Tesamorelin
Tesamorelin is an FDA-approved growth-hormone-releasing peptide for reducing visceral, deep abdominal fat in adults with HIV-associated lipodystrophy. It's the only compound in this growth-hormone-releasing category with a current, active FDA approval, giving it the most established regulatory track record here. It's delivered as a daily subcutaneous injection directly into the abdomen, the area targeted by its fat-reduction effect.
$100 / 10 mg vial
Dosing
Community reported
| Timeframe | Dosage | Frequency | Note |
|---|---|---|---|
| Week 1 | 1 mg | once daily, evening | Starting dose1 |
| Weeks 2+ | 2 mg | once daily, evening | Maintenance2 |
- A titrated research-vial schedule, distinct from the fixed-dose FDA-approved product; see Full research for the label dose.
- 2 mg/day matches the FDA-approved EGRIFTA SV maintenance dose, but this titration path itself is peptidedosages.com's own community protocol, not FDA prescribing information.
Batches on hand
Availability
10 vials on hand.
DAND-TM10-31072610 vials
Full research
Evidence tier
Approved drug, human RCT evidence
Tesamorelin has a current FDA-approved prescribing label built on randomized controlled trials for a specific indication, plus an independent published meta-analysis of RCT data; this is the only compound in this category with an active, on-market regulatory approval.
Original dosing schedule
The Dosing table above this section now shows a community- or vendor-sourced schedule (peptidedosages.com). The regulatory-label or clinical-trial dosing this entry was originally built on is kept here, unchanged, rather than removed.
Regulatory label
| Timeframe | Dosage | Frequency | Note |
|---|---|---|---|
| Ongoing | 1.4 mg | once daily, evening |
Regulatory label
| Timeframe | Dosage | Frequency | Note |
|---|---|---|---|
| Ongoing | 1.28 mg | once daily | 1 |
- Reported as 0.16 mL of reconstituted solution in secondary summarization of the WR label; the underlying vial-strength and diluent-volume figures do not arithmetically reconcile in the sources reviewed and should be verified against the primary label before use.
Identity
| Full name | Tesamorelin (INN), tesamorelin acetate, developmental code TH9507 |
|---|---|
| Class | GHRH-receptor agonist, synthetic GHRH(1-44)-NH2 analog |
| Brand names | Egrifta, Egrifta SV, Egrifta WR |
| Molecular weight | 5135.9 g/mol |
Mechanism of action
Plain language
This is an engineered version of the brain's own growth-hormone-releasing signal, modified so it survives a bit longer in the blood and specifically reduces the fat that builds up around internal organs.
Technical
GHRH-receptor agonist, same receptor class and mechanism as sermorelin and both CJC-1295 forms, binding GHRHR on anterior pituitary somatotrophs, activating Gs/cAMP signaling, stimulating GH synthesis and pulsatile release. The N-terminal trans-3-hexenoic acid modification is intended to confer resistance to enzymatic degradation, but despite this modification the FDA label reports a measured human half-life of only 8 minutes, materially shorter than the multi-day half-life of CJC-1295 with DAC. This illustrates that DPP-4-type resistance modifications alone do not automatically produce a long half-life; the DAC albumin-conjugation mechanism used in CJC-1295-with-DAC is a categorically different and much more potent half-life-extension strategy. Tesamorelin stimulates GH production and consequently increases serum IGF-1; its approved effect is a selective reduction in visceral adipose tissue.
Why: FDA-approved, one use
Tesamorelin is FDA-approved for a single, narrow indication: reduction of excess abdominal fat in HIV-infected adults with lipodystrophy. It is explicitly not indicated for general weight loss, and long-term cardiovascular safety has not been established.
Sources: FDA-approved prescribing information,
Why: Discard after reconstitution
The EGRIFTA SV label requires the reconstituted solution be used immediately, with any unused solution and diluent discarded, because it is reconstituted with plain Sterile Water for Injection, which carries no antimicrobial preservative. This is stricter than the multi-week refrigerated stability commonly claimed by compounding and vendor sources for other peptides in this category, which are typically reconstituted with bacteriostatic water instead.
Sources: FDA-approved prescribing information,
Why: Shortest half-life in class
Despite an N-terminal modification intended to confer resistance to enzymatic degradation, the FDA label reports a measured human half-life of only 8 minutes, materially shorter than CJC-1295 with DAC's multi-day half-life. This shows that DPP-4-type resistance modifications alone do not automatically produce long half-life; albumin conjugation is a categorically more potent extension strategy.
What it’s used for
Approved
- Reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy.
Human trials, not approved for this use
- A meta-analysis of five randomized controlled trials in HIV-associated lipodystrophy found a significant reduction in visceral adipose tissue (mean difference -27.71 cm2, 95% CI -38.37 to -17.06, P < 0.001), described as an approximately 18 percent reduction in visceral fat, achieved without significant worsening of pooled glucose or lipid parameters across the trials reviewed. Long-term cardiovascular safety has not been established, and the drug is explicitly not indicated for general weight loss.
Sources: Body composition, hepatic, FDA-approved prescribing information,
Pharmacokinetics
| Bioavailability |
Regulatory label Less than 4 percent after subcutaneous administration |
|---|---|
| Tmax |
Regulatory label 0.15 hours (approximately 9 minutes), median |
| Cmax |
Regulatory label 2956.1 pg/mL, mean |
| Half-life |
Regulatory label 8 minutes |
| Volume of distribution |
Regulatory label 4.8 +/- 1.9 L/kg |
| AUC (0 to infinity) |
Regulatory label 889.1 pg-h/mL |
| Route |
Regulatory label Subcutaneous, once daily |
Reconstitution
| Vial strength | EGRIFTA SV: 2 mg single-dose vial of lyophilized powder |
|---|---|
| Diluent | Sterile Water for Injection, provided in the kit; not bacteriostatic |
| Diluent volume | 0.5 mL |
| Concentration | 4 mg/mL (4000 mcg/mL) |
Worked example
2 mg / 0.5 mL = 4 mg/mL = 4000 mcg/mL. The 1.4 mg dose is drawn as 0.35 mL (1.4 mg / 4 mg/mL = 0.35 mL, confirmed). On a U-100 insulin syringe, 0.35 mL corresponds to 35 units (0.35 mL x 100 units/mL); each unit therefore delivers 4000 mcg/mL x 0.01 mL = 40 mcg, and 35 units x 40 mcg/unit = 1400 mcg = 1.4 mg, which checks out arithmetically. Mix by rolling the vial gently for about 30 seconds; do not shake. EGRIFTA WR reconstitution figures are separately flagged as unconfirmed: secondary sources describe an 11.6 mg vial reconstituted with 1.3 mL of Bacteriostatic Water for Injection, but 11.6 mg / 1.3 mL = 8.92 mg/mL, and 0.16 mL at that concentration would deliver approximately 1.43 mg, not the reported 1.28 mg dose. This arithmetic does not reconcile, and the WR vial-strength and diluent-volume figures should be verified against the primary WR label before publication rather than presented with the false precision of a worked example.
Sources: FDA-approved prescribing information,
Dose calculator
Enter a vial strength, diluent volume, and desired dose to see the resulting concentration, dose volume, and units on a standard U-100 insulin syringe. Nothing entered here is saved, stored, or sent anywhere – the calculation runs only in your browser.
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Storage and post-reconstitution stability
Unopened storage
20-25 degrees C (68-77 degrees F), excursions permitted to 15-30 degrees C; keep in the original carton to protect from light (FDA label, EGRIFTA SV).
Post-reconstitution stability – Regulatory label
Use immediately; discard unused reconstituted solution and diluent. Do not store, refrigerate, or freeze. Reconstituted with plain Sterile Water for Injection, which carries no antimicrobial preservative.
Safety
Contraindications
- Disruption of the hypothalamic-pituitary axis, from hypophysectomy, pituitary tumor or surgery, head irradiation, or head trauma.
- Active malignancy; pre-existing malignancy must be inactive with treatment completed.
- Known hypersensitivity to tesamorelin or its excipients.
- Pregnancy.
Notable risks
- Neoplasm risk: monitor for malignancy recurrence and discontinue if evidence emerges.
- IGF-1 elevation: the label states EGRIFTA SV stimulates GH production and increases serum IGF-1. At 26 weeks, 47 percent of patients had IGF-1 levels more than 2 standard deviation scores above normal, and 36 percent had scores greater than 3; at 52 weeks among patients who continued treatment, 34 percent had scores greater than 2 and 23 percent had scores greater than 3.
- Fluid retention, which may cause edema, arthralgia, or carpal tunnel syndrome.
- Glucose intolerance: 5 percent of treated patients developed elevated HbA1c (at or above 6.5 percent) versus 1 percent on placebo, hazard ratio 3.3 (95% CI 1.4-9.6); baseline HbA1c was 5.3 percent in both treatment and placebo groups. By contrast, the independent RCT meta-analysis described the class-level glycemic effect across pooled trials as not significantly worsening glucose or lipid parameters. Both findings are reported here rather than reconciled, since they reflect different endpoints: categorical HbA1c threshold-crossing in the label's pivotal population versus pooled continuous glucose and lipid parameters in the meta-analysis.
Sources: FDA-approved prescribing information,, Body composition, hepatic
- Hypersensitivity reactions in 4 percent of patients; injection-site reactions in 25 percent of patients versus 14 percent on placebo during the first 26 weeks; consider discontinuation in acutely critically ill patients. Most common adverse reactions (greater than 5 percent): arthralgia, injection-site erythema, injection-site pruritus, pain in an extremity, peripheral edema, myalgia.
- Monitoring recommendations: IGF-1 levels during therapy with consideration of discontinuation if persistently elevated; glucose status prior to and periodically during therapy; malignancy screening prior to initiation and ongoing surveillance; monitoring for retinopathy development or worsening in diabetic patients; possible need for glucocorticoid dose adjustment in patients on glucocorticoid replacement.
Sources
- FDA-approved prescribing information, EGRIFTA SV (tesamorelin for injection). DailyMed.
- FDA-approved prescribing information, EGRIFTA WR (tesamorelin for injection). DailyMed. WR-specific reconstitution figures are flagged unconfirmed in the source research and should be verified against this primary source before publication.
- Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials.
- peptidedosages.com, Tesamorelin 5 mg vial dosage protocol
This is a research and educational reference, not medical advice. Nothing on this site is a recommendation to use any compound.