Tesamorelin

Grade A applies only to the FDA-approved Egrifta products, backed by two large placebo-controlled phase 3 trials; it does not extend to research material.

Strengths: 10, 20 mg
Also known as: Egrifta, Egrifta SV, Egrifta WR, TH9507, GRF(1–44) analog
Molecule: 44-amino-acid GHRH analog
Formula: C221H366N72O67S
Mol. weight: 5135.86 g/mol
CAS: 218949-48-5

Origin

A lab-made version of the body's growth hormone–releasing hormone (GHRH 1–44) with a stabilizing group on the first amino acid. It was developed by Theratechnologies and first approved in the US in 2010.

How it works

It binds GHRH receptors on the pituitary and triggers the body's own growth hormone release, which raises IGF-1 and IGFBP-3. Growth hormone drives fat breakdown, especially visceral (deep abdominal) fat. The label reports no meaningful changes in other pituitary hormones.

What the research shows

Two phase 3 randomized trials in 806 adults with HIV-related abdominal fat found visceral fat fell about 14–18% over 26 weeks versus little change on placebo, while total body weight stayed flat and lean mass rose slightly. Fat returned within 26 weeks of stopping. A 12-month trial in people with HIV and fatty liver found liver fat fell by 37% relative to placebo, with fewer cases of fibrosis progressing. Long-term cardiovascular safety has not been established, and there are no outcome trials in people without HIV.

Key studies

Falutz et al., NEJM 2007 Phase 3, 412 adults with HIV: visceral fat −15.2% vs about +5% on placebo over 26 weeks.
Egrifta WR label (FDA), 2025 Pooled phase 3 data: visceral fat −18%/−14% vs +2%/−2%; regained after switching to placebo.
Stanley et al., Lancet HIV 2019 Fatty liver in HIV: liver fat normalized in 35% vs 4% on placebo over 12 months.

Safety findings

In trials, injection-site reactions, joint pain, swelling, muscle pain and tingling were more common than on placebo. The label warns about raised IGF-1 (47% above 2 SDS), glucose intolerance, fluid retention, carpal tunnel and possible effects on existing tumors. Rat studies found fetal hydrocephaly, the basis for a pregnancy contraindication.

Regulatory status

FDA-approved as Egrifta (2010), Egrifta SV and Egrifta WR (2025) for reducing excess abdominal fat in adults with HIV-related lipodystrophy. It is regulated as a biologic since March 2020, which excludes it from compounding. WADA prohibits it at all times (S2, GHRH analogs).

Catalog notes

Available in 10 and 20 mg, both with certificates tested August 17, 2026: lot TESA10-0803 (99.79%, COA7630) and lot TESA20-0803 (99.79%, COA7605). Follow the storage stated on the label and certificate. A research vial is not the approved Egrifta product.

In kits: Metabolix Bundle