Last updated: May 18, 2026
What tesamorelin is
Tesamorelin is a synthetic analog of the full 44-amino-acid GHRH. The “stabilization” comes from a trans-3-hexenoic acid group attached to the N-terminal tyrosine, which protects against DPP-IV cleavage. Brand name: Egrifta. Manufacturer: Theratechnologies.
Mechanism
Tesamorelin binds the GHRH receptor with high affinity, stimulating endogenous GH release. Unlike sermorelin (which produces discrete pulses), tesamorelin’s longer half-life produces more sustained GHRH signaling, which in clinical trials translated to significant visceral adipose tissue reduction.
FDA-approved indication
HIV-associated lipodystrophy (visceral adiposity in HIV-infected adults): Approved 2010 for reduction of excess abdominal fat in HIV patients with lipodystrophy syndrome.
Clinical evidence
Pivotal Phase 3 trials:
- ~15-20% reduction in visceral adipose tissue (VAT) over 26 weeks
- Modest improvements in IGF-1 (40-80% increase)
- Modest improvements in triglycerides, body image scores
- No significant change in subcutaneous fat (selective visceral effect)
Dosing
FDA-approved Egrifta: 2 mg subcutaneous injection, once daily.
Egrifta SV (single-vial formulation, approved 2019): 1.4 mg daily, easier preparation.
Off-label uses
Outside of HIV lipodystrophy, tesamorelin has been studied for:
- Visceral obesity in non-HIV patients
- NAFLD/NASH (non-alcoholic fatty liver disease)
- Cognitive function (sustained GH may improve cognition in older adults)
Tesamorelin vs other GHRH analogs
| Sermorelin | Tesamorelin | CJC-1295 No-DAC | CJC-1295 DAC | |
|---|---|---|---|---|
| Amino acids | 29 | 44 | 30 (modified) | 30 + DAC |
| Half-life | ~12 min | ~26 min | ~30 min | ~6-8 days |
| FDA status | Approved 1990 | Approved 2010 | Not approved | Not approved |
| Indication | GH deficiency dx | HIV lipodystrophy | Research only | Research only |
Side effects
From clinical trials in HIV lipodystrophy population:
- Injection-site reactions (most common)
- Arthralgia, myalgia (joint/muscle pain)
- Carpal-tunnel-like symptoms (paresthesias)
- Elevated glucose (mild, occasional)
- Possible hypersensitivity
Cost (2026)
Egrifta SV list price: roughly $24,000-30,000 per year. Insurance coverage varies. Compounded versions sometimes available through specialty pharmacies.
How is tesamorelin different from sermorelin?<br />
Tesamorelin is the full GHRH (1-44) with a stability modification. Sermorelin is the GHRH (1-29) fragment. Tesamorelin has longer half-life and is FDA-approved; sermorelin is FDA-approved but commercial production was discontinued.
Does tesamorelin cause general weight loss?<br />
It reduces visceral fat selectively without major changes in subcutaneous fat or body weight. Different from GLP-1 drugs which produce general weight loss.
Can tesamorelin be used by non-HIV patients?<br />
Off-label use exists for visceral obesity in non-HIV patients. Coverage and access are challenging since indication is HIV-specific.
Why is tesamorelin so expensive?<br />
Niche indication (HIV lipodystrophy) means limited market and high per-patient pricing. The cost is set for insurance reimbursement at the rare-disease tier.