Tesamorelin (Egrifta SV)

FDA Approved

GHRH Analog | Visceral Fat Reduction

Weight: 5,135.9 Da
Half-life: 26-38 minutes
Chain: 44 amino acids
5 studies
2025 latest
2 recent
FDA Approved
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

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.

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.

01 FDA-approved formulation
02 Selective visceral fat targeting (15-20% reduction)
03 Proven clinical efficacy
04 Standardized dosing
05 37% liver fat reduction in NAFLD
06 Preserved subcutaneous fat

Molecular Data

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
Peak 0.0 mcg
Trough 0.0 mcg
SS Peak 0.0 mcg
SS Trough 0.0 mcg

Research Indications

Weight Loss
HIV-Associated Lipodystrophy most effective

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

Selective Visceral Fat Targeting most effective

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

Sustained Fat Loss effective

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

Metabolic
Triglyceride Reduction effective

12.3% reduction in triglyceride levels.

Cholesterol Profile Improvement effective

7.2% improvement in cholesterol markers.

NAFLD Treatment effective

37% liver fat reduction over 12 months.

Body Composition
Lean Mass Preservation moderate

Preserves lean muscle mass during fat loss.

IGF-1 Elevation moderate

26% increase in IGF-1 levels.

Dosing Protocols

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

Interactions

~
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

What to Expect

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

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 Adults
    Baker, 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 Trial
    Stanley, 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 Trials
    Elgenidy, 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.