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Tesamorelin

TH9507 · Egrifta (brand)

Approved for another indicationProhibited in sportReviewed 12 Aug 2026

Tesamorelin is a stabilised analogue of growth hormone releasing hormone, and it is the outlier in this category: it holds FDA approval, backed by randomised placebo-controlled phase 3 trials, for one specific indication, reducing excess visceral abdominal fat in adults with HIV-associated lipodystrophy.

That approval is narrow and worth reading precisely. It is for a defined patient population with a defined condition, not for body composition in healthy adults. The trials that support it enrolled people with HIV-associated lipodystrophy, and their results describe what happened in those people.

It is included here because it is the useful reference point for the whole category. When ipamorelin or CJC-1295 is described as 'well studied', tesamorelin is what actually well studied looks like: named trials, published endpoints, a regulator's review, and a specific approved use.

How it works

Like other GHRH analogues, tesamorelin binds the GHRH receptor on the pituitary and increases growth hormone release, which in turn raises IGF-1. Amino acid modification protects it from the enzyme that clears natural GHRH within minutes.

The reason its approved indication concerns visceral fat specifically is that visceral adipose tissue is unusually responsive to growth hormone's lipolytic effect. The trials measured visceral fat by CT scan and found reductions of roughly 15% against placebo. A genuine and specific effect, not a general body composition claim.

Regulatory status — United States

Approved by the FDA as a prescription medicine for reducing excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It is not approved for body composition, athletic performance or anti-ageing use, and material sold as a research chemical is not the approved product.

Last reviewed 12 Aug 2026. Regulatory positions in this category change frequently; we date this line so you can see how current it is.

What it is studied for

Each entry states the evidence behind it. We do not rank indications by effectiveness — for most compounds here, that would be a claim nobody can support.

Visceral fat in HIV-associated lipodystrophy

Clinical trial

The approved indication, and the one the trials tested.

EvidenceTwo randomised, double-blind, placebo-controlled phase 3 trials, over 26 weeks, with visceral fat measured by CT.

Body composition in healthy adults

Community practice

Frequently discussed, and outside what was studied.

EvidenceNot studied. The trial population had a specific condition, and results in that population do not establish effects in healthy adults.

Identity and clearance

Molecule

Class
GHRH analogue, trans-3-hexenoyl modified
Molecular weight
5135.9 Da
Length
44 amino acids

The full 44-amino-acid GHRH sequence with an N-terminal modification that resists enzymatic breakdown.

Pharmacokinetics

Clinical trial
Peak0.3 h
Half-life0.4 h
Substantially cleared3 h
100%50%25%0%half-life 0hdose1h2h2h3h
Modelled from the half-life above, assuming first-order elimination. Illustrative rather than measured — it shows the shape of clearance, not a prediction for any individual.

Cleared rapidly. This is why the approved regimen is a daily injection.

Dose protocols reported in sources

Displayed for reference only. Every row says where it came from, and a trial protocol and a community convention are not the same kind of information. None of this is fed into the calculator, and none of it is a recommendation.

Dose protocols reported in sources, with the source of each.
GoalDoseFrequencyRouteUnits, 2 mg vialSourceStart this protocol
Approved regimen for the licensed indication2 mgOnce dailySubcutaneousAbdominal injection, rotating sites.100 uClinical trialStart this

Start this copies a row into a protocol of your own, which you can then edit. Where a source gave a dose range or an ambiguous frequency, those fields arrive empty — we will not pick a number on your behalf.

Calculator

Work out what to draw

Pre-filled with a 10 mg vial as a worked example. These are not recommended values — change them to match the vial in front of you.

Dose unit
Your syringe
010203040506070809010040 units0.4 mL

Draw to 40 units on a 1 mL U-100 syringe. That is 0.4 mL, containing 2 mg of Tesamorelin.

Concentration5mg / mL
Volume drawn0.4mL
Doses per vial5doses
Per unit50mcg / unit

40 units sits exactly on a printed line.

Bioalmanac performs arithmetic on values you enter. It does not recommend doses, schedules or compounds, and nothing here is medical advice. Confirm every calculation against your vial and syringe before drawing, and speak with a licensed healthcare provider.

Open this calculation in the full calculator

Units, concentration, bacteriostatic water — the glossary defines the vocabulary, and a unit is not a fixed volume.

Safety

Reported effects

  • Injection site redness, itching or painClinical trial

    Common in trials

    The most frequently reported effect in the phase 3 programme.

  • Joint pain and muscle achesClinical trial

    Common in trials

  • Swelling in the hands or feetClinical trial

    Common in trials

    Fluid retention is a recognised growth hormone effect.

  • Raised blood glucoseClinical trial

    Documented in trials

    Growth hormone opposes insulin. Glucose was monitored throughout the trial programme for this reason.

  • Carpal tunnel symptomsClinical trial

    Uncommon but documented

When to stop

  • Persistent numbness, tingling or wrist pain. Carpal tunnel symptoms are a documented effect.
  • Noticeable swelling of the hands, feet or face.
  • Unusual thirst, frequent urination or blurred vision, which can indicate raised blood glucose.
  • Any new lump or growth. Investigate rather than watch.
  • Any allergic response: rash, hives, facial swelling or difficulty breathing. Seek urgent care.

Interactions and situations that need care

  • Active or previous cancerAvoid

    The approved labelling contraindicates use in active malignancy, because raising growth hormone raises IGF-1 and IGF-1 promotes cell proliferation.

  • Disruption of the pituitary axisAvoid

    Contraindicated after pituitary surgery, hypophysectomy, head irradiation or head trauma. The mechanism depends on an intact pituitary responding normally.

  • Pregnancy and breastfeedingAvoid

    Contraindicated in pregnancy. There is no benefit to weigh against unknown fetal risk.

  • Diabetes or impaired glucose toleranceUse caution

    Glucose rose measurably in the trials. Anyone managing blood sugar needs that monitored by whoever manages it.

  • Competing in a tested sportAvoid

    Prohibited at all times under WADA's S2 category.

SportProhibited by the World Anti-Doping Agency under S2: Peptide Hormones, Growth Factors and Related Substances, at all times.

What to expect

  • In the phase 3 trials, visceral adipose tissue fell by roughly 15% against placebo over 26 weeks, measured by CT scan.
  • That result is in adults with HIV-associated lipodystrophy. It is not a prediction for anyone else, and the trials did not enrol healthy adults.
  • The effect reversed when treatment stopped, so it was studied as ongoing therapy, not a course.
  • Subcutaneous fat and overall weight were not the endpoints. This was a visceral fat result specifically.

Storage and handling

Freeze-dried powder
Refrigerated at 2–8 °C, protected from light.
After mixing
Refrigerated at 2–8 °C. The approved product is intended for use shortly after reconstitution rather than stored for weeks.
Long-term, frozen
Unopened powder is stable at −20 °C or colder.

Printable one-pagerHow to reconstitute a vial, step by step

In use

Stacks with Tesamorelin in them

Documented combinations, with full schedules.

Checking your vial

Research chemicals carry no manufacturing standard, so what the vial looks like is often the only quality signal available before you use it. More on assessing quality and COAs.

  • White cake, clear solution

    Standard for this class.

  • Cloudy or discoloured after mixing

    Do not use. This is also the instruction that accompanies the approved product.

Questions

Is tesamorelin approved?
Yes, but narrowly: for reducing excess visceral abdominal fat in adults with HIV-associated lipodystrophy. It is not approved for body composition in healthy adults, for athletic performance, or for anti-ageing use.
How does it compare with CJC-1295?
Both are GHRH analogues acting on the same receptor. The difference is evidence: tesamorelin completed a phase 3 programme and holds an approval, while CJC-1295 has early pharmacology and no outcome trials. They are not equivalent products with different names.
Why is the approved dose so much larger than ipamorelin doses?
Tesamorelin is dosed at 2 mg daily, around ten times a typical ipamorelin dose. Different compounds in the same category can have very different potencies. That is why the calculator refuses a dose larger than the vial rather than assuming you meant micrograms.

References

  1. Effects of tesamorelin on visceral fat in HIV-associated lipodystrophy

    New England Journal of Medicine / phase 3 programme, 2010 · Randomised, double-blind, placebo-controlled phase 3 trial

    Adults with HIV-associated abdominal fat accumulation · n = 412 · 2 mg once daily, subcutaneous · 26 weeks

    Visceral adipose tissue measured by CT fell by roughly 15% against placebo. Effects reversed after discontinuation. Injection site reactions and joint pain were the most common adverse events.

    10.1056/NEJMoa0810687

  2. Commonly reported community protocols

    Bioalmanac editorial summary of public community sources, 2026 · Not a study

    Records that tesamorelin is discussed for body composition outside its approved indication. Carries no evidential weight about safety or effect in that context.

Keep this page honest

If something here is wrong, out of date, or missing a source, tell us and we will fix it and say that we did.

Suggest a correction

This page is educational. It describes what published research reports, not what you should do. Peptides discussed here are largely not approved for human use, and nothing on Bioalmanac is medical advice. No clinician reviews these pages.

Page last updated 12 Aug 2026