Tesofensine

Tesofensine (NS 2330) is a small-molecule triple monoamine reuptake inhibitor, first developed for Parkinson's and Alzheimer's disease and later studied for obesity. It reached Phase 2 trials in people, but the pivotal obesity trial carries a Lancet Expression of Concern, the US FDA lists no approval, and Mexico's COFEPRIS did not approve the application in 2024.

Last updated: September 2026

What is Tesofensine?

Tesofensine (development code NS 2330) is a small organic molecule, not a peptide. PubChem lists it with the molecular formula C17H23Cl2NO and a molecular weight of 328.3, a tropane-type structure that carries no amino acid residues and no peptide bond (PubChem CID 11370864). It appears in our peptide library as a small-molecule reference point, in the same way as other non-peptide compounds we cover.

Its mechanism is monoamine reuptake inhibition. PubChem classifies it as a serotonin-norepinephrine-dopamine reuptake inhibitor, and the peer-reviewed literature calls it a triple monoamine reuptake inhibitor that blocks the reuptake of dopamine, norepinephrine, and serotonin (PubChem CID 11370864; PMID 19777399, PMID 21889317). A 2025 structural study reported that tesofensine stabilizes the dopamine transporter in an outward-facing conformation (PMID 41392177).

Tesofensine was first developed by NeuroSearch, with Boehringer Ingelheim, for Parkinson's and Alzheimer's disease. It was ineffective for those neurodegenerative conditions, but an unintended pattern of weight loss redirected it toward obesity (review, PMID 19777399). It is given as an oral tablet, once daily in the trials that studied it (Saniona pipeline page; PMID 18356831). A different, GLP-1 based approach to weight research is covered in our semaglutide guide.

One caution belongs up front: the pivotal Phase 2 obesity trial that produced tesofensine's best-known results carries a Lancet Expression of Concern (PMID 23561987), and a separate 2013 Lancet letter is titled "Under-reporting of adverse effects of tesofensine" (PMID 23849924). The abstract records do not state the substance of these notices, so this page reports only that they exist.

How It Works

Triple monoamine reuptake inhibition: tesofensine blocks the presynaptic reuptake of dopamine, norepinephrine, and serotonin, raising the availability of all three in the brain. PubChem classifies it as a serotonin-norepinephrine-dopamine reuptake inhibitor (PubChem CID 11370864).

Appetite pathways: in diet-induced obese rats, the fall in food intake caused by tesofensine was almost completely reversed by the alpha-1 adrenoceptor blocker prazosin and partly by a dopamine D1 blocker, which the authors read as its route to appetite suppression (animal study, rat, subcutaneous, PMID 20200509).

Forebrain dopamine: obese rats show lowered dopamine in reward-related brain regions, and tesofensine normalized accumbal dopamine in obese rats while leaving lean rats unchanged (animal study, rat, PMID 23932919).

Hypothalamic neurons: a 2024 study reported that tesofensine silences a subset of GABAergic neurons in the lateral hypothalamus of transgenic mice, reducing their drive to promote feeding (animal study, mice and rats, PMID 38656972).

Cardiovascular effect: in rats, tesofensine raised heart rate and blood pressure by increasing sympathetic activity, and a beta-1 blocker prevented the cardiovascular effects without blunting the appetite effect, which became the rationale for the later tesofensine plus metoprolol combination (animal study, rat, PMID 23784901).

Benefits

Weight loss in obese patients: in the pivotal Phase 2 trial (TIPO-1), tesofensine plus an energy-restricted diet produced mean weight loss of 4.5% at 0.25 mg, 9.2% at 0.5 mg, and 10.6% at 1.0 mg over 24 weeks, versus 2.0% for diet plus placebo (trial results, PMID 18950853); that trial carries a Lancet Expression of Concern (PMID 23561987).
Weight loss as a side finding in neurology trials: pooled Parkinson's and Alzheimer's data showed dose-related weight loss over 14 weeks, up to 2.8% at the 1.0 mg dose with no weight-loss program (meta-analysis, PMID 18356831).
Appetite suppression is the proposed mechanism: in diet-induced obese rats, reduced food intake was almost fully reversed by an alpha-1 adrenoceptor blocker and partly by a dopamine D1 blocker (animal study, rat, subcutaneous, PMID 20200509).
Modest motor and off-time changes in advanced Parkinson's at individual dose levels, though the authors could not establish a dose-response relationship (Phase 2, ADVANS, PMID 18474731).
Sponsor-reported Phase 3: Saniona states its partner Medix ran a 372-patient Phase 3 in obesity with about 10% average weight loss at 24 weeks; these are sponsor-reported, not peer-reviewed figures (Saniona regulatory disclosure, 2024).

Doses Used in Trials and Research

Phase	Dose	Frequency	Duration
Obesity, Phase 2 (TIPO-1)	0.25, 0.5, and 1.0 mg once daily (trial doses, not a recommendation, PMID 18950853); the trial carries a Lancet Expression of Concern (PMID 23561987)	Oral tablet, once daily	24 weeks, n=203, after a 2-week run-in, all on an energy-restricted diet
Parkinson's disease, Phase 2 (ADVANS)	0.125, 0.25, 0.5, and 1.0 mg once daily (trial doses, not a recommendation, PMID 18474731)	Oral tablet, once daily	14 weeks; registry enrollment 254 (ClinicalTrials.gov, NCT00148512)
Developer's stated target dose	0.5 mg per day (developer's stated target, Saniona, not a trial result and not a recommendation)	Oral tablet, once daily	Saniona pipeline statement; TIPO-1 measured 9.2% weight loss at 0.5 mg and 10.6% at 1.0 mg, and that trial carries a Lancet Expression of Concern (PMID 18950853, PMID 23561987)
Tesofensine plus metoprolol (Tesomet), Phase 2	0.5 mg tesofensine with 50 mg metoprolol (trial dose, not a recommendation, ClinicalTrials.gov registry record NCT03845075); a type 2 diabetes study used 0.5 mg tesofensine with 100 mg metoprolol (trial dose, not a recommendation, ClinicalTrials.gov registry record NCT02737891)	Oral tablet, once daily	24 weeks plus a 24-week open-label extension, n=21 (hypothalamic injury-induced obesity)
Diet-induced obese rats (mechanism studies)	0.5 to 3.0 mg/kg, ED50 about 1.3 mg/kg for reduced food intake (animal study, rat, subcutaneous, PMID 20200509); other rat studies used 2.0 mg/kg (animal study, rat, route not stated in abstract, PMID 23932919; PMID 21889317)	Subcutaneous (PMID 20200509); route not stated in the other rat abstracts	In PMID 20200509 the 0.5 to 3.0 mg/kg dose-ranging was an acute food-intake test, while a separate 2.0 mg/kg experiment in the same study ran 16 days; the other rat studies ran 14 days (PMID 23932919) and 28 days plus a treatment-free period (PMID 21889317)
Obesity, Phase 3 (sponsor-reported)	0.25 and 0.5 mg daily, as described by Saniona (sponsor-reported, not peer-reviewed, not a recommendation)	Oral, once daily	372 patients per Saniona; no peer-reviewed publication or ClinicalTrials.gov record was retrieved

These figures summarise the doses that published trials and animal studies administered. Tesofensine has no approved label anywhere, so none of these is an approved or recommended dose. They are educational, not a personal protocol. Any dose, schedule, or decision to use a compound belongs with a licensed prescriber.

Side Effects

Common

⚠Dry mouth, among the most common adverse events in the 24-week obesity trial (PMID 18950853)
⚠Nausea (obesity trial, PMID 18950853)
⚠Constipation and hard stools (obesity trial, PMID 18950853)
⚠Diarrhoea (obesity trial, PMID 18950853)
⚠Insomnia (obesity trial, PMID 18950853)
⚠Increased heart rate: about 7.4 beats per minute in the 0.5 mg group over 24 weeks (trial finding, PMID 18950853)

Rare

•Blood pressure increase at the highest dose tested, per a 2009 review, while the lower doses showed no significant blood-pressure change in trials (PMID 19777399, PMID 18950853)
•Gastrointestinal and neuropsychiatric adverse events, more frequent at higher doses in advanced Parkinson's (PMID 18474731)
•Adverse-event reporting for the pivotal obesity trial was publicly challenged in a 2013 Lancet letter titled "Under-reporting of adverse effects of tesofensine" (PMID 23849924)

Who Should NOT Use Tesofensine

✕People with cardiovascular conditions or high blood pressure have particular reason for caution: tesofensine raised heart rate in trials and raised blood pressure at the highest dose tested (trial and review findings, PMID 18950853, PMID 19777399).
✕Anyone looking for an approved therapy: tesofensine has no US FDA approval or label, and Mexico's COFEPRIS did not approve the application in 2024, so there is no approved use or established dose (US FDA drug databases, no record, 2026; Saniona regulatory disclosure, 2024).
✕This is an investigational research compound, not a self-administered supplement; any decision about use belongs with a licensed physician.

Timeline in the Research

Neurology trials, 14 weeks

The Parkinson's and Alzheimer's trials dosed once daily for 14 weeks; pooled data showed dose-related weight loss up to 2.8% at the 1.0 mg dose with no weight-loss program (meta-analysis, PMID 18356831).

Obesity trial, 24 weeks

TIPO-1 ran 24 weeks alongside an energy-restricted diet and reported the largest weight-loss figures; that trial carries a Lancet Expression of Concern (PMID 18950853, PMID 23561987).

After stopping (animal)

In diet-induced obese rats, food intake and body-weight gain gradually increased again once tesofensine was discontinued (animal study, rat, PMID 21889317).

No approved course

There is no approved course of treatment: tesofensine has no approved label and no established human dose anywhere in the record reviewed for this page.

Notes from Ho Chi Minh City

In Ho Chi Minh City the tesofensine questions come from the weight-loss crowd who have read the headline Phase 2 numbers, usually people who have already tried or priced GLP-1 options. The honest answer is the dull one. This is a small molecule, not a peptide, that never produced a clean published Phase 2 record: the pivotal obesity trial carries a Lancet Expression of Concern, a separate 2013 Lancet letter is titled 'Under-reporting of adverse effects of tesofensine', Mexico's COFEPRIS did not approve it in 2024, and a search of Long Châu returns no product. Whether it is registered with the Drug Administration of Vietnam I could not confirm, so I do not claim it either way. Heart rate went up in the trials. None of that tells anyone to use it or to avoid it, and dose, if it ever has an approved one, is a prescriber's call rather than a forum's.

Sourcing in Vietnam

Tesofensine is not a peptide and is not stocked at Long Châu, Vietnam's largest pharmacy chain, whose on-site search returns no product under either spelling (checked 2026). Availability at some other Vietnamese pharmacies could not be confirmed for this page because those sites blocked automated checks, and its registration status with the Drug Administration of Vietnam was not established, so this page makes no claim that it is registered, unregistered, or banned. Because there is no approved label or established dose anywhere in the record reviewed here, there is no legitimate retail listing to price, and any figure quoted by an unverified seller has no trial or label behind it.

FAQ

Q: Is tesofensine approved for weight loss?

A: No. Tesofensine has no US FDA approval or label, and in 2024 Mexico's COFEPRIS did not approve the application from its partner Medix; Saniona said Medix was entering a dialogue with the agency about the path forward. A favorable technical-committee opinion in February 2023 was a step in that process, not an approval. Its registration status with the Drug Administration of Vietnam could not be confirmed for this page, so we do not claim it is either registered or banned.

Q: What doses were used in tesofensine trials?

A: Human trials used oral tablets given once daily. The obesity trial (TIPO-1) tested 0.25, 0.5, and 1.0 mg over 24 weeks, and the Parkinson's and Alzheimer's trials tested 0.125 to 1.0 mg over 14 weeks (trial doses, not a recommendation, PMID 18950853, PMID 18474731, PMID 18356831). These are the doses the studies administered; tesofensine has no established or approved dose.

Q: What is the Expression of Concern on the main obesity study?

A: The pivotal Phase 2 obesity trial (TIPO-1, Lancet 2008) is the source of the widely cited figures of 9.2% weight loss at 0.5 mg and 10.6% at 1.0 mg. In 2013 the Lancet published an Expression of Concern attached to that paper, and a separate 2013 Lancet letter was titled "Under-reporting of adverse effects of tesofensine". The abstract records do not state the substance of these notices, so we report only that they exist and quote their titles (PMID 23561987, PMID 23849924).

Q: Is tesofensine a peptide?

A: No. It often appears next to peptides in weight-research discussions, but tesofensine is a small organic molecule, molecular formula C17H23Cl2NO and molecular weight 328.3, a tropane-type structure with no amino acid residues and no peptide bond (PubChem CID 11370864). It is a triple monoamine reuptake inhibitor, included here as a small-molecule reference point, not as a peptide.

Q: Can you buy tesofensine in Vietnam?

A: A search of Long Châu, Vietnam's largest pharmacy chain, returns no tesofensine product under either spelling, so it is not sold there (Long Châu on-site search, 2026). We could not confirm its registration with the Drug Administration of Vietnam, and checks at some other pharmacies were inconclusive because those sites blocked automated access, so this page does not claim it is registered, unregistered, or banned. Neither the US FDA nor Mexico's COFEPRIS has approved it, so there is no approval on record that would support a legal retail listing.

Where to Get Tesofensine in Vietnam

See our community-verified supplier list with COA verification and cold-chain shipping to Vietnam.

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Research & Sources

PubChem Compound Summary: Tesofensine (CID 11370864) · US National Library of Medicine · PubChem (accessed 2026) Link
Chemical record: molecular formula C17H23Cl2NO, molecular weight 328.3, and the serotonin-norepinephrine-dopamine reuptake inhibitor (SNDRI) mechanism.
Tesofensine, a monoamine reuptake inhibitor for the treatment of obesity · Current Opinion in Investigational Drugs (2009) (PMID: 19777399)
Narrative review of the compound history and early obesity data, not a trial.
Structural basis for pharmacotherapeutic action of triple reuptake inhibitors · Nature Communications (2025) (PMID: 41392177)
Structural biology: reports tesofensine stabilizing the dopamine transporter in an outward-facing conformation. No human or animal dosing.
Effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients: a randomised, double-blind, placebo-controlled trial · The Lancet (2008) (PMID: 18950853)
The pivotal Phase 2 obesity trial (TIPO-1), NCT00394667. This paper carries the Lancet Expression of Concern listed below.
Expression of concern: effect of tesofensine on bodyweight loss, body composition, and quality of life in obese patients · The Lancet (2013) (PMID: 23561987)
Journal Expression of Concern attached to the TIPO-1 paper. The record carries no abstract, so only its title and status are quotable.
Under-reporting of adverse effects of tesofensine · The Lancet (2013) (PMID: 23849924)
Correspondence letter. No abstract on the record, so the specific allegations are not quotable from this source.
Weight loss produced by tesofensine in patients with Parkinson's or Alzheimer's disease · Obesity (Silver Spring) (2008) (PMID: 18356831)
Meta-analysis of four randomised trials, tesofensine n=740 versus placebo n=228, once daily for 14 weeks.
Tesofensine (NS 2330), a monoamine reuptake inhibitor, in patients with advanced Parkinson disease and motor fluctuations: the ADVANS Study · Archives of Neurology (2008) (PMID: 18474731)
Phase 2 Parkinson disease trial, NCT00148512. Doses 0.125 to 1.0 mg once daily; no dose-response relationship established.
Tesofensine: registered studies (NCT records) · ClinicalTrials.gov, US National Library of Medicine · ClinicalTrials.gov (accessed 2026) Link
Trial registry: the tesofensine and Tesomet program records, including two Phase 2b Tesomet studies withdrawn at zero enrollment in 2022.
Tesofensine (pipeline page) · Saniona AB · Saniona pipeline (accessed 2026) Link
Developer pipeline page. Forward-looking marketing statements, not peer-reviewed, and stale on approval status relative to the 2024 press release below.
Mexican Application for Tesofensine Not Yet Approved · Saniona AB · Regulatory disclosure (2024) Link
Company disclosure dated 2024-11-06: COFEPRIS did not approve the application. The Phase 3 efficacy and safety figures in it are sponsor-reported and unpublished.
US FDA drug approval and label databases (no matching record) · openFDA, US FDA · openFDA (accessed 2026) Link
Both the drug approvals and labelling endpoints returned no match for tesofensine: a served negative result, not a blocked request.
Tesofensine, a novel triple monoamine reuptake inhibitor, induces appetite suppression by indirect stimulation of alpha1 adrenoceptor and dopamine D1 receptor pathways in the diet-induced obese rat · Neuropsychopharmacology (2010) (PMID: 20200509)
Rat study, subcutaneous. 0.5 to 3.0 mg/kg dose-dependent hypophagia, ED50 1.3 mg/kg.
Tesofensine induces appetite suppression and weight loss with reversal of low forebrain dopamine levels in the diet-induced obese rat · Pharmacology Biochemistry and Behavior (2013) (PMID: 23932919)
Rat study, 2.0 mg/kg/day for 14 days. Route not stated in the abstract.
Triple monoamine inhibitor tesofensine decreases food intake, body weight, and striatal dopamine D2/D3 receptor availability in diet-induced obese rats · European Neuropsychopharmacology (2012) (PMID: 21889317)
Rat study, 2.0 mg/kg for 28 days plus a treatment-free period. Weight gain rebounded after discontinuation.
Anti-hypertensive treatment preserves appetite suppression while preventing cardiovascular adverse effects of tesofensine in rats · Obesity (Silver Spring) (2013) (PMID: 23784901)
Rat telemetry study. Metoprolol prevented the cardiovascular effects while appetite suppression was preserved; tesofensine dose not stated in the abstract.
Tesofensine, a novel antiobesity drug, silences GABAergic hypothalamic neurons · PLoS One (2024) (PMID: 38656972)
Mouse and rat mechanism study of lateral hypothalamus GABAergic neurons. Dose and route not stated in the abstract.
Long Châu pharmacy on-site product search (no result) · Nhà thuốc Long Châu · On-site search (accessed 2026) Link
The chain on-site search returned zero products for both "tesofensine" and "tesofensin": a served empty result, not a blocked request.

Important Disclaimer

Educational content only. Not medical advice. Tesofensine has no US FDA approval and was not approved by Mexico's COFEPRIS as of 2024; a search of Long Châu, Vietnam's largest pharmacy chain, returns no tesofensine product, and its registration status with the Drug Administration of Vietnam could not be confirmed for this page. Consult a licensed physician before any use.