Tesamorelin
Egrifta · TH9507
~−15–18% visceral adipose tissue at 26 weeks (pivotal trials)
Overview
Tesamorelin is a stabilized analog of growth-hormone-releasing hormone (GHRH), consisting of the full 44-amino-acid human GHRH sequence with an added trans-3-hexenoic acid group that resists enzymatic degradation. It is the only GHRH analog with a major regulatory approval: marketed as Egrifta, it is FDA-approved to reduce excess visceral abdominal fat in adults with HIV-associated lipodystrophy.
Mechanistically it stimulates the pituitary to release endogenous growth hormone, which in turn raises IGF-1 and drives lipolysis preferentially in visceral adipose tissue. In the pivotal Phase 3 program (Falutz et al., NEJM 2007 and a companion trial), 2 mg once-daily tesamorelin reduced visceral adipose tissue by roughly 15–18% over 26 weeks versus placebo, with IGF-1 rising as expected; much of the visceral-fat benefit reversed after discontinuation.
Although Egrifta is an approved drug, research-vial tesamorelin is not a finished pharmaceutical and is labeled for laboratory use only. The figures here summarize the approved label and published trials and are provided as an educational research reference, not medical advice.
Key parameters
- Dose range
- 2 mg daily (approved dose)
- Frequency
- Once daily
- Half-life
- ~26–38 minutes
- Route
- Subcutaneous
- Vial sizes
- 5 mg · 10 mg
- Regulatory status
- FDA-approved (Egrifta) for HIV-associated lipodystrophy; research-vial material is laboratory use only.
Mechanism of action
GHRH receptor agonism (pituitary somatotrophs)
Binds GHRH receptors on the anterior pituitary to stimulate synthesis and pulsatile release of endogenous growth hormone.
Stabilized GHRH(1-44) backbone
A hexenoyl modification protects the native 44-amino-acid GHRH sequence from rapid breakdown, improving exposure relative to unmodified GHRH while keeping action short.
Visceral-fat lipolysis via GH/IGF-1
Elevated GH preferentially mobilizes visceral adipose tissue and raises hepatic IGF-1, the basis for its approved indication in HIV-associated lipodystrophy.
Dosing protocol & phases
| Phase | Weeks | Dose | Notes |
|---|---|---|---|
| Standard (approved) | Ongoing | 2 mg once daily | Label dose for HIV-associated lipodystrophy; administered subcutaneously, typically rotating abdominal sites. |
| Response assessment | ~Week 26 and periodically | Continue 2 mg daily | Per label, continued benefit and need for therapy are reassessed; effect reverses on discontinuation. |
Reconstitution guide
For educational and research reference only. Not intended for human consumption, not medical advice. Compounds discussed are sold and used for laboratory research purposes only.
10 mg vial + 2 mL bacteriostatic water
Concentration5,000 mcg/mL · 5 mg/mL
| Target dose | Draw volume | U-100 units |
|---|---|---|
| 1,000 mcg | 0.2 mL | 20 |
| 2,000 mcg | 0.4 mL | 40 |
Makes the 2 mg daily dose a tidy 0.4 mL (40-unit) draw.
5 mg vial + 2 mL bacteriostatic water
Concentration2,500 mcg/mL · 2.5 mg/mL
| Target dose | Draw volume | U-100 units |
|---|---|---|
| 1,000 mcg | 0.4 mL | 40 |
| 2,000 mcg | 0.8 mL | 80 |
Smaller vial; the 2 mg dose is 0.8 mL (80 units).
Reconstitution calculator
Pre-filled with Tesamorelin's vial sizes. Adjust the water volume and target dose to see the exact draw, with warnings for doses that are hard to measure or won't fit a syringe.
At 2,500 micrograms per millilitre, a 1,000 microgram dose is 0.4 millilitres, or 40 units on a U-100 syringe, giving 5 doses per vial.
Supplies needed
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Recommended supply
Tesamorelin — research vial
From our verified partner Dynotides, with a third-party certificate of analysis per batch.
Injection supplies
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Bacteriostatic water
Diluent for reconstituting lyophilized vials.
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Insulin syringes (U-100)
0.3–0.5 mL, 29–31 G for accurate small draws.
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Alcohol prep pads
Sterile swabs for the vial stopper and site.
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Sharps container
Safe disposal of used needles.
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Storage fridge
Keeps reconstituted vials at 2–8 °C.
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Insulated travel case
Cooled, TSA-friendly case for travel.
Missed-dose guidance
Per the Egrifta labeling, if a dose is missed it should be skipped and the next dose taken at the regular time the following day; doses are not doubled. Because the half-life is under an hour, a late dose offers no advantage.
Side effects & safety
| Category | Effect | Trial incidence |
|---|---|---|
| Injection site | Erythema, pruritus, pain, irritation, or swellingInjection-site reactions occurred in ~24.5% on tesamorelin vs ~14.4% on placebo across the pooled pivotal trials (Egrifta label). | 24.5% |
| Musculoskeletal | Arthralgia / myalgia / pain in extremityEach reported in >5% of treated patients and among the most common label-listed events; consistent with raised GH activity. | — |
| Fluid balance | Peripheral edema / fluid retentionReported in >5% of patients; an edema-related class effect of GHRH analogs. | — |
| Metabolic | Hyperglycemia / reduced insulin sensitivityGH is counter-regulatory to insulin; the label lists hyperglycemia and advises glucose monitoring, especially in patients with diabetes. | — |
| Immunologic | Hypersensitivity reactions (rash, urticaria)Label-listed; discontinue if a serious hypersensitivity reaction occurs. | — |
| Neurological | Headache | — |
Clinical trials & evidence
Falutz et al. pivotal Phase 3
Phase 326 weeks · 412 adults with HIV-associated abdominal fat accumulation
Tesamorelin 2 mg daily reduced visceral adipose tissue by about 15% vs a ~5% increase on placebo (roughly a 15–18% net difference), with IGF-1 rising as expected.
NCT00123253 ↗Confirmatory Phase 3 (companion trial)
Phase 326 weeks plus a 26-week extension · Adults with HIV-associated lipodystrophy
Replicated the visceral-fat reduction; participants re-randomized to placebo at week 26 regained visceral fat, showing the effect depends on continued therapy.
NCT00435136 ↗
Storage & handling
- Lyophilized
- Per the Egrifta label, store lyophilized tesamorelin refrigerated at 2–8 °C and protect from light; follow product-specific instructions for reconstitution.
- Reconstituted
- Reconstitute immediately before use and administer promptly; do not store reconstituted solution beyond the label's stated window, and do not freeze.
Comparisons
| Vs. | Target | Half-life | Dosing | Efficacy | Status |
|---|---|---|---|---|---|
| CJC-1295 (no-DAC) | GHRH (both) | ~26–38 min vs ~30 min | 2 mg daily vs ~100 mcg 1–3× daily | Clinically proven visceral-fat reduction vs community data | FDA-approved (Egrifta) vs research-only |
| Sermorelin | GHRH (both) | ~26–38 min vs ~10–20 min | Daily (both) | Stronger, label-backed effect on visceral fat | FDA-approved vs formerly approved (withdrawn) |
| Ipamorelin | GHRH vs ghrelin/GHS-R | ~26–38 min vs ~2 h | Daily vs 1–3× daily | Different receptor; sometimes combined for broader GH-axis stimulation | FDA-approved vs research-only |
Featured in these stacks
Tesamorelin + Ipamorelin
This pairing follows the classic GH-secretagogue logic of combining a GHRH analog with a ghrelin-receptor (GHRP) agonist, but upgrades the GHRH side to tesamorelin — a stabilized GHRH analog that is the only growth-hormone-axis peptide in this category with FDA-approved human efficacy data, specifically for reducing visceral adipose tissue in HIV-associated lipodystrophy (marketed as Egrifta). The premise is that tesamorelin amplifies the size of each GH pulse at the pituitary while ipamorelin, a highly selective ghrelin-receptor agonist, both adds a second, independent pulse trigger and suppresses somatostatin, the brake on GH release.
Sources & references
Frequently asked questions
What is tesamorelin actually approved for?
Under the brand Egrifta it is FDA-approved to reduce excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It is not approved for general body recomposition or anti-aging use.
How is it different from CJC-1295 or sermorelin?
All three are GHRH analogs, but tesamorelin uses the full 44-amino-acid GHRH sequence with a stabilizing modification and is the only one of the group with a major regulatory approval backed by Phase 3 visceral-fat data.
Does the visceral-fat benefit last after stopping?
No. In the pivotal trials much of the visceral adipose reduction reversed after tesamorelin was discontinued, indicating the effect depends on continued therapy.
Related protocols
CJC-1295 (no-DAC)
Mod GRF 1-29
Short-acting GHRH analog dosed for natural GH pulses
Ipamorelin
NNC 26-0161
Selective GH pulse with minimal cortisol or prolactin effect
Sermorelin
GRF 1-29
GHRH(1-29) — the shortest fully active GHRH fragment, dosed nightly to reinforce the natural GH pulse
Looking to match this protocol to a verified research vial? Our partner supplier publishes a certificate of analysis per batch.
For educational and research reference only. Not intended for human consumption, not medical advice. Compounds discussed are sold and used for laboratory research purposes only.