Tesamorelin quick reference
What is Tesamorelin?
Lab-made copy of growth-hormone-releasing hormone.
Used to cut deep belly fat in adults with HIV lipodystrophy.
US-approved as Egrifta; other uses are off-label.
How Tesamorelin works
Binds the pituitary and releases your own growth hormone.
More GH raises IGF-1; the label says to monitor it.
Gone from blood in 8-11 minutes, so dosing is daily.
Trials used CT scans of deep belly fat.
What Tesamorelin is studied for
Deep fat fell 14-18% vs -2 to +2% on placebo at 26 weeks.
People switched to placebo regained belly fat by week 52.
Liver fat fell 4.1 points more than placebo at 12 months.
1 mg daily for 20 weeks gave a modest gain (152 adults).
Body fat fell 7.4% in that same trial.
Tesamorelin dosing protocol
| Product or study | Daily amount (one injection a day) |
|---|---|
| Egrifta SV (2 mg vial) | 1.4 mg |
| Egrifta WR (11.6 mg vial; one vial lasts 7 days) | 1.28 mg |
| Pivotal trials (older 1 mg-per-vial product), 26 weeks | 2 mg |
From the US prescribing information for Egrifta SV and Egrifta WR (DailyMed). WR and SV are not substitutable because strength, dose and mixing differ, so follow the label for the product you have. The calculator uses the SV vial (2 mg mixed in 0.5 mL gives 1.4 mg in 0.35 mL).
Label and trial amounts come from the sources below. Community amounts are what people report; they have not been tested.
Mixing
Label kit (WR): one vial lasts 7 days. SV: 2 mg in 0.5 mL.
What the research found
Two placebo-controlled trials of about 400 adults each with HIV lipodystrophy, 26 weeks, 2 mg a day. Measured: change in deep belly fat (visceral fat):
US prescribing information, Egrifta SV and WR (DailyMed). In weeks 26-52, people switched to placebo regained belly fat (about +25 and +24 cm2), so the effect needs continued use.
Tesamorelin community experience
What users report. Not tested in trials.
Positive reports
- Smaller waist Waist and belly fullness shrink over 3-6 months.
- Better sleep Often noticed within 2-4 weeks.
- Recovery Some feel it once IGF-1 settles.
- Muscle tone A few report firmer muscle as belly fat drops.
Negative & mixed
- Site reactions Redness, itching and flushing, more than other GH peptides.
- Daily injections Every-day dosing wears on some users.
- Fluid retention Swelling, joint aches or tingling sometimes limit dosing.
- Sleep disruption Some sleep worse; morning dosing helped them.
Tesamorelin stacking
Common GH pairing: two signals. Not studied together.
Discussed for appetite plus belly fat. Not studied together.
Conflicting signals. Not studied together.
Tesamorelin side effects & safety
Common
- Injection-site reactions: 17% vs 6% on placebo.
- Joint pain: 13% vs 11%.
- Muscle pain: 6% vs 2%.
- Swelling in arms or legs: 6% vs 2%.
- Carpal tunnel symptoms can come with fluid retention.
Less common
- Allergic reactions: 4% in trials.
- Diabetes risk higher: odds ratio 3.3 for HbA1c of 6.5% or more.
- IGF-1 above 2 SD in 34% by week 52.
- Long-term heart safety is not established (label).
Precautions
- Label bars use with active cancer or pregnancy.
- Label bars use after pituitary disease, surgery or head injury.
- Label calls for IGF-1 and glucose checks.
- Label bars use with allergy to tesamorelin or its ingredients.
- WR and SV products cannot be swapped.
Our verdict on Tesamorelin
Best-evidenced GH peptide: approved for HIV belly fat with solid trials. Fat returns when stopped; other uses are unproven.
Tesamorelin FAQ
Is tesamorelin FDA approved?
Yes, as Egrifta, for belly fat in adults with HIV lipodystrophy.
Does the fat come back?
Yes. People switched to placebo regained deep belly fat.
Is it a weight-loss drug?
No. The label says it is weight neutral.
Why 2 mg in trials but 1.4 mg on the label?
Trials used an older product. The new formulations carry different doses.
Sources
- EGRIFTA WR (tesamorelin) US prescribing information, DailyMed setid 839334d3-8c1d-4c26-9036-2ab524a6ea75
- EGRIFTA SV (tesamorelin) US prescribing information, DailyMed setid 3d783378-b02d-4f19-99dd-0fc91a042224
- Stanley TL et al. Lancet HIV 2019 (tesamorelin, HIV fatty liver), PMID 31611038, NCT02196831
- Baker LD et al. Arch Neurol 2012 (GHRH, cognition in older adults), PMID 22869065, NCT00257712