Tesamorelin
Tesamorelin is a synthetic analogue of growth-hormone-releasing hormone, approved as an injectable prescription drug (Egrifta) to reduce excess visceral abdominal fat in HIV-associated lipodystrophy.
Regulatory status: FDA-approved in 2010 as Egrifta / Egrifta SV for reduction of excess visceral abdominal fat in HIV-infected patients with lipodystrophy. Where an approved indication exists, the approved prescribing information governs — not community convention.
Default vial
2 mg
Default mix
2 mL
Reported range
1–2 mg
Draw (U-100)
200 u
Approved prescribing dose for HIV-associated lipodystrophy is 2 mg daily.
What it is
- A 44-amino-acid peptide: a stabilised analogue of human GHRH(1-44) carrying a trans-3-hexenoic acid modification.
- A GHRH-receptor agonist, not a ghrelin-pathway compound.
- Given once daily by subcutaneous injection in the studied and approved regimens.
- Trials were conducted specifically in HIV-associated lipodystrophy populations, not as a general anti-ageing agent.
How it is described to act
- 1
Administered subcutaneously once daily, as evaluated in the phase 3 programme.
- 2
Distributes systemically; the authors describe action at the hypothalamic-pituitary level.
- 3
Binds the GHRH receptor on pituitary somatotrophs, stimulating pulsatile growth-hormone release.
- 4
Trial reports describe increased GH pulses raising IGF-1, associated with reduced visceral adipose tissue in the studied population.
What the research has looked at
Phase 3 programme in HIV lipodystrophy
- In a pooled analysis of two multicentre, double-blind, placebo-controlled phase 3 trials, researchers reported that tesamorelin significantly reduced visceral adipose tissue versus placebo in HIV patients with excess abdominal fat (J Clin Endocrinol Metab, 2010).
- A companion randomised placebo-controlled trial reported similar reductions in visceral fat with an acceptable short-term safety profile (2010).
Metabolic follow-up
- Researchers reported that visceral-fat reduction with tesamorelin was associated with improvements in triglycerides and other metabolic markers in HIV-infected patients (2012).
- A 2024 study in AIDS examined efficacy and safety in people with HIV taking integrase inhibitors, reflecting current treatment context.
Strength of evidence: Approved drug (for a specific indication)
This is the only GH-axis peptide in the library with completed phase 3 trials and an FDA-approved indication, and that evidence is specific to HIV-associated lipodystrophy.
This molecule is an approved medicine for at least one indication. Where that is the case, the approved prescribing information — not community convention — governs its use.
Reported cautions and unknowns
- Injection-site reactions such as redness and itching were reported as common adverse events in the phase 3 trials.
- Trials reported increases in blood glucose and reduced glucose tolerance in some participants, which is why glucose monitoring is part of the labelled use.
- IGF-1 elevation is the expected pharmacodynamic effect and was monitored as part of the trial safety programme.
References
- 1.Falutz J et al., pooled analysis of two phase 3 tesamorelin trials, J Clin Endocrinol Metab (2010)
- 2.Falutz J et al., tesamorelin in HIV-infected patients with abdominal fat accumulation (2010)
- 3.FDA approves tesamorelin for HIV-related lipodystrophy (2010)
- 4.Russo SC et al., tesamorelin in people with HIV on integrase inhibitors, AIDS (2024)
Handling this vial
- Lyophilized vials are generally stored at 2–8 °C and kept out of light; once reconstituted with bacteriostatic water they are refrigerated and commonly discarded after 28 days.
- Mix by aiming water down the vial wall and rolling gently — do not shake — and never re-freeze a reconstituted vial.
- Pep-Tidy cannot verify what is in your vial. Ask your supplier for a current Certificate of Analysis (HPLC/MS).
Tesamorelin questions people ask
How do you reconstitute Tesamorelin?
A common starting point for a 2 mg vial of Tesamorelin is 2 mL of bacteriostatic water, which gives 1 mg per mL. Aim the water down the inside wall of the vial, let it dissolve on its own, and roll gently instead of shaking. Pep-Tidy's reconstitution calculator will recalculate the numbers for any other vial size or water volume you use.
How many units of Tesamorelin is one dose?
At 1 mg per mL, that works out to about 200 units on a U-100 insulin syringe for a 2000 mcg dose. Change the vial size, water volume, or target dose in the calculator and the syringe reading updates with it. This is arithmetic, not a dosing recommendation.
What dosing schedule is reported for Tesamorelin?
Published and community sources describe 1–2 mg, subcutaneous, every day, typically run 12 weeks on. These figures describe what has been reported, not what anyone should take — talk to a licensed clinician first.
How should Tesamorelin be stored?
Lyophilized Tesamorelin vials are generally kept at 2–8 °C and out of light. Once reconstituted with bacteriostatic water they are refrigerated and commonly discarded after about 28 days. Never re-freeze a reconstituted vial and never shake it.
Read this before you act on anything above
Everything on this page is a summary of what other people have published — it is not medical advice, not a recommendation, and not a dosing instruction. Reported dose ranges describe what appears in the literature or in community protocols, not what anyone should take. Talk to a licensed clinician before using any peptide.