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Peptide (FDA approved drug)Human trialsFDA approved

Tesamorelin

Tesamorelin

Last reviewed October 27, 2026 · 24 sources · Written for general readers · Compare with another compound →

The bottom line

Tesamorelin is an FDA approved drug, sold as Egrifta, that reduces deep belly fat in adults with HIV who have lipodystrophy.[1] Large placebo controlled trials, confirmed by two 2026 meta analyses, showed real but modest belly fat loss with no change in body weight, and smaller trials found less liver fat.[2][3][4] It raises IGF-1 and can raise blood sugar, the fat comes back after stopping, and it is not approved for general weight loss.[1]

Where the evidence stands

What it is

Tesamorelin is a lab made copy of the full 44 building block chain of human growth hormone releasing hormone (GHRH), with a small fatty group added to the front end.[1] Its first 29 building blocks match sermorelin.[19][20]

FDA first approved it in November 2010.[21] It is approved to reduce excess belly fat in adults with HIV who have lipodystrophy, a change in where the body stores fat.[1]

The label says it is not for weight loss, and its long term heart safety is not known.[1]

Name
Tesamorelin (Tesamorelin)
Other names
Egrifta, Egrifta SV, Egrifta WR, tesamorelin acetate, TH9507
Type
Peptide (FDA approved drug)
Sequence
YADAIFTNSYRKVLGQLSARKLLQDIMSRQQGESNQERGARARL (with a hexenoyl group on the first tyrosine)
CAS number
218949-48-5
Formula
C221H366N72O67S
Molecular weight
About 5135.9 g/mol (free base)

What it does in the body

Tesamorelin is a lab made copy of the full 44 building block chain of growth hormone releasing hormone (GHRH), a natural hormone from the hypothalamus of the brain, with a small fatty group added to the front end.[1] It binds GHRH receptors on the pituitary gland about as strongly as the natural hormone and makes the gland release pulses of the body's own growth hormone, which then raises IGF-1.[1]

This is the biology, area by area. A change measured in the body, like a higher blood level, does not always mean a person feels a benefit. The claims check below covers that.

Hormones

Well established

The FDA label says tesamorelin raises growth hormone, IGF-1 and a related protein called IGFBP-3, without meaningful changes in thyroid, sex, stress or milk hormones.[1] In the first large trial IGF-1 rose 81%, and at 26 weeks 47% of patients had IGF-1 above the normal range for their age.[5][1] It is broken down fast, with a half life of about 11 minutes, and under 4% of a shot reaches the blood.[1]

Fat and appetite

Well established

In two 26 week trials of 816 adults with HIV, deep belly fat fell 14% to 18% versus little change on placebo, trunk fat fell about 1 kg and waist size shrank 2 to 3 cm, with no real change in weight.[1] Pooled across 806 patients, the treatment effect on deep belly fat was about 15%.[6] A 2026 meta analysis of 4 trials with 909 people confirmed the drop.[2] People switched to placebo regained the fat.[1]

Liver

Measured in people

In 61 adults with HIV and fatty liver, a year of tesamorelin cut liver fat by 37% compared with placebo, and 35% reached normal liver fat versus 4% on placebo.[4] Liver samples from that trial showed more activity of energy genes and less activity of inflammation and scarring genes.[7] A 2024 trial found similar liver and belly fat drops in people on newer HIV drugs called integrase inhibitors.[8]

Muscle and strength

Measured in people

Lean body mass rose about 1.2 to 1.3 kg over 26 weeks.[1] In a scan analysis of 341 trial participants, with the tesamorelin group limited to people whose belly fat responded, trunk muscles became denser, meaning less fat inside them, and two muscle groups grew slightly.[9] In 39 obese adults, bigger IGF-1 rises went with faster muscle energy recovery after exercise.[10] Strength itself has not been reported; a trial adding it to exercise is underway.[11]

Brain and mood

Measured in people

In 30 older adults given daily shots for 20 weeks, brain scans showed higher levels of GABA, a calming brain chemical, in all three regions measured.[12] In 152 older adults, thinking test scores improved modestly, mainly planning and focus.[13] But in 73 adults with HIV and thinking problems over 6 months, it did not improve cognition compared with usual care.[14]

Blood sugar

Measured in people

By week 26, 5% on tesamorelin versus 1% on placebo had HbA1c, a three month blood sugar measure, in the diabetes range.[1] In 53 adults with type 2 diabetes over 12 weeks, blood sugar control did not worsen compared with placebo.[15] People whose belly fat fell the most had smaller blood sugar rises than those whose belly fat did not respond.[16]

Heart and blood vessels

Measured in people

Pooled across two large trials, triglycerides fell about 12% more than on placebo.[6] In 60 obese adults without HIV, a year of treatment lowered triglycerides and CRP, an inflammation marker, and slightly thinned the neck artery wall.[17] The label says long term heart safety has not been established.[1]

How it works

Tesamorelin binds GHRH receptors on the pituitary gland and makes it release the body's own growth hormone.[1]

  • Growth hormone then raises IGF-1 and a related protein called IGFBP-3.[1]
  • In lab tests it worked on human GHRH receptors about as strongly as natural GHRH.[1]
  • Growth hormone helps break down stored fat, and in trials the drop was mostly in deep belly fat, not the fat just under the skin.[1][17]

The hormone pathway is well established, though exactly how it shrinks belly fat is less detailed.

What the research shows

We keep animal and human evidence apart. A result in animals is a reason to study something in people, not proof that it works in people.

Animal and lab studies

Animal work mostly checked safety

  • In rats, offspring developed hydrocephaly (fluid on the brain) at about 2 to 4 times human exposure, and lower exposures delayed skull bone formation. This is why it is not used in pregnancy.[1]
  • In rabbits, no harm to developing babies was seen even at very high exposures.[1]
  • It did not damage genes in standard lab and mouse tests, and it did not affect fertility in rats. Lifetime cancer studies in rodents have not been done.[1]

Limit: Animal safety results do not show how often harm happens in people.

Human studies

Large trials showed modest belly fat loss

  • Two placebo controlled trials enrolled 816 adults with HIV and excess belly fat for 26 weeks, using shots under the skin. Deep belly fat fell 18% and 14% on tesamorelin, versus a 2% rise and a 2% drop on placebo. Lean body mass rose about 1.2 to 1.3 kg, trunk fat fell about 1 kg and waist size shrank 2 to 3 cm, but body weight barely changed.[1]
  • In the first trial of 412 people, triglycerides fell on tesamorelin and rose on placebo, and IGF-1 rose 81%. Blood sugar measures did not differ, but more people on tesamorelin quit because of side effects.[5] Pooled with the second trial, triglycerides fell about 12% more than placebo, and it was described as generally well tolerated.[6]
  • People who stayed on it through 52 weeks kept their fat loss, while those switched to placebo regained deep belly fat.[1]
  • Two 2026 meta analyses pooling 4 to 5 trials and about 900 people confirmed less deep belly fat, trunk fat and waist size and more lean mass. Quitting because of side effects was about twice as common, but the difference was not statistically certain.[2][3]
  • In a trial of 50 adults with HIV over 6 months, tesamorelin cut deep belly fat and modestly lowered liver fat compared with placebo. Fasting blood sugar rose at 2 weeks but was no different from placebo by 6 months.[18]
  • In 61 adults with HIV and fatty liver disease over 12 months, liver fat fell 37% compared with placebo, and 35% of the tesamorelin group reached normal liver fat versus 4% on placebo. More people on tesamorelin reported injection site complaints, none serious.[4] In 38 people on integrase inhibitor HIV drugs, belly fat and liver fat fell with side effects, including high blood sugar, at similar rates to placebo.[8]
  • In 60 adults with belly fat obesity and low growth hormone, but no HIV, 12 months of tesamorelin cut deep belly fat, lowered triglycerides and CRP, a marker of inflammation, and slightly thinned the neck artery wall, with no change in blood sugar.[17]
  • In 53 adults with type 2 diabetes over 12 weeks, insulin response, fasting sugar and HbA1c did not differ from placebo, and no one quit because of loss of sugar control.[15]
  • In 152 adults aged 55 to 87, including 66 with mild memory problems, 20 weeks of tesamorelin modestly improved thinking test scores, mainly planning and focus, while the memory gain was not significant. Side effects, mostly mild, were reported by 68% on tesamorelin versus 36% on placebo.[13] A brain scan substudy of 30 of them found higher GABA levels.[12]
  • In an open label trial of 73 adults with HIV, abdominal obesity and thinking problems, 6 months of tesamorelin shrank waist size by about 2.7 cm more than usual care, but cognition did not differ.[14]

Limit: Most trials covered adults with HIV lipodystrophy, so results do not show it is safe or useful for healthy people seeking fat loss. The newer Egrifta WR form was not tested in its own fat loss trial.[1]

Claims check

The most common claims about this compound, and what studies actually found. Verdicts rate the evidence, not whether you should use it.

Reduces belly fat

Shown in people

In two 26 week placebo controlled trials of 816 adults with HIV, deep belly fat fell 14% to 18% versus little change on placebo.[1] Two 2026 meta analyses of 4 and 5 trials confirmed the effect.[2][3] A 12 month trial in 60 obese adults without HIV also found less deep belly fat.[17] The fat returned in people who stopped.[1]

Causes weight loss

No benefit in trials so far

In the large trials, body weight changed by less than 1 kg and did not differ from placebo, because lean mass rose while belly fat fell.[1] The FDA label says it is not for weight loss.[1]

Reduces liver fat

Shown in people

Placebo controlled trials in adults with HIV found less liver fat, one with 50 people over 6 months and one with 61 people with fatty liver disease over 12 months, where liver fat fell 37% compared with placebo.[18][4] A 2024 trial and a 2026 meta analysis agree.[8][3] Whether this prevents liver failure is unknown.[4]

Builds muscle

Mixed results

Lean body mass rose about 1.2 to 1.3 kg over 26 weeks in large trials, versus almost no change on placebo, and muscles held less fat on scans.[1][9] But no trial has reported strength, so it is unknown whether this means stronger muscles. A trial pairing it with exercise is underway.[11]

Improves cholesterol and triglycerides

Mixed results

In pooled data from 806 people with HIV, triglycerides fell about 12% more than on placebo.[6] In 53 adults with type 2 diabetes, total cholesterol fell slightly in the higher strength group.[15] The label notes that long term heart safety has not been established.[1]

Sharpens memory and thinking

Mixed results

In one 20 week trial of 152 older adults, thinking test scores improved modestly, mainly for planning and focus, but the memory gain was not significant.[13] A 2025 trial in 73 adults with HIV found no cognitive benefit over 6 months.[14]

Known risks and side effects

  • High IGF-1. At 26 weeks, 47% of patients had IGF-1 above the normal range for their age and 36% were far above it, so the label calls for monitoring.[1]
  • Blood sugar. By week 26, 5% on tesamorelin versus 1% on placebo reached a diabetes range HbA1c, and the risk of developing diabetes was about 3 times higher, so glucose should be checked.[1]
  • Injection site, allergy and antibodies. Injection site reactions such as redness, itching and pain affected 25% versus 14% on placebo, and about 4% had allergic reactions such as itching, flushing or hives. About half developed antibodies to the drug, and about 10% had antibodies that could block it.[1]
  • Swelling and joint pain. Joint pain (13% versus 11% on placebo), muscle pain (6% versus 2%), leg swelling (6% versus 2%), tingling (5% versus 2%) and numbness can occur, along with carpal tunnel symptoms.[1]
  • Not for pregnancy, cancer or online copies. It must not be used in pregnancy, with active cancer or with pituitary damage.[1] Versions sold online outside pharmacies are not the approved product, and WADA bans it in sport.[22][23]

Regulatory status

Today: Tesamorelin is FDA approved and sold by prescription as Egrifta products, most recently Egrifta WR, only for excess belly fat in adults with HIV lipodystrophy.[1][21] It is not one of the six peptides in the October 2026 HHS compounding policy.[24] WADA names tesamorelin as banned on its 2026 and 2027 lists.[22][23]

  1. FDA approved Egrifta for excess belly fat in adults with HIV lipodystrophy.[21]
  2. FDA approved labeling for Egrifta WR, a new formulation that cannot be swapped one for one with Egrifta SV.[1]

Sources

  1. U.S. Food and Drug Administration. EGRIFTA WR (tesamorelin for injection) prescribing information. Revised March 2025. FDA label, application 022505
  2. Ditta AM, Naeem RM, Sami MM, Rafey MA, Ali H, Amjad MW. Efficacy and Safety of Tesamorelin in People Living With HIV (PLWH) With Lipodystrophy: A Systematic Review and Meta-Analysis. J Int Assoc Provid AIDS Care. 2026;25:23259582261475549. PMID 42538058
  3. Badran AS, Helal A, Shata KS, Ayesh H. Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials. Obes Res Clin Pract. 2026;20(1):2-12. PMID 41545261
  4. Stanley TL, Fourman LT, Feldpausch MN, Purdy J, Zheng I, Pan CS, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV. 2019;6(12):e821-e830. PMID 31611038
  5. Falutz J, Allas S, Blot K, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007;357(23):2359-2370. PMID 18057338
  6. Falutz J, Mamputu JC, Potvin D, Moyle G, Soulban G, Loughrey H, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. J Clin Endocrinol Metab. 2010;95(9):4291-4304. PMID 20554713
  7. Fourman LT, Billingsley JM, Agyapong G, Ho Sui SJ, Feldpausch MN, Purdy J, et al. Effects of tesamorelin on hepatic transcriptomic signatures in HIV-associated NAFLD. JCI Insight. 2020;5(16):e140134. PMID 32701508
  8. Russo SC, Ockene MW, Arpante AK, Johnson JE, Lee H, Toribio M, et al. Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors. AIDS. 2024;38(12):1758-1764. PMID 38905488
  9. Adrian S, Scherzinger A, Sanyal A, Lake JE, Falutz J, Dubé MP, et al. The Growth Hormone Releasing Hormone Analogue, Tesamorelin, Decreases Muscle Fat and Increases Muscle Area in Adults with HIV. J Frailty Aging. 2019;8(3):154-159. PMID 31237318
  10. Makimura H, Murphy CA, Feldpausch MN, Grinspoon SK. The effects of tesamorelin on phosphocreatine recovery in obese subjects with reduced GH. J Clin Endocrinol Metab. 2014;99(1):338-343. PMID 24178787
  11. Erlandson KM, et al. Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV (TRIUMPH): a clinical trial protocol. BMJ Open. 2026;16(7):e120740. PMID 42419889
  12. Friedman SD, Baker LD, Borson S, Jensen JE, Barsness SM, Craft S, et al. Growth hormone-releasing hormone effects on brain gamma-aminobutyric acid levels in mild cognitive impairment and healthy aging. JAMA Neurol. 2013;70(7):883-890. PMID 23689947
  13. Baker LD, Barsness SM, Borson S, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Arch Neurol. 2012;69(11):1420-1429. PMID 22869065
  14. Ellis RJ, Vaida F, Hu K, Dube M, Henry B, Chow F, et al. Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity. J Infect Dis. 2025;231(5):1230-1238. PMID 39813152
  15. Clemmons DR, Miller S, Mamputu JC. Safety and metabolic effects of tesamorelin, a growth hormone-releasing factor analogue, in patients with type 2 diabetes: A randomized, placebo-controlled trial. PLoS One. 2017;12(6):e0179538. PMID 28617838
  16. Stanley TL, Falutz J, Marsolais C, Morin J, Soulban G, Mamputu JC, et al. Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin. Clin Infect Dis. 2012;54(11):1642-1651. PMID 22495074
  17. Makimura H, Feldpausch MN, Rope AM, Hemphill LC, Torriani M, Lee H, Grinspoon SK. Metabolic effects of a growth hormone-releasing factor in obese subjects with reduced growth hormone secretion: a randomized controlled trial. J Clin Endocrinol Metab. 2012;97(12):4769-4779. PMID 23015655
  18. Stanley TL, Feldpausch MN, Oh J, et al. Effect of tesamorelin on liver fat and visceral fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA. 2014. PMID 25038357
  19. U.S. FDA and NCATS Global Substance Registration System (GSRS). Tesamorelin. FDA GSRS
  20. U.S. FDA and NCATS Global Substance Registration System (GSRS). Sermorelin, UNII 89243S03TE. FDA GSRS
  21. U.S. Food and Drug Administration. Drugs@FDA: EGRIFTA, application 022505. Drugs@FDA
  22. World Anti-Doping Agency. The 2026 Prohibited List, section S2.2.4 Growth hormone releasing factors. In force January 1, 2026. WADA 2026
  23. World Anti-Doping Agency. The 2027 Prohibited List. Comes into effect 1 January 2027. WADA 2027 List
  24. U.S. Department of Health and Human Services. 503A Peptide Enforcement Discretion Policy, Appendix B: peptide identity and route limits. October 2026. HHS policy appendix
Medical disclaimer

This page is educational information only. It is not medical advice and does not replace care from a licensed medical provider. Do not use this page to decide whether to take any substance. Talk to a licensed medical provider first.

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