade-off.
What people use it for
Weight loss
Appetite control
Weight gain from damage to the brain's hunger center (hypothalamic obesity), studied in trials with the heart drug metoprolol
The evidence
Some human studies
Moderate. In an early (phase 2) 24-week trial (Astrup, 2008) of 203 people with obesity on a diet, people lost about 4.5%, 9.2% and 10.6% of their weight on 0.25, 0.5 and 1 mg a day versus 2% on placebo, and heart rate rose about 7 beats per minute on 0.5 mg; the journal later flagged concerns about how that paper reported side effects. A late-stage (phase 3) program in Mexico reported about 10% weight loss in 24 weeks, but those results aren't fully published, and a small 2022 trial tested it with the heart drug metoprolol for hypothalamic obesity.
Why: The 2008 trial tested these three daily doses. 0.5 mg worked almost as well as 1 mg with fewer side effects. So 0.5 mg became the main dose studied after that.
Common community dose
Reported
Dose
0.25–0.5 mg
How often
Once a day
When
Morning
Cycle
8–24 weeks, often starting at 0.25 mg for the first weeks
Route
By mouth
Why: It stays in your body for more than a week, so levels build up over the first few weeks. Starting low gives you time to see how your heart rate, blood pressure and sleep react.
Start at the low end, and change one thing at a time. If you take medication or have a health condition, check with a doctor first.
We may earn a commission from these links. Counts include one syringe and two swabs per dose.
Stay safe
Side effects
Dry mouth (very common)
Trouble sleeping
Nausea, constipation, diarrhea
Faster heart rate
Higher blood pressure, especially at 1 mg
Anxiety, irritability or mood changes
Headache and dizziness
Skip it if
Heart disease, heart rhythm problems or high blood pressure that isn't under control
Past stroke
Anxiety disorders, bipolar disorder, psychosis or a history of seizures
Past misuse of stimulants
Pregnant or breastfeeding
Under 18
Glaucoma (high pressure in the eye)
Interactions
MAO inhibitors (an older type of antidepressant): dangerous; never combine
Antidepressants (SSRIs, SNRIs, bupropion), tramadol, migraine triptans: risk of too much serotonin or noradrenaline
Stimulants (ADHD meds, lots of caffeine, pre-workouts): extra strain on heart rate and blood pressure
Blood-pressure meds may work less well
Alcohol: may make sleep and mood effects worse
Get help right away for swelling of the face or throat, trouble breathing, chest pain, or a spreading, hot, red injection site.
Storage & legal
Storage
Tablets or capsules: room temperature, somewhere dry, out of the light.
Legal status
FDA: Not approved. Investigational drug.
Sport (WADA): Not named on the WADA list, but non-approved substances are prohibited at all times under S0; it may also fall under stimulants (S6) in competition.
Common questions
Is it a peptide?
No. It's a regular drug that works on brain chemicals, and you take it as a pill.
Why does it take so long to kick in, and wear off?
It takes over a week for your body to clear half of it. So levels keep rising for several weeks after you start, and side effects can hang around for weeks after you stop.
Is it safe for my heart?
It raises heart rate in most people and can raise blood pressure. Check both often, and don't use it if you have heart problems.
Sources
Astrup A, et al. Effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients: a randomised, double-blind, placebo-controlled trial. Lancet. 2008;372(9653):1906-1913. PubMed 18950853
Expression of concern--effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients: a randomised, double-blind, placebo-controlled trial. Lancet. 2013;381(9873):1167. PubMed 23561987
Lehr T, et al. Population pharmacokinetic modelling of NS2330 (tesofensine) and its major metabolite in patients with Alzheimer's disease. Br J Clin Pharmacol. 2007;64(1):36-48. PubMed 17324246
Sjödin A, et al. The effect of the triple monoamine reuptake inhibitor tesofensine on energy metabolism and appetite in overweight and moderately obese men. Int J Obes (Lond). 2010;34(11):1634-43. PubMed 20479765
Huynh K, et al. Randomized controlled trial of Tesomet for weight loss in hypothalamic obesity. Eur J Endocrinol. 2022;186(6):687-700. PubMed 35294397