Tesamorelin (Egrifta SV)
FDA ApprovedGHRH Analog | Visceral Fat Reduction
Community Research
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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.
Subcutaneous injection provides optimal bioavailability for GHRH receptor binding and pulsatile GH release stimulation, selectively targeting visceral adipose tissue while sparing subcutaneous fat.
Molecular Data
HADGIFTNSYRKVLGQLSARKLLQDIMSRQQGESNQERGARARLHistidine
Position 1
Alanine
Position 2
Aspartic Acid
Position 3
Glycine
Position 4
Isoleucine
Position 5
Phenylalanine
Position 6
Threonine
Position 7
Asparagine
Position 8
Serine
Position 9
Tyrosine
Position 10
Arginine
Position 11
Lysine
Position 12
Valine
Position 13
Leucine
Position 14
Glycine
Position 15
Glutamine
Position 16
Leucine
Position 17
Serine
Position 18
Alanine
Position 19
Arginine
Position 20
Lysine
Position 21
Leucine
Position 22
Leucine
Position 23
Glutamine
Position 24
Aspartic Acid
Position 25
Isoleucine
Position 26
Methionine
Position 27
Serine
Position 28
Arginine
Position 29
Glutamine
Position 30
Glutamine
Position 31
Glycine
Position 32
Glutamic Acid
Position 33
Serine
Position 34
Asparagine
Position 35
Glutamine
Position 36
Glutamic Acid
Position 37
Arginine
Position 38
Glycine
Position 39
Alanine
Position 40
Arginine
Position 41
Alanine
Position 42
Arginine
Position 43
Leucine
Position 44
Research Indications
FDA-approved indication showing 15-20% visceral fat reduction in clinical trials.
Unique mechanism that reduces dangerous visceral fat while sparing subcutaneous fat.
Maintained weight loss with continuous treatment over 52+ weeks in clinical studies.
12.3% reduction in triglyceride levels.
7.2% improvement in cholesterol markers.
37% liver fat reduction over 12 months.
Preserves lean muscle mass during fat loss.
26% increase in IGF-1 levels.
Dosing Protocols
Subcutaneous injection to abdomen (avoid navel ±2 inches). Evening injection preferred for GH circadian rhythm alignment.
| Goal | Dose | Frequency | Route |
|---|---|---|---|
| HIV Lipodystrophy (FDA-approved) | 1.4mg | Once daily | SubQ |
| Visceral Fat Reduction | 2mg | Once daily | SubQ |
| Anti-aging/Body Composition | 1-2mg | 5-7x weekly | SubQ |
| NAFLD Treatment | 2mg | Once daily (12 months) | SubQ |
| Cognitive Enhancement | 1mg | Once daily (20 weeks) | SubQ |
Reconstitution Instructions
- Tesamorelin lyophilized powder
- Sterile water (Egrifta SV) or Bacteriostatic water (Egrifta WR)
- Insulin syringes
- Alcohol prep pads
- 1 Allow vial to reach room temperature
- 2 Egrifta SV: Add 0.5mL sterile water to 2mg vial - use immediately
- 3 Egrifta WR: Add 1.3mL bacteriostatic water to 11.6mg vial - stable 7 days
- 4 Gently swirl (don't shake vigorously)
- 5 Withdraw appropriate dose (~0.35mL for 1.4mg)
- 6 Inject SubQ, rotating sites
- 7 Store reconstituted WR at room temperature up to 7 days
Interactions
What to Expect
Side Effects & Safety
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
Quality Checklist
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
References
- Metabolic Effects of a Growth Hormone-Releasing Factor in Patients with HIV (LIPO-010)Falutz, J., et al.New England Journal of Medicine (2007)
Pivotal Phase III trial in 412 HIV patients. Tesamorelin 2mg daily for 26 weeks significantly decreased visceral fat and improved lipid profiles compared to placebo.
- Effects of Tesamorelin in HIV-Infected Patients with Abdominal Fat Accumulation: Randomized Placebo-Controlled Trial with Safety Extension (CTR-1011)Falutz, J., et al.Journal of Acquired Immune Deficiency Syndromes (2010)
404 HIV patients treated for up to 12 months. 69% achieved ≥8% VAT reduction vs 33% placebo. VAT benefits were lost upon discontinuation, confirming need for continuous therapy.
- Effects of Growth Hormone-Releasing Hormone on Cognitive Function in Adults with MCI and Healthy Older AdultsBaker, L.D., et al.Archives of Neurology (2012)
152 adults (ages 55-87) treated with tesamorelin 1mg daily for 20 weeks. Favorable effect on cognition (P=0.03), with particular benefit on executive function (P=0.005) and IGF-1 increase of 117%.
- Effects of Tesamorelin on Non-Alcoholic Fatty Liver Disease in HIV: A Randomised, Double-Blind, Multicentre TrialStanley, T.L., et al.Lancet HIV (2019)
61 HIV patients with NAFLD randomized to tesamorelin 2mg vs placebo for 12 months. 37% relative reduction in hepatic fat fraction (P=0.02), with prevention of fibrosis progression on liver biopsy.
- Body Composition, Hepatic Fat, Metabolic, and Safety Outcomes of Tesamorelin: A Meta-Analysis of Randomized Controlled TrialsElgenidy, A., et al.HIV Medicine (2025)
Meta-analysis of 5 RCTs showing significant VAT reduction (MD=-27.71 cm², P<0.001), increased lean body mass (MD=1.42 kg, P<0.001), and improved hepatic fat and IGF-1 levels without serious safety concerns.
Disclaimer
This information is for educational and research purposes only. Consult a healthcare professional before use.