Visceral fat reduction, growth hormone signaling, IGF-1, body composition, liver
Tesamorelin
A GHRH analog studied for increasing endogenous GH/IGF-1 signaling and reducing visceral abdominal fat, with additional research involving liver fat, body composition, and metabolic health.
Administration Reference
Subcutaneous
Source / Evidence Context
Approved prescribing information / clinical guidance
Dose Information
2 mg
Frequency
Once daily
Duration / Cycle
26–52 weeks
Off-Cycle
No scheduled off-cycle period is established
Timing
No established time, community reports 2 hours fasted before bed
Storage Guidance
Refrigerate after reconstitution and use within approximately 30 days, Freeze for lyophilized powder form
Supplies
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Listings are not a required kit or confirmation of suitability for a particular peptide, formulation, or route. Check the product specifications and intended use.
Syringes & transfer supplies
EasyTouch U-100 Insulin Syringes (31G 0.5cc 5/16″) – 100ct.U-100 Insulin Syringes (31G 0.5cc 5/16") – 100ctInsulin syringes – Polybag, 50 Unit Capacity, 5/16” Needle Length, Bold Markings for Accurate Dosing, Disposable, Box of 100View at AMAZON →
Protective supplies & disposal
MED PRIDE Sterile Alcohol Prep Pads1 BOX OF 200INDIVIDUALLY WRAPPED ISOPROPYL ALCOHOL WIPES, PACK OF 1 BOX OF 200, MEDIUM SIZE PREP PADSView at AMAZON →
Inspire Black Nitrile Gloves HEAVY DUTY 6 Mil100ctView at AMAZON →
Square Sharps Container, 2 QuartQTY 1View at AMAZON →
Commonly Reported Uses
Reduction of excess visceral abdominal fat in adults with HIV-associated lipodystrophy; body-composition research; GH/IGF-1 signaling; liver-fat research; metabolic-health research; lean-mass and waist-circumference outcomes. Tesamorelin is not FDA approved for general weight loss.
Commonly Reported Indicators
Reduced visceral abdominal fat, smaller waist circumference, changes in abdominal appearance, increased IGF-1, reduced trunk fat, and increased lean body mass have been measured in clinical studies. Liver-fat reduction has also been demonstrated. Body weight and BMI may change relatively little because the primary effect is on body composition rather than generalized weight loss.
Mechanism Overview
Tesamorelin binds GHRH receptors on pituitary somatotroph cells and stimulates endogenous pulsatile growth-hormone secretion. Increased GH raises circulating IGF-1 and promotes lipolysis, contributing to reductions in visceral adipose tissue while preserving the physiological pituitary pathway rather than supplying exogenous GH.
Safety
Safety Considerations
Tesamorelin increases endogenous GH and serum IGF-1. Important monitoring includes IGF-1, glucose and glycemic status, fluid-retention symptoms, injection-site reactions, hypersensitivity, and treatment response. FDA labeling notes that the effects of prolonged IGF-1 elevation are unknown and advises considering discontinuation with persistent IGF-1 elevation above approximately 3 SDS, particularly when clinical response is limited.
Reported Adverse Effects
Injection-site reactions, arthralgia, myalgia, extremity pain, peripheral edema, paresthesia, hypoesthesia, rash, pruritus, joint swelling, musculoskeletal stiffness, carpal-tunnel-type symptoms, hypersensitivity reactions, and glucose intolerance or hyperglycemia.
Contraindications & Cautions
Active malignancy; disruption of the hypothalamic-pituitary axis caused by hypophysectomy, hypopituitarism, pituitary tumor or surgery, head irradiation, or significant head trauma; known hypersensitivity to tesamorelin or formulation components; and pregnancy. Additional caution applies to impaired glucose regulation, diabetes, and diabetic retinopathy.
Cancer Considerations
Editorial evidence assessment, not a validated risk score or clearance for use. Unknown risk does not mean low risk; these notes do not establish safety during active cancer or remission.
Cancer Concern Assessment
Strong caution / avoidance generally discussed
Basis for Concern
Tesamorelin stimulates endogenous GH and increases IGF-1, both of which participate in cellular growth signaling. FDA labeling specifically addresses potential neoplasm risk, contraindicates use with active malignancy, and notes that prolonged elevations of IGF-1 have uncertain long-term consequences.
Active Cancer
Generally avoided
Active malignancy is a formal contraindication. FDA labeling states that tesamorelin induces endogenous GH, a known growth factor, and should not be used while malignancy is active.
Prior Cancer / Remission
Elevated caution
For previously treated and stable malignancy, FDA labeling recommends careful evaluation of potential treatment benefit against the risk of reactivation. Therapy should be discontinued if malignancy recurs. No universal evidence-based remission interval is established.
Status
Regulatory Status
Tesamorelin is FDA approved for reduction of excess abdominal fat in adults with HIV-associated lipodystrophy. It is not approved for general obesity or weight-loss management, anti-aging, athletic performance, or routine reduction of abdominal fat outside the labeled indication.
Development / Research Status
Approved medication
Market Classification
Prescription medication
Status Notes
Current U.S. formulations include EGRIFTA WR and EGRIFTA SV. They have different strengths, doses, reconstitution procedures, and storage requirements and are not substitutable. Tesamorelin is also prohibited at all times in WADA-regulated sport as a growth-hormone-releasing factor.
Research & Evidence
Evidence Level
Approved clinical use
Research Last Reviewed
2026-09-05
Research Overview
Tesamorelin has multiple randomized controlled trials and long-term extension data supporting reductions in visceral adipose tissue in adults with HIV-associated lipodystrophy. Additional controlled studies demonstrate liver-fat reduction. Two 2026 meta-analyses further support reductions in visceral fat, waist circumference, trunk fat and hepatic fat, with increases in lean body mass.
Human Research
A 412-participant randomized trial found that 2 mg daily tesamorelin for 26 weeks reduced visceral adipose tissue by 15.2%, compared with a 5.0% increase with placebo, while improving triglycerides and cholesterol-related measures. A separate 404-participant study confirmed significant visceral-fat reduction over six months and showed that benefits were maintained with continued therapy but diminished after discontinuation. In a randomized trial of adults with HIV and abdominal adiposity, tesamorelin also reduced liver fat over six months. A later 12-month trial in 61 adults with HIV and NAFLD reported a 37% relative reduction in hepatic fat compared with placebo.
Animal Research
Preclinical pharmacology supported development of tesamorelin as a stabilized GHRH analog capable of stimulating the pituitary GH axis. The clinically relevant evidence base, however, is dominated by human pharmacology and randomized clinical trials.
In Vitro Research
Tesamorelin binds and stimulates human GHRH receptors with potency similar to endogenous GHRH. Receptor activation drives pituitary GH release and downstream IGF-1 production, providing the mechanistic basis for its effects on visceral adipose tissue.
References
U.S. Food and Drug Administration. EGRIFTA WR (tesamorelin) for injection Prescribing Information. Revised March 2025.
DailyMed. EGRIFTA SV (tesamorelin) for injection Prescribing Information.
Falutz J, Allas S, Blot K, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007;357(23):2359-2370. PMID 18057338. DOI 10.1056/NEJMoa072375.
Falutz J, Allas S, Mamputu JC, et al. Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS. 2008;22(14):1719-1728. PMID 18690162.
Falutz J, Potvin D, Mamputu JC, et al. Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. J Acquir Immune Defic Syndr. 2010;53(3):311-322. PMID 20101189.
Stanley TL, Feldpausch MN, Oh J, 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;312(4):380-389. PMID 25038357. DOI 10.1001/jama.2014.8334.
Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV. 2019;6(12):e821-e830. PMID 31611038. DOI 10.1016/S2352-3018(19)30338-8.
Badran AS, Helal A, Shata KS, Ayesh H. Body composition, hepatic fat, metabolic, and safety outcomes of tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: a meta-analysis of randomized controlled trials. Obes Res Clin Pract. 2026;20(1):2-12. PMID 41545261. DOI 10.1016/j.orcp.2026.01.002.
Ditta AM, Naeem RM, Sami MM, et al. Efficacy and Safety of Tesamorelin in People Living With HIV With Lipodystrophy: A Systematic Review and Meta-Analysis. J Int Assoc Provid AIDS Care. 2026;25:23259582261475549. PMID 42538058. DOI 10.1177/23259582261475549.
World Anti-Doping Agency. 2026 Prohibited List. Tesamorelin listed under growth-hormone-releasing factors prohibited at all times.