Tesamorelin
Tesamorelin is the one in this lineup built for a single, proven target: the deep abdominal fat that sits around the organs rather than under the skin. It was developed for people with HIV-associated lipodystrophy, and that same visceral-fat effect is why others outside that group have taken an interest. Treatment comes with real monitoring, bloodwork before you start and regular checks while you're on it, the kind of routine you'd expect from a drug with an established track record. It's a daily shot into the belly, mixed fresh each time since it clears the body within minutes.
What it does
Visceral fat is the target
This isn't a general weight-loss peptide. Tesamorelin is approved for one specific job: shrinking the visceral fat that builds up around the organs in HIV-associated lipodystrophy, and across a pooled analysis of five trials it cut that fat by roughly 18%, without meaningfully moving the group's blood sugar or cholesterol numbers. That's the only population and the only outcome it's proven for; long-term heart-health effects haven't been established.
Sources: Body composition, hepatic, FDA-approved prescribing information
A daily shot, mixed fresh
It's a daily injection straight into the abdomen, the spot it's built to work on. The chemical tweak meant to help it last longer doesn't do much: it clears the body in about 8 minutes, the shortest half-life of anything in this class, so the reconstituted solution gets used the same day rather than stored for later doses. That short window is also why the daily schedule doesn't flex much.
Sources: FDA-approved prescribing information
Monitoring that comes with it
Because this is an approved drug rather than an off-label peptide, starting it looks different: your doctor checks IGF-1, glucose, and screens for cancer before you begin, then rechecks periodically while you're on it. It isn't used in anyone with active cancer, a pituitary history, or during pregnancy. Most people get mild injection-site irritation or joint pain; blood sugar markers do rise more often than on placebo, so the monitoring is not just paperwork.
Sources: FDA-approved prescribing information
Dosing
Community reportedCommunity titration (peptidedosages.com)1 mg to 2 mg, once daily, evening
| 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.
Primary structure
No sequence recorded for this compound.
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.
Sources: FDA-approved prescribing information
What it’s used for
Approved
- Reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy.
Sources: FDA-approved prescribing information
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 Sources: FDA-approved prescribing information |
|---|---|
| Tmax |
Regulatory label 0.15 hours (approximately 9 minutes), median Sources: FDA-approved prescribing information |
| Cmax |
Regulatory label 2956.1 pg/mL, mean Sources: FDA-approved prescribing information |
| Half-life |
Regulatory label 8 minutes Sources: FDA-approved prescribing information |
| Volume of distribution |
Regulatory label 4.8 +/- 1.9 L/kg Sources: FDA-approved prescribing information |
| AUC (0 to infinity) |
Regulatory label 889.1 pg-h/mL Sources: FDA-approved prescribing information |
| Route |
Regulatory label Subcutaneous, once daily Sources: FDA-approved prescribing information |
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) |
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.
This calculator needs JavaScript. The arithmetic it runs is: concentration = vial strength in mg divided by diluent volume in mL; dose volume in mL = dose in mg divided by concentration; units on a U-100 syringe = dose volume in mL times 100.
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.
Sources: FDA-approved prescribing information
Safety
Contraindications
- Disruption of the hypothalamic-pituitary axis, from hypophysectomy, pituitary tumor or surgery, head irradiation, or head trauma.
Sources: FDA-approved prescribing information
- Active malignancy; pre-existing malignancy must be inactive with treatment completed.
Sources: FDA-approved prescribing information
- Known hypersensitivity to tesamorelin or its excipients.
Sources: FDA-approved prescribing information
- Pregnancy.
Sources: FDA-approved prescribing information
Notable risks
- Neoplasm risk: monitor for malignancy recurrence and discontinue if evidence emerges.
Sources: FDA-approved prescribing information
- 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.
Sources: FDA-approved prescribing information
- Fluid retention, which may cause edema, arthralgia, or carpal tunnel syndrome.
Sources: FDA-approved prescribing information
- 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.
Sources: FDA-approved prescribing information
- 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
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.