--- title: "Tesamorelin: Benefits, Dosage, Side Effects & Results" description: "Tesamorelin (Egrifta) explained: how it works, what trials found on visceral and liver fat, who responds, side effects and what the label covers." canonical: "https://www.vitalsvault.com/peptides/tesamorelin" last-updated: 2026-08-22 --- # Tesamorelin: Benefits, Dosage, Side Effects & Results > Tesamorelin (Egrifta) explained: how it works, what trials found on visceral and liver fat, who responds, side effects and what the label covers. ![A man in his mid fifties sits on the edge of a bed buttoning a crisp light blue shirt, morning light from a window beside him, quietly pleased…](https://www.vitalsvault.com/_next/image?url=%2Fpublic-v3%2Fshoot%2Fpeptides%2Fpep-tesamorelin.webp&w=3840&q=75&dpl=shadow-production-f0162cb4d465-40992538108-1) Peptide Guide · Growth hormone and muscle # Tesamorelin Egrifta, TH9507, GHRH(1-44) analog Tesamorelin was built to shrink one kind of fat, the deep belly fat that builds up in some people on HIV treatment. It carries a current FDA approval for exactly that use. [Get early access to peptide care](https://www.vitalsvault.com/peptides-waitlist)[Start with 120+ lab tests · $99](https://www.vitalsvault.com/labs#plans) Free to join · One email when peptide care opens · Most lab results in 3–5 business days Studied forVisceral fat, liver fat and lipids in HIV-associated lipodystrophy EvidenceFDA-approved Taken asDaily injection under the skin, per the label Studied forVisceral fat, liver fat and lipids in HIV-associated lipodystrophy EvidenceFDA-approved Taken asDaily injection under the skin, per the label ## Tesamorelin, in short Tesamorelin (Egrifta) is an FDA-approved growth hormone releasing factor analog. Its label states it is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. It prompts the pituitary to release growth hormone, which breaks down fat. In phase 3 trials it cut visceral fat by about 15%. It is not indicated for weight loss. Medically reviewed by [Robert Lufkin, MD (opens in a new tab)](https://www.robertlufkinmd.com/) Chief Medical Officer, Vitals Vault · Updated October 29, 2026 · 14 sources ## At a glance FDA-approved TypeSynthetic growth hormone releasing factor (GHRH) analog[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) BrandEgrifta SV (Theratechnologies)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) FDA-approved forReduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) Not indicated forWeight loss management[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) First approvedNovember 10, 2010[3](https://www.vitalsvault.com/peptides/tesamorelin#source-drugsfda-egrifta) Taken asDaily injection under the skin, per the label[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) SportGrowth hormone releasing factors are prohibited by WADA[14](https://www.vitalsvault.com/peptides/tesamorelin#source-wada) ## Before you consider Tesamorelin - Safety The label lists warnings for raised IGF-1, fluid retention and higher blood sugar. Long-term heart safety has not been established.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) [Side effects and safety](https://www.vitalsvault.com/peptides/tesamorelin#safety) - Legal status FDA approved it as Egrifta in 2010, only for extra belly fat in adults with HIV and lipodystrophy. Other uses are off-label.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[3](https://www.vitalsvault.com/peptides/tesamorelin#source-drugsfda-egrifta) [FDA status](https://www.vitalsvault.com/peptides/tesamorelin#fda-status) - How it’s taken A daily injection under the skin of the abdomen, with sites rotated. The label sets the dose and a prescriber decides on use.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) [Forms and dosage](https://www.vitalsvault.com/peptides/tesamorelin#how-taken) ## How does Tesamorelin work? Tesamorelin copies the body’s own signal to make growth hormone. - ### Copies a natural signal It is a lab-made version of the brain signal that tells the pituitary gland to make growth hormone.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) - ### Growth hormone is released The pituitary releases growth hormone in pulses, and growth hormone helps the body break down fat.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) - ### Growth factor levels rise Growth hormone makes the liver produce more IGF-1. It rose 81% in the main trial, so doctors monitor it.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) ## Tesamorelin benefits: what it is studied for All of this comes from human trials in adults with HIV and extra belly fat. Results may differ in people without HIV. 1. Human study01 ### Less visceral fat In a 26-week trial of 412 people with HIV, visceral fat fell 15.2% on tesamorelin and rose 5.0% on placebo. A pooled analysis found it held for 52 weeks.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) 2. Human study02 ### Better blood fats Triglycerides fell by 50 mg per deciliter on tesamorelin and rose by 9 on placebo, and the ratio of total to HDL cholesterol improved.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) 3. Human study03 ### Less liver fat In a 50-person randomized trial, tesamorelin reduced both visceral fat and liver fat over 6 months. The authors called the finding preliminary.[11](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2014) 4. Human study04 ### Better body image In the pooled analysis of two phase 3 trials with 806 people, body image improved alongside the drop in visceral fat.[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) ## What the research shows FDA-approved 1. 1 · Cells in a labNot cited This guide cites no findings at this level. Shows a mechanism 2. 2 · AnimalsNot cited This guide cites no findings at this level. Shows an effect in a body 3. 3 · People Studied Placebo-controlled phase 3 trials in 806 adults with HIV cut visceral fat by about 15%, with the loss holding to 52 weeks.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) Shows it works in people Tesamorelin has the strongest evidence in this library: placebo-controlled phase 3 trials, a regulatory approval and a long safety extension. All of it is in adults with HIV and abdominal fat. Using it for general fat loss, anti-aging or sport is outside the trial evidence and the label.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) The full guide to Tesamorelin 8 min read · Medically reviewed by Robert Lufkin, MD ## A belly that HIV medicine left behind By the 2000s, antiretroviral therapy had turned HIV into a condition people could live with for decades. Many of them then noticed something their doctors could see on a CT scan: fat collecting deep inside the abdomen, around the organs. Researchers call it visceral adipose tissue, and in people on HIV treatment it was linked to higher cardiovascular risk. The change also weighed on how people felt about their bodies. A team led by Julian Falutz at McGill University in Montreal, with Steven Grinspoon at Harvard, set out to test whether a growth hormone signal could shrink it, since growth hormone breaks down fat. The molecule they used traces back to 1982, when Roger Guillemin’s lab read the full 44-amino-acid sequence of growth hormone releasing hormone, GHRH, from a pancreatic tumor that had caused acromegaly. Tesamorelin is a synthetic analog built on that full-length sequence, developed by Theratechnologies. That makes tesamorelin unusual in the peptide world. It was developed for a narrow, measurable problem, tested in large placebo-controlled trials, and judged on a CT scan. The story of what it does well, and where it stops, is unusually clear as a result.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010)[8](https://www.vitalsvault.com/peptides/tesamorelin#source-guillemin-1982)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) ## How tesamorelin works Tesamorelin speaks the same language as your own hypothalamus. In laboratory tests, it binds and stimulates human GHRH receptors with potency similar to the natural hormone. Those receptors sit on growth hormone cells in the pituitary, which respond by making and releasing growth hormone in pulses. Growth hormone does two jobs that matter here. It is anabolic, supporting protein building, and it is lipolytic, meaning it breaks stored fat down into fatty acids the body can burn. It also signals the liver to make IGF-1. In the 2007 trial, IGF-1 rose 81% on tesamorelin and fell 5% on placebo, which is why the label tells prescribers to monitor it. Because tesamorelin works through the pituitary, the body’s feedback stays in the loop. It asks for growth hormone and leaves the gland to decide how much to release. The same pathway also explains the watch points on the label: growth hormone changes how tissues respond to insulin and how the body holds water, so glucose and fluid retention are monitored.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) ## Tesamorelin benefits for visceral fat: the phase 3 trials The landmark trial appeared in the New England Journal of Medicine in 2007. It enrolled 412 people with HIV and excess abdominal fat, 86% of them men, and randomly assigned them to a daily injection of tesamorelin or placebo for 26 weeks. The main outcome was the change in visceral fat measured by CT. Visceral fat fell 15.2% on tesamorelin and rose 5.0% on placebo. Triglycerides fell by 50 milligrams per deciliter on tesamorelin and rose by 9 on placebo, and the ratio of total to HDL cholesterol improved. Glucose and insulin measures were not significantly different between groups at 26 weeks. A second phase 3 trial followed, and in 2010 the two were pooled: 806 people in total. The visceral fat result held, the fat just under the skin of the belly barely changed, and people reported less distress about how their bellies looked. Their physicians rated the belly profile as improved too. At 26 weeks, people on tesamorelin were randomly assigned to keep going or switch to placebo for another 26 weeks. Those who kept going maintained the drop in visceral fat at 52 weeks, along with smaller waists and lower triglycerides. The overall pattern was a targeted effect on the deep fat, while the fat under the skin was largely spared.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) ## Responders, non-responders and what happens when you stop Averages hide something important about tesamorelin. Before the phase 3 data were analyzed, the trial plan defined a responder as someone whose visceral fat fell by at least 8%. Most people on tesamorelin met that bar. Some did not. In 2012, researchers asked what separated the two groups, and the answer is practical. Among 402 participants initially assigned to tesamorelin and kept in the per-protocol analysis, responders saw triglycerides fall, while non-responders saw little change. Responders’ fasting glucose and HbA1c stayed essentially flat over 52 weeks. Non-responders’ glucose and HbA1c drifted upward. Adiponectin, a protective hormone made by fat tissue, improved more in responders. Changes in lipids and glucose tracked the percentage of visceral fat lost. Put plainly, greater visceral fat loss went along with better triglycerides and steadier glucose. One way to read this is that shrinking visceral fat offsets growth hormone’s tendency to nudge glucose up, so people whose fat did not shrink got the hormonal push without the payoff. These were post hoc analyses, so they show association and cannot say why the groups differed. They are still the most practical insight in the tesamorelin literature. The 2017 follow-up adds the second half of the story. Among people with raised liver enzymes at the start, responders saw ALT and AST fall over 26 weeks. When some were switched to placebo, visceral fat partly came back, though the liver enzyme improvement held through 52 weeks. The fat effect depends on staying on the drug, which is one reason a clinician tracks how someone is responding.[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012)[13](https://www.vitalsvault.com/peptides/tesamorelin#source-fourman-2017) ## Tesamorelin and liver fat Visceral fat and liver fat travel together, so the next question was obvious. In a 2014 JAMA trial at Massachusetts General Hospital, 50 people with HIV and abdominal fat were randomly assigned to tesamorelin or placebo for six months. Tesamorelin reduced visceral fat and, more modestly, liver fat. Fasting glucose rose slightly on tesamorelin at two weeks, then settled, with no significant difference from placebo across the six months. The authors called the study preliminary and asked for longer trials to understand what the liver changes meant clinically. They ran one. A 2019 trial in The Lancet HIV enrolled 61 people with HIV and fatty liver disease for 12 months. Liver fat fell by 4.1 percentage points more on tesamorelin than on placebo, a 37% relative reduction, and 35% of people on tesamorelin ended with liver fat below 5%, the study’s entry threshold, against 4% on placebo. Glucose and HbA1c did not differ between groups at 12 months. Fatty liver is not part of the approved indication, and these were mid-sized trials. They do suggest that the visceral fat effect extends to the organ where fat does some of its quietest damage.[11](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2014)[6](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2019) ## Beyond HIV: tesamorelin and the aging brain The most intriguing tesamorelin study had nothing to do with HIV. At the University of Washington, 152 adults aged 55 to 87, 66 of them with mild cognitive impairment, used daily tesamorelin or placebo injections for 20 weeks. The researchers wanted to know whether a growth hormone releasing signal could help the aging brain, since GHRH, growth hormone and IGF-1 all fall with age. Cognition improved on tesamorelin compared with placebo, in people with mild cognitive impairment and in healthy older adults alike. The clearest effect was on executive function, the skills of planning, focusing and switching between tasks, with a trend for verbal memory. IGF-1 rose 117% but stayed within the normal range, and percent body fat fell 7.4% from baseline. There were trade-offs. Fasting insulin rose 35% in the people with mild cognitive impairment, though within the normal range, and mild adverse events were reported by 68% on tesamorelin against 36% on placebo. The authors called for longer trials. This is a single study, cognition is not an approved use, and it remains one of the more interesting open threads in growth hormone research.[7](https://www.vitalsvault.com/peptides/tesamorelin#source-baker-2012) Know your baseline before any peptide 120+ lab tests at Quest Diagnostics, every result reviewed by a licensed clinician. Most results in 3–5 business days. A baseline today gives your clinician something to compare against if you start Tesamorelin later. [Start with 120+ lab tests · $99](https://www.vitalsvault.com/labs#plans)[Get early access to peptide care](https://www.vitalsvault.com/peptides-waitlist) Full refund before your blood draw · No membership ## Tesamorelin vs sermorelin and CJC-1295 All three peptides are versions of GHRH. Sermorelin is the first 29 amino acids, the shortest fully active fragment, and was once sold as Geref. CJC-1295 is a long-acting GHRH analog with an estimated half-life of 5.8 to 8.1 days in its human trials. Tesamorelin is built on the full 44-amino-acid sequence. The real difference is the evidence. Tesamorelin has placebo-controlled phase 3 trials with CT-measured outcomes, a 52-week extension and a current approval. Sermorelin’s record is mostly pediatric. CJC-1295 has small, short trials measuring hormone levels in healthy adults. That does not make tesamorelin the right choice for everyone curious about growth hormone. Its phase 3 evidence for shrinking abdominal fat comes from adults with HIV-associated abdominal fat, and use outside that group is off-label and a prescriber’s decision.[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[9](https://www.vitalsvault.com/peptides/tesamorelin#source-prakash-1999)[10](https://www.vitalsvault.com/peptides/tesamorelin#source-teichman-2006) ## Tesamorelin side effects and safety Tesamorelin has a full prescribing label, which makes its safety picture clearer than that of most peptides. The most common adverse reactions, each in more than 5% of people in trials, were joint pain, redness and itching at the injection site, pain in the arms or legs, swelling in the lower limbs and muscle pain. The label also carries warnings for raised IGF-1, fluid retention, glucose intolerance or diabetes, hypersensitivity reactions, injection site reactions, an increased risk of neoplasms and increased mortality in people with acute critical illness. In the label’s trials, HbA1c of 6.5% or higher developed in 5% of people on tesamorelin against 1% on placebo. It is contraindicated in people with disruption of the hypothalamic-pituitary axis from surgery, tumor, head irradiation or head trauma, in active malignancy, in known hypersensitivity and in pregnancy. The label also says long-term cardiovascular safety has not been established. In the 2007 trial, overall adverse events did not differ significantly from placebo, though more people on tesamorelin stopped because of one. Taken together, it is generally tolerated, with real metabolic watch points that call for monitoring.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) ## The labs that track tesamorelin The label asks for glucose checks before and during treatment, so fasting glucose is the starting point. HbA1c, the three-month average of blood sugar, catches the slower drift the trials watched for, such as the 5% versus 1% rate of new HbA1c readings at or above 6.5%. ALT, a liver enzyme, has a special place here. In the phase 3 data, among people whose ALT or AST was raised at the start, visceral fat responders saw larger falls in liver enzymes than non-responders, and liver fat itself dropped in later trials. Triglycerides, a blood fat, fell sharply in the 2007 trial and fell further in responders, so they help track metabolic change, though no blood marker can tell you whether your own visceral fat has shrunk. IGF-1 sits alongside them as the drug’s own fingerprint. It rose 81% in the 2007 trial and 117% in the older-adult cognition study, and the label tells prescribers to monitor it, since persistently high IGF-1 is one of the warnings. It shows that the pituitary is answering, while the four markers above show whether the body is better for it. Together these markers give a clinician both sides of the ledger: how metabolism is moving and whether blood sugar is holding. Vitals Vault starts with a blood panel, a licensed clinician reviews it with your history, and the same markers are retested to show which way you are moving.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012)[13](https://www.vitalsvault.com/peptides/tesamorelin#source-fourman-2017)[7](https://www.vitalsvault.com/peptides/tesamorelin#source-baker-2012) ## Tesamorelin’s FDA approval and label FDA first approved tesamorelin as Egrifta on November 10, 2010. The current Egrifta SV label states that it is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. The label adds that it is not indicated for weight loss management, that long-term cardiovascular safety has not been established, and that there are no data supporting improved adherence to antiretroviral therapy. In sport, the World Anti-Doping Agency prohibits growth hormone releasing factors, including tesamorelin, in and out of competition.[3](https://www.vitalsvault.com/peptides/tesamorelin#source-drugsfda-egrifta)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[14](https://www.vitalsvault.com/peptides/tesamorelin#source-wada) ## What this means for you Tesamorelin has two placebo-controlled phase 3 trials behind it and a current FDA approval. In adults with HIV and excess abdominal fat, it reliably shrank the deep fat around the organs, improved triglycerides and, in later trials, liver fat. The benefit lasted while people took it and partly faded when they stopped, and the metabolic gains were associated with how much visceral fat actually came off. If you are wondering about it, start with whether visceral fat is really your problem, and how you would know if it was responding. Your waist, your triglycerides, your ALT and your blood sugar give a clinician context, while imaging is what actually measures visceral fat.[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010)[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012)[13](https://www.vitalsvault.com/peptides/tesamorelin#source-fourman-2017) Know your baseline before any peptide 120+ lab tests at Quest Diagnostics, every result reviewed by a licensed clinician. Most results in 3–5 business days. A baseline today gives your clinician something to compare against if you start Tesamorelin later. [Start with 120+ lab tests · $99](https://www.vitalsvault.com/labs#plans)[Get early access to peptide care](https://www.vitalsvault.com/peptides-waitlist) Full refund before your blood draw · No membership ## What to expect with Tesamorelin The phase 3 trials judged tesamorelin at 26 weeks, when visceral fat was measured by CT, and the reduction held to 52 weeks in people who continued. In the liver fat trials, changes were measured at 6 and 12 months. IGF-1 rises earlier, which is one reason the label asks for it to be monitored. Because responses vary, follow-up matters. Triglycerides, waist size, ALT and blood sugar help a clinician see how metabolism is moving and whether glucose is holding steady, though only imaging measures visceral fat directly.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010)[11](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2014)[6](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2019)[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) ## Key Tesamorelin studies - Falutz et al., 2007 (NEJM)[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) Randomized, double-blind, placebo-controlled, 26 weeks · 412 adults with HIV and abdominal fat (86% men) Visceral fat down 15.2% vs up 5.0% on placebo; triglycerides and cholesterol ratio improved Limits: HIV population only; more withdrawals for adverse events - Falutz et al., 2010[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) Pooled analysis of two phase 3 trials with 26-week extension · 806 adults with HIV and abdominal fat Visceral fat reduction held to 52 weeks on continued treatment; belly fat under the skin unchanged; body image improved Limits: HIV population only - Stanley et al., 2012[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012) Post hoc responder analysis · 402 tesamorelin-assigned participants in the per-protocol analysis Responders had better triglycerides, adiponectin and stable glucose; benefits were associated with fat lost Limits: Post hoc; association, not proof - Stanley et al., 2019 (Lancet HIV)[6](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2019) Randomized, double-blind, placebo-controlled, 12 months · 61 adults with HIV and fatty liver disease Liver fat down 37% relative to baseline; 35% vs 4% fell below the fatty liver threshold Limits: Mid-sized; long-term liver outcomes unknown - Baker et al., 2012[7](https://www.vitalsvault.com/peptides/tesamorelin#source-baker-2012) Randomized, double-blind, placebo-controlled, 20 weeks · 152 adults aged 55 to 87, 66 with mild cognitive impairment Better executive function; IGF-1 up 117%; percent body fat down 7.4% from baseline Limits: Single trial; more mild adverse events; not an approved use Key studies on Tesamorelin | Study | Design | Who | What it found | Limits | | --- | --- | --- | --- | --- | | Falutz et al., 2007 (NEJM)[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) | Randomized, double-blind, placebo-controlled, 26 weeks | 412 adults with HIV and abdominal fat (86% men) | Visceral fat down 15.2% vs up 5.0% on placebo; triglycerides and cholesterol ratio improved | HIV population only; more withdrawals for adverse events | | Falutz et al., 2010[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) | Pooled analysis of two phase 3 trials with 26-week extension | 806 adults with HIV and abdominal fat | Visceral fat reduction held to 52 weeks on continued treatment; belly fat under the skin unchanged; body image improved | HIV population only | | Stanley et al., 2012[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012) | Post hoc responder analysis | 402 tesamorelin-assigned participants in the per-protocol analysis | Responders had better triglycerides, adiponectin and stable glucose; benefits were associated with fat lost | Post hoc; association, not proof | | Stanley et al., 2019 (Lancet HIV)[6](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2019) | Randomized, double-blind, placebo-controlled, 12 months | 61 adults with HIV and fatty liver disease | Liver fat down 37% relative to baseline; 35% vs 4% fell below the fatty liver threshold | Mid-sized; long-term liver outcomes unknown | | Baker et al., 2012[7](https://www.vitalsvault.com/peptides/tesamorelin#source-baker-2012) | Randomized, double-blind, placebo-controlled, 20 weeks | 152 adults aged 55 to 87, 66 with mild cognitive impairment | Better executive function; IGF-1 up 117%; percent body fat down 7.4% from baseline | Single trial; more mild adverse events; not an approved use | ## Tesamorelin myths and evidence - ### Tesamorelin is a weight loss drug Its label says it is not indicated for weight loss management. In trials it targeted visceral fat around the organs, while fat under the skin of the belly barely changed.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) - ### Once the belly fat is gone, it stays gone In the phase 3 extension, people switched to placebo saw visceral fat partly come back. The reduction held in those who continued treatment.[13](https://www.vitalsvault.com/peptides/tesamorelin#source-fourman-2017)[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) - ### Everyone on tesamorelin gets the same result Most people met the 8% visceral fat response bar, but some did not. Non-responders saw glucose and HbA1c drift up without the metabolic benefits.[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012)[13](https://www.vitalsvault.com/peptides/tesamorelin#source-fourman-2017) - ### Tesamorelin is approved for anti-aging and fat loss in anyone The approval covers the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. Other uses, including cognition or general aging, are off-label.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) Know your baseline first 120+ lab tests at Quest, every result reviewed by a licensed clinician. Most results in 3–5 business days. [Start with 120+ lab tests · $99](https://www.vitalsvault.com/labs#plans) ## How is Tesamorelin taken? Egrifta SV is a prescription medicine injected under the skin once a day in the abdomen, with injection sites rotated, according to its label. The label sets the dose, and a prescriber decides on use.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) ## Tesamorelin dosage For its approved use, reducing excess abdominal fat in adults with HIV and lipodystrophy, the label sets one injection under the skin of the abdomen once daily. The amount differs between Egrifta SV and Egrifta WR, which are not interchangeable; the dosage table lists both, plus the dose used in the first phase 3 trial. No dose is established for other uses, and your clinician sets your dose.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[2](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-wr-label)[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) ## Typical Tesamorelin dosage Tesamorelin is FDA-approved to reduce excess abdominal fat in adults with HIV and lipodystrophy. The label dose is one injection under the skin of the abdomen once daily, and the amount depends on the formulation (Egrifta SV or Egrifta WR, which are not interchangeable). No dose is established for other uses, and a clinician sets the actual dose. These are reference doses from FDA labels, studies in people and clinical practice reports, shown for education. They are not a recommendation or a prescription. Your dose, form and schedule should be set by a licensed clinician who knows your history and lab results. Already have a prescribed dose? The [peptide dosage calculator](https://www.vitalsvault.com/peptides/tools/dosage-calculator) turns it into the units to draw on an insulin syringe. - FDA label · Injection under the skin of the abdomen 1.4 mg Once daily[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) Egrifta SV; adults with HIV and lipodystrophy - FDA label · Injection under the skin of the abdomen 1.28 mg Once daily[2](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-wr-label) Egrifta WR; adults with HIV and lipodystrophy. Not interchangeable with Egrifta SV - Human trial · Injection under the skin 2 mg Once daily for 26 weeks[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) Adults with HIV and excess abdominal fat; original formulation used in the phase 3 trial Typical Tesamorelin doses in people, by source | Source | Form | Amount | How often | Notes | | --- | --- | --- | --- | --- | | FDA label[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label) | Injection under the skin of the abdomen | 1.4 mg | Once daily | Egrifta SV; adults with HIV and lipodystrophy | | FDA label[2](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-wr-label) | Injection under the skin of the abdomen | 1.28 mg | Once daily | Egrifta WR; adults with HIV and lipodystrophy. Not interchangeable with Egrifta SV | | Human trial[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) | Injection under the skin | 2 mg | Once daily for 26 weeks | Adults with HIV and excess abdominal fat; original formulation used in the phase 3 trial | ## Is Tesamorelin right for you? A clinician makes the call. These are the questions they will ask first. ### It may suit - Adults with HIV and lipodystrophy with excess abdominal fat, as the label describes, under a prescriber’s care - People willing to have glucose, HbA1c and IGF-1 checked before and during treatment ### Talk to a clinician first if you are - Active malignancy (a contraindication on the label); prior cancer needs careful review - Pituitary disease, hypophysectomy, pituitary tumor, head irradiation or head trauma (contraindicated) - Pregnancy (contraindicated on the label); breastfeeding should be discussed with a prescriber - Diabetes or prediabetes, since glucose intolerance can develop - Critical illness - Tested athletes (WADA prohibits growth hormone releasing factors) Vitals Vault peptide care starts with a blood panel and a licensed clinician, and ends with a retest. [Get early access to peptide care](https://www.vitalsvault.com/peptides-waitlist) ## Tesamorelin vs sermorelin Tesamorelin vs sermorelin | Attribute | Tesamorelin | Sermorelin | | --- | --- | --- | | Based on | Full 44-amino-acid GHRH, modified | First 29 amino acids of GHRH | | FDA status | Approved (Egrifta SV) | Geref discontinued; no approved product | | Approved use | Excess abdominal fat in HIV-infected adults with lipodystrophy | Previously diagnostic use and pediatric growth hormone deficiency | | Evidence | Phase 3 trials with 52-week extension | Mostly older pediatric studies and small adult studies | ## Visceral fat is a hormone organ Visceral fat is the fat packed around the organs. In some people on HIV treatment it builds up out of proportion to body weight. Growth hormone breaks fat down. In these trials, losing visceral fat went along with better liver enzymes and a better metabolic profile. The label watches blood sugar, IGF-1 and fluid retention, since growth hormone also affects insulin and water balance.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007)[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[12](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2012)[13](https://www.vitalsvault.com/peptides/tesamorelin#source-fourman-2017) ### What else moves the same system 1. 01Resistance and aerobic trainingBoth reduce visceral fat and raise insulin sensitivity. 2. 02Protein and fiber-rich mealsThey protect muscle and steady glucose and insulin. 3. 03SleepShort sleep raises visceral fat and blunts growth hormone pulses. 4. 04Track liver and glucose labsALT and HbA1c show how liver fat and blood sugar are moving. ## Labs to check with Tesamorelin A blood test before you start and a retest after shows what actually changed for you. It is how Vitals Vault approaches every treatment. 1. TestA baseline panel at Quest Diagnostics. 2. DecideA licensed clinician reviews your history and results. 3. RetestThe same markers again, side by side. [Start with 120+ lab tests · $99](https://www.vitalsvault.com/labs#plans) - [Fasting glucoseA simple metabolic marker to retest.](https://www.vitalsvault.com/biomarkers/glucose) - [HbA1cYour average blood sugar over about three months.](https://www.vitalsvault.com/biomarkers/hemoglobin-a1c) - [Liver enzymes (ALT)Part of a metabolic panel. Checks the liver before and during any new prescription.](https://www.vitalsvault.com/biomarkers/alt) - [TriglyceridesA blood fat that fell on tesamorelin in the 2007 trial.](https://www.vitalsvault.com/biomarkers/triglycerides) ## Is Tesamorelin FDA approved? Yes, for one use. FDA approved Egrifta (tesamorelin) on November 10, 2010. The current label states that Egrifta SV is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. The label adds that long-term cardiovascular safety has not been established, that it is not indicated for weight loss management, and that there are no data supporting improved adherence to antiretroviral therapy. Use outside that indication is off-label.[1](https://www.vitalsvault.com/peptides/tesamorelin#source-egrifta-label)[3](https://www.vitalsvault.com/peptides/tesamorelin#source-drugsfda-egrifta) ### Tesamorelin timeline 1. 2007 Phase 3 trial in 412 people with HIV shows a 15.2% drop in visceral fat on tesamorelin.[4](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2007) 2. November 10, 2010 FDA approves Egrifta (tesamorelin) for reduction of excess abdominal fat in HIV-infected patients with lipodystrophy.[3](https://www.vitalsvault.com/peptides/tesamorelin#source-drugsfda-egrifta) 3. 2010 Pooled analysis of two phase 3 trials shows the visceral fat reduction held for 52 weeks.[5](https://www.vitalsvault.com/peptides/tesamorelin#source-falutz-2010) 4. 2014 Randomized trial in 50 people shows reductions in visceral and liver fat.[11](https://www.vitalsvault.com/peptides/tesamorelin#source-stanley-2014) ![A Latina woman, 57, medium build, dark-brown bob with a grey streak, round glasses reads on a tiled patio](https://www.vitalsvault.com/_next/image?url=%2Fpublic-v3%2Fshoot%2Fpeptides%2Ffaq-tesamorelin.webp&w=3840&q=75&dpl=shadow-production-f0162cb4d465-40992538108-1) ## Tesamorelin questions What is tesamorelin used for? Tesamorelin (Egrifta SV) is FDA-approved for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. It is not indicated for weight loss management. What are the benefits of tesamorelin? In HIV trials it reduced visceral fat by 15.2% against a 5.0% rise on placebo, improved triglycerides, and in a smaller trial reduced liver fat. These benefits were shown in adults with HIV. How does tesamorelin work? It binds the GHRH receptor on the pituitary, which releases growth hormone in pulses. Growth hormone breaks down fat and raises IGF-1. What are the side effects of tesamorelin? The most common are joint pain, injection site reactions, pain in the extremities, swelling and muscle pain. The label also warns of raised IGF-1, glucose intolerance or diabetes, fluid retention, hypersensitivity and neoplasm risk. What is the tesamorelin dosage? For adults with HIV and excess abdominal fat, the label dose is one injection under the skin of the abdomen once daily, with the amount set by the formulation. There is no established dose for other uses. Your clinician sets your dose. Is tesamorelin FDA approved? Yes, for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. FDA first approved Egrifta on November 10, 2010. Other uses are off-label. Tesamorelin vs sermorelin: what is the difference? Both are GHRH analogs. Tesamorelin is a modified full-length 44-amino-acid analog and is FDA-approved today. Sermorelin is the first 29 amino acids, and its Geref products were discontinued. Can people without HIV use tesamorelin? The label covers HIV-infected adults with lipodystrophy. Trials in other groups are limited. Any other use is off-label and a prescriber’s decision. Is tesamorelin banned in sports? Yes. The World Anti-Doping Agency prohibits growth hormone releasing factors in and out of competition. Can I get tesamorelin through Vitals Vault? Vitals Vault is opening clinician-led peptide care that starts with a blood test. Join the peptides waitlist to hear first. A licensed clinician reviews your history and labs and decides whether tesamorelin is right for you. ## Peptides, prescribed and measured Vitals Vault is opening peptide care that starts with your blood work, is prescribed by licensed US clinicians and ends with a retest. Join the waitlist to hear first. - Prescription only - Licensed US clinicians - Quest Diagnostics labs [Get early access to peptide care](https://www.vitalsvault.com/peptides-waitlist)[Start with 120+ lab tests · $99](https://www.vitalsvault.com/labs#plans) ## Keep reading [Full Peptide Guide](https://www.vitalsvault.com/peptides) - SermorelinA 29-amino-acid fragment of growth hormone releasing hormone, once FDA-approved as Geref and since discontinued. - CJC-1295A long-acting growth hormone releasing hormone analog, studied for raising growth hormone and IGF-1. - IpamorelinA five-amino-acid growth hormone secretagogue that mimics ghrelin, studied for its selective release of growth hormone. - AOD-9604A fragment of human growth hormone designed to break down fat. It reached human obesity trials but did not beat placebo. ## Sources 1. 1. [DailyMed. EGRIFTA SV (tesamorelin for injection) prescribing information (opens in a new tab)](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=3d783378-b02d-4f19-99dd-0fc91a042224) 2. 2. [DailyMed. EGRIFTA WR (tesamorelin for injection) prescribing information (opens in a new tab)](https://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=839334d3-8c1d-4c26-9036-2ab524a6ea75) 3. 3. [Drugs@FDA. Egrifta (tesamorelin), BLA 022505, original approval November 10, 2010 (opens in a new tab)](https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=022505) 4. 4. [Falutz J, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/18057338/) 5. 5. [Falutz J, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. J Clin Endocrinol Metab. 2010 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/20554713/) 6. 6. [Stanley TL, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV. 2019 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/31611038/) 7. 7. [Baker LD, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Arch Neurol. 2012 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/22869065/) 8. 8. [Guillemin R, et al. Growth hormone-releasing factor from a human pancreatic tumor that caused acromegaly. Science. 1982 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/6812220/) 9. 9. [Prakash A, et al. Sermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency. BioDrugs. 1999 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/18031173/) 10. 10. [Teichman SL, et al. Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults. J Clin Endocrinol Metab. 2006 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/16352683/) 11. 11. [Stanley TL, et al. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA. 2014 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/25038357/) 12. 12. [Stanley TL, et al. Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin. Clin Infect Dis. 2012 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/22495074/) 13. 13. [Fourman LT, et al. Visceral fat reduction with tesamorelin is associated with improved liver enzymes in HIV. AIDS. 2017 (opens in a new tab)](https://pubmed.ncbi.nlm.nih.gov/28832410/) 14. 14. [World Anti-Doping Agency. Prohibited List (opens in a new tab)](https://www.wada-ama.org/en/prohibited-list) Written by the Vitals Vault editorial team, medically reviewed by Robert Lufkin, MD, and updated October 29, 2026. This is general education, not medical advice. None of these peptides is FDA-approved to diagnose, treat, cure or prevent any disease, and compounded medicines are not FDA-reviewed for safety, effectiveness or quality. 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