Tesamorelin
Egrifta / TH9507
Tesamorelin (trade name Egrifta) is a synthetic growth hormone-releasing hormone (GHRH) analog consisting of the full 44-amino-acid sequence of human GHRH with a trans-3-hexenoic acid modification at the N-terminus to improve stability and receptor binding. It is the only FDA-approved GHRH analog, specifically indicated for the reduction of excess abdominal/visceral fat in HIV-infected patients with lipodystrophy. Its mechanism stimulates pulsatile endogenous GH release from the pituitary gland, preserving normal physiological feedback regulation unlike exogenous GH administration.
Mechanism of Action
Synthetic GHRH analog with a trans-3-hexenoic acid modification for enhanced stability. Specifically targets visceral adipose tissue reduction via GH-mediated lipolysis. FDA-approved mechanism preserves physiologic GH pulsatility and IGF-1 negative feedback.
Research Protocols
For research purposes only. Not medical advice.
FDA-approved protocol: 2mg daily via subcutaneous injection. Research protocols follow the same dosing. Administered at a consistent time daily, typically in the morning.
Research Notes
Clinical Research Status
Tesamorelin received FDA approval in November 2010 for the treatment of HIV-associated lipodystrophy and is marketed by Theratechnologies as Egrifta and Egrifta SV (single-vial formulation). Multiple Phase III clinical trials (including the landmark studies with over 800 HIV patients) demonstrated statistically significant visceral adipose tissue reduction of approximately 15-18% over 26 weeks. Ongoing research explores applications in non-alcoholic fatty liver disease (NAFLD), cognitive decline in aging and HIV, and broader metabolic syndrome indications beyond the HIV population.
Key Published Findings
Pivotal trials demonstrated that tesamorelin 2mg daily subcutaneous injection reduced visceral adipose tissue by a mean of 15.2% versus placebo over 26 weeks, with continued maintenance of reduction over 52 weeks of treatment. A landmark study published in Neurology showed tesamorelin improved cognitive function in older adults with mild cognitive impairment or subjective cognitive complaints, suggesting neuroprotective properties mediated through GH/IGF-1 signaling. Research has also demonstrated improvements in liver fat content and NAFLD biomarkers, with hepatic fat reduction of approximately 35% in HIV patients with fatty liver.
Safety Profile
Tesamorelin is generally well-tolerated with the most common adverse effects being injection site reactions (erythema, pruritus, pain) reported in approximately 8-13% of clinical trial participants. Fluid retention, arthralgia, and paresthesias occur at rates slightly above placebo, consistent with physiological GH elevation. The compound is contraindicated in pregnancy, patients with active malignancy, and those with disruption of the hypothalamic-pituitary axis, and carries warnings regarding potential glucose intolerance.
Drug Interactions & Contraindications
Tesamorelin may reduce the efficacy of cortisol replacement therapy by increasing cortisol-binding globulin, and patients on glucocorticoid replacement should be monitored. It should be used cautiously with drugs affecting glucose metabolism (insulin, oral hypoglycemics) as GH elevation can impair insulin sensitivity. The compound is contraindicated in patients with active malignancy due to the proliferative effects of elevated GH/IGF-1, and patients with a history of hypothalamic-pituitary tumors should not use it.
Comparison to Related Compounds
Unlike synthetic GH (somatropin) which provides a constant supraphysiological GH level, tesamorelin preserves the natural pulsatile pattern of GH release and maintains hypothalamic-pituitary feedback, resulting in a more physiological GH profile. Compared to CJC-1295 (a modified GHRH analog popular in peptide research), tesamorelin has the advantage of FDA approval, extensive clinical trial data, and insurance coverage for qualifying HIV patients. Sermorelin is a shorter GHRH fragment (1-29) with similar mechanism but lower potency and shorter half-life, requiring more frequent dosing.
Community Observations
Practitioners and patients report that the visceral fat reduction becomes measurable on DEXA scans within 3-4 months, with peak effects at 6-9 months of consistent daily use. The research and TRT community has adopted tesamorelin for its GH-elevating effects beyond the HIV population, noting improvements in sleep quality, body composition, and skin quality. Users frequently note that results reverse within 3-6 months of discontinuation, indicating the need for ongoing treatment, and many physicians prescribe it alongside testosterone replacement therapy for synergistic metabolic benefits.
Half-Life
~26-38 minutes
Reconstitution
Sterile water (provided with kit)
Storage
Lyophilized
Refrigerate 2-8C. Protect from light.
Reconstituted
Use immediately after reconstitution. Discard unused portion.
US Legal Status
Also Known As
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