Tesamorelin: the one GHRH analogue that finished the approval process
Almost every growth-hormone peptide in this reference is a research compound. This one is an approved drug, for one narrow indication, with the trial data that implies. Both halves of that sentence matter when reading anything written about it.
- Also known as
- Egrifta, TH9507
- Class
- Growth hormone secretagogue
- Regulatory status
- FDA APPROVED for HIV-associated lipodystrophy. Off-label use for general body composition and cognitive health.
- Modelled half-life
- 36 min
- Time to peak
- 15 min
- Formulation
- Aqueous (reconstituted powder)
- Before mixing
- Sealed powder tolerates room temperature in transit, but keep it refrigerated at 2–8 °C (36–46 °F) for anything beyond a few weeks, or frozen for months. Keep it dark — the carton it shipped in is doing a job.
- After mixing
- Once reconstituted with bacteriostatic water: refrigerate at 2–8 °C and use within about 28 days. The benzyl alcohol in bacteriostatic water is what buys that window — plain sterile water has no preservative, so a vial mixed with it should be treated as one sitting only. Kits are usually ten vials: only the one you mixed is on that 28-day clock — the sealed ones keep their own, much longer shelf life, so store them as powder, not as solution.
- What ruins it
- Do not freeze a reconstituted vial. Repeated freeze–thaw is one of the more reliable ways to degrade a peptide.
- Handling caveat
- General handling practice for this formulation. Your supplier’s own insert or COA overrides anything here.
What it is, and what it was approved for
Tesamorelin is a stabilised analogue of growth-hormone-releasing hormone: the native 44-amino-acid sequence with a trans-3-hexenoyl group attached at the N-terminus, which is what keeps DPP-4 from cutting it. Like every GHRH analogue it acts on the pituitary rather than replacing its output, so the axis’s own feedback stays in place and growth hormone is released in pulses rather than held up continuously.
Established clinical use The approval is for excess visceral adipose tissue in adults with HIV-associated lipodystrophy, and that is a narrower thing than "body composition". The trials measured visceral fat by CT scan and reported reductions in the region of 15 to 18 per cent against placebo over six to twelve months, with IGF-1 rising into the normal range and triglycerides improving. Subcutaneous fat did not change much, which is the point: the drug was developed for the compartment that carries the metabolic risk.
The finding that travels least well is what happened on withdrawal. In the extension phase, participants who stopped regained the visceral fat they had lost. That is not a criticism of the drug — it is a description of what kind of intervention it is, and it is the single most useful thing to know before starting one.
A half-life of minutes, an effect measured in months
The app models the peptide at a half-life well under an hour, which is normal for this class and tells you almost nothing about the effect. What the injection does is trigger a growth hormone pulse; what the pulse does is raise hepatic IGF-1, which turns over on a scale of days; what IGF-1 does to visceral fat took the trials months to measure. Three different timescales stacked on top of each other, and only the shortest of them is the half-life.
That is why the monitoring marker is IGF-1 rather than growth hormone, and why the protocol is daily rather than as-needed. The IGF-1 page covers why the reference interval is age-dependent and what a change in it does and does not mean. The half-life page has the curve for the peptide itself.
The trade-off that shows up on the panel
Established clinical use Raising growth hormone reduces insulin sensitivity, and tesamorelin is not exempt. The trials recorded increases in fasting glucose and in HbA1c, mostly modest and mostly reversible, and glycaemic monitoring is part of the approved labelling rather than an optional extra. In a population being treated for a metabolic problem, a drug that improves visceral fat while nudging glucose the other way is a trade to be measured rather than assumed.
Fluid retention, joint discomfort and injection-site reactions are the other reported effects, and they are dose-related and familiar from the whole GH axis. Off-label or community practice Use outside the approved indication — general body composition, or the cognitive question a small trial in older adults has raised — is off-label and rests on evidence collected in a different population for a different endpoint. Whether any of it applies to a particular person is a prescribing decision, and anything experienced while taking it belongs with the clinician who prescribed it.
The curve, the accumulation ratio and the peak-to-trough figures have a page of their own: Tesamorelin half-life and steady state.
The dosing rows the app records
Established clinical use Reproduced from the app’s reference so you can see what it holds, not as a recommendation. Which row applies to a particular person, if any, is a clinical decision this page does not make — and rows describing supraphysiological or post-cycle use are filtered out before this table is built, so what you see here is a subset.
| Label | Amount | Route and frequency | Duration recorded |
|---|---|---|---|
| FDA Approved use | 2mg/day | SubQ daily | Ongoing with monitoring |
| Off-label body composition | 1-2mg/day | SubQ daily fasted AM or pre-bed | 3-6 months |
| Standard | 1mg/day | SubQ injection, morning | 3–6 months |
| Body Composition | 2mg/day | SubQ injection, morning fasted | 3–6 months |
What the app monitors alongside it
The panel below is the app’s own monitoring note for Tesamorelin, verbatim. The analytes in it that have a page here are linked; those pages cover what each one measures, which assay produced it and how to read a trend.
- Monitoring panel
- IGF-1 every 3 months (critical), fasting glucose, HbA1c, visceral fat assessment, lipid panel.
Drawbacks and risks the app records
From the app’s own entry. Unusually reliable for a peptide, because these came out of a trial programme that reached a regulator rather than from case reports.
- Expensive — approved drug pricing
- Approved only for HIV lipodystrophy — off-label for other uses
- Requires refrigeration
- Daily injection
- May cause fluid retention and joint pain at higher doses
- IGF-1 monitoring required
- Expensive compared to other GH peptides
- Can induce insulin resistance
- Requires physician prescription
- Not widely available
- Injection site reactions common
Interaction rules that name Tesamorelin
From the app’s interaction data, filtered so no rule naming a compound this site does not publish appears. Not exhaustive, and not a safety clearance: a combination that is not listed is one nobody has documented here, which is not the same as one that is fine. The combination checker has the rest.
Excellent GHRH + GHRP Synergistic Pairing
Tesamorelin (GHRH analogue) and Ipamorelin (GHRP) work synergistically to produce larger GH pulses than either alone — the GHRH primes the somatotrophs and the GHRP amplifies the pulse. This is the FDA-validated compound type pairing with the most evidence.
What to watch: IGF-1 every 3 months, fasting glucose, HbA1c.
Questions people actually ask
Is it better than the research GHRH analogues?
It is the one with a completed trial programme and an approved label, which is a statement about evidence rather than about potency. Sermorelin and modified GRF(1-29) act at the same receptor; what they do not have is a body of controlled human data for any indication. That difference is the whole reason this page can quote percentages.
Does the visceral fat come back?
In the trial extension it did, in people who stopped. Treat it as an ongoing intervention rather than a course with an end point, and have the conversation about stopping before starting rather than after.
Why is IGF-1 the marker rather than growth hormone?
Because growth hormone is released in pulses and cleared in hours, so a single measurement mostly reports where in a pulse the needle went. IGF-1 integrates exposure over a longer window. That is true across this whole class of compounds.
What does it cost metabolically?
Reduced insulin sensitivity, showing up as fasting glucose and HbA1c drifting upward. It was modest and largely reversible in the trials, and it is monitored rather than ignored — the HbA1c page covers why those two markers can disagree.
Where the load-bearing numbers come from
Named rather than linked. Publisher URLs move, and a citation that resolves to a 404 two years from now is worse than one you can search for by name — every entry below is findable from the title and year alone.
- Visceral fat reduction and the withdrawal result
- The tesamorelin phase III programme in HIV-associated lipodystrophy, reported 2010 onward, including the extension phase
- Approved indication and glycaemic monitoring
- The approval string in the fact box is app.html’s own field; the monitoring requirement comes from the approved labelling
- GHRH analogue mechanism
- Standard endocrinology references on growth hormone releasing hormone
- Modelled half-life and time to peak
- app.html’s TL_PK entry
A daily injection judged on a quarterly lab and a scan is exactly the case for a written record. TherapyLog keeps the dose beside the IGF-1.
Save this dose to your log