Also known as: Egrifta · TH9507
Tesamorelin is an FDA-approved synthetic analog of human growth hormone-releasing hormone (GHRH), conjugated with trans-3-hexenoic acid to improve stability. It is approved under the brand name Egrifta for treatment of HIV-associated lipodystrophy — excess abdominal fat accumulation caused by antiretroviral therapy.
Tesamorelin was developed by Theratechnologies and received FDA approval in 2010 for HIV-associated lipodystrophy — making it the only GHRH analog with full FDA approval for human therapeutic use. The compound addresses a significant clinical need: antiretroviral drugs, particularly older NRTIs and PIs, cause characteristic visceral fat accumulation that increases cardiovascular risk and severely impacts patient quality of life.
In Phase 3 trials (LIPO-010 and LIPO-011), tesamorelin reduced visceral adipose tissue by 18–26% over 26 weeks compared to placebo. Unlike GH administration, tesamorelin preserves the pulsatile nature of GH secretion and is less likely to cause insulin resistance, making it a significantly safer approach than direct GH replacement.
Tesamorelin is a full-length GHRH(1-44) analog that activates GHRH receptors on pituitary somatotrophs with native-like potency. The trans-3-hexenoic acid conjugation at the N-terminus protects the otherwise labile Tyr-Ala dipeptide from DPP-IV cleavage, extending half-life from ~7 minutes to ~26 minutes.
Elevated GH signaling promotes lipolysis (fat breakdown) in adipocytes through hormone-sensitive lipase activation. Visceral fat is particularly responsive to GH-mediated lipolysis due to higher GH receptor density. GH also opposes insulin-stimulated triglyceride storage in visceral depots.
Tesamorelin is the only full-length GHRH(1-44) analogue to reach FDA approval. Its trans-3-hexenoic acid modification at the N-terminus prevents DPP-IV cleavage at Ala², dramatically extending its half-life while preserving full GHRHR agonism. It is specifically approved for reducing excess abdominal visceral fat in HIV patients (Egrifta, Theratechnologies) and represents the highest-evidence GHRH analogue for visceral fat reduction. Unlike HGH, it preserves pulsatility and pituitary feedback regulation.
For the FDA-approved indication, tesamorelin is used continuously without formal off-cycling — similar to GLP-1 agents. For body composition research in non-HIV adults, 12–26 week cycles are used with an off-period to allow IGF-1 normalisation. Visceral fat reductions from the approved trials (mean ~18% at 26 weeks) partially reverse upon discontinuation, supporting the chronic-use model for those with ongoing visceral adiposity.
Tesamorelin is contraindicated in active malignancy, disruption of the hypothalamic-pituitary axis, and pregnancy. As with all GHRH analogues, elevated IGF-1 carries a theoretical risk of promoting pre-existing malignant cells. Monitor IGF-1 during extended use and maintain levels within normal physiological range (not supraphysiological).
Ask anything about Tesamorelin — mechanisms, dosing protocols, interactions, or research comparisons.
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