Tesamorelin
Aliases: Egrifta · TH9507
Last verified: 2026-09-23
The short version
Tesamorelin is one of the few peptides on this list that is a genuine, regulator-approved drug: FDA approved it in 2010 to reduce visceral abdominal fat in HIV-associated lipodystrophy. In large RCTs it reduced visceral adipose tissue ~15–18% with an acceptable profile; IGF-1 rises were consistent. What is not established is long-term cardiovascular safety — that is an explicit label limitation. Off-indication use (bodybuilding, 'anti-aging') is off-label and evidence-free.
Identity & type
- Molecular type
- analog
- Sequence / structure
- trans-3-hexenoyl GHRH(1–44), 44 aa
- Molecular weight
- ~5136 Da
- Origin
- Analog of human GHRH(1–44) with an N-terminal trans-3-hexenoyl modification — FDA-approved drug (Egrifta SV).
Mechanism of action
GHRH receptor agonist → pulsatile GH → IGF-1; reduces visceral adipose tissue (VAT) and triglycerides.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. Approved regimen: 1.4 mg SC once daily (Egrifta SV); the original 2 mg formulation was discontinued.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
1.4 mg SC once daily (Egrifta SV, approved regimen); the original 2 mg formulation was discontinued. In HIV lipodystrophy (approved use): measurable visceral belly-fat reduction within 8–26 weeks. The off-label community values it as the most "targeted" GH peptide for abdominal fat.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
Effects seen: measurable visceral belly-fat reduction within 8–26 weeks in HIV-associated lipodystrophy (approved indication, phase III evidence); off-label abdominal-fat claims rest on anecdote.
Protocol — official vs community
Official / label
Egrifta SV: 1.4 mg SC once daily (original 2 mg formulation discontinued in favor of 1.4 mg).
- 01No titration — flat daily dose from day 1
Duration: Continuous for the approved indication (HIV-associated lipodystrophy). Effects reverse on discontinuation.
IGF-1 must be monitored; active malignancy is a labeled contraindication. Not approved for general weight loss.
Community (anecdotal)
1–2 mg SC daily, typically at night, mirroring the label.
- Cycle:
- 8–16 weeks on is the common biohacker pattern (as opposed to the label's continuous use).
- Break:
- 4+ weeks off between cycles, nominally to reassess IGF-1 and 're-sensitize' — the sensitization claim is folklore, not data.
The cycling practice is community-invented; the label knows nothing about it. The reversal-on-stop data, however, is real.
Human evidence
Robust: two large randomized phase III studies with quantitative CT measurement of visceral fat; reproduced in open-label extensions up to 26 weeks.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Joint pain, edema, paresthesia (common, mild)characterized
- IGF-1 elevation — long-term CV effects not established (explicit label limitation)characterized
- Contraindicated with active malignancycharacterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Long-term cardiovascular safety
- Benefit in people without HIV lipodystrophy
Frequently asked questions
References
- Falutz J. et al., phase III tesamorelin trials in HIV lipodystrophy (AIDS, 2010)
- Egrifta SV (tesamorelin) — FDA label