Tesamorelin
A stabilised GHRH analogue that is FDA-approved under the brand Egrifta — but only for a narrow indication: reducing excess abdominal fat in adults with HIV-associated lipodystrophy. Other uses are off-label and less established.
Quick take
- What it is: a stabilised synthetic analogue of growth-hormone-releasing hormone (GHRH), sold as Egrifta.
- What it is approved for: reducing excess belly (visceral) fat in adults with HIV-associated lipodystrophy — and only that.
- What we actually know: good controlled trial evidence for the approved use; off-label uses are far less established.
- Status: FDA-approved for a narrow indication, off-label elsewhere, and banned in competitive sport.
What it is
Tesamorelin is a stabilised synthetic analogue of growth-hormone-releasing hormone (GHRH). A small chemical modification makes it more resistant to breakdown than the natural hormone, so it more effectively stimulates the pituitary to release the body’s own growth hormone (GH).1
It is important because it occupies an unusual position among the peptides on this site: Tesamorelin is genuinely FDA-approved. It is marketed as Egrifta for a narrow indication — reducing excess visceral (abdominal) fat in adults with HIV-associated lipodystrophy. That approval does not extend to general fat loss, anti-aging or athletic use.
How it works
Tesamorelin binds the GHRH receptor on the pituitary, increasing pulsatile release of GH and, in turn, IGF-1.1,2 The clinically relevant downstream effect in its approved use is a reduction in visceral adipose tissue — the deep abdominal fat that accumulates in some people with HIV on long-term therapy.
What the evidence shows
Animal & mechanistic studies
The GHRH pathway and Tesamorelin’s enhanced stability are well characterized, providing a clear mechanistic basis for its effect on GH/IGF-1.2
Human studies
Tesamorelin is supported by randomized, placebo-controlled clinical trials in adults with HIV-associated lipodystrophy, which demonstrated meaningful reductions in visceral fat — the basis for its FDA approval.3 This is a notably stronger evidence base than most peptides discussed here. However, that evidence is specific to the approved population and indication. For off-label uses — fat loss in healthy adults, anti-aging, or athletic recovery — the controlled evidence is limited, and the benefit-to-risk balance is not established.
Dosages reported in the literature
Informational only. The figures below describe doses used in trials and the approved label. They are not a recommendation or a prescription, and appropriate use should be determined by a qualified healthcare professional who can account for your individual situation.
| Setting | Route | Reported range |
|---|---|---|
| Approved indication (Egrifta label) | Subcutaneous | A fixed once-daily dose, per the prescribing information |
| Clinical trials | Subcutaneous | Once-daily dosing over several months |
| Off-label / anecdotal | Subcutaneous | Variable; not supported by controlled outcome data |
The approved daily dose and administration details are defined in the official prescribing information and should come from that source rather than informal protocols.
Safety & side effects
Reported side effects include injection-site reactions, joint pain (arthralgia), swelling (edema) and muscle aches. A clinically important effect is its tendency to raise blood glucose and reduce insulin sensitivity, which is why glucose monitoring is part of its labeling, especially in people with or at risk of diabetes.3 It is contraindicated in certain situations described in the prescribing information (for example, active malignancy and pregnancy).
Because Tesamorelin is an approved finished drug, the standardized product has defined quality — but unregulated or compounded “tesamorelin” sold outside that channel does not carry the same assurances of purity and potency.
Legal & regulatory status
Tesamorelin is FDA-approved as Egrifta for the narrow indication of reducing excess abdominal fat in adults with HIV-associated lipodystrophy.3 Use outside that indication is off-label. It is also banned in competitive sport — the World Anti-Doping Agency prohibits GHRH analogues and growth-hormone secretagogues at all times (category S2).4 Rules vary by country and change over time.
References
- Tesamorelin. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; updated 2018. Bookshelf ID NBK548730. [ncbi.nlm.nih.gov]
- Tesamorelin. In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bethesda (MD): NIDDK; updated 2018. Bookshelf ID NBK548730. (Supporting human mechanism/outcome: Falutz J, Allas S, Blot K, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007;357(23):2359-2370.) [ncbi.nlm.nih.gov]
- Falutz J, Allas S, Blot K, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007;357(23):2359-2370. PMID 18057338; DOI 10.1056/NEJMoa072375. AND Falutz J, Potvin D, Mamputu JC, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. J Acquir Immune Defic Syndr. 2010;53(3):311-322. PMID 20101189; DOI 10.1097/QAI.0b013e3181cbdaff. AND U.S. FDA. EGRIFTA SV (tesamorelin for injection) Prescribing Information. [PMID 18057338, PMID 20101189, doi:10.1056/NEJMoa072375, doi:10.1097/QAI.0b013e3181cbdaff]
- World Anti-Doping Agency. The 2026 Prohibited List — International Standard. Section S2 (Peptide Hormones, Growth Factors, Related Substances and Mimetics). Effective 1 January 2026. WADA, Montreal. [wada-ama.org]