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Tesamorelin

Also known as th9507, egrifta sv, egrifta wr, ghrh(1–44) analog, tesamorelin acetate · Wikipedia

Tesamorelin (TH9507; Egrifta SV; Egrifta WR) is a stabilized synthetic analogue of human growth hormone-releasing hormone GHRH(1-44) developed by Theratechnologies. It binds the GHRH receptor on anterior pituitary somatotrophs and stimulates physiologic pulsatile release of endogenous growth hormone, which raises hepatic IGF-1 while preserving negative feedback. It is FDA-approved for the reduction of excess visceral abdominal fat in HIV-infected patients with lipodystrophy (Egrifta, 2010; Egrifta SV, 2019; the room-temperature-stable Egrifta WR formulation approved in 2023). Pivotal Phase 3 trials reported by Falutz and colleagues (NEJM 2007) demonstrated approximately 15-18% reduction in CT-measured visceral adipose tissue at 26 weeks versus placebo. Outside the labeled indication, tesamorelin is widely used off-label in research and body-composition self-experimentation protocols for GH/IGF-1 support, visceral-fat reduction, and investigation of cognitive endpoints.

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Mechanism of action

Tesamorelin is a stabilized synthetic analogue of human growth hormone-releasing hormone (GHRH 1-44) modified with an N-terminal trans-3-hexenoic acid (hexenoyl-trans-3) group at Tyr1 that protects it from rapid degradation by dipeptidyl peptidase-4 (DPP-4) and prolongs its plasma residence. It binds the GHRH receptor (GHRHR) on anterior pituitary somatotrophs, activating Gαs–cAMP–PKA signaling and stimulating pulsatile physiologic release of endogenous growth hormone (GH).

Tesamorelin is a stabilized synthetic analogue of human growth hormone-releasing hormone (GHRH 1-44) modified with an N-terminal trans-3-hexenoic acid (hexenoyl-trans-3) group at Tyr1 that protects it from rapid degradation by dipeptidyl peptidase-4 (DPP-4) and prolongs its plasma residence. It binds the GHRH receptor (GHRHR) on anterior pituitary somatotrophs, activating Gαs–cAMP–PKA signaling and stimulating pulsatile physiologic release of endogenous growth hormone (GH). Released GH acts on hepatic GH receptors to increase IGF-1 production and on adipose tissue to stimulate hormone-sensitive lipase, driving lipolysis preferentially in visceral adipose depots. Because tesamorelin acts upstream of the pituitary rather than replacing GH directly, it preserves the natural pulsatile GH secretory pattern and the somatostatin-mediated negative feedback loop that exogenous recombinant GH bypasses, which may explain its more favorable metabolic profile in long-term use. Clinically, reduction in visceral adipose tissue and modest improvement in triglycerides have been the most consistent effects, with smaller signals on liver fat (Stanley et al., JAMA 2014; Stanley et al., Lancet HIV 2019).

Pharmacokinetic properties

Half-life

~26-38 min subcutaneous (steady state); ~8 min after single dose

Routes

subcutaneous

Bioavailability

Absolute subcutaneous bioavailability is low (<4%); administered once daily in the abdomen with site rotation. Egrifta WR (F8 formulation, 2023) is more concentrated and stable at room temperature.

Amino-acid sequence

44-amino-acid GHRH(1-44)-NH2 backbone with N-terminal trans-3-hexenoyl modification at Tyr1; full sequence corresponds to native human GHRH(1-44).

Use & research dosing

GH/IGF-1 SupportVisceral Fat ReductionLiver Fat Reduction

The FDA-approved label for Egrifta and Egrifta SV (HIV-associated lipodystrophy) prescribes 2 mg subcutaneously once daily, injected into the abdomen with site rotation. The newer Egrifta WR (F8) formulation (approved 2023) uses 1.28 mg SC once daily and is room-temperature stable. In pivotal trials (Falutz et al., NEJM 2007), the 2 mg/day dose reduced CT-measured visceral adipose tissue by approximately 15% over 26 weeks. In off-label longevity and body-composition self-experimentation protocols, 1-2 mg/day SC at bedtime is commonly reported to align administration with the natural overnight GH pulse. Treatment duration should account for the requirement that benefits regress within months of discontinuation; periodic monitoring of IGF-1 and HbA1c is commonly recommended in research contexts.

Research-use framing only. SavePeptides sells nothing for human consumption. Doses above reflect reported research / self-experimentation ranges, not clinical recommendations.

Editorial perspective

Tesamorelin is one of only two FDA-approved peptides operating through the GH/IGF-1 axis (alongside recombinant GH itself) and the only approved GHRH analogue. Falutz et al. (NEJM 2007) established the visceral-fat reduction effect; Stanley et al. (JAMA 2014) extended the data to demonstrate liver-fat improvement in HIV-associated NAFLD, and Stanley et al. (Lancet HIV 2019) confirmed reductions in hepatic steatosis and fibrosis markers. The Egrifta WR (F8) formulation approved in 2023 simplified handling by removing the cold-chain requirement. Long-term cardiovascular safety in non-HIV populations has not been formally studied; off-label use in aging and body-composition contexts continues despite the absence of regulator-grade efficacy or safety data outside the HIV-lipodystrophy population.

— SavePeptides editorial desk · last updated 2026-05-25

Cautions & contraindications

Before researching this compound, note:

  • Contraindicated in active malignancy (GH/IGF-1 axis may promote tumor growth)
  • Contraindicated in pregnancy
  • Contraindicated in disrupted hypothalamic-pituitary axis (hypophysectomy, pituitary tumor, pituitary surgery, head irradiation)
  • Contraindicated in known hypersensitivity to tesamorelin or mannitol
  • May cause glucose intolerance, hyperglycemia, or worsen diabetes — monitor HbA1c and fasting glucose
  • Injection-site reactions (erythema, pruritus, pain) are the most common adverse events
  • Arthralgia, myalgia, and peripheral edema reported
  • Fluid retention, peripheral edema, and carpal tunnel syndrome possible (GH class effect)
  • Acute critical illness (post-open-heart surgery, abdominal surgery, multiple accidental trauma, acute respiratory failure) — increased mortality reported with GH-related therapies
  • IGF-1 elevations above age-adjusted normal range warrant dose adjustment or discontinuation
  • Avoid concurrent use with exogenous GH
  • Reconstituted Egrifta SV must be used immediately; Egrifta WR (F8) does not require reconstitution and is room-temperature stable

Research foundation

The papers behind the page.

  1. [01]https://www.nejm.org/doi/full/10.1056/NEJMoa072375
  2. [02]https://jamanetwork.com/journals/jama/fullarticle/1889139
  3. [03]https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(19)30338-8/abstract
  4. [04]https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/022505s020lbl.pdf
  5. [05]https://pubmed.ncbi.nlm.nih.gov/20101189/

Facts verified

2026-05-25

Confidence

high

What this means

  • all pivotal data are in HIV-associated lipodystrophy; off-label use in general aging/body-composition is unstudied at scale
  • research-grade material is not bioequivalent to Egrifta SV/WR

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Tesamorelin · SavePeptides