Tesamorelin
Tesa
Metabolic
CAS
218949-48-5
Human RCT
A synthetic analog of Growth Hormone Releasing Hormone (GHRH) and the only GHRH analog with an FDA-approved indication, making it one of the most clinically validated peptides in this catalog. Approved under the brand name Egrifta for the reduction of excess visceral abdominal fat in HIV patients with lipodystrophy. Widely used off-label in longevity and metabolic health contexts for its targeted visceral fat reduction and emerging cognitive benefits. Requires a prescription through a licensed provider.
Injectable
Prescription
What It Is
Tesamorelin is a synthetic stabilized analog of endogenous GHRH comprising the full 44 amino acid sequence with a trans-3-hexenoic acid group added to improve stability. Unlike direct growth hormone injections, it stimulates the pituitary gland to produce GH naturally, preserving the body's own regulatory feedback mechanisms. It was developed by Canadian biotech Theratechnologies and received FDA approval in November 2010, the first treatment ever approved for HIV-associated lipodystrophy. A newer long-acting formulation (Egrifta WR) was approved more recently, reducing injection frequency significantly.
Mechanism of Action
Tesamorelin binds to GHRH receptors in the pituitary gland, stimulating the pulsatile release of endogenous growth hormone. GH then acts on adipose tissue — particularly visceral adipose tissue (VAT) surrounding internal organs, to promote lipolysis and fat oxidation. Unlike exogenous GH which produces supraphysiological levels, tesamorelin works within the body's natural feedback loop, meaning GH levels remain regulated by somatostatin. This targeted mechanism produces visceral fat reduction without the generalized weight loss or off-target effects associated with direct GH administration. Emerging research suggests GH-mediated effects on brain glucose metabolism may explain the cognitive benefits observed in clinical trials.
Use Cases
Tesamorelin's strongest and most validated application is visceral fat reduction, supported by two large Phase III trials enrolling over 800 HIV patients that demonstrated 12-20% VAT reduction at 26 weeks compared to placebo, measured by CT scan, a hard endpoint. This data formed the basis of FDA approval and represents one of the most rigorous evidence bases of any peptide in this catalog.
Off-label use in the longevity and metabolic health community centers on visceral fat reduction in non-HIV populations, where VAT accumulation is associated with cardiovascular disease, insulin resistance, and metabolic syndrome. A notable 2012 JAMA study found tesamorelin improved executive function and verbal memory in adults over 60, opening a compelling area of research into cognitive applications. A separate trial showed approximately 32% liver fat reduction versus placebo with lower fibrosis progression rates, raising interest in NAFLD applications. It is important to note that the FDA approval is specific to HIV-associated lipodystrophy, off-label use in general populations is not FDA sanctioned and the evidence base outside this indication, while promising, is less established.
Known Risks
The most commonly reported adverse effects in clinical trials include joint pain, injection site reactions, peripheral edema, and myalgia. Tesamorelin carries a meaningful risk of glucose dysregulation, trials showed a 5% vs 1% rate of developing diabetes compared to placebo, with a hazard ratio of 3.3. Anti-tesamorelin antibodies developed in approximately 50% of patients after 26 weeks, though their clinical significance remains unclear. Not recommended for patients with active malignancy, pituitary disorders, or those who are pregnant. Should not be used without baseline metabolic labs and ongoing provider supervision given the glucose risk profile.
Available Forms
Tesamorelin is available exclusively as a subcutaneous injectable. The original formulation (Egrifta) is supplied as a lyophilized powder requiring daily reconstitution and injection. The newer long-acting formulation (Egrifta WR) is a weekly injectable that significantly reduces administration burden, a single reconstituted vial provides seven days of dosing. Both formulations are administered subcutaneously into the abdomen only. Not available in oral, topical, or nasal form. Prescription required, not available through research compound channels given FDA prescription status.
Regulatory Status
FDA approved (Egrifta, Egrifta WR) for HIV-associated lipodystrophy. Prescription only. Available through licensed providers and compounding pharmacies for approved indications. Off-label prescribing exists but is at provider discretion. Not available OTC or as a research compound through standard channels given its prescription status.
Sources
https://pubmed.ncbi.nlm.nih.gov/20554713/
https://pubmed.ncbi.nlm.nih.gov/18057338/
https://pubmed.ncbi.nlm.nih.gov/22869065/
https://pubmed.ncbi.nlm.nih.gov/31611038/
Similar Compounds
Sermorelin, CJC-1295, Ipamorelin
