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Growth Hormone — GHRH Analog (FDA-approved)✓ FDA Approved

Tesamorelin

Also known as: Egrifta · Egrifta SV · TH9507

MW

5135.87 Da

Amino Acids

44 AA

Half-Life

26 minutes (stimulates GH for 2-4 hours)

Route

SubQ

CAS

218949-48-5

Formula

C221H366N72O67S

Amino Acid Sequence

YADAIFTNSYRKVLGQLSARKLLQDI-NH2

Mechanism of Action

Tesamorelin is a synthetic 44-amino acid GHRH analog — the ONLY GHRH analog currently FDA-approved for any indication. It corresponds to the full GHRH(1-44) sequence with a trans-3-hexenoic acid modification at the N-terminus for enhanced stability.

MECHANISM: Binds GHRHR on pituitary somatotrophs → cAMP/PKA → GH release. Same fundamental pathway as CJC-1295 and sermorelin but with the full 44-amino acid GHRH sequence (vs 29 for CJC-1295/sermorelin).

FDA APPROVAL: Approved as Egrifta (and Egrifta SV) specifically for HIV-associated lipodystrophy — reducing excess visceral adipose tissue (VAT) that accumulates with antiretroviral therapy. Phase III trial showed 15–18% VAT reduction.

COGNITIVE: Stanley et al. 2016 showed tesamorelin improved verbal memory in patients with mild cognitive impairment — GH/IGF-1 elevation supporting hippocampal neuroplasticity. This cognitive application is under active investigation.

The only currently available FDA-approved option for practitioners who want GHRH-based GH optimization within the regulatory framework.

Dosing Protocol

Low Dose

███ – ███ mcg/day

Standard Dose

███ mcg/day

High Dose

███ – ███ mcg/day

Dosing protocols are for paid members

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Frequency

Once daily SubQ.

Half-Life

26 minutes (stimulates GH for 2-4 hours)

Reconstitution Guide

Full reconstitution protocol with BAC water volumes, concentration math, and units-to-draw per dose is available on the Clinical plan.

Unlock reconstitution guide →

Clinical Warnings

FDA warnings: fluid retention, arthralgia, injection site reactions.

May worsen glucose intolerance.

IGF-1 monitoring required.

Cancer contraindication.

Hypersensitivity reactions.

Expensive (branded).

Contraindications

Absolute

Active malignancy

Pregnancy

Pituitary surgery/disease

Hypersensitivity

Relative Cautions

Diabetes

History of cancer

Fluid retention disorders

Side Effect Profile

Mild

  • Injection site reactions
  • Mild edema
  • Arthralgia

Moderate

  • Peripheral edema
  • Myalgia
  • Paresthesia
  • Increased blood glucose

Severe (Rare)

  • Fluid retention
  • Hypersensitivity reactions

Synergistic Peptides

CJC-1295IpamorelinSermorelin

Common Stacks

CJC-1295

Ipamorelin

Research Status

FDA APPROVED. PMID 20357177 (Falutz 2010 NEJM): Phase III HIV lipodystrophy — 15–18% VAT reduction. PMID 29912869 (Stanley 2016): Cognitive improvement in MCI — verbal memory enhancement. One of only two FDA-approved GH secretagogues.

Frequently Asked Questions

How does Tesamorelin work?

Tesamorelin is a synthetic 44-amino acid GHRH analog — the ONLY GHRH analog currently FDA-approved for any indication. It corresponds to the full GHRH(1-44) sequence with a trans-3-hexenoic acid modification at the N-terminus for enhanced stability. MECHANISM: Binds GHRHR on pituitary somatotrophs → cAMP/PKA → GH release. Same fundamental pathway as CJC-1295 and sermorelin but with the full 44-amino acid GHRH sequence (vs 29 for CJC-1295/sermorelin). FDA APPROVAL: Approved as Egrifta (and Egri

What is the standard dose of Tesamorelin?

Tesamorelin dosing protocols are available with a ClinPep Clinical subscription. Dosing varies by indication and patient factors — consult a licensed healthcare provider. General frequency: Once daily SubQ.

What is the half-life of Tesamorelin?

The half-life of Tesamorelin is 26 minutes (stimulates GH for 2-4 hours). This determines optimal dosing frequency and timing.

Who should not use Tesamorelin?

Tesamorelin is absolutely contraindicated in: Active malignancy; Pregnancy; Pituitary surgery/disease; Hypersensitivity. Use with caution in: Diabetes; History of cancer; Fluid retention disorders.

What are the side effects of Tesamorelin?

Common mild side effects include: Injection site reactions, Mild edema, Arthralgia. Moderate effects: Peripheral edema, Myalgia, Paresthesia, Increased blood glucose.

What peptides stack well with Tesamorelin?

Tesamorelin is commonly stacked with: CJC-1295, Ipamorelin, Sermorelin.

How do you reconstitute Tesamorelin?

Tesamorelin is reconstituted with bacteriostatic water. Exact volumes, concentrations, and units-to-draw calculations are available in the ClinPep Clinical plan. Always follow your compounding pharmacy's instructions.

How long should you cycle Tesamorelin?

Tesamorelin cycle protocols vary by indication. Detailed cycle length, on/off schedules, and monitoring guidelines are available with ClinPep Clinical access. Consult your healthcare provider for personalized cycling guidance.

References & Citations

10 PubMed studies · 3 clinical trials

Analysis of growth hormone releasing hormone and its analogs in urine using nano liquid chromatography coupled with quadrupole/orbitrap mass spectrometry.

Uçaktürk Ebru, Nemutlu Emirhan. Journal of pharmaceutical and biomedical analysis. 2026

PubMed: 41138283DOI ↗C — Research Article

Growth hormone-releasing hormone (GHRH) and its synthetic analogs are considered performance-enhancing substances and are therefore prohibited by the World Anti-Doping Agency (WADA). The analysis of G

Carpal Tunnel Syndrome Attributed to Medication Use: A Pharmacovigilance Study.

Mihalache Andrew, Volfson Emily, Huang Ryan, Zuo Kevin et al.. Cureus. 2025

PubMed: 40510111DOI ↗C — Research Article

Carpal tunnel syndrome (CTS) is a prevalent compression neuropathy with multiple well-documented mechanical and systemic risk factors. However, the role of pharmacological agents in the development of

Metabolic dysfunction-associated steatotic liver disease in people with HIV.

Gattu Arijeet K, Fourman Lindsay T. Current opinion in HIV and AIDS. 2025

PubMed: 40397552DOI ↗C — Research Article

Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent among people with HIV (PWH) and increasingly recognized as a major contributor to morbidity and mortality. The fiel

Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity.

Ellis Ronald J, Vaida Florin, Hu Keren, Dube Michael et al.. The Journal of infectious diseases. 2025

PubMed: 39813152DOI ↗B — Clinical Trial

In people with HIV who are virally suppressed with antiretroviral therapy, abdominal obesity (AO) is linked to neurocognitive impairment (NCI), potentially due to visceral adiposity, inflammation, and

CROI 2024: Neuropsychiatric Complications in People With HIV.

Corley Michael J, Letendre Scott L, Nightingale Sam. Topics in antiviral medicine. 2024

PubMed: 39746672C — Research Article

The 2024 Conference on Retroviruses and Opportunistic Infections featured new and impactful findings about neuropsychiatric complications in people with HIV and other infections. Reports included new

Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors.

Russo Samuel C, Ockene Mollie W, Arpante Allison K, Johnson Julia E et al.. AIDS (London, England). 2024

PubMed: 38905488DOI ↗C — Research Article

Tesamorelin is the only FDA-approved therapy to treat abdominal fat accumulation in people with HIV (PWH). Phase III clinical trials were conducted prior to the introduction of integrase inhibitors (I

Dietary regimens appear to possess significant effects on the development of combined antiretroviral therapy (cART)-associated metabolic syndrome.

Chege Boniface M, Mwangi Peter W, Githinji Charles G, Bukachi Frederick. PloS one. 2024

PubMed: 38416754DOI ↗C — Research Article

This study investigated the interactions between a low protein high calorie (LPHC) diet and an integrase inhibitor-containing antiretroviral drug regimen (INI-CR)in light of evidence suggesting that t

Chromatographic-mass spectrometric analysis of peptidic analytes (2-10 kDa) in doping control urine samples.

Thomas Andreas, Walpurgis Katja, Thevis Mario. Journal of mass spectrometry : JMS. 2024

PubMed: 38197510DOI ↗C — Research Article

Peptides with a molecular mass between 2 and 10 kDa that are prohibited in elite sports usually require dedicated sample preparation and mass spectrometric detection that commonly cannot be combi

Registered Clinical Trials

Egrifta Replacement and Sleep Disordered Breathing

Growth Hormone Dynamics and Cardiac Steatosis in HIV

Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV

NCT06554717RECRUITINGPHASE2

Symptom Indications

HIV lipodystrophyVisceral fatLow GHNAFLDCognitive decline

Full Clinical Access

Complete Tesamorelin Protocol

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This information is for educational and research reference purposes only. ClinPep does not provide medical advice, diagnosis, or treatment recommendations. All protocols should be reviewed by a licensed healthcare provider.