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Specimen Atlas of Research Peptides30 plates · MIT
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XXVIPlate XXVIFDA approved · 2010Reviewed 2026-04-25

Tesamorelin

GHRH Analogue

also known as Egrifta, TH9507, tesamorelin acetate

Synthetic 44-amino-acid GHRH analogue, FDA-approved (2010) for HIV-associated lipodystrophy. Stimulates pulsatile growth hormone release from the anterior pituitary, elevating IGF-1 and reducing visceral adipose tissue by 15–20% over 26 weeks. Distinguished from native GHRH by a trans-3-hexenoic-acid modification that extends plasma half-life from ~7 minutes to ~26 minutes.

§ I

At a glance

Daily dose
2 mg
[fda-egrifta-label-2010]
VAT reduction
15–20%
[falutz-2010]
Half-life
~26 min
[fda-egrifta-label-2010]
Route

SQ · Abdomen · Once Daily

§ II

Mechanism

Primary target — Hypothalamic GHRH receptors [fda-egrifta-label-2010].

Pathway — GHRH → Pituitary GH release → Liver IGF-1 synthesis [falutz-2007].

Downstream effect — Increased GH pulsatility, elevated IGF-1, lipolysis of visceral adipose tissue [falutz-2010].

Origin — Synthetic 44-AA GHRH analogue with trans-3-hexenoic-acid modification for stability [fda-egrifta-label-2010].

Feedback intact — Yes — physiological pulsatility preserved.

§ III

Dosage

Protocols described in the cited literature; not medical advice.

ParameterValue
Standard dose2 mg / day [fda-egrifta-label-2010]FDA-approved protocol.
FrequencyOnce daily (morning or pre-sleep)Aligns with natural GH pulse.
Lower / starter dose1 mg / day [falutz-2010]1 mg still produces significant IGF-1 elevation.
Evidence basisRCT / FDA-approved [falutz-2007][falutz-2010]
Duration12–52 weeksVAT returns within months of stopping.
ReconstitutionSterile water per labelingPreserved at 2–8 °C after reconstitution.
TimingEmpty stomach, pre-sleep preferred
Half-life~26 min (plasma) [fda-egrifta-label-2010]Modified vs native GHRH (7 min t½).
§ III · b

Reconstitution

A pure mass-to-volume utility. Enter what you have in the vial; the atlas computes the volume per dose. No prescription information.

Inputs
The calculator does pure mass-to-volume math. It does not recommend a dose. Refer to Tesamorelin's cited literature for protocol specifics.
Volumetric outputFig. C — reconstitution math
Volume per dose
0.250mL
≈ 25.0 units on a U-100 insulin syringe
Concentration
1000
mcg per mL
Doses per vial
8
at this dose
§ IV

Evidence

Strength
90/100
fda approved

816-person double-blind RCT · FDA Phase 3 · 26–52 weeks

OutcomeFinding
Primary fat targetVisceral adipose tissue (VAT) — abdominal
Quantified reduction15–20% VAT ↓ [falutz-2010]By CT at 26 weeks (Falutz et al., NEJM).
IGF-1 impact+66 ng/mL (2 mg dose) · +81% mean elevation [falutz-2007]
Effect on lean massModest lean mass preservation / slight increase
Insulin sensitivityNeutral to slight impairment (monitor HbA1c) [clarke-2018]
TriglyceridesSignificant TG reduction noted in Phase 3 [falutz-2010]
Glucose metabolismGenerally neutral; 4.5% HbA1c elevation risk [clarke-2018]
Effect reversibilityVAT returns within months of stopping
Key publicationFalutz et al. NEJM 2007 · Falutz JCEM 2010 · FDA approval 2010 [falutz-2007][falutz-2010][fda-egrifta-label-2010]
§ V

Adverse events

Severities follow the FDA / CTCAE convention.

Injection site reactionmild
Erythema, pruritus, redness (common)
Fluid retention / Edemamoderate
Peripheral edema, arthralgia, carpal tunnel (GH-axis effect)
Glucose intolerancemoderate
HbA1c ↑ in 4.5% vs 1.3% placebo; HbA1c ≥6.5% hazard OR 3.3 [clarke-2018]
IGF-1 elevationmoderate
Dose-dependent; supraphysiological levels = discontinue
Cancer risksevere
Contraindicated in active malignancy (GH/IGF-1 axis); theoretical tumour growth risk [fda-egrifta-label-2010]
Antibody formationmild
~50% at 26 weeks; non-neutralising in most; rare hypersensitivity (<1%) [sevigny-2018]
GI symptomsmild
Nausea, diarrhea (mild, transient)
Pregnancy / OBsevere
Contraindicated [fda-egrifta-label-2010]
Absolute contraindications
  • — Active malignancy or history of treated cancer
  • — Pregnancy
  • — Hypersensitivity to tesamorelin or mannitol
  • — Disruption of hypothalamic-pituitary axis (trauma, tumour, radiation)
Relative contraindications
  • — Untreated diabetes (monitor HbA1c)
  • — Severe carpal tunnel syndrome
  • — Acute critical illness
§ VI

Administration

  1. 01
    Reconstitution

    Add 2.1 mL sterile water to 2 mg lyophilised vial. Roll gently — do not shake. Solution should be clear.

  2. 02
    Injection site

    Subcutaneous — abdomen preferred. Rotate sites (avoid same spot within 2 cm). Avoid navel and waistband area.

  3. 03
    Timing

    Once daily. Preferred: evening, 2–3 hrs post-meal, before sleep — aligns with natural GH secretion pulse.

  4. 04
    Storage

    Lyophilised: room temp, light-protected. Reconstituted: refrigerate 2–8 °C, use within 21 days.

  5. 05
    Needle

    27–31G, 4–8 mm insulin syringe. Pinch skin, 45° angle for lean individuals.

§ VII

Synergies

strong synergy
+
Tesamorelin + Ipamorelin

Tesamorelin (GHRH analogue) and ipamorelin (GHRP / ghrelin mimetic) act on two distinct receptor systems to amplify GH release synergistically — GHRH receptor + ghrelin receptor. This dual-axis stimulation produces a more robust, sustained GH pulse than either alone while maintaining physiological pulsatility. Ipamorelin is highly selective with minimal cortisol or prolactin elevation, making it the preferred GHRP pairing.

Primary benefit — Maximal GH pulsatility, fat loss, recovery, sleep quality
Appendix

Sources

40%

of 68 rendered claims carry a resolvable citation.

  1. [clarke-2018]
    Clarke 2018 — Effects of tesamorelin on insulin sensitivity and lipid metabolism in HIV-infected patients with abdominal fat accumulation
    Metabolism, 2018
    PubMed →
  2. [falutz-2007]
    Falutz 2007 — Metabolic effects of a growth hormone-releasing factor in patients with HIV
    N Engl J Med, 2007
    PubMed →
  3. [falutz-2010]
    Falutz 2010 — Effects of tesamorelin on visceral fat and serum lipids in HIV-infected patients with abdominal fat accumulation: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials
    J Clin Endocrinol Metab, 2010
    PubMed →
  4. [fda-egrifta-label-2010]
    EGRIFTA® (tesamorelin for inje 2010 — EGRIFTA® (tesamorelin for injection) prescribing information
    fda-label, 2010
    Source →
  5. [raun-1998]
    Raun 1998 — Ipamorelin, the first selective growth hormone secretagogue
    Eur J Endocrinol, 1998
    PubMed →
  6. [sevigny-2018]
    Sévigny 2018 — Long-term safety and effects of tesamorelin
    AIDS, 2018
    PubMed →
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