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The Peptide Effect
approvedGrowth Hormone & Fat Loss

Tesamorelin

Also known as: Egrifta, Egrifta SV, Tesamorelin Acetate, TH9507

Tesamorelin is a synthetic analog of the full 44-amino acid growth hormone-releasing hormone (GHRH), modified with a trans-3-hexenoic acid group. It is the only FDA-approved GHRH analog currently on the market, indicated for the reduction of excess abdominal fat (lipodystrophy) in HIV-infected patients. Tesamorelin has generated significant interest for its potent visceral fat-reducing effects and emerging research on hepatic fat reduction and cognitive benefits.

Key Facts

Mechanism
Tesamorelin binds to GHRH receptors on anterior pituitary somatotroph cells, stimulating the synthesis and pulsatile release of endogenous growth hormone. The trans-3-hexenoic acid modification at the tyrosine-1 position enhances stability and receptor binding affinity. The resulting GH elevation increases IGF-1 levels and promotes lipolysis, particularly in visceral adipose tissue. Tesamorelin has demonstrated a unique tropism for reducing trunk and visceral fat that exceeds what would be expected from GH elevation alone, suggesting possible direct effects on adipocyte metabolism.
Research Status
approved
Half-Life
~26 minutes
Molecular Formula
C₂₂₁H₃₆₆N₇₂O₆₇S₁
Primary Use
Growth Hormone & Fat Loss
Table of Contents

Benefits

  • Significantly reduces visceral abdominal fat (FDA-approved indication for HIV lipodystrophy)strong
  • Improves trunk fat distribution and body composition in HIV-associated lipodystrophystrong
  • Increases IGF-1 levels to the normal physiological rangestrong
  • May reduce hepatic fat and improve markers of non-alcoholic fatty liver disease (NAFLD)moderate
  • Preliminary evidence suggests cognitive benefits — improved executive function and verbal memorypreliminary
  • May improve triglyceride levels and cardiovascular risk markersmoderate

Dosage Protocols

RouteDosage RangeFrequencyNotes
Subcutaneous injection2 mgOnce dailyFDA-approved dose for HIV lipodystrophy; inject into the abdomen. Rotate injection sites.
Subcutaneous injection1–2 mgOnce dailyOff-label dose range used in anti-aging and body composition clinics; 1 mg may be sufficient for non-HIV patients
Subcutaneous injection2 mgFive days on, two days offProtocol used by some practitioners to reduce cost and manage IGF-1 levels while maintaining efficacy

Medical disclaimer

Dosage information is provided for educational reference only. Always follow your prescriber's instructions and consult a qualified healthcare provider before starting any peptide protocol.

Side Effects

  • Injection site reactions (erythema, pruritus, pain, swelling)common
  • Arthralgia (joint pain)common
  • Peripheral edema (fluid retention in extremities)common
  • Myalgia (muscle pain)common
  • Glucose intolerance or worsening of pre-existing diabetesserious
  • Carpal tunnel syndrome (from GH/IGF-1 elevation)rare

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Articles

Frequently Asked Questions

Can tesamorelin be used off-label for general fat loss?
While tesamorelin is FDA-approved specifically for HIV-associated lipodystrophy, it is increasingly prescribed off-label by physicians for visceral fat reduction in non-HIV patients. Clinical data shows significant reductions in trunk fat and visceral adipose tissue. However, fat tends to return after discontinuation. Off-label use should be supervised by a physician with appropriate monitoring. This is for informational purposes only and is not medical advice.
How does tesamorelin compare to sermorelin?
Tesamorelin is an analog of the full 44-amino acid GHRH sequence with a stabilizing modification, while sermorelin uses only the first 29 amino acids. Tesamorelin produces a more robust and sustained GH response and has demonstrated specific efficacy for visceral fat reduction that sermorelin has not. Tesamorelin is also the only GHRH analog with active FDA approval. However, tesamorelin is significantly more expensive (often $500–1,000+/month), which drives many patients toward sermorelin.
How much does tesamorelin cost?
Brand-name Egrifta SV can cost $1,000–$2,000+ per month without insurance. Compounded tesamorelin from specialty pharmacies is typically $300–$800 per month, depending on dosing and the pharmacy. Some insurance plans cover tesamorelin for the FDA-approved HIV lipodystrophy indication. Off-label use is rarely covered by insurance. Prices vary by region and provider.
Can tesamorelin be combined with ipamorelin?
Yes. Some clinicians combine tesamorelin (a GHRH analog) with ipamorelin (a GHRP) for synergistic GH release, following the same GHRH + GHRP stacking principle used with CJC-1295 + ipamorelin. The combination may produce greater GH elevation than either alone. However, this is an off-label approach without extensive clinical trial data specifically for this combination. Close monitoring of IGF-1 levels and metabolic markers is advisable.
Does tesamorelin affect blood sugar or insulin resistance?
Tesamorelin can increase fasting glucose and impair glucose tolerance in some patients, particularly those with pre-existing insulin resistance or diabetes. Growth hormone has inherent anti-insulin effects. In clinical trials, a small percentage of patients developed new-onset diabetes. Regular monitoring of fasting glucose and HbA1c is recommended during tesamorelin use. Patients with active diabetes should use tesamorelin with caution and under close medical supervision.

References

  1. 1
    Effects of tesamorelin on body composition and visceral fat in HIV-infected patients with abdominal fat accumulation(2010)PubMed ↗
  2. 2
    Tesamorelin reduces liver fat in HIV-associated NAFLD: a randomized, placebo-controlled trial(2016)PubMed ↗
  3. 3
    Tesamorelin effects on cognition in HIV-infected adults: the CLEAR study(2017)PubMed ↗
  4. 4
    Efficacy and safety of tesamorelin in treating HIV-associated lipodystrophy: a meta-analysis(2019)PubMed ↗

Last updated: 2026-02-14