Tesamorelin — Peptide Protocol Wiki reference
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Tesamorelin (Egrifta): GHRH Analog Research Guide | Peptide Protocol Wiki Skip to main content 🧬 Peptide Protocol Wiki Peptides Side Effects New Learn Directory Tools Blog News About ⌘K ⌘K 🌱 New to Peptides? Start the 7-step beginner guide Peptides Side Effects New Directory Learn Tools Blog News About Tesamorelin 📋 Overview 🧬 Molecule 🔄 Similar ⚠️ Side Effects 💉 Dosing 🔬 Research 🚨 Risks 👥 Community 📊 Community Data Home Peptides Tesamorelin Growth Hormone Weight Loss & Metabolism approved Tesamorelin Also known as: Egrifta, Tesamorelin Acetate, TH9507 Compare with 3 peptide s Research compiled by Peptide Protocol Wiki 📅 Updated January 29, 2026 Citations Verified TL;DR Tesamorelin is an FDA-approved synthetic analog of growth hormone-releasing hormone (GHRH) used for the treatment of HIV-associated lipodystrophy. It consists of 44 amino acids with a trans-3-hexenoic acid modification that improves stability.
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Linked assets (10) · phenotypes (1)
evidence_reference, safety_reference, dosing_reference, contraindication_reference, mechanism, monitoring_reference
Phenotypes: immune_dysregulation
Findings (99) · awaiting review (51)
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Non-HDL cholesterol showed trends toward improvement.
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Upon receptor engagement, the Gs-alpha subunit activates adenylate cyclase, leading to increased intracellular cyclic AMP (cAMP) levels.
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quency Once daily Duration Ongoing; reassess periodically based on clinical response 💊 Administration Route SC Schedule Once daily Timing Any time of day; consistency preferred.
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📋 Protocol Quick-Reference Reduction of visceral adipose tissue in HIV-associated lipodystrophy (FDA-approved as Egrifta/Egrifta SV) 💉 Dosing Amount 2 mg Fre
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Tesamorelin (Egrifta): GHRH Analog Research Guide | Peptide Protocol Wiki Skip to main content 🧬 Peptide Protocol Wiki Peptides Side Effects New Learn Directory Tools Blog News About ⌘K ⌘K 🌱 New to Peptides?
dosing · pending
Start the 7-step beginner guide Peptides Side Effects New Directory Learn Tools Blog News About Tesamorelin 📋 Overview 🧬 Molecule 🔄 Similar ⚠️ Side Effects 💉 Dosing 🔬 Research 🚨 Risks 👥 Community 📊 Community Data Home Peptides Tesamorelin Growth Hormone Weight Loss & Metabolism approved Tesamorelin Also known as: Egrifta, Tesamorelin Acetate, TH9507 Compare with 3 peptide s Research compiled by Peptide Protocol Wiki 📅 Updated January 29, 2026 Citations Verified TL;DR Tesamorelin is an FDA-approved synthetic analog of growth hormone-releasing hormone (GHRH) used for the treatment of HIV-associated lipodystrophy.
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It consists of 44 amino acids with a trans-3-hexenoic acid modification that improves stability.
safety · pending
Browse all growth hormone peptides → Table of Contents 📌 TL;DR • FDA-approved for HIV lipodystrophy • Reduces visceral adipose tissue • Stimulates physiological GH secretion • Improved lipid profiles in clinical trials Community-Reported Side Effects Anecdotal ?
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⚗️ Suggested Bloodwork ( 6 tests) IGF-1 When: Baseline Why: Primary monitoring marker; tesamorelin stimulates GH which raises IGF-1 Fasting glucose and HbA1c When: Baseline Why: GH stimulation can worsen glucose tolerance Lipid panel When: Baseline Why: Baseline cardiovascular markers CMP with liver enzymes When: Baseline Why: Liver function baseline (also studied for NASH) Pregnancy test (women of childbearing potential) When: Baseline Why: Tesamorelin is contraindicated in pregnancy IGF-1 When: 3 months Why: Discontinue if persistently elevated above age-adjusted ULN 💡 Key Considerations → Abdomen is the only FDA-approved injection site → Reconstituted solution must be used immediately (no preservative) → Store unreconstituted vials at room temperature (20-25C) → Contraindication: Contraindicated in pregnancy; disruption of p
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Restore access No thanks, continue reading Related Reading Peptide Hexarelin growth hormone secretagogue peptide Peptide GHRP-2 growth hormone releasing peptide Peptide Hgh 191aa peptide How Tesamorelin works at the cellular level Overview of Tesamorelin benefits and applications Scientific Details Molecular Formula C221H366N72O67S1 Molecular Weight 5135.9 Da CAS Number 218949-48-5 Sequence (Trans-3-hexenoic acid)-Tyr-Ala-Asp-Ala-Ile-Phe-Thr-Asn-Ser-Tyr-Arg-Lys-Val-Leu-Gly-Gln-Leu-Ser-Ala-Arg-Lys-Leu-Leu-Gln-Asp-Ile-Met-Ser-Arg-Gln-Gln-Gly-Glu-Ser-Asn-Gln-Glu-Arg-Gly-Ala-Arg-Ala-Arg-Leu-NH2 What is Tesamorelin?
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This lipophilic modification distinguishes tesamorelin from native GHRH (1-44) and confers improved stability against enzymatic degradation by dipeptidyl peptidase-IV (DPP-IV), the primary enzyme responsible for GHRH inactivation in the circulation.
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It received FDA approval in November 2010 for the reduction of excess abdominal fat in HIV-infected patients with lipodystrophy.
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It was the first and remains the only FDA-approved treatment specifically indicated for HIV-associated lipodystrophy, a condition characterized by abnormal accumulation of visceral adipose tissue (VAT) that occurs as a metabolic complication of antiretroviral therapy and HIV infection itself.
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The drug is administered as a once-daily subcutaneous injection at a dose of 2 mg.
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Unlike exogenous GH replacement, which bypasses the hypothalamic-pituitary axis and delivers supraphysiological GH levels, tesamorelin works by stimulating the patient's own pituitary gland to produce and release GH in a regulated manner.
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This physiological approach preserves the normal feedback mechanisms involving insulin -like growth factor-1 (IGF-1) and somatostatin, theoretically reducing the risk of adverse effects associated with GH excess.
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In 2020, Theratechnologies received FDA approval for Egrifta SV, a reformulated version requiring smaller injection volumes and improved ease of use.
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The clinical pharmacology and efficacy profile remain equ
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Mechanism of Action # GHRH Receptor Activation # Tesamorelin binds to and activates the GHRH receptor (GHRHR), a G-protein coupled receptor expressed primarily on somatotroph cells of the anterior pituitary gland.
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The trans-3-hexenoic acid modification at the N-terminus of tesamorelin does not alter receptor binding specificity but provides steric protection against DPP-IV cleavage at the Tyr1-Ala2 bond, which is the primary site of native GHRH degradation.
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This modification extends the effective half-life of tesamorelin compared to native GHRH, allowing once-daily dosing to achieve therapeutically meaningful GH stimulation.
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By acting at the level of the pituitary GHRH receptor, tesamorelin resp
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ects this regulatory architecture.
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GH release occurs in augmented pulses rather than continuous elevation, and the somatostatin-mediated feedback mechanisms remain intact.
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This is in contrast to direct GH injection, which produces an immediate, non-physiological peak followed by decline, bypassing normal regulatory control.
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The pulsatile stimulation pattern is considered clinically advantageous because it maintains sensitivity of GH receptors in target tissues and avoids the tachyphylaxis and supraphysiological IGF-1 levels more commonly associated with exogenous GH.
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In adipose tissue, GH promotes lipolysis by activating hormone-sensitive lipase (HSL) and inhibiting lipoprotein lipase (LPL), resulting in mobilization of stored triglycerides and reduction of adipocyte size.
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Visceral adipose tissue is particularly responsive to GH-mediated lipolysis due to its high density of GH receptors and beta-adrenergic receptors, which may explain the preferential reduction of visceral fat observed with tesamorelin treatment.
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GH also has anabolic effects in skeletal muscle and other lean tissues, mediated largely through IGF-1 signaling via the IGF-1 receptor and downstream PI3K/Akt/mTOR pathways.
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In clinical studies of tesamorelin, increases in IGF-1 levels were observed but remained within the age-adjusted normal range for the
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Additionally, GH influences hepatic lipid metabolism by reducing hepatic de novo lipogenesis and enhancing very low-density lipoprotein (VLDL) clearance.
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These effects may contribute to the improvements in lipid parameters observed in tesamorelin clinical trials, including reductions in triglycerides and total cholesterol in some study populations.
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Therapeutic Applications and Clinical Evidence # HIV-Associated Lipodystrophy (Approved Indication) # The pivotal clinical evidence for tesamorelin comes from two Phase 3, randomized, double-blind, placebo-controlled trials that established its efficacy for HIV-associated lipodystrophy.
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In the first pivotal trial, 412 HIV-infected patients with excess abdominal fat (waist circumference greater than the 95th percentile for age and sex or CT-confirmed visceral adiposity) were randomized to tesamorelin 2 mg or placebo for 26 weeks.
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Tesamorelin produced a mean reduction in trunk fat of 15.2% from baseline, compared to a 5.0% increase in the placebo group (treatment difference -20.2%, p 0.0001).
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CT imaging demonstrated a mean reduction in visceral adipose tissue of approximately 15.4% in the tesamorelin group versus a 5.2% increase with placebo.
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The second pivotal trial (n=404) confirmed these findings, with tesamorelin reducing VAT by approximately 14% compared to baseline while placebo-treated patients showed no significant change.
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he VAT reduction was evident by week 13 and maintained through week 26.
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Improvements in patient-reported body image and trunk fat distribution were also statistically significant.
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Notably, an extension study examining the durability of response found that discontinuation of tesamorelin led to reaccumulation of visceral fat, indicating that ongoing treatment is necessary to maintain the metabolic benefit.
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