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.
Researched and maintained by the PepHookup team. Regulatory status last verified April 12, 2026.
In healthy men, two weeks of tesamorelin increased mean overnight growth hormone and GH pulse area while preserving the natural pulsatile pattern, raising IGF-1 without the flat supraphysiologic exposure of injected growth hormone.[3]
Tesamorelin is a synthetic analog of human growth hormone-releasing hormone built on the full 44-amino-acid GHRH(1-44) sequence. What sets it apart from native GHRH is a trans-3-hexenoic acid group attached to the alpha-amino position of the N-terminal tyrosine. This lipophilic modification sterically blocks dipeptidyl peptidase-4 (DPP-4), the enzyme that rapidly clears endogenous GHRH, giving tesamorelin a longer functional half-life while it retains the natural GHRH sequence rather than substituting amino acids the way some other analogs do.
Developed by Theratechnologies in Montreal, tesamorelin is the first and only therapy approved specifically to reduce excess abdominal fat in HIV-infected patients with lipodystrophy. The FDA approved it in November 2010 as Egrifta. A more concentrated single-vial formulation, Egrifta SV, followed, and in March 2025 the FDA approved Egrifta WR, an eight-fold concentrated F8 formulation that needs reconstitution only once a week while still being injected daily. It is not approved for general weight loss, athletic performance, or obesity.
Tesamorelin binds GHRH receptors on the somatotroph cells of the anterior pituitary. These are G-protein-coupled receptors linked to the Gs alpha subunit, so activation stimulates adenylyl cyclase, raises intracellular cAMP, and engages protein kinase A. The result is phosphorylation of CREB and increased transcription and secretion of growth hormone.
Because the signal acts one step upstream of the pituitary rather than replacing growth hormone directly, the body's own pulsatile release pattern is preserved. In healthy men, tesamorelin raised mean overnight GH, GH pulse area, and basal secretion and increased IGF-1, while leaving fasting glucose and insulin-stimulated glucose uptake statistically unchanged. The released GH then acts on the liver and peripheral tissues to drive IGF-1 production.
The growth hormone and IGF-1 axis favors lipolysis in visceral fat, which carries a higher density of GH receptors than subcutaneous fat. That selectivity is the leading explanation for the targeted reduction in abdominal fat seen in trials. Secondary metabolic shifts have included lower triglycerides and improvements in hepatic fat and liver-related gene expression.
The only FDA-approved GHRH analog
Tesamorelin activates pituitary GHRH receptors through the cAMP/PKA/CREB cascade, prompting pulsatile, physiologic growth hormone release. The resulting GH and IGF-1 signaling preferentially mobilizes visceral fat while preserving the hypothalamic-pituitary feedback loop, producing targeted abdominal fat reduction alongside lower triglycerides and reduced liver fat.
Tesamorelin 2 mg subcutaneously once daily reduced visceral adipose tissue by 15.2% versus a 5% increase on placebo (P<0.001). Triglycerides fell by about 50 mg/dL versus a 9 mg/dL rise on placebo. Self-image and IGF-1 also improved.
Falutz J, Allas S, Blot K, Potvin D, Kotler D, Somero M, Berger D, Brown S, Richmond G, Fessel J, Turner R, Grinspoon S · N Engl J Med, 357(23):2359-2370 (2007) · PubMed
At 26 weeks the treatment effect on visceral adipose tissue was -15.4% versus placebo (P<0.001) with a -12.3% treatment effect on triglycerides. Anti-tesamorelin IgG antibodies developed in roughly half of treated patients but were generally non-neutralizing.
Falutz J, Mamputu JC, Potvin D, Moyle G, Soulban G, Loughrey H, Marsolais C, Turner R, Grinspoon S · J Clin Endocrinol Metab, 95(9):4291-4304 (2010) · PubMed
Visceral fat gains made during the first 26 weeks were rapidly lost in patients switched from tesamorelin to placebo, while continued treatment maintained the reduction. This established that ongoing therapy is required to sustain benefit.
Falutz J, Potvin D, Mamputu JC, Assaad H, Zoltowska M, Michaud SE, Berger D, Somero M, Moyle G, Brown S, Martorell C, Turner R, Grinspoon S · J Acquir Immune Defic Syndr, 53(3):311-322 (2010) · PubMed
Tesamorelin lowered hepatic fat fraction with an absolute effect of -4.1% and a relative reduction of 37% versus placebo. By 12 months, 35% of treated patients reached a hepatic fat fraction below 5% versus 4% on placebo, with a lower rate of fibrosis progression.
Stanley TL, Fourman LT, Feldpausch MN, Purdy J, Zheng I, Pan CS, Aepfelbacher J, Buckless C, Tsao A, Kellogg A, Branch K, Lee H, Liu CY, Corey KE, Chung RT, Torriani M, Kleiner DE, Hadigan CM, Grinspoon SK · Lancet HIV, 6(12):e821-e830 (2019) · PubMed
Tesamorelin 1 mg subcutaneously once daily produced a favorable effect on cognition (P=0.03 in the intent-to-treat analysis), strongest for executive function, in both healthy older adults and those with mild cognitive impairment. A companion study found increased brain GABA levels.
Baker LD, Barsness SM, Borson S, Merriam GR, Friedman SD, Craft S, Vitiello MV · Arch Neurol, 69(11):1420-1429 (2012) · PubMed
start low, go slow
Subcutaneous Injection (Egrifta WR, F8 formulation)
Subcutaneous Injection (Egrifta SV)
Subcutaneous Injection (cognitive research dose)
Subcutaneous Injection (Egrifta WR, F8 formulation): FDA-approved 2025 formulation. Reconstituted once weekly; one vial supplies seven daily 1.28 mg doses injected into the abdomen.
Subcutaneous Injection (Egrifta SV): Earlier single-vial formulation. Reconstituted daily and injected into the abdomen with rotation of sites. The original Egrifta was dosed at 2 mg daily.
Subcutaneous Injection (cognitive research dose): Lower dose used in the Baker et al. cognitive function trial, not an approved indication.
Dosing is determined by a licensed provider, and the approved indication is HIV-associated lipodystrophy rather than general weight loss or anti-aging use.
Visceral fat reduction reverses after stopping. In the 52-week extension, patients switched from tesamorelin to placebo lost the gains they had made, so continued treatment is needed to maintain results.
IGF-1 should be monitored periodically. Treatment is typically discontinued if IGF-1 stays elevated above the age-adjusted upper limit of normal, since the long-term effects of sustained IGF-1 elevation are unknown.
Anti-tesamorelin IgG antibodies developed in about 50% of patients at 26 weeks and 47% at 52 weeks. They are generally non-neutralizing and have not been linked to loss of efficacy, though incidence was higher in patients who had hypersensitivity reactions.
Tesamorelin has the strongest clinical evidence base among GHRH analogs, with more than 800 HIV patients studied across two pivotal Phase III randomized controlled trials plus extension data. Most adverse reactions were mild injection site or fluid-retention effects.
The pulsatile GH release pattern preserves hypothalamic-pituitary feedback, a meaningful contrast with injected growth hormone. In healthy men at the 2 mg dose, fasting glucose and insulin-stimulated glucose uptake were not significantly affected, and a separate 12-week trial in type 2 diabetics found no worsening of insulin response or glycemic control.
Long-term IGF-1 monitoring is advised because the consequences of sustained IGF-1 elevation are unknown and carry a theoretical proliferative risk. Treatment is reassessed if IGF-1 consistently exceeds age-appropriate limits.
| Peptide | Primary Use | Administration | Cycle Length | Key Differentiator |
|---|---|---|---|---|
| Tesamorelin | Visceral Fat & GHRH Signaling | Subcutaneous Injection | Ongoing daily | The only FDA-approved GHRH analog, with Phase III data in over 800 patients, documented liver-fat reduction, and physiologic pulsatile GH release |
| Semaglutide | Weight Management & Metabolic Health | Injection (weekly), Oral (daily) | Ongoing | The most clinically validated GLP-1 medicine, with outcomes data spanning weight, heart, kidney, and liver disease |
| Tirzepatide | Weight Loss & Type 2 Diabetes | Injection (weekly) | Ongoing | Only dual GIP/GLP-1 agonist; the deepest weight loss of any approved obesity drug, up to about 21% of body weight |
| Sermorelin | GH restoration and healthy aging | Subcutaneous injection, daily at bedtime | 3-6 months | The GHRH analog with prior FDA approval and a multi-decade clinical record, preserving natural feedback rather than replacing growth hormone |
| Ipamorelin | GH stimulation for body composition and recovery | Subcutaneous injection (1-3x daily) | Determined by provider | The most selective GH secretagogue in preclinical work: a clean GH pulse without the cortisol, prolactin, or appetite effects of older GHRPs |
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, Mamputu JC, Potvin D, Moyle G, Soulban G, Loughrey H, Marsolais C, Turner R, Grinspoon S “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 data.” J Clin Endocrinol Metab, 95(9):4291-4304 (2010)
Falutz J, Potvin D, Mamputu JC, Assaad H, Zoltowska M, Michaud SE, Berger D, Somero M, Moyle G, Brown S, Martorell C, Turner R, Grinspoon S “Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension.” J Acquir Immune Defic Syndr, 53(3):311-322 (2010)
Stanley TL, Fourman LT, Feldpausch MN, Purdy J, Zheng I, Pan CS, Aepfelbacher J, Buckless C, Tsao A, Kellogg A, Branch K, Lee H, Liu CY, Corey KE, Chung RT, Torriani M, Kleiner DE, Hadigan CM, Grinspoon SK “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, Billingsley JM, Agyapong G, Ho Sui SJ, Feldpausch MN, Purdy J, Zheng I, Pan CS, Corey KE, Torriani M, Kleiner DE, Hadigan CM, Stanley TL, Chung RT, Grinspoon SK “Effects of tesamorelin on hepatic transcriptomic signatures in HIV-associated NAFLD.” JCI Insight, 5(16):e140134 (2020)
Looking into Tesamorelin? Find a provider who knows this peptide and can walk you through your options.
Find a ProviderA GLP-1 receptor agonist that slows gastric emptying and reduces appetite signaling.
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A selective ghrelin receptor agonist that prompts GH release without cortisol or prolactin effects.
Studied for body composition and recovery; ineligible for 503A compounding following the FDA PCAC safety review.
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