Tesamorelin

Introduction

Tesamorelin is a 44-amino-acid synthetic analogue of human growth-hormone-releasing hormone (GHRH), N-terminally modified with a hexenoyl group to resist DPP-IV cleavage and prolong half-life. FDA-approved as Egrifta for the reduction of excess abdominal fat (visceral adipose tissue, VAT) in HIV-infected patients with lipodystrophy. Off-label investigation continues in non-HIV abdominal adiposity and non-alcoholic fatty liver disease.

Mechanism of Action

Binds the GHRH receptor on anterior-pituitary somatotrophs, driving physiologic pulsatile growth-hormone release. Unlike exogenous recombinant HGH, the endogenous-release pathway preserves pituitary feedback regulation. Downstream effects: modest IGF-1 elevation, lipolysis in visceral depots, reductions in liver-fat measurements.

Approved and Investigated Indications

Approved: HIV-associated lipodystrophy with excess abdominal fat. Investigational/off-label: non-HIV abdominal adiposity, non-alcoholic fatty liver disease, hepatic steatosis, cognitive endpoints in mild cognitive impairment (small studies show signal).

Reconstitution

Approved Egrifta is supplied as a 1 mg or 2 mg lyophilized vial paired with a diluent vial. Per labeling: reconstitute the 2 mg vial with 2.1 mL of supplied diluent (sterile water for injection), yielding 2 mg/mL — the entire vial is the daily dose.

Compounded research-grade preparations: a 5 mg vial reconstituted with 2.5 mL of bacteriostatic water yields 2 mg/mL — each 1 mL delivers 2 mg.

Dosing Protocol (research literature)

Egrifta labeled regimen: 2 mg subcutaneously once daily at bedtime. Off-label and research protocols for non-HIV abdominal adiposity have used 1–2 mg SC nightly. Body-composition reassessment at 13 and 26 weeks (the pivotal-trial endpoint timeline).

Administration

Subcutaneous into abdominal fat, rotating sites within the abdomen. Bedtime dosing aligns with endogenous GH pulses.

Storage & Handling

Lyophilized Egrifta: refrigerate (2–8°C). Reconstituted Egrifta per labeling: use within 24 hours, refrigerate. Compounded research-grade with bacteriostatic water: refrigerate; stable approximately 14–28 days depending on preparation. Protect from light.

Side Effects

Most frequent: injection-site reactions, arthralgia, peripheral edema, modest fluid retention. Less common: glucose intolerance, carpal-tunnel-like symptoms. Caution in diabetes — fasting glucose can rise.

Contraindications

Active malignancy, pregnancy, hypopituitarism with disruption of the GH axis, acute critical illness.

Monitoring

Baseline IGF-1, fasting glucose, HbA1c, lipid panel, waist circumference (or imaging-based VAT measurement where available). Re-measure IGF-1 at 6–8 weeks; titrate or discontinue if trough exceeds the age-adjusted reference range. Re-measure metabolic parameters at 13 and 26 weeks.

Disclaimer

This article is for informational and research-reference purposes only. Nothing in this document constitutes medical advice, a prescription, or a recommendation from a physician. The reconstitution, dosing, and protocol information above reflects ranges commonly cited in published research and clinician-directed protocols — it is provided as reference material only, not as instructions, an endorsement of off-label use, or a substitute for individualized medical evaluation.

Customers should do their own research and consult their own physician before considering any peptide protocol. Whether a given compound is appropriate for an individual — and at what dose, for what duration, and alongside what monitoring — is a decision that only a licensed clinician with knowledge of that individual's medical history, current medications, and conditions can make.

The platform and the author make no claim that any compound described here is safe, effective, or appropriate for any particular person or purpose, and accept no responsibility for outcomes arising from self-directed use of the information.