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Tesamorelin

Tags: GHRH, Fat Loss, FDA-Approved

Quick Summary

Tesamorelin is an FDA-approved GHRH analog with trans-3-hexenoic acid modification that selectively targets visceral adipose tissue; proven clinical efficacy reduces VAT while preserving subcutaneous fat with pulsatile growth hormone stimulation.

Quick Facts

  • Typical Dose: 1.4-2 mg
  • Frequency: Once daily
  • Route: Injectable (SubQ — abdomen; avoid navel ±2 inches; rotate sites)
  • Cycle: Continuous (typical)
  • Storage: 20-25°C (room temperature before reconstitution); refrigerated after reconstitution per product guidance

Overview

Tesamorelin is an FDA-approved synthetic growth hormone-releasing hormone (GHRH) analog designed for treating HIV-associated lipodystrophy. This 44-amino acid peptide with a trans-3-hexenoic acid modification selectively reduces visceral adipose tissue while preserving subcutaneous fat, making it unique among growth hormone therapies.

Key Benefits

  • FDA-approved formulation
  • Selective visceral fat targeting (reduces VAT while preserving subcutaneous fat)
  • Proven clinical efficacy in pivotal trials

Mechanism of Action

Subcutaneous injection provides optimal bioavailability for GHRH receptor binding and pulsatile GH release stimulation.

Molecular Information

  • Weight: 5,135.9 Da
  • Length: 44 amino acids
  • Type: GHRH analog

Amino Acid Sequence:

His-Ala-Asp-Gly-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

Modified with trans-3-hexenoic acid at N-terminus for enhanced stability

Research Protocols

Goal Dose Frequency Route
HIV Lipodystrophy (FDA Approved) 1.4 mg Once daily Subcutaneous injection (abdomen)
Visceral Fat Reduction 2 mg Once daily Subcutaneous injection (rotate sites)
Anti-aging / Body Composition (research) 1-2 mg 5-7 days/week Subcutaneous injection (evening)
NAFLD Treatment 2 mg Once daily Subcutaneous injection for 12 months
Cognitive Enhancement (research) 1 mg Once daily Subcutaneous injection for 20 weeks
Research Protocol 1-2 mg Daily Subcutaneous with cycle breaks

Timing: Evening injection aligns with natural growth hormone circadian rhythm. Take after dinner but before bedtime for optimal efficacy.

How to Reconstitute

  1. Allow vial to reach room temperature before reconstitution.
  2. For Egrifta SV: add 0.5 mL sterile water to 2 mg vial — use immediately after mixing.
  3. For Egrifta WR: add 1.3 mL bacteriostatic water to 11.6 mg vial — stable for 7 days.
  4. Gently swirl to dissolve — do not shake vigorously to prevent protein denaturation.
  5. Withdraw appropriate dose (typically 0.35 mL for 1.4 mg from SV preparation).
  6. Inject subcutaneously in abdomen, rotating sites to prevent lipodystrophy.
  7. Store reconstituted WR at room temperature for up to 7 days; discard SV after use.

Important: Always use bacteriostatic water (BAC) where indicated and follow manufacturer instructions.

Interactions

!!! info "Compatible" - Metformin — Compatible

!!! warning "Monitor" - Ipamorelin — Monitor combination - CJC-1295 — Monitor combination - Sermorelin — Dose dependent - Insulin — Monitor combination - Prednisone — Use caution

!!! danger "Avoid" - Octreotide — Avoid combination - Growth Hormone — Avoid combination

Quality Indicators

!!! success - FDA-approved formulations (Egrifta SV or Egrifta WR) from licensed pharmacy with proper documentation - White crystalline, uniform lyophilized powder with cake-like appearance - Clear, colorless reconstituted solution without particles - Proper packaging integrity with sealed vials, intact rubber stoppers, and aluminum seals

!!! danger - Discolored solution (yellow/brown) indicating degradation or contamination - Visible particles or precipitate indicating protein aggregation or bacterial contamination - Non-FDA compounded formulations with quality/potency variability - Broken seals or damaged vials

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; slight improvements in energy and sleep quality
  • 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

  • Monitor blood glucose regularly — increased diabetes risk documented
  • IGF-1 levels should be checked monthly — many patients exceed normal range at extended treatment
  • Contraindicated in active malignancy or pituitary disorders
  • Common side effects: injection site reactions (~17%) and joint pain (~13%)

References

!!! quote - Humans | 2 mg subcutaneous daily | 26 weeks | 15.4% VAT reduction vs placebo

LIPO-010 FDA Approval Trial (2010)

Pivotal Phase III trial demonstrating significant visceral adipose tissue reduction (-24 ± 41 cm² vs +2 ± 35 cm² placebo, p < 0.001) in HIV patients with lipodystrophy.

https://clinicaltrials.gov/study/NCT00123253

!!! quote - Humans | 2 mg daily | 26-52 weeks | 69% achieved ≥8% VAT reduction

CTR-1011 Extended Safety Study (2011)

Long-term safety and efficacy study showing sustained visceral fat reduction with 69% responder rate vs 33% placebo.

https://clinicaltrials.gov/study/NCT00435136

!!! quote - Humans | 2 mg daily | 12 months | 37% liver fat reduction

NAFLD Treatment Trial (2019)

Landmark study demonstrating significant hepatic fat reduction and prevented fibrosis progression in HIV patients with NAFLD.

https://pubmed.ncbi.nlm.nih.gov/31611038/