Tesamorelin

The only approved GHRH drug. It strips deep visceral fat and largely leaves the fat under the skin alone.

Evidence: AApproved what's this?
Grade A for HIV-associated visceral fat (since 2010). Use outside that group is extrapolated.
Also known as: Egrifta · Egrifta SV · Egrifta WR · TH9507
Class: Stabilised full-length GHRH(1–44) analogue. Approved prescription medicine.

The 30-second version

WhatThe full 44-amino-acid GHRH with a protective group that blocks breakdown by DPP-4.

ResultsAbout 15–18% less visceral fat in 26 weeks, plus lower liver fat, without the glucose penalty of GH.

The honest catchThe fat comes back after stopping, so the results last only while you keep using it.

What it is

CJC-1295 and sermorelin are fragments of GHRH. Tesamorelin is the whole 44-amino-acid hormone, with a small chemical cap on its front end that stops the enzyme DPP-4 from breaking it down within minutes. That change turned GHRH into a usable drug: Egrifta, approved in 2010 for HIV-associated lipodystrophy, where antiretroviral therapy drives deep abdominal fat gain.

How it works

GHRH receptor on the pituitary is activated.

Your own GH is released in natural pulses, not a flat flood.

Visceral fat around the organs responds to GH more than fat under the skin, so it’s broken down preferentially.

IGF-1 rises within the normal physiological range.

Gentler glucose. Far less blood-sugar penalty than injecting GH directly.

What the research shows

Phase 3, HIV lipodystrophy: 2 mg daily cut visceral fat by about 15–18% over 26 weeks against placebo, improved lipids and spared glucose control¹. JAMA 2014: it confirmed the visceral-fat drop and also reduced liver fat, which drove interest in fatty-liver disease². In every study, people switched to placebo regained the visceral fat toward baseline^2,3.

Tesamorelin is a maintenance treatment, not a one-off fix. It works while you take it.

Evidence at a glance

Use	Grade	Best evidence	Main gap	Read
Visceral fat (HIV)	AApproved	15–18% reduction¹	Reverses on stopping	Proven
Liver fat	BHuman trials	Reduced liver fat²	HIV population	Promising
General visceral fat	DCommunity use	Extrapolated from HIV data	Not trialled	Reasonable inference
GH and IGF-1	AApproved	Raised physiologically	GH-axis cautions	Established

Dosing: what has been reported

Not a recommendation. These figures describe what was studied or what circulates in practice, kept separate so you can see how solid each one is. Speak with a qualified clinician before acting on any of it.

Setting	Figure	Route	Grade
Egrifta (approved)	2 mg once daily	Subcutaneous	A
Egrifta SV (approved)	1.4 mg once daily (different concentration)	Subcutaneous	A
Egrifta WR (2025)	Daily injection, weekly reconstitution, per label	Subcutaneous	A
Off-label	1–2 mg daily, often at night on an empty stomach, cycled	Subcutaneous	D

The formulations aren’t interchangeable milligram for milligram, so always follow the specific product’s instructions.

Preparing & storing

More delicate than small research peptides. Keep the powder refrigerated, use promptly once mixed, keep it cold and away from light, and never shake it. Inject into the abdomen and rotate sites.

Reported side effects

Joint and muscle pain, pain in the extremities
Injection-site reactions
Fluid retention and swelling; carpal-tunnel-type tingling
Milder glucose effects than GH, but still worth watching
Uncommon hypersensitivity

Worth tracking: IGF-1 every 4–8 weeks, plus waist, glucose and lipids.

Who should avoid it

Active cancer (GH and IGF-1 are growth signals)
Pituitary tumour, surgery or head irradiation (label contraindication)
Pregnancy and breastfeeding
Diabetes: only with monitoring; corticosteroids can blunt the response
Tested athletes: WADA prohibited (S2)

Regulatory status checked Oct 2026

Body	Status	Detail
FDA (US)	Approved	Egrifta, SV and WR for HIV-associated lipodystrophy; off-label otherwise.
EMA (EU)	Not approved	No current authorisation identified.
CDSCO (India)	Not approved	No approval identified.
WADA	Prohibited	GHRH analogue, banned at all times; detectable.

The NexGen read

The proven visceral-fat specialist

Tesamorelin is the GH-axis peptide with full approval behind it, and its selectivity for deep belly fat is unique in this family. Plan for ongoing use, because the fat comes back after stopping. Monitor IGF-1 and glucose throughout.

References

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.
Stanley TL, Feldpausch MN, Oh J, et al. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients. JAMA. 2014;312(4):380–389.
Theratechnologies. Egrifta and Egrifta WR (tesamorelin) prescribing information.