Tesamorelin
Also known as: Egrifta SV, Egrifta WR
GHRH Analog | Visceral Fat Reduction
Overview
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.
Key benefits
- FDA-approved formulation
- Selective visceral fat targeting (15-20% reduction)
- Proven clinical efficacy
- Standardized dosing
- 37% liver fat reduction in NAFLD
- Preserved 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.
Molecular data
- Type
- GHRH analog
- Half-life
- 26-38 minutes
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
Indications
What the research community uses this compound for, with self-reported effectiveness.
Weight Loss
HIV-Associated Lipodystrophy
Most effectiveFDA-approved indication showing 15-20% visceral fat reduction in clinical trials.
Selective Visceral Fat Targeting
Most effectiveUnique mechanism that reduces dangerous visceral fat while sparing subcutaneous fat.
Sustained Fat Loss
EffectiveMaintained weight loss with continuous treatment over 52+ weeks in clinical studies.
Metabolic
Triglyceride Reduction
Effective12.3% reduction in triglyceride levels.
Cholesterol Profile Improvement
Effective7.2% improvement in cholesterol markers.
NAFLD Treatment
Effective37% liver fat reduction over 12 months.
Body Composition
Lean Mass Preservation
ModeratePreserves lean muscle mass during fat loss.
IGF-1 Elevation
Moderate26% increase in IGF-1 levels.
Dosing protocols
Common protocols by delivery method. Adjust the curve below to model accumulation in your own cycle.
Injectable
Subcutaneous injection to abdomen (avoid navel ±2 inches). Evening injection preferred for GH circadian rhythm alignment.
| Protocol | Dose | Frequency | Route / duration |
|---|---|---|---|
| HIV Lipodystrophy (FDA-approved) | 1.4mg | Once daily | SubQ |
| Visceral Fat Reduction | 2mg | Once daily | SubQ |
| Anti-aging/Body Composition | 1-2mg | 5-7x weekly | SubQ |
| NAFLD Treatment | 2mg | Once daily (12 months) | SubQ |
| Cognitive Enhancement | 1mg | Once daily (20 weeks) | SubQ |
Preparation
You will need
- Tesamorelin lyophilized powder
- Sterile water (Egrifta SV) or Bacteriostatic water (Egrifta WR)
- Insulin syringes
- Alcohol prep pads
Steps
- Allow vial to reach room temperature
- Egrifta SV: Add 0.5mL sterile water to 2mg vial - use immediately
- Egrifta WR: Add 1.3mL bacteriostatic water to 11.6mg vial - stable 7 days
- Gently swirl (don't shake vigorously)
- Withdraw appropriate dose (~0.35mL for 1.4mg)
- Inject SubQ, rotating sites
- Store reconstituted WR at room temperature up to 7 days
Work out the water volume and syringe units in the reconstitution calculator →
Interactions
Pairwise interactions with other compounds you might be cycling — the same data behind the cycle builder's safety check.
Octreotide
AvoidBlocks GH release, negates tesamorelin effects.
Growth Hormone
AvoidRedundant; risk of acromegaly-like effects.
Ipamorelin
MonitorSynergistic GH stimulation; monitor IGF-1 levels.
CJC-1295
MonitorCombined use may elevate IGF-1 supraphysiologically.
Sermorelin
MonitorSimilar mechanism; risk of excessive effects at higher doses.
Insulin
Monitor3.3-fold diabetes risk increase; monitor glucose closely.
Prednisone
MonitorDecreases corticosteroid effectiveness.
Metformin
CompatibleMay mitigate glucose intolerance associated with tesamorelin.
Timeline
Typical week-by-week effects reported in clinical and observational data.
- 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
Safety
Reported adverse effects, contraindications, and what to monitor on cycle.
Common side effects
- Injection site reactions (17%)
- Joint pain (13%)
- Water retention
Stop signs — stop and seek advice
- 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
Monitoring
- Monitor blood glucose regularly - 3.3-fold increased diabetes risk documented
- IGF-1 levels should be checked monthly - 47% exceed normal range at 26 weeks
Quality checks
What a legitimate product looks like, what should give pause, and what should make you stop.
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
Stop signs — don't use
- Discolored or cloudy solution (yellow/brown indicates degradation)
- Visible particles or precipitate
Recent research
Newer papers and trial readouts on file for this compound, with source and date.
June 2025 · Journal of Infectious Diseases
Tesamorelin for Neurocognitive Impairment in HIV with Abdominal Obesity
Phase 2 open-label trial in 73 HIV patients. Tesamorelin group showed trend toward improved neurocognition and greater waist circumference reduction (median -2.7 cm) vs standard of care, though between-group cognitive differences were not significant.
June 2024 · AIDS
Efficacy and Safety of Tesamorelin in People with HIV on Integrase Inhibitors
First dedicated data on tesamorelin efficacy in HIV patients on INSTI-based regimens. Tesamorelin had beneficial effects on body composition with no exacerbation of glycemic control.
References
Primary literature and clinical-trial data informing this entry.
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.
Last updated . How this page was sourced is described in the methodology.