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Tesamorelin

From PeptidePlaza, the free peptide reference · Entry #012 · Metabolic · Hand-curated entry · Editorial standards

Research warning. FDA-approved for HIV-associated lipodystrophy only. May raise IGF-1 levels above normal range in some patients — monitor for acromegaly symptoms.

Tesamorelin (also known as Egrifta, TH9507) is a metabolic research peptide. A 44-amino acid GHRH analog with a trans-3-hexenoic acid N-terminal modification. FDA-approved for HIV-associated lipodystrophy. The most clinically validated GHRH analog for visceral adipose tissue reduction.

Tesamorelin is a synthetic GHRH analog consisting of the full 44-amino acid GHRH sequence with a trans-3-hexenoic acid group attached at the N-terminus for increased stability. It was FDA-approved in 2010 (brand: Egrifta) for reduction of excess visceral adipose tissue (VAT) in HIV-positive patients with lipodystrophy. Clinical trials demonstrate significant VAT reduction (~15%), increased IGF-1, and improved lipid profiles. Unlike exogenous GH, tesamorelin preserves pulsatile GH release and avoids supraphysiological GH spikes, resulting in a favorable safety profile with low rates of glucose dysregulation.

1 Mechanism of action

Binds pituitary GHRHR, stimulating pulsatile GH release. GH then stimulates hepatic IGF-1 production and activates adipose lipolysis — particularly in visceral adipose depots. Preserves physiological pulsatility vs exogenous GH.

Primary targets: GHRHR

2 Reported effects

Effects below are those reported in the published literature cited on this page. They are not claims of clinical benefit and not medical advice.

2.1 Reported benefits

  • Clinically proven visceral fat reduction (~15% in Phase 3)
  • Preserves pulsatile GH release with favorable safety profile
  • Improves lipid profiles without significant glucose effects

2.2 Side effects

  • Mild arthralgia and joint discomfort
  • Injection site reactions (erythema, pruritus)
  • Peripheral edema and carpal tunnel symptoms

3 Chemical and physical properties

CAS number218949-48-5
Molar mass5135.89 g/mol
Purity (typical)>99.3%
Half-life~38 min
Storage−20 °C, lyophilised powder, desiccated
SolubilitySterile water / bacteriostatic water
Receptors / targetsGHRHR

4 Research dosages

2 mg SC once daily (FDA-approved); research exploring 1–4 mg dose range.

Dosages are reported from published protocols for reference only. Research chemicals are not for human consumption.

5 Research studies (8)

  1. Tesamorelin for the Treatment of HIV-Associated Abdominal Fat Accumulation
    New England Journal of Medicine (2010) · RCT · N=404
    Phase 3 RCT. Tesamorelin 2 mg/day reduced visceral adipose tissue by 15.2% vs placebo increase of 5.0% at 26 weeks. Led to FDA approval.
    Key finding: 15.2% visceral fat reduction vs +5.0% placebo — led to FDA approval for HIV-associated lipodystrophy.
  2. Tesamorelin Effects on Metabolic Parameters in HIV-Infected Patients
    Journal of Clinical Endocrinology & Metabolism (2012) · RCT · N=350
    Extended analysis showing sustained VAT reduction, improved triglycerides, and non-significant effect on glucose in tesamorelin-treated HIV patients.
    Key finding: Sustained VAT reduction over 52 weeks with no significant glucose dysregulation — favorable safety vs exogenous GH.
  3. Efficacy and Safety of Tesamorelin in People Living With HIV (PLWH) With Lipodystrophy: A Systematic Review and Meta-Analysis
    Journal of the International Association of Providers of AIDS Care (2026) · Meta-Analysis · n=909
    Overall, tesamorelin appeared quite useful as long as it is continued, but more research is needed to understand its long-term safety and benefits.
  4. Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV (TRIUMPH): a clinical trial protocol
    BMJ open (2026) · RCT
    Theratechnologies provided study product (tesamorelin) at reduced rate for this trial.
  5. Differing Presentations of Excess Visceral Abdominal Fat in People Living With HIV: Two Clinical Cases Highlighting Distinct Therapeutic Pathways With Tesamorelin and Glucagon-Like Peptide-1 Receptor Agonists
    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (2026) · Preclinical
    These cases highlight the heterogeneity of EVAF in PLWH and support individualized management strategies informed by fat distribution rather than weight alone.
  6. Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials
    Obesity research & clinical practice (2026) · Meta-Analysis
    Tesamorelin improves body composition, hepatic fat, lean body mass, and IGF-1 levels in HIV-associated lipodystrophy, without serious side effects or perturbation of glucose.
  7. Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity
    The Journal of infectious diseases (2025) · RCT
    While tesamorelin reduced WC, the cognitive benefits did not significantly differ between groups.
  8. Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors
    AIDS (London, England) (2024) · RCT · n=38
    The current analysis provides the first dedicated data on the efficacy and safety of tesamorelin among PWH on INSTI-based regimens.

6 Safety and risk profile

6.1 Regulatory status

Tesamorelin is currently classified as FDA approved. Approval applies to specific clinical indications and dosing; research-grade material is not the approved product.

Safety score: 78/100 — low concern. Derived from clinical data volume, known risks and regulatory status.

6.2 Contraindications

Conditions and populations in which use is contraindicated:

  • Active malignancy (underlying malignancy may be unmasked)
  • Pituitary tumor or history of pituitary surgery
  • Pregnancy
  • Known hypersensitivity to mannitol (excipient)

6.3 Drug interactions

Drug or classInteractionRisk
CorticosteroidsGlucocorticoids suppress GH axis — may blunt tesamorelin's visceral fat reduction.Moderate
Estrogen-containing productsOral estrogens reduce hepatic IGF-1 production — may reduce tesamorelin efficacy.Moderate

6.4 Long-term risks

  • IGF-1 elevation and associated cancer risk with prolonged use
  • Potential for insulin resistance with extended therapy
  • Acromegalic features with sustained IGF-1 above normal range

6.5 Research best practices

  • Store lyophilized at 2–8 °C (refrigerated); reconstituted vial stable 24h at room temp
  • Monitor IGF-1 levels and discontinue if >2 SD above age-adjusted normal
  • Administer at bedtime to align with natural GH surge
Safety data disclaimer. Safety assessments are based on published literature and are for educational reference only. Clinical evidence varies significantly between peptides. Always consult primary research and current regulatory guidance.

7 Frequently asked questions

How does Tesamorelin differ from growth hormone itself?
Tesamorelin stimulates the body's own natural, pulsatile GH release rather than flooding the system with exogenous GH. This preserves physiological feedback loops and results in a much lower rate of glucose intolerance and other GH-related side effects.
Is Tesamorelin used for fat loss in non-HIV populations?
Tesamorelin is specifically FDA-approved for HIV-associated lipodystrophy only. Research on its use for general obesity or visceral fat reduction in non-HIV populations is limited but ongoing.

8 References

  1. Efficacy and Safety of Tesamorelin in People Living With HIV (PLWH) With Lipodystrophy: A Systematic Review and Meta-Analysis PubMed (2026). Ditta AM, et al.. View source
  2. Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV (TRIUMPH): a clinical trial protocol PubMed (2026). Erlandson KM, et al.. View source
  3. Differing Presentations of Excess Visceral Abdominal Fat in People Living With HIV: Two Clinical Cases Highlighting Distinct Therapeutic Pathways With Tesamorelin and Glucagon-Like Peptide-1 Receptor Agonists PubMed (2026). Beach R, et al.. View source
  4. Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials PubMed (2026). Badran AS, et al.. View source

Related compounds

Entries that share a target, a mechanism, or a research area with Tesamorelin.

CJC-1295anti-aging

Also targets GHRHR

A tetrasubstituted GHRH analog with four amino acid substitutions that increase receptor affinity and proteolytic resistance. Most commonly studied in combination with Ipamorelin for synergistic GH pulse amplification.

AOD-9604metabolic

Shares activates and lipolysis pharmacology

A modified C-terminal fragment of human growth hormone (amino acids 177-191) with a tyrosine substitution. Studied primarily for its lipolytic (fat-burning) effects without the growth-promoting activity of full-length hGH.

GHRP-2anti-aging

Shares pituitary and stimulates pharmacology

A second-generation synthetic hexapeptide GHRP and potent GHSR-1a agonist. More selective than GHRP-6 with less ghrelin-like appetite stimulation, making it widely used in GH axis research protocols.

Ipamorelinanti-aging

Shares pituitary and stimulates pharmacology

A pentapeptide ghrelin mimetic renowned for its exceptional receptor selectivity. Unlike other GHSRs, Ipamorelin does not significantly raise cortisol, ACTH, or prolactin — making it a clean research tool for isolated GH axis studies.

Survodutidemetabolic

Shares stimulates and hepatic pharmacology

A 29-amino-acid dual agonist that pairs GLP-1 appetite suppression with glucagon-driven energy expenditure and hepatic fat oxidation. Its liver-fat data is the standout: up to 63% reduction.

Retatrutidemetabolic

Shares adipose and lipolysis pharmacology

A novel triple receptor agonist targeting GLP-1, GIP, and glucagon receptors simultaneously — the first of its kind in human Phase 2 trials. Early data suggests it may surpass dual agonists.

9 See also

For research reference only. Not medical advice. Peptides may be regulated or restricted in your jurisdiction. Entry validated by the PeptidePlaza Biomedical Research Desk; see editorial standards.

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