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Tesamorelin

FDA Approved

GHRH Analog | Visceral Fat Reduction

Dose 1.4-2mg daily (FDA-approved: 2mg for HIV lipodystrophy)
Frequency Once daily (evening preferred for GH rhythm)
Cycle Continuous therapy for maintained benefits
Storage Powder: 20-25°C. Egrifta SV: use immediately. Egrifta WR: room temp up to 7 days
Accumulation Plotter

Tesamorelin is an FDA-approved synthetic GHRH analog designed for HIV-associated lipodystrophy treatment. It provides selective visceral fat targeting with 15-20% visceral fat reduction in clinical trials while preserving subcutaneous fat.

Mechanism of Action

Subcutaneous injection provides optimal bioavailability for GHRH receptor binding and pulsatile GH release stimulation, selectively targeting visceral adipose tissue while sparing subcutaneous fat.

Key Benefits

  • FDA-approved formulation
  • Selective visceral fat targeting (15-20% reduction)
  • Proven clinical efficacy
  • Standardized dosing
  • 37% liver fat reduction in NAFLD
  • Preserved subcutaneous fat
Molecular Weight
5,135.9 Da
Chain Length
44 amino acids
Type
GHRH analog
Amino Acid Sequence
One-letter: HADGIFTNSYRKVLGQLSARKLLQDIMSRQQGESNQERGARARL
H₂N
H 1
O ‖ C
N
A 2
O ‖ C
N
D 3
O ‖ C
N
H
G 4
O ‖ C
N
I 5
O ‖ C
N
F 6
O ‖ C
N
T 7
O ‖ C
N
N 8
O ‖ C
N
S 9
O ‖ C
N
Y 10
O ‖ C
N
R 11
O ‖ C
N
K 12
O ‖ C
N
V 13
O ‖ C
N
L 14
O ‖ C
N
H
G 15
O ‖ C
N
Q 16
O ‖ C
N
L 17
O ‖ C
N
S 18
O ‖ C
N
A 19
O ‖ C
N
R 20
O ‖ C
N
K 21
O ‖ C
N
L 22
O ‖ C
N
L 23
O ‖ C
N
Q 24
O ‖ C
N
D 25
O ‖ C
N
I 26
O ‖ C
N
M 27
O ‖ C
N
S 28
O ‖ C
N
R 29
O ‖ C
N
Q 30
O ‖ C
N
Q 31
O ‖ C
N
H
G 32
O ‖ C
N
E 33
O ‖ C
N
S 34
O ‖ C
N
N 35
O ‖ C
N
Q 36
O ‖ C
N
E 37
O ‖ C
N
R 38
O ‖ C
N
H
G 39
O ‖ C
N
A 40
O ‖ C
N
R 41
O ‖ C
N
A 42
O ‖ C
N
R 43
O ‖ C
N
L 44
COOH
His
1

Histidine

Position 1

Ala
2

Alanine

Position 2

Asp
3

Aspartic Acid

Position 3

Gly
4

Glycine

Position 4

Ile
5

Isoleucine

Position 5

Phe
6

Phenylalanine

Position 6

Thr
7

Threonine

Position 7

Asn
8

Asparagine

Position 8

Ser
9

Serine

Position 9

Tyr
10

Tyrosine

Position 10

Arg
11

Arginine

Position 11

Lys
12

Lysine

Position 12

Val
13

Valine

Position 13

Leu
14

Leucine

Position 14

Gly
15

Glycine

Position 15

Gln
16

Glutamine

Position 16

Leu
17

Leucine

Position 17

Ser
18

Serine

Position 18

Ala
19

Alanine

Position 19

Arg
20

Arginine

Position 20

Lys
21

Lysine

Position 21

Leu
22

Leucine

Position 22

Leu
23

Leucine

Position 23

Gln
24

Glutamine

Position 24

Asp
25

Aspartic Acid

Position 25

Ile
26

Isoleucine

Position 26

Met
27

Methionine

Position 27

Ser
28

Serine

Position 28

Arg
29

Arginine

Position 29

Gln
30

Glutamine

Position 30

Gln
31

Glutamine

Position 31

Gly
32

Glycine

Position 32

Glu
33

Glutamic Acid

Position 33

Ser
34

Serine

Position 34

Asn
35

Asparagine

Position 35

Gln
36

Glutamine

Position 36

Glu
37

Glutamic Acid

Position 37

Arg
38

Arginine

Position 38

Gly
39

Glycine

Position 39

Ala
40

Alanine

Position 40

Arg
41

Arginine

Position 41

Ala
42

Alanine

Position 42

Arg
43

Arginine

Position 43

Leu
44

Leucine

Position 44

N-terminus C-terminus
Hydrophobic
Polar
Positive (+)
Negative (-)
Modified

Weight Loss

  • HIV-Associated Lipodystrophy

    FDA-approved indication showing 15-20% visceral fat reduction in clinical trials.

  • Selective Visceral Fat Targeting

    Unique mechanism that reduces dangerous visceral fat while sparing subcutaneous fat.

  • Sustained Fat Loss

    Maintained weight loss with continuous treatment over 52+ weeks in clinical studies.

Metabolic

  • Triglyceride Reduction

    12.3% reduction in triglyceride levels.

  • Cholesterol Profile Improvement

    7.2% improvement in cholesterol markers.

  • NAFLD Treatment

    37% liver fat reduction over 12 months.

Body Composition

  • Lean Mass Preservation

    Preserves lean muscle mass during fat loss.

  • IGF-1 Elevation

    26% increase in IGF-1 levels.

Subcutaneous injection to abdomen (avoid navel ±2 inches). Evening injection preferred for GH circadian rhythm alignment.

GoalDoseFrequencyRoute
HIV Lipodystrophy (FDA-approved)1.4mgOnce dailySubQ
Visceral Fat Reduction2mgOnce dailySubQ
Anti-aging/Body Composition1-2mg5-7x weeklySubQ
NAFLD Treatment2mgOnce daily (12 months)SubQ
Cognitive Enhancement1mgOnce daily (20 weeks)SubQ

Reconstitution Instructions

Materials Needed:
  • Tesamorelin lyophilized powder
  • Sterile water (Egrifta SV) or Bacteriostatic water (Egrifta WR)
  • Insulin syringes
  • Alcohol prep pads
  1. 1 Allow vial to reach room temperature
  2. 2 Egrifta SV: Add 0.5mL sterile water to 2mg vial - use immediately
  3. 3 Egrifta WR: Add 1.3mL bacteriostatic water to 11.6mg vial - stable 7 days
  4. 4 Gently swirl (don't shake vigorously)
  5. 5 Withdraw appropriate dose (~0.35mL for 1.4mg)
  6. 6 Inject SubQ, rotating sites
  7. 7 Store reconstituted WR at room temperature up to 7 days
Ipamorelin

Synergistic GH stimulation; monitor IGF-1 levels.

monitor
CJC-1295

Combined use may elevate IGF-1 supraphysiologically.

monitor
Sermorelin

Similar mechanism; risk of excessive effects at higher doses.

monitor
Insulin

3.3-fold diabetes risk increase; monitor glucose closely.

monitor
Metformin

May mitigate glucose intolerance associated with tesamorelin.

compatible
Prednisone

Decreases corticosteroid effectiveness.

monitor
Octreotide

Blocks GH release, negates tesamorelin effects.

avoid
Growth Hormone

Redundant; risk of acromegaly-like effects.

avoid
Week 1-2

IGF-1 levels begin to rise, possible mild water retention or joint discomfort

Week 4-6

Early metabolic changes; improved energy/sleep

Week 8-12

Visible visceral fat reduction begins, waist circumference may decrease

Week 12-26

Peak effects achieved with significant body composition improvements

Common Side Effects

  • Injection site reactions (17%)
  • Joint pain (13%)
  • Water retention

Stop Signs - Discontinue if:

  • Development of diabetes or severe glucose intolerance (HbA1c ≥6.5%)
  • Signs of malignancy
  • Severe hypersensitivity reactions
  • Excessive IGF-1 elevation (>2 SD above normal) with acromegaly symptoms

Contraindications

  • Active malignancy
  • Pituitary disorders
  • Pregnancy

Good Signs

  • FDA-approved formulations (Egrifta SV/WR from licensed pharmacy)
  • White crystalline powder (uniform, cake-like)
  • Clear reconstituted solution (colorless, no particles)
  • Proper packaging (sealed vials, intact stoppers)

Warning Signs

  • Compounded formulations may have quality/potency variability

Bad Signs

  • Discolored or cloudy solution (yellow/brown indicates degradation)
  • Visible particles or precipitate
  • LIPO-010 FDA Pivotal Trial
    (2010)

    Significant visceral adipose tissue reduction (-24 ± 41 cm² vs +2 ± 35 cm² placebo, p < 0.001) in HIV patients over 26 weeks.

  • CTR-1011 Extended Safety Study
    (2011)

    69% achieved ≥8% VAT reduction vs 33% placebo at 26-52 weeks.

  • NAFLD Treatment Trial
    (2019)

    37% liver fat reduction over 12 months with fibrosis progression prevention.

  • Cognitive Enhancement Study
    (2012)

    Improved executive function and verbal memory in healthy elderly and mild cognitive impairment cohorts at 1mg daily.

Disclaimer

This information is for educational and research purposes only. Consult a healthcare professional before use.