Tesamorelin
Growth Hormone / IGF-1 AxisFDA ApprovedAlso known as: Tesa, TH9507
Tesamorelin is a stabilized synthetic analog of human growth hormone-releasing hormone (GHRH) — specifically the full 44-amino-acid GHRH sequence with a single N-terminal trans-3-hexenoyl fatty-acid modification. That modification protects the peptide from rapid dipeptidyl peptidase-4 (DPP-4) degradation, extending its circulating half-life to approximately 30 minutes (vs <2 minutes for native GHRH). Tesamorelin was developed by Theratechnologies and is marketed in the US as Egrifta (branded injectable) and Egrifta SV (updated formulation launched 2019).
Overview
At A Glance
Tesamorelin activates the same GHRH receptor (GHRHR) as endogenous GHRH and CJC-1295 / MOD-GRF 1-29, but with a distinct pharmacokinetic profile driven by its trans-3-hexenoyl N-terminal modification.…
Mechanism of Action
Tesamorelin activates the same GHRH receptor (GHRHR) as endogenous GHRH and CJC-1295 / MOD-GRF 1-29, but with a distinct pharmacokinetic profile driven by its trans-3-hexenoyl N-terminal modification.
1. GHRH receptor agonism (Gs / cAMP / PKA / CREB pathway)
- Tesamorelin binds GHRHR — a Class B1 GPCR on anterior pituitary somatotrophs
- Receptor activation engages Gs, elevating intracellular cAMP
- cAMP activates PKA, which phosphorylates CREB
- Phospho-CREB upregulates GH-1 gene transcription and mobilizes preformed GH from secretory granules
- Net effect: GH pulse within 15-30 min of injection, peaking around 60 min
Tesamorelin has full agonist activity at GHRHR with receptor binding affinity comparable to native GHRH and significantly higher potency than native GHRH due to its longer plasma presence (Ferdinandi et al., 2007).
2. Preserved pulsatile GH release (key differentiator from CJC-1295-DAC)
Tesamorelin has a plasma half-life of ~30-50 minutes — short enough to clear between physiologic GH pulses while long enough to provide dose-response amplification of endogenous pulses. This preserves:
- Somatotroph sensitivity — continuous GHRH exposure (as with CJC-1295 with DAC's ~8-day half-life) desensitizes pituitary receptors; tesamorelin's pulsatile exposure does not
- Somatostatin-mediated negative feedback — between tesamorelin pulses, somatostatin can appropriately suppress GH, preventing supra-physiologic elevation
- Circadian integration — the daily pre-bed dose amplifies rather than replaces the nocturnal GH burst
This is the mechanistic argument for why tesamorelin became FDA-approvable where CJC-1295-DAC did not (Makimura et al., 2009).
3. Downstream IGF-1 elevation
Acute GH pulses → hepatic IGF-1 synthesis, peaking ~24h post-dose. In the key Phase 3 trial, tesamorelin 2 mg daily elevated mean IGF-1 from 185 ng/mL at baseline to 327 ng/mL at week 26 — approximately a 1.7-fold increase and within the upper end of the age-adjusted reference range for most adults (Falutz et al., 2007).
IGF-1 drives the downstream metabolic effects:
- Lipolysis in visceral adipose tissue (preferentially) → VAT reduction
- Hepatic triglyceride mobilization → decreased hepatic steatosis
- Muscle protein synthesis → lean body mass preservation
- Connective tissue anabolism → accelerated repair
4. Preferential visceral fat mobilization
Tesamorelin's most clinically distinctive effect is its preferential reduction of visceral adipose tissue over subcutaneous fat. In the key trials, VAT decreased ~18% at 26 weeks while subcutaneous abdominal fat was largely unchanged (Falutz et al., 2007). This selectivity is driven by:
- Higher β-adrenergic receptor density on visceral adipocytes vs subcutaneous
- Greater sensitivity of visceral fat to GH-mediated lipolysis
- Portal delivery of visceral-origin FFAs to the liver, which the GH pulse mobilizes for oxidation
5. Secondary effects beyond the GH axis
- Hepatic fat reduction — independent of weight loss; mediated by GH-driven hepatic lipid export (Stanley et al., 2014)
- Cognitive effects in HIV-associated cognitive impairment — likely IGF-1-mediated neuroprotection (Adrian et al., 2018)
- Potential modest HDL elevation and triglyceride reduction — secondary lipid changes observed in extension trials
Overview
Tesamorelin is a stabilized synthetic analog of human growth hormone-releasing hormone (GHRH) — specifically the full 44-amino-acid GHRH sequence with a single N-terminal trans-3-hexenoyl fatty-acid modification. That modification protects the peptide from rapid dipeptidyl peptidase-4 (DPP-4) degradation, extending its circulating half-life to approximately 30 minutes (vs <2 minutes for native GHRH).
Tesamorelin was developed by Theratechnologies and is marketed in the US as Egrifta (branded injectable) and Egrifta SV (updated formulation launched 2019). It is the only FDA-approved GHRH secretagogue in the United States, approved in 2010 for the reduction of excess abdominal fat in HIV-infected patients with lipodystrophy. The approval was based on two Phase 3 trials showing ~18% reduction in visceral adipose tissue (VAT) at 26 weeks and sustained effect through 52 weeks (Falutz et al., 2007; Falutz et al., 2010).
Unlike CJC-1295 with DAC, tesamorelin produces a pulsatile rather than sustained GH elevation. It preserves the negative-feedback regulation of the somatotroph axis because its half-life is short enough to clear between pulses, and this is the primary clinical reason it was developable as a long-term therapy where CJC-1295-DAC's continuous GH elevation raised safety concerns.
Beyond the FDA-approved HIV lipodystrophy indication, tesamorelin is being studied and used off-label for:
- Non-alcoholic fatty liver disease (NAFLD / NASH) — Phase 2 trial showed reductions in hepatic fat fraction and liver enzymes (Stanley et al., 2014)
- HIV-associated cognitive decline — pilot data on executive function and memory (Adrian et al., 2018)
- General visceral adiposity in non-HIV metabolically-unhealthy adults (off-label biohacker use)
- Adjunct to CJC-1295 / MOD-GRF 1-29 + Ipamorelin stacks — when GHRH-only amplification is desired without the pulsatility trade-off of CJC-1295 with DAC
Typical dosing: 2 mg subcutaneous once daily pre-bed (matches the FDA-approved protocol). Dose escalation above 2 mg/day has been studied but does not produce proportional IGF-1 elevation and raises fluid-retention burden.
Regulatory status: FDA-approved for HIV lipodystrophy; available by prescription in the US. Biohacker use is off-label and typically sourced through compounding pharmacies or (controversially) research-chemical vendors. See our Tesamorelin Dosage Guide for protocol specifics.
Potential Research Fields
Chemical Information
IUPAC Name
trans-3-hexenoyl-GHRH(1-44)amide
CAS Number
218949-48-5
Molecular Formula
C221H366N72O67S
Molecular Mass
5135.8 g/mol
Dosing & Protocols
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Interactions
Interaction Matrix
Contraindications
Absolute contraindications (per FDA label)
- Disruption of the hypothalamic-pituitary axis — pituitary tumor or removal, hypopituitarism, hypothalamic injury. Tesamorelin requires an intact pituitary to work and can potentially accelerate residual tumor growth
- Active malignancy — GH/IGF-1 axis may accelerate tumor growth. Absolute contraindication during active cancer treatment or within 5 years of complete remission
- Pregnancy — category X; do not use
- Active proliferative or severe non-proliferative diabetic retinopathy — GH elevation can worsen retinopathy
- Known hypersensitivity to tesamorelin or mannitol (excipient in commercial formulation)
Additional off-label biohacking contraindications
- Uncontrolled T2DM — tesamorelin acutely impairs glucose tolerance; should be optimized before starting
- Active diabetic retinopathy (any grade) — even non-proliferative
- History of acromegaly or pituitary adenoma — absolute
- Severe heart failure (NYHA III-IV) — fluid retention can precipitate decompensation
- Acute critical illness — tesamorelin is not safe during severe acute illness (sepsis, post-surgical critical care); this mirrors recombinant GH warnings
Relative contraindications (consult physician before use)
- Type 2 diabetes or pre-diabetes — use with monitoring; expect HbA1c elevation of ~0.1-0.3 points
- Uncontrolled hypertension — fluid retention can exacerbate blood pressure
- History of carpal tunnel syndrome — fluid retention can reactivate symptoms
- Hypothyroidism — thyroid status affects GH axis; optimize thyroid first
- Age >70 — limited efficacy data; safety data from HIV trials does not include most elderly populations
Drug interactions
- Glucocorticoids (chronic systemic) — suppress GH axis and blunt tesamorelin efficacy
- Insulin and oral hypoglycemics — tesamorelin's effect on glucose tolerance may require dose adjustments
- CYP3A4 substrates — tesamorelin is not a CYP3A4 inhibitor or inducer; minimal interactions
- Exogenous recombinant GH — do not combine; redundant
- Other GHRH analogs — do not use simultaneously at the same receptor
Monitoring requirements
- Baseline: IGF-1, fasting glucose, HbA1c, complete metabolic panel, thyroid (TSH, free T4), PSA (men >40), CBC, lipid panel
- Week 4-6: IGF-1 (target: within age-adjusted reference range, typically <250 ng/mL for adults 30-50)
- Every 12 weeks on therapy: IGF-1, HbA1c, fasting glucose
- Annually: Full panel + reassess need for continued therapy
Discontinuation criteria
Stop tesamorelin and consult a clinician if you develop:
- IGF-1 > age-adjusted upper limit
- HbA1c rising >0.4 points within one cycle
- Persistent peripheral edema or new carpal tunnel symptoms
- Any new palpable mass, changing mole, or unexplained weight loss (cancer workup indicated)
- Severe headache, visual changes (rule out pituitary pathology)
- Signs of fluid overload or CHF decompensation
Research Disclaimer
This interaction data is compiled from published research and community reports. It may not be exhaustive. Always consult a healthcare professional before combining compounds.
$44.99
up to $119.95
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| Vendor | Product | Form | Qty | Price | $/mg | Coupon | |
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RC-Tesamorelin 10mg | vial | 1 vial● In Stock | $64.99BEST | $6.499 | ||
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Tesamorelin 10mg | vial | 1 vial● In Stock | $69.99 | $6.999 | ||
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Tesamorelin 5mg | vial | 1 vial● Out of Stock | $45.00 | $9.000 | — | Sign in for stock alert |
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Tesamorelin 10mg | vial | 1 vial● In Stock | $69.95 | $6.995 | — | |
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Tesamorelin 20mg | vial | 1 vial● Out of Stock | $119.95 | $5.998 | — | Sign in for stock alert |
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Tesamorelin 10mg | vial | 1 vial● In Stock | $59.99 | $5.999 | — | |
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Tesamorelin 10mg | vial | 1 vial● In Stock | $69.99 | $6.999 | — | |
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Tesamorelin 5mg Vial | vial | 1 vial● In Stock | $45.00 | $9.000 | ||
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Tesamorelin 10mg Vial | vial | 1 vial● In Stock | $87.00 | $8.700 | ||
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Tesamorelin/Ipamorelin 10+2mg | vial | 1 vial● In Stock | $80.00 | $6.667 | ||
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Tesamorelin/Ipamorelin Blend | vial | 1 vial● In Stock | $89.99 | $5.999 | ||
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Tesamorelin/Ipamorelin 10+5mg | vial | 1 vial● In Stock | $90.00 | $6.000 | ||
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Tesamorelin 2mg | vial | 2mg vial● In Stock | $44.99 | $22.495 | ||
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Tesamorelin 5mg | vial | 5mg vial● In Stock | $69.99 | $13.998 |
Tracking since Mar 13, 2026 · 9 data points
Price History
4 data pointsVendors Selling Tesamorelin
VANDL Labs
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Ion Peptide
BioMyst Labs
ResearchChemHQ
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Paramount Peptides
How we score these vendors
Every supplier above is graded 0–100 on COA verification, payment transparency, shipping, reviews, and active listings. Methodology published, no pay-to-rank.
Related Compounds
View AllCJC-1295 (Mod GRF 1-29)
Growth Hormone / IGF-1 AxisPreclinicalCJC-1295 without DAC (also called Modified GRF 1-29 or MOD-GRF 1-29) is a 30-amino-acid analog of the first 29 residues of endogenous Growth Hormone Releasing Hormone (GHRH), with four strategic substitutions (D-Ala² for DPP-4 resistance, Gln⁸, Ala¹⁵, Leu²⁷) that extend its plasma half-life from <2 minutes (native GHRH) to ~30 minutes.
CJC-1295 with DAC
Growth Hormone / IGF-1 AxisPhase 2CJC-1295 with DAC (Drug Affinity Complex) is a modified form of CJC-1295 that incorporates a maleimidopropionic acid (MPA) reactive group at the C-terminus.
GHRP-2
Growth Hormone / IGF-1 AxisPhase 2GHRP-2 (growth hormone-releasing peptide-2), also known as pralmorelin and KP-102, is a synthetic hexapeptide growth hormone secretagogue that was among the first GHRPs developed in the seminal research of Cyril Bowers and colleagues at Tulane University in the late 1980s and early 1990s.
GHRP-6
Growth Hormone / IGF-1 AxisPhase 2GHRP-6 (growth hormone-releasing peptide-6) is a synthetic hexapeptide with the sequence His-D-Trp-Ala-Trp-D-Phe-Lys-NH2 that binds the ghrelin receptor (GHS-R1a) to stimulate endogenous growth hormone release.
Hexarelin
Growth Hormone / IGF-1 AxisPhase 2Hexarelin (also called examorelin) is a potent synthetic hexapeptide growth hormone secretagogue with the sequence His-D-2-methyl-Trp-Ala-Trp-D-Phe-Lys-NH2.
IGF-1 LR3
Growth Hormone / IGF-1 AxisPhase 2IGF-1 LR3 (Long R3 IGF-1) is a synthetic analog of human insulin-like growth factor 1 modified at two positions to dramatically extend its serum half-life and amplify its tissue bioactivity compared to native IGF-1.
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5/18/2026Research Score
8 PubMed studies
Quality Indicators
Data Completeness
100%COA Verification
10
Verified COAs
2
Vendors w/ COA
High verification rate (83%)
Latest test: 3/1/2026
Research Credibility
Limited research available
Quick Facts
Half-Life
30-50 minutes (plasma)
Molecular Weight
5135.8 g/mol
Administration
subcutaneous
CAS Number
218949-48-5
Trial Phase
FDA Approved
Safety Profile
Low RiskCommon Side Effects
- • Injection site reactions
- • Fluid retention
- • Arthralgias
- • Myalgias
Stop Use If
- Active malignancy
- Pregnancy
- Pituitary surgery or radiation history
- Acute illness
Research Disclaimer
This information is for educational and research purposes only. Not intended as medical advice. Consult a healthcare professional before use.
Frequently Asked Questions
What is tesamorelin and what is it FDA-approved for?
Tesamorelin is a stabilized synthetic analog of human growth hormone-releasing hormone (GHRH) — specifically the full 44-amino-acid sequence with a trans-3-hexenoyl N-terminal modification that extends its plasma half-life to ~30-50 minutes. It is FDA-approved (2010) for the reduction of excess abdominal fat in HIV-infected patients with lipodystrophy and is marketed as Egrifta / Egrifta SV by Theratechnologies. It is the only FDA-approved GHRH secretagogue in the United States. Approval was based on two Phase 3 trials showing ~15-18% reduction in visceral adipose tissue (VAT) at 26 weeks (Falutz et al., 2007).
How is tesamorelin different from CJC-1295 with DAC?
Both activate the GHRH receptor (GHRHR), but their pharmacokinetics are fundamentally different. Tesamorelin has a 30-50 minute half-life — short enough to clear between physiologic GH pulses, preserving the pulsatile architecture and somatostatin-mediated negative feedback. CJC-1295 with DAC has a ~8-day half-life due to albumin-binding, producing continuous, non-pulsatile GH elevation. The continuous elevation of CJC-1295-DAC drives long-term safety concerns (somatotroph desensitization, supra-physiologic IGF-1, theoretical acromegalic progression) that tesamorelin avoids. This is the primary mechanistic reason tesamorelin became FDA-approvable where CJC-1295-DAC did not (Makimura et al., 2009).
What's the correct dose and how often should I inject tesamorelin?
The FDA-approved dose is 2 mg subcutaneous, once daily, pre-bed, fasted. This is the dose used in all Phase 3 trials and is the standard for both the HIV lipodystrophy label indication and off-label biohacker use. Dose escalation above 2 mg/day has been studied (up to 4 mg) and does not produce proportional IGF-1 elevation — the dose-response plateaus while side-effect burden rises. The fasted state is essential: post-meal dosing blunts the GH pulse by 50-70%. Pre-bed timing leverages the body's largest natural GH pulse (the nocturnal burst).
Is tesamorelin safer than injecting actual growth hormone (somatropin)?
Mechanistically, yes. Tesamorelin amplifies the body's own pulsatile GH release through the pituitary, preserving negative feedback and physiologic pulse architecture. Exogenous somatropin bypasses the pituitary, produces tonic non-pulsatile GH elevation, and carries an FDA black-box warning for critical-illness mortality. Tesamorelin has no black-box warning. However, both share the GH/IGF-1 safety envelope — active malignancy, diabetic retinopathy, and pituitary tumors are absolute contraindications for both. Tesamorelin is FDA-approved for a specific indication (HIV lipodystrophy); somatropin is approved for multiple indications. Neither is a direct replacement for the other.
How much visceral fat can I expect to lose on tesamorelin?
In the FDA Phase 3 trials, patients on tesamorelin 2 mg/day lost an average of 15-18% of visceral adipose tissue (VAT) at 26 weeks, sustained through 52 weeks with continued dosing (Falutz et al., 2007; Falutz et al., 2010). The effect is preferential for visceral over subcutaneous fat — subcutaneous abdominal fat was largely unchanged in the same trials. Waist circumference typically reduces by 1-3 cm visibly. Effect plateaus around 26-52 weeks; patients who discontinue regain VAT within 26 weeks (the therapy is suppressive, not curative). Biohacker results in non-HIV populations are less systematically documented but generally consistent with the HIV lipodystrophy data when combined with proper diet and training.
What are the common side effects of tesamorelin?
The FDA-documented profile from Phase 3 trials: common — injection site reactions (~22%), arthralgia (joint aches), mild peripheral edema, myalgia, pain in extremities. Uncommon — carpal tunnel symptoms (fluid-shift-mediated), hand paresthesias, mild insulin resistance (HbA1c rises ~0.1% vs placebo). Rare — hyperglycemia / new-onset diabetes (rare in Phase 3 but possible with pre-existing risk factors), hypersensitivity reactions. Most effects are dose-dependent and resolve with dose reduction or cessation. Tesamorelin has no FDA black-box warning, unlike recombinant GH. Monitor IGF-1, fasting glucose, and HbA1c quarterly on long-term therapy.
Can I stack tesamorelin with ipamorelin or semaglutide?
Yes. Tesamorelin + ipamorelin is the canonical biohacking GHS stack: 2 mg tesamorelin + 200 mcg ipamorelin in the same pre-bed injection, producing a GH pulse 3-5x larger than either agent alone via GHRH × ghrelin receptor synergy. Tesamorelin + semaglutide or tirzepatide is an effective body recomposition stack: GLP-1 drives the caloric deficit while tesamorelin + ipamorelin preserves lean mass and preferentially reduces visceral fat. DO NOT stack tesamorelin with CJC-1295 with DAC (contradictory pharmacodynamics) or with recombinant GH (redundant and mechanistically confused).
Does tesamorelin work for NAFLD (fatty liver disease)?
Yes, off-label. The Stanley et al., 2014 JAMA trial in HIV patients with NAFLD showed tesamorelin 2 mg/day for 12 months reduced hepatic fat fraction by 3.6 absolute percentage points vs placebo, with reductions in ALT and NAFLD-activity score (Stanley et al., 2014). The mechanism is GH-driven hepatic lipid export and reduced portal free-fatty-acid flux from visceral adipose. For documented NAFLD (imaging-confirmed hepatic fat >5%), a 6-12 month tesamorelin protocol with monthly liver enzyme monitoring and baseline + 6-month MRI-PDFF is the off-label framework. The FDA has not approved tesamorelin for NAFLD; use is physician-supervised off-label.
Is tesamorelin legal and how do I get it?
Tesamorelin is FDA-approved and available by prescription in the US, marketed as Egrifta SV by Theratechnologies. The FDA-approved indication is HIV-associated lipodystrophy; off-label prescription for non-HIV visceral adiposity or NAFLD is physician-dependent and less common due to insurance coverage limitations. Compounding pharmacy versions are available through integrative medicine clinics — typically less expensive than branded Egrifta. Research-chemical grade tesamorelin is sold online; quality varies enormously and users should verify with HPLC/mass spec COAs before use. See our Best Peptide Vendors 2026 guide for vetted sources. Legal status for personal use varies by jurisdiction.
How long does tesamorelin take to work?
Timeline from Phase 3 data: (1) IGF-1 elevation detectable at week 2, reaches steady state by week 4-6; (2) Sleep quality and subjective recovery improvements in weeks 1-3; (3) Waist circumference reduction measurable at week 8-12 (typically 1-2 cm); (4) Visceral fat reduction (VAT) — by CT or DEXA, measurable reduction begins at week 12 and reaches ~15% at week 26; (5) Hepatic fat reduction (NAFLD) — detectable at 3-6 months with continued therapy; (6) Effect plateaus around 26-52 weeks of continuous therapy. Discontinuation causes gradual reversal over 6-12 months — tesamorelin is a suppressive therapy, not curative for visceral adiposity.
Research Tools
Related Compounds
View AllCJC-1295 (Mod GRF 1-29)
Growth Hormone / IGF-1 AxisPreclinicalCJC-1295 without DAC (also called Modified GRF 1-29 or MOD-GRF 1-29) is a 30-amino-acid analog of the first 29 residues of endogenous Growth Hormone Releasing Hormone (GHRH), with four strategic substitutions (D-Ala² for DPP-4 resistance, Gln⁸, Ala¹⁵, Leu²⁷) that extend its plasma half-life from <2 minutes (native GHRH) to ~30 minutes.
CJC-1295 with DAC
Growth Hormone / IGF-1 AxisPhase 2CJC-1295 with DAC (Drug Affinity Complex) is a modified form of CJC-1295 that incorporates a maleimidopropionic acid (MPA) reactive group at the C-terminus.
GHRP-2
Growth Hormone / IGF-1 AxisPhase 2GHRP-2 (growth hormone-releasing peptide-2), also known as pralmorelin and KP-102, is a synthetic hexapeptide growth hormone secretagogue that was among the first GHRPs developed in the seminal research of Cyril Bowers and colleagues at Tulane University in the late 1980s and early 1990s.
GHRP-6
Growth Hormone / IGF-1 AxisPhase 2GHRP-6 (growth hormone-releasing peptide-6) is a synthetic hexapeptide with the sequence His-D-Trp-Ala-Trp-D-Phe-Lys-NH2 that binds the ghrelin receptor (GHS-R1a) to stimulate endogenous growth hormone release.
Hexarelin
Growth Hormone / IGF-1 AxisPhase 2Hexarelin (also called examorelin) is a potent synthetic hexapeptide growth hormone secretagogue with the sequence His-D-2-methyl-Trp-Ala-Trp-D-Phe-Lys-NH2.
IGF-1 LR3
Growth Hormone / IGF-1 AxisPhase 2IGF-1 LR3 (Long R3 IGF-1) is a synthetic analog of human insulin-like growth factor 1 modified at two positions to dramatically extend its serum half-life and amplify its tissue bioactivity compared to native IGF-1.
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