At a glance
- Mechanism of action
- Tesamorelin is a 44-amino acid synthetic analog of human GHRF (1-44). It binds to GHRF receptors in the anterior pituitary, triggering pulsatile release of endogenous growth hormone (GH). The released GH stimulates hepatic IGF-1 production; IGF-1 in turn drives fat breakdown, preferentially in the visceral compartment.
- Benefits & use
- Reduces visceral abdominal fat in HIV patients with lipodystrophy (~15% VAT reduction in 26 weeks); positive effects on lipid profile; under active investigation for MASLD in HIV. Off-label often marketed as a "belly-fat drug", though not approved for that use.
- Study status
- Level 4: FDA-approved since November 2010 (Egrifta, F1), 2019 (Egrifta SV, F4), 2020 (Egrifta WR, F8). Phase 3 trials LIPO-010 and LIPO-011 (> 800 HIV patients) demonstrated significant VAT reduction vs. placebo with moderate IGF-1 elevation into the upper normal range. Rebound after discontinuation within months - thus maintenance therapy. Long-term cardiovascular safety not definitively established per label. New 2025 data on MASLD in HIV under antiretroviral therapy.
- Dosing note
- Approved dose (Egrifta SV/WR): 2 mg subcutaneously once daily (per FDA label). Before initiation: IGF-1 baseline, exclusion of pituitary tumors, pregnancy test in women of childbearing potential. Not a dosing instruction - information only.
Use in the injection calculator
Tesamorelin is a synthetic peptide hormone and analog of human growth hormone-releasing factor (GHRF). It has been FDA-approved since November 2010 under the brand name Egrifta as the first medication specifically for reducing excess abdominal fat in HIV patients with lipodystrophy. The peptide stimulates endogenous growth hormone release via the pituitary, reducing visceral fat without chronically disrupting insulin levels.
How does tesamorelin work?
Tesamorelin is a 44-amino acid synthetic analog of human GHRF (1-44). It binds to GHRF receptors in the anterior pituitary, triggering pulsatile release of endogenous growth hormone (GH). The released GH stimulates hepatic IGF-1 production; IGF-1 in turn drives fat breakdown, preferentially in the visceral compartment.
Unlike direct growth hormone (HGH) injection, tesamorelin preserves the body's own regulatory axis: the pituitary continues to secrete GH in its natural pulses. IGF-1 therefore rises only moderately into the upper normal range rather than spiking to supraphysiological levels.
What is tesamorelin used for?
- FDA-approved: Reduction of excess abdominal fat in HIV-infected adults with lipodystrophy.
- Actively studied: MASLD (metabolic dysfunction-associated steatotic liver disease) in HIV, cardiovascular risk markers, cognitive effects.
- Off-label / experimental: Visceral fat reduction in non-HIV patients, anti-aging use.
What does the evidence show?
Two randomized, placebo-controlled Phase 3 trials (LIPO-010 and LIPO-011) with more than 800 HIV patients demonstrated an average ~15% reduction in visceral adipose tissue versus placebo over 26 weeks. IGF-1 rose moderately into the upper normal range. After discontinuation, visceral fat returned within a few months - tesamorelin is thus a maintenance therapy, not a cure.
Current research (2025) increasingly focuses on MASLD in HIV patients under antiretroviral therapy. Data are encouraging but not yet confirmed in a Phase 3 trial.
What side effects are documented?
The safety profile in studies is favorable. Most commonly reported adverse events:
- Injection site reactions (pain, redness, itching)
- Arthralgia (joint pain)
- Myalgia (muscle pain)
- Peripheral edema
- IGF-1 elevation (usually into the upper normal range)
Important: tesamorelin is not a general weight-loss drug and not a classic anti-aging medication. Long-term cardiovascular safety has not been definitively established per the FDA label.
How does tesamorelin differ from CJC-1295/Ipamorelin?
Like CJC-1295/Ipamorelin, tesamorelin is a GHRH secretagogue - it stimulates the body's own GH release instead of supplying GH directly. The key difference: tesamorelin has clear FDA approval with documented efficacy and safety, while CJC-1295/Ipamorelin only have off-label status. On the downside, tesamorelin is very expensive (monthly therapy often > $1,000 in the US) and only reimbursed for the HIV lipodystrophy indication.
What do you need to know about use?
- Dosage (per FDA label): 2 mg subcutaneously once daily.
- Administration: Subcutaneous into the abdomen; rotate the injection site daily.
- Storage: Reconstituted Egrifta WR stable for 7 days at room temperature; Egrifta SV in the refrigerator at 2-8 °C.
- Contraindications: Active malignancy (especially pituitary tumors), pregnancy.
These details are information only - not a dosing instruction. Use only under medical prescription and in line with the current FDA label.
Regulatory status
In the US, tesamorelin is approved in three formulations:
- Egrifta (F1, 2010) - original 1 mg/vial, daily reconstitution required.
- Egrifta SV (F4, 2019) - more concentrated, 2 mg/vial.
- Egrifta WR (F8, 2020) - 8-fold concentrated (11.6 mg/vial); reconstituted, stable for 7 days at room temperature.
In the EU, tesamorelin is not approved. Use outside the HIV indication is experimental and not covered by approval data.
This article is informational - it does not replace medical advice. Tesamorelin is prescription-only and must be used under medical supervision. Peptipedia does not link to suppliers.
Related peptides
Sources
- EGRIFTA / EGRIFTA SV / EGRIFTA WR Prescribing Information (FDA Label 2025)
- Spooner LM et al. Tesamorelin: a growth hormone-releasing factor analogue for HIV-associated lipodystrophy (Ann Pharmacother 2012)
- Traynor K. FDA approves tesamorelin for HIV-related lipodystrophy (Am J Health Syst Pharm 2010)
- Gattu AK et al. Metabolic dysfunction-associated steatotic liver disease in people with HIV (Curr Opin HIV AIDS 2025)