Tesamorelin
Approved medicine · off-labelFat lossFit:Clinician-supervised·Evidence:High·Status:Rx off-label·
GHRH analog. Approved as EGRIFTA SV for HIV-associated visceral fat reduction; off-label use chases the same effect in non-HIV bodies. Engine caps dosing at the label ceiling (1.4 mg/day).
⚠ Safety⚠ 4 stop signals✕ 5 do-not-useDo not use if hypothalamic-pituitary axis disruption, active malignancy, or history of proliferative diabetic retinopathy.Show full safety →
⚠ Stop signals
- › severe joint pain or swelling
- › vision changes / new headaches
- › hand numbness or tingling (carpal tunnel signal)
- › injection-site reactions persisting >48h
✕ Do not use if
- › hypothalamic-pituitary axis disruption (head trauma/radiation/tumor; Tesa requires intact GHRH→GH signaling; FDA contraindication)
- › active malignancy (FDA contraindication; IGF-1 elevation may accelerate proliferation)
- › history of proliferative diabetic retinopathy (EGRIFTA SV label warns IGF-1 elevation worsens retinopathy)
- › glucocorticoid replacement therapy (chronic steroids reverse Tesa effect; safety not established)
- › pregnancy / trying to conceive
Often researched with Retatrutide, AOD-9604, MOTS-C, and CJC-1295/Ipamorelin.
Auto-added when a GLP-1 is in your plan (fires alongside Retatrutide / Tirzepatide / Semaglutide).
Inside the dossier: mechanism, outcomes, dosing detail, evidence breakdown, identity, sources.Expand ›
Class
GHRH analog · Best for Fat loss
Background
A synthetic Growth-Hormone-Releasing Hormone analog. FDA-approved as EGRIFTA SV for the reduction of excess abdominal fat in HIV-associated lipodystrophy. The labeled daily dose is 1.4 mg subcutaneous. The label explicitly states that EGRIFTA SV is not indicated for weight management.
Detailed dosing
Labeled EGRIFTA SV dose: 1.4 mg subcutaneous daily before bed (HIV-associated lipodystrophy). Pivotal Phase 3 trials used 2 mg/day SC × 26 weeks (Falutz 2010, 20554713 pooled analysis). Community off-label cycles use the labeled 1.4 mg; engine caps at 1.4 mg per current label.
How it works
- ·GHRH analog; amplifies endogenous GH-pulse amplitude from the pituitary
- ·Elevated GH drives lipolysis and visceral adipose mobilization via the GH/IGF-1 axis
- ·Daily pre-bed dosing aligns with the body's natural GH-pulse peak during slow-wave sleep
Potential outcomes
- ·~15-18% visceral adipose tissue reduction over 26 weeks (EGRIFTA SV trials in HIV-associated lipodystrophy)
- ·IGF-1 elevation is the on-target effect and the source of most precautions (cancer history, diabetic retinopathy)
- ·Off-label use for general visceral fat is widespread but not FDA-indicated
- ·Daily 1.4 mg subq is the labeled ceiling; community cycles respect this cap
Evidence breakdown
Human dosing: FDA-labeled dose · Safety: FDA label warnings · Source class: FDA label
Sources
Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in HIV-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data · Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial · Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults · Mendias & Awan, "Safety and Efficacy of Approved and Unapproved Peptide Therapies for Musculoskeletal Injuries and Athletic Performance" (Sports Med 2026) · Falutz et al, "Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension" (J AIDS 2010) · Stanley et al, "Effects of a growth hormone-releasing hormone analog on endogenous GH pulsatility and insulin sensitivity in healthy men" (J Clin Endocrinol Metab 2011) · Adrian et al, "The growth hormone releasing hormone analogue, tesamorelin, decreases muscle fat and increases muscle area in adults with HIV" (J Cachexia Sarcopenia Muscle 2019) · Spooner & Olin, "Tesamorelin: a growth hormone-releasing factor analogue for HIV-associated lipodystrophy" (Drugs 2012 review)