Tesamorelin is a lab-made version of growth hormone-releasing hormone (GHRH) sold as Egrifta. It is the only GHRH analog currently FDA-approved, specifically to reduce excess abdominal fat in adults with HIV who have lipodystrophy.[1] In its main trial, it cut deep belly (visceral) fat by 15.2% in 26 weeks, versus a 5% gain on placebo.[6]

This profile covers what tesamorelin is, its FDA approval, the trial results (including liver fat and cognition), how it compares with sermorelin and ipamorelin, side effects and dosage.

What is tesamorelin?

Tesamorelin is the full 44-amino-acid sequence of human GHRH with a small fatty chain attached at one end.[1] That chain protects it from being broken down by the enzyme DPP-4, so it works longer than natural GHRH.[15] It was developed by Theratechnologies in Montreal and approved by the FDA in November 2010.[2][3]

How tesamorelin works

Tesamorelin signals the pituitary gland to release more of the body’s own growth hormone, which in turn raises IGF-1. Growth hormone promotes the breakdown of visceral fat, the deep fat around the organs.[1] Despite a half-life of only about 8 to 11 minutes, daily injections keep IGF-1 raised.[1][6]

FDA approval and uses

  • Approved use: reducing excess abdominal fat in adults with HIV and lipodystrophy.[1]
  • Not approved for weight loss: the label notes it has a weight-neutral effect.[1]
  • Unknown long-term heart safety: the label says long-term cardiovascular safety has not been established.[1]
  • Formulations: the original Egrifta (2010), the single-vial Egrifta SV (2018) and Egrifta WR (2025), which is mixed once a week and injected daily.[2][5][4]

Tesamorelin results: what the research shows

Belly fat in HIV

  • First phase 3 trial (412 people): visceral fat fell 15.2% in 26 weeks versus a 5% rise on placebo; triglycerides fell 50 mg/dL and IGF-1 rose 81%, with no significant change in blood sugar.[6]
  • Second phase 3 trial (404 people): visceral fat fell 10.9% versus 0.6% on placebo, reaching about 18% by 12 months on continued treatment.[8]
  • The fat returns after stopping in both trials.[7][8]
  • Better responders, better metabolism: people whose visceral fat fell at least 8% also had better triglycerides and blood sugar.[10]

Liver fat

In 61 adults with HIV and fatty liver disease, a year of tesamorelin cut liver fat by 37% relative to placebo, and 35% of patients reached normal liver fat versus 4% on placebo.[12] An earlier trial also found reductions in both visceral and liver fat.[11]

Without HIV

In 60 adults with obesity and low growth hormone (no HIV), a year of tesamorelin reduced visceral fat and triglycerides and slightly thinned the carotid artery wall, without changing blood sugar.[13]

Memory and thinking

In 152 adults aged 55 to 87, including people with mild cognitive impairment, 20 weeks of tesamorelin improved cognitive scores, especially executive function. Side effects were more common than on placebo (68% vs 36%).[14]

Tesamorelin vs sermorelin and ipamorelin

TesamorelinSermorelinIpamorelin
TypeGHRH analog (44 amino acids)[1]GHRH analog (29 amino acids)Ghrelin-receptor agonist
FDA statusApproved (Egrifta)[2]Approved 1990–2008, then discontinuedNever approved
Largest trialsTwo phase 3 trials, 800+ patients[9]Pediatric growth trialsPhase 2 after surgery

Tesamorelin is also often paired with ipamorelin; no study has tested that combination. See our CJC-1295 + ipamorelin guide for how GHRH analogs and ipamorelin differ, and the CJC-1295 with DAC profile for a longer-acting, never-approved GHRH analog.

Tesamorelin side effects

From the prescribing information:[1]

  • Most common (over 5%): joint pain, injection-site redness and itching, pain in the arms or legs, swelling of the legs, and muscle pain.
  • Raised IGF-1: at 26 weeks, 47% of patients had IGF-1 more than 2 standard deviations above normal.
  • Blood sugar: HbA1c of 6.5% or higher developed in 5% on tesamorelin versus 1% on placebo; people with diabetes should be monitored, including for eye disease.
  • Fluid retention: swelling, joint pain and carpal tunnel symptoms.
  • Other warnings: allergic reactions, injection-site reactions, and a possible increased risk of tumors.

It should not be used during pregnancy, with active cancer, or by people whose pituitary gland has been damaged or removed.[1] MedlinePlus also lists hand and wrist numbness, vomiting, heartburn and night sweats.[17]

Tesamorelin dosage

SettingDose
Egrifta SV (label)1.4 mg under the skin of the abdomen once daily[1]
Egrifta WR (label)1.28 mg once daily; one vial lasts 7 days[1]
Original Egrifta and phase 3 trials2 mg once daily[6]
Cognition trial1 mg once daily[14]

Egrifta SV and WR doses are not interchangeable.[1] In a Canadian-American dose-ranging study, 1 mg and 2 mg raised IGF-1 by 48% and 65%.[22]

What users report

  • Prescription only: Egrifta requires a prescription.[2]
  • Not for compounding: according to the Alliance for Pharmacy Compounding, tesamorelin was reclassified as a biologic in 2020 and can no longer be compounded.[18]
  • Banned in sport: WADA prohibits tesamorelin at all times as a GHRH analog.[16]

This is general information, not legal advice.