Growth Hormone & IGF Axis
Tesamorelin
Commonly used for
Visceral Fat ReductionBody CompositionMetabolic Health
What is it?
Tesamorelin is a synthetic growth hormone-releasing hormone (GHRH) analogue that stimulates endogenous growth hormone secretion and reduces visceral adipose tissue. Available as the original Egrifta SV (2 mg, reconstituted daily injection) and the newer Egrifta WR (a ready-to-use 1.28 mg once-daily formulation).
Brand names: Egrifta SV®, Egrifta WR®
Mechanism of action: GHRH receptor agonist; Stimulates pulsatile growth hormone release; Increases insulin-like growth factor-1 (IGF-1); Reduces visceral adipose tissue
What do people use it for?
Approved indications: Reduction of excess visceral abdominal fat in adults with HIV-associated lipodystrophy
Proposed indications: Non-alcoholic fatty liver disease (NAFLD/MASH); Cognitive impairment in HIV; Age-related visceral adiposity; Body composition optimization; Muscle preservation in catabolic states
How is it used? / Dosing
Administration: Subcutaneous injection — Daily
How does it compare?
Compare with:
How well does it work? / Evidence
~ Moderate evidence
Evidence rating: ⭐⭐⭐⭐ (Approved for a specific indication) — Well-supported for HIV-associated lipodystrophy; other uses remain investigational.
Landmark trials: Falutz J, et al. — Demonstrated significant reductions in visceral adipose tissue in HIV-associated lipodystrophy.; Subsequent studies — Showed reductions in liver fat among people with HIV and NAFLD.
Safety & side effects
Common side effects: Injection-site reactions, Arthralgia, Peripheral edema, Myalgia, Increased IGF-1 levels
Serious risks: Elevated IGF-1 requiring monitoring; Glucose intolerance; Fluid retention; Potential stimulation of malignancy growth in susceptible individuals
Drug interactions: No major drug interactions identified, though concurrent therapies affecting glucose metabolism warrant monitoring.
Monitoring: IGF-1, Fasting glucose and HbA1c, Waist circumference/visceral adiposity, Signs of edema, Evaluation for malignancy recurrence where appropriate
Legal & regulatory status
Legal status: Prescription required. This is an FDA-approved medication available only through a licensed prescriber — dosing is determined by your prescriber based on your medical history and is not provided here.
Regulatory status: FDA Approved • EMA: Not broadly approved
Who should avoid it?
Contraindications: Active malignancy; Disruption of the hypothalamic-pituitary axis; Pregnancy; Known hypersensitivity to tesamorelin or formulation components
Pregnancy & breastfeeding: Contraindicated during pregnancy. Safety during breastfeeding has not been established.
Research & references
Falutz J, et al. (2010). Effects of Tesamorelin, a Growth Hormone-Releasing Factor, in HIV-Infected Patients with Abdominal Fat Accumulation. Journal of Clinical Endocrinology & Metabolism, 95(9), 4291–4304. Stanley TL, et al. (2019). Effects of Tesamorelin on Nonalcoholic Fatty Liver Disease in HIV. The Lancet HIV, 6(12), e821–e830. https://doi.org/10.1016/S2352-3018(19)30338-8