Important limitations
- Individual claims and source links have not yet completed editorial verification.
- Evidence level, applicable study model, formulation, route and population remain unassigned.
Tesamorelin
Tesamorelin is a synthetic analog of human growth hormone-releasing hormone (GHRH 1-44) with a trans-3-hexenoyl group on its N-terminus that protects it from enzymatic breakdown.
Dosing & scaling, explained
The moderated mass amounts below are retained for comparison. Near-duplicates, mix-dependent volumes and device markings are excluded. This is educational source context, not a protocol or recommendation.
Mass amounts available for comparison
- Lower range500 mcgDose
Recorded example with no verified study backing; shown for amount literacy only.
- Mid range2 mgDose
Recorded example with no verified study backing; shown for amount literacy only.
Only mcg or mg amounts are retained. The calculator derives mL, syringe units or pen clicks from the current vial strength, water volume and device.
No independently verified schedule
Evidence context
No clinical amount or schedule is inferred from this material. Source verification is pending, and every displayed amount remains educational context rather than guidance.
Storage, handling and interpretation
Product identity
Verify the exact compound, formulation and amount against the product label or certificate before calculation.
Storage & handling
Follow the product label, certificate and validated laboratory SOP; no universal storage assumption is applied here.
Prepared solutions
Label concentration and preparation date, use sterile technique where applicable, and follow a validated stability protocol.
Reported protocols for Tesamorelin
What published studies and recent community write-ups report about amounts, timing and course length. 8 clinical and 5 community-reported rows, each linked to its source. These are descriptions of what others report, not instructions, and nothing here is medical advice.
| Context | Dose | Frequency | Route | Course | Source |
|---|---|---|---|---|---|
| Clinical8 rows | |||||
| FDA label, Egrifta WR (11.6 mg vial)Adults with HIV and lipodystrophy | 1.28 mg (0.16 mL of reconstituted solution) | Once daily | Subcutaneous, abdomen, rotating sites | Continuous while benefit persists; long-term cardiovascular safety not establishedNone described; one reconstituted vial covers 7 daily doses | DailyMed, National Library of Medicine2025 |
| The 2025 label pairs weekly reconstitution with a lower 1.28 mg daily dose, accepted on pharmacokinetic bridging to the 2 mg dose used in the original 1 mg vial trials. The label states that the product is not indicated for weight loss and that WR and SV are not substitutable. | |||||
| FDA label, Egrifta SV (2 mg vial)Adults with HIV and lipodystrophy | 1.4 mg (0.35 mL of reconstituted solution) | Once daily | Subcutaneous, abdomen, rotating sites | Continuous while benefit persistsNone described | DailyMed, National Library of Medicine2024 |
| Each 2 mg vial is reconstituted with 0.5 mL of sterile water, 0.35 mL is injected right away and the rest is discarded. The label warns against injecting into scar tissue, bruises or the navel. | |||||
| Pivotal phase 3 trial412 adults with HIV and abdominal fat accumulation | 2 mg | Once daily, between 6 a.m. and noon | Subcutaneous | 26 weeksNone | New England Journal of Medicine (PubMed)2007 |
| Visceral fat fell 15.2% versus a 5.0% rise on placebo, with triglycerides and the cholesterol to HDL ratio also improving and IGF-1 rising 81%. Adverse event rates were similar between groups, although more tesamorelin patients withdrew because of them. | |||||
| Pooled phase 3 trials with 52-week extension806 antiretroviral-treated adults with HIV and excess abdominal fat | 2 mg | Once daily | Subcutaneous | 26 weeks, then re-randomized for a further 26 weeks (52 weeks total)Patients switched to placebo at week 26 regained visceral fat | Journal of Clinical Endocrinology and Metabolism (PubMed)2010 |
| The visceral fat reduction (treatment effect 15.4% at 26 weeks) was maintained through 52 weeks in those who continued, while abdominal subcutaneous fat was unchanged and glucose measures showed no clinically meaningful shift. Mean IGF-1 rose by about 108 ng/mL. | |||||
| Second phase 3 trial with 12-month extension404 adults with HIV and excess abdominal fat on antiretroviral therapy | 2 mg | Once daily | Subcutaneous | 6 months, then re-randomized to 12 months totalSwitching to placebo at 6 months reversed the visceral fat loss | Journal of Acquired Immune Deficiency Syndromes (PubMed)2010 |
| Visceral fat fell 10.9% at 6 months and about 18% in those who continued to 12 months, with no change in glucose parameters. The authors reported that the gains were lost quickly after discontinuation. | |||||
| Visceral and liver fat trial50 antiretroviral-treated adults with HIV and abdominal fat accumulation | 2 mg | Once daily | Subcutaneous | 6 monthsNone | JAMA2014 |
| Visceral fat fell by 34 cm2 versus an 8 cm2 increase on placebo, and liver fat fell modestly (a net 2.9 percentage-point difference in lipid to water ratio). Fasting glucose rose at 2 weeks but was no longer different from placebo at 6 months. | |||||
| Fatty liver disease trial in HIV61 adults with HIV and a hepatic fat fraction of 5% or more | 2 mg | Once daily | Subcutaneous | 12 months, followed by 6 months of open-label treatment for allNone | The Lancet HIV2019 |
| Hepatic fat fraction fell by an absolute 4.1% (a 37% relative reduction) and fewer tesamorelin patients progressed in fibrosis on biopsy. Injection-site complaints were more common than with placebo, though none were judged serious. | |||||
| Cognition trial in older adults152 adults aged 55-87, 66 of them with mild cognitive impairment | 1 mg | Once daily, 30 minutes before bedtime | Subcutaneous, abdomen | 20 weeks, with a 10-week washoutNone during treatment | Archives of Neurology (PubMed)2012 |
| Cognition improved modestly overall, mainly executive function, while IGF-1 rose 117% and remained within the physiological range and body fat fell 7.4%. Mild adverse events were reported by 68% of treated participants versus 36% on placebo. | |||||
| Community-reported5 rows | |||||
| Off-label body-composition cycle | 1-2 mg | Once daily, often fasted in the morning | Subcutaneous | 3-6 months2-4 month break; or 5 days on and 2 days off as an alternative to long breaks | Community resource2026 |
| This 2026 guide describes beginners starting at 1 mg before moving to the 2 mg trial-style dose, and cycles of 3-6 months when the goal is measurable visceral fat change. It acknowledges that no trial has compared the 5-days-on pattern with continuous dosing. | |||||
| Clinic protocol, bedtime injection 5 days a week | 1 mg (25 units from a 10 mg vial reconstituted in 2.5 mL) | 5 days on, 2 days off | Subcutaneous, before bed and at least 2 hours after the last meal | 3 months (three monthly blocks of 20 injections)2-month rest before repeating | Community resource2026 |
| A Florida clinic's published protocol uses a 1 mg bedtime injection five days a week across a three-month cycle, then a two-month break. It cites the label dose as the reference point and says the exact dose is confirmed after lab review. | |||||
| Community 1 mg protocol | 1 mg (20 units at 5 mg/mL) | 5 days on, 2 days off | Subcutaneous | 8 weeks on8 weeks off | Community resource2026 |
| Presents 1 mg with weekend breaks as the common community pattern, half the labeled 2 mg dose, cycled 8 weeks on and 8 weeks off for cost and receptor-sensitivity reasons. It contrasts this with the trial record of 52 weeks of continuous 2 mg dosing without loss of response. | |||||
| Protocol comparison table | 2 mg standard; 1 mg conservative | Once daily (evening preferred), or 5 days per week | Subcutaneous | 26 weeks standard; 52 weeks extendedCyclical option of 26 weeks on, 8-12 weeks off | Community resource2026 |
| Lists the 2 mg daily label dose as the only one with phase 3 support, with 1 mg and 5-on/2-off described as practice patterns that lack trial data. It notes that the dose is fixed regardless of body weight and that visceral fat tends to return after stopping. | |||||
| Research-vial dosing matched to the original trial dose | 2 mg | Once daily, full dose from day one | Subcutaneous, abdomen, rotating sites | 4-26 weeks, with 26 weeks described as matching phase 3 exposureNone described | Community resource2026 |
| States that research-grade 2, 5 and 10 mg vials are usually dosed like the original Egrifta at 2 mg a day with no ramp-up, and tabulates the SV (1.4 mg) and WR (1.28 mg) label doses alongside. Its planning tables count vials for 4, 8, 12 and 26 week courses. | |||||
How a course is commonly described
- Weeks 1-4Community-reported
Both the labels and community guides describe starting at the full dose with no titration, injected subcutaneously in the abdomen at a consistent time, often at bedtime or fasted in the morning. The 2014 JAMA trial recorded a small, transient rise in fasting glucose at 2 weeks that had resolved by 6 months.
- Weeks 8-12Community-reported
Community sources place the first visible change in waist or abdominal fat at 8-12 weeks, and some guides time a first IGF-1 and glucose check here. Community 8-week cycles end at this point and pause for 8 weeks.
- Weeks 13-26Clinical
The pivotal trials measured their primary endpoint at 26 weeks, where visceral fat had fallen about 15% relative to placebo on 2 mg daily, with lipid improvements alongside. This is the course length most community guides anchor to.
- Weeks 27-52Clinical
Continuing at 2 mg daily held the visceral fat reduction through 52 weeks with no sign of tachyphylaxis, while patients switched to placebo at week 26 regained the fat. The 2019 liver trial ran 12 months of blinded treatment followed by 6 open-label months.
- BreakCommunity-reported
Community cycles stop after 8 weeks to 6 months and pause for 8 weeks to 4 months, or build the rest into each week as 5 days on and 2 days off; the labels describe no break at all. Guides that describe breaks give pituitary sensitivity and cost as the reasons.
- The 5-days-on, 2-days-off pattern and the 1 mg dose come from community and clinic practice. The trials and both current labels used continuous daily dosing with no scheduled breaks.
- Trial data show visceral fat returns within months of stopping, so community cycle breaks trade away benefit for cost savings and a presumed recovery of pituitary sensitivity, a rationale that has not been tested.
- Tesamorelin is approved only for HIV-associated lipodystrophy. The label states it is not indicated for weight loss and that long-term cardiovascular safety has not been established.
Sources for this section (13)
- EGRIFTA WR (tesamorelin) for injection: Prescribing Information
- EGRIFTA SV (tesamorelin) for injection: Prescribing Information
- Metabolic Effects of a Growth Hormone-Releasing Factor in Patients with HIV
- Effects of Tesamorelin (TH9507) in HIV-Infected Patients with Excess Abdominal Fat: A Pooled Analysis of Two Phase 3 Trials with Safety Extension Data
- Effects of Tesamorelin in HIV-Infected Patients With Abdominal Fat Accumulation: A Randomized Placebo-Controlled Trial With a Safety Extension
- Effect of Tesamorelin on Visceral Fat and Liver Fat in HIV-Infected Patients With Abdominal Fat Accumulation: A Randomized Clinical Trial
- Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial
- Effects of Growth Hormone-Releasing Hormone on Cognitive Function in Adults With Mild Cognitive Impairment and Healthy Older Adults
Plus 5 community resources (dosing guides, forum threads and vendor write-ups), reported above but not linked.
Overview
Tesamorelin is a synthetic analog of human growth hormone-releasing hormone (GHRH 1-44) with a trans-3-hexenoyl group on its N-terminus that protects it from enzymatic breakdown. Developed by Theratechnologies under the code TH9507, it was approved by the FDA in 2010 as Egrifta to reduce excess abdominal fat in adults with HIV-associated lipodystrophy, and is sold today as Egrifta SV and Egrifta WR. It has also been studied for liver fat in people with HIV and fatty liver disease and for cognition in older adults, and is used off-label in body-composition and anti-aging practice.
What researchers are exploring
These themes organize the educational information currently available. Individual claims remain under source review and are not treatment claims.
- 1
Research on Tesamorelin
Tesamorelin: An Analogue of GHRH Tesamorelin is an analogue of growth hormone-releasing hormone (GHRH), and it shares similar effects with GHRH and other GHRH analogues like sermorelin, GRF (1-29), and CJC-1295.…
- 2
Conclusion
Tesamorelin reduces inflammation, lowers cardiovascular risk, and supports healthy growth hormone levels, particularly in HIV patients. It also shows promise in treating peripheral nerve damage and cognitive impairment.
What is known and what still needs verification
Available context is organized without assigning unsupported study models or evidence grades.
- Not graded
Research on Tesamorelin
Tesamorelin: An Analogue of GHRH Tesamorelin is an analogue of growth hormone-releasing hormone (GHRH), and it shares similar effects with GHRH and other GHRH analogues like sermorelin, GRF (1-29), and CJC-1295.…
- Not graded
Conclusion
Tesamorelin reduces inflammation, lowers cardiovascular risk, and supports healthy growth hormone levels, particularly in HIV patients. It also shows promise in treating peripheral nerve damage and cognitive impairment.
Amounts recorded for Tesamorelin
These amount records are independent from vial strength, reconstitution volume and measuring device. A recorded source is not the same as study backing, and these values are not recommendations.
- 1Dose · lower endpointSign in for schedule, duration and source context.500 mcg
- 2Dose · upper endpointSign in for schedule, duration and source context.2 mg
Chemistry identifiers
Sequence, synonyms and registry identifiers as recorded in PubChem, the National Library of Medicine's open chemistry database. Formula, mass and CAS number are summarized at the top of the page.
Sequence
(trans-3-hexenoyl)-Tyr-Ala-Asp-Ala-Ile-Phe-Thr-Asn-Ser-Tyr-Arg-Lys-Val-Leu-Gly-Gln-Leu-Ser-Ala-Arg-Lys-Leu-Leu-Gln-Asp-Ile-Met-Ser-Arg-Gln-Gln-Gly-Glu-Ser-Asn-Gln-Glu-Arg-Gly-Ala-Arg-Ala-Arg-Leu-NH2
Also listed as
Egrifta, TH9507, TH-9507, (3E)-hex-3-enoylsomatoliberin, GHRH(1-44), CAS 804475-66-9 (second registry number listed by PubChem), UNII MQG94M5EEO, CHEBI:63626
InChIKey
QBEPNUQJQWDYKU-BMGKTWPMSA-N
IUPAC name
(4S)-4-[[2-[[(2S)-5-amino-2-[[(2S)-5-amino-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S,3S)-2-[[(2S)-2-[[(2S)-5-amino-2-[[(2S)-2-[[(2S)-2-[[(2S)-6-amino-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-5-amino-2-[[2-[[(2S)-2-[[(2S)-2-[[(2S)-6-amino-2-[[(2S)-2-[[(2S)-2-[[(2S)-2-[[(2S)-4-amino-2-[[(2S,3R)-2-[[(2S)-2-[[(2S,3S)-2-[[(2S)-2-[[(2S)-3-carboxy-2-[[(2S)-2-[[(2S)-2-[[(E)-hex-3-enoyl]amino]-3-(4-hydroxyphenyl)propanoyl]amino]propanoyl]amino]propanoyl]amino]propanoyl]amino]-3-methylpentanoyl]amino]-3-phenylpropanoyl]amino]-3-hydroxybutanoyl]amino]-4-oxobutanoyl]amino]-3-hydroxypropanoyl]amino]-3-(4-hydroxyphenyl)propanoyl]amino]-5-carbamimidamidopentanoyl]amino]hexanoyl]amino]-3-methylbutanoyl]amino]-4-methylpentanoyl]amino]acetyl]amino]-5-oxopentanoyl]amino]-4-methylpentanoyl]amino]-3-hydroxypropanoyl]amino]propanoyl]amino]-5-carbamimidamidopentanoyl]amino]hexanoyl]amino]-4-methylpentanoyl]amino]-4-methylpentanoyl]amino]-5-oxopentanoyl]amino]-3-carboxypropanoyl]amino]-3-methylpentanoyl]amino]-4-methylsulfanylbutanoyl]amino]-3-hydroxypropanoyl]amino]-5-carbamimidamidopentanoyl]amino]-5-oxopentanoyl]amino]-5-oxopentanoyl]amino]acetyl]amino]-5-[[(2S)-1-[[(2S)-4-amino-1-[[(2S)-5-amino-1-[[(2S)-1-[[(2S)-1-[[2-[[(2S)-1-[[(2S)-1-[[(2S)-1-[[(2S)-1-[[(2S)-1-amino-4-methyl-1-oxopentan-2-yl]amino]-5-carbamimidamido-1-oxopentan-2-yl]amino]-1-oxopropan-2-yl]amino]-5-carbamimidamido-1-oxopentan-2-yl]amino]-1-oxopropan-2-yl]amino]-2-oxoethyl]amino]-5-carbamimidamido-1-oxopentan-2-yl]amino]-4-carboxy-1-oxobutan-2-yl]amino]-1,5-dioxopentan-2-yl]amino]-1,4-dioxobutan-2-yl]amino]-3-hydroxy-1-oxopropan-2-yl]amino]-5-oxopentanoic acid
Limitations and unknowns
Sources
1 link carried over from the earlier page, awaiting verification.