The only FDA-approved GHRH analog
A stabilized 44-residue GHRH analog that stimulates endogenous growth hormone secretion.
Educational content. This page describes Tesamorelin for informational purposes only and is not medical advice, diagnosis, or treatment. Consult a licensed provider before starting, stopping, or modifying any therapy.
Stimulates the pituitary to release growth hormone in a natural pulsatile pattern rather than providing a flat supraphysiologic bolus, preserving the hypothalamic-pituitary feedback loop.[8]
Tesamorelin is a synthetic 44-amino-acid analog of human growth hormone-releasing hormone (GHRH). What distinguishes it from endogenous GHRH(1-44) is the addition of a trans-3-hexenoic acid group covalently attached to the N-terminal tyrosine residue. This lipophilic modification confers resistance to enzymatic degradation by dipeptidyl aminopeptidase IV (DPP-IV), extending its biological activity compared to native GHRH.
Developed by Theratechnologies in Montreal, tesamorelin is the first and only treatment specifically approved for reduction of excess abdominal fat in HIV-infected patients with lipodystrophy. The FDA approved it in November 2010 under the brand name Egrifta. An updated single-vial formulation, Egrifta SV, was subsequently approved. It is not indicated for general weight management or obesity.
Tesamorelin binds to GHRH receptors on somatotroph cells in the anterior pituitary. These are G-protein-coupled receptors linked to the Gs alpha subunit. Receptor activation stimulates adenylyl cyclase, increasing intracellular cAMP, which activates protein kinase A and phosphorylates CREB to enhance growth hormone gene transcription and secretion.
Unlike exogenous growth hormone administration, tesamorelin preserves the natural pulsatile release pattern. Studies in healthy men demonstrated increased mean overnight GH, GH pulse area, and basal GH secretion without disrupting the feedback loop. The released GH acts on liver and peripheral tissues to stimulate IGF-1 production.
The GH/IGF-1 axis promotes lipolysis preferentially in visceral adipose tissue, which has a higher density of GH receptors than subcutaneous fat. This selectivity accounts for the targeted visceral fat reduction seen in clinical trials. Secondary metabolic benefits include improvements in triglycerides, cholesterol ratios, adiponectin, and inflammatory markers.
The only FDA-approved GHRH analog
Tesamorelin activates pituitary GHRH receptors to stimulate pulsatile, physiologic growth hormone release via the cAMP/PKA/CREB cascade. The resulting GH/IGF-1 signaling promotes preferential lipolysis in visceral adipose tissue while preserving feedback regulation, producing targeted abdominal fat reduction with secondary improvements in lipid profiles and hepatic fat.
Key studies supporting the therapeutic use of this peptide.
Tesamorelin 2 mg SC daily reduced visceral adipose tissue by 15.2% versus 5.1% for placebo (p < 0.001). Triglycerides improved by -50 mg/dL versus +9 for placebo (p < 0.001). Lean body mass increased by 1.3 kg versus -0.2 kg (p < 0.001).
Falutz J, Allas S, Blot K, et al. — J Clin Endocrinol Metab, 92(12):4867-4875 (2007) · PubMed
VAT reduction of approximately 18% sustained through 52 weeks. Patients switched from tesamorelin to placebo showed VAT rebound toward baseline, indicating ongoing treatment is necessary to maintain benefit.
Falutz J, Allas S, Kotler D, et al. — J Acquir Immune Defic Syndr, 53(3):311-322 (2010) · PubMed
Tesamorelin significantly reduced hepatic fat fraction and attenuated fibrosis progression over 12 months. First RCT to demonstrate a GH-based therapy can reduce liver fat and prevent fibrosis progression in this population.
Stanley TL, Fourman LT, Feldpausch MN, et al. — Lancet HIV, 6(12):e821-e830 (2019) · PubMed
Tesamorelin 1 mg SC daily for 20 weeks produced favorable cognitive effects in both healthy older adults and those with MCI, supporting augmentation of the GH/IGF-1 axis for cognitive benefit in aging.
Baker LD, Barsness SM, Borson S, et al. — Arch Neurol, 69(11):1420-1429 (2012) · PubMed
Typical protocols used in clinical practice. Always consult a licensed provider for personalized dosing.
Subcutaneous Injection (FDA-Approved)
Subcutaneous Injection (Cognitive Studies)
Subcutaneous Injection (FDA-Approved): Administered into the abdomen with rotation of injection sites. Reconstitute lyophilized powder with provided sterile water.
Subcutaneous Injection (Cognitive Studies): Lower dose used in the Baker et al. cognitive function trial.
Visceral fat reduction reverses upon treatment discontinuation. The 52-week extension study showed VAT rebound toward baseline in patients switched to placebo, meaning tesamorelin requires ongoing use for sustained benefit.
IGF-1 levels should be monitored periodically. Treatment should be discontinued if persistent IGF-1 elevation above the age-adjusted upper limit of normal is observed.
Approximately 50% of patients develop anti-tesamorelin IgG antibodies, but these are generally non-neutralizing and have no documented clinical significance.
Tesamorelin has the strongest clinical evidence base among GHRH analogs, with over 800 patients studied across multiple Phase III randomized controlled trials. Serious adverse events occurred in less than 4% over 26 weeks and were not attributable to the drug.
The pulsatile GH release pattern preserves hypothalamic-pituitary feedback, which is a meaningful safety advantage over exogenous GH administration. Studies in healthy men showed no significant effect on fasting glucose or insulin-stimulated glucose uptake at the 2 mg daily dose.
Long-term IGF-1 monitoring is recommended because sustained IGF-1 elevation carries theoretical risks related to cell proliferation. Treatment should be reassessed if IGF-1 consistently exceeds age-appropriate limits.
See how Tesamorelin compares to peptides with overlapping benefits.
| Peptide | Primary Use | Administration | Cycle Length | Key Differentiator |
|---|---|---|---|---|
| Tesamorelin | Body Composition & GHRH | Subcutaneous Injection | Ongoing daily | The only FDA-approved GHRH analog with Phase III data in over 800 patients, proven hepatoprotective effects, and physiologic pulsatile GH release |
| Semaglutide | Weight Loss | Injection (weekly), Oral (daily) | Ongoing | Most clinically validated weight-loss peptide with cardiovascular outcomes data from the SELECT trial |
| Tirzepatide | Weight Loss | Injection (weekly) | Ongoing | Only dual GIP/GLP-1 agonist, producing up to 22.5% weight loss — the highest of any pharmacotherapy |
| Sermorelin | Anti-Aging & GH Restoration | Injection (daily) | 3–6 months | Only GHRH analog with FDA approval history and multi-decade safety record, uniquely preserving natural GH feedback |
| Ipamorelin | Anti-Aging & Body Composition | Injection (1-3x daily) | 8–12 weeks | Most selective GH secretagogue — clean pulsatile GH release without cortisol, prolactin, or appetite effects |
Current FDA classification and compounding eligibility.
This peptide is an FDA-approved drug available via standard prescription.
FDA-approved as Egrifta (2010) and Egrifta WR (2025) for HIV-associated lipodystrophy. As a biologic, compounding is restricted. Pharmacies cannot compound biologics without a biologics license.
FDA approved Egrifta WR (tesamorelin F8 formulation) with improved weekly reconstitution convenience
FDA approved Egrifta (tesamorelin) for reduction of excess abdominal fat in HIV-infected adults with lipodystrophy
Last verified April 12, 2026. PepHookup tracks public FDA actions. This is not legal or medical advice.
Falutz J, Allas S, Blot K, et al. “Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension.” J Clin Endocrinol Metab, 92(12):4867-4875 (2007)
Falutz J, Allas S, Kotler D, et al. “A placebo-controlled, dose-ranging study of a growth hormone releasing factor in HIV-infected patients with fat accumulation.” J Acquir Immune Defic Syndr, 53(3):311-322 (2010)
Stanley TL, Fourman LT, Feldpausch MN, et al. “Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial.” Lancet HIV, 6(12):e821-e830 (2019)
Fourman LT, Czerwonka N, Engstrom JL, et al. “Effects of tesamorelin on hepatic transcriptomic signatures in HIV-associated NAFLD.” JCI Insight, 5(16):e140134 (2020)
Baker LD, Barsness SM, Borson S, et al. “Effects of Growth Hormone-Releasing Hormone on Cognitive Function in Adults with Mild Cognitive Impairment and Healthy Older Adults: Results of a Controlled Trial.” Arch Neurol, 69(11):1420-1429 (2012)
Friedman SD, Baker LD, Borson S, et al. “Growth Hormone-Releasing Hormone Effects on Brain Gamma-Aminobutyric Acid Levels in Mild Cognitive Impairment and Healthy Aging.” JAMA Neurol, 70(7):883-890 (2013)
Dhillon S “Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy.” Drugs, 71(8):1071-1091 (2011)
Spooner LM, Olin JL “Tesamorelin: a growth hormone-releasing factor analogue for HIV-associated lipodystrophy.” Ann Pharmacother, 46(2):240-247 (2012)
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