Tesamorelin (5mg)
Tesamorelin (Egrifta®) is a synthetic 44-amino acid GHRH analog, FDA-approved (2010) for reducing visceral fat. It acts by binding to GHRH receptors on the anterior pituitary, inducing pulsatile secretion of growth hormone (GH) without suppressing the natural axis. Reconstitute with 2mL of bacteriostatic water for a concentration of 2.5mg/mL (250mcg per 10 units).
Reviewed by the AllPeptides.eu Editorial Team·Last reviewed: 2026-06-16
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
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Research monograph
See the full Tesamorelin encyclopedia page with mechanism, evidence tier, related variants and research context.
How It Works
Tesamorelin is a **synthetic 44-amino acid analog** of human GHRH (Growth Hormone-Releasing Hormone). It binds to GHRH receptors on the somatotroph cells of the **anterior pituitary**, triggering the pulsatile secretion of growth hormone (GH). This increases circulating levels of **IGF-1** (Insulin-like Growth Factor 1), which mediates lipolysis — particularly in **visceral adipose tissue**. Unlike exogenous GH, tesamorelin **preserves the negative feedback mechanism** via somatostatin, avoiding supraphysiological GH levels. Clinical studies have also highlighted a **neuroprotective effect**, with a reduction in brain amyloid-beta deposition in older adults.
Quick Start
- Typical dose: 1–2mg subcutaneously, daily
- Frequency: Daily, 30–60 minutes before bedtime, on an empty stomach
- Storage: 2–8°C after reconstitution, use within 21 days
- Mechanism of action: GHRH analog → pulsatile GH secretion → increased IGF-1
Dosing Table — Tesamorelin 5mg
Route: Subcutaneous injection | Frequency: Daily, before bedtime
| Week | Dose | Units (per injection) |
|---|---|---|
| 1–2 | 1mg | 40 Units (0.40 mL) |
| 3+ | 2mg | 80 Units (0.80 mL) |
Studies report administration before bedtime on an empty stomach (at least 2 hours without food). The 5mg vial is reconstituted in 2mL of BAC water (concentration 2.5mg/mL) and provides ~2.5 doses of 2mg. Evening administration synchronizes with the natural nocturnal GH secretion.
Related compounds
Reconstitution Steps
- Clean the vial and BAC water stoppers with an alcohol pad.
- Withdraw 2mL of bacteriostatic water (BAC water).
- Inject slowly against the wall of the vial — do not spray directly onto the powder.
- Gently swirl until fully dissolved — do not shake (risk of denaturation).
- Mark the reconstitution date on the vial.
- Store immediately in the refrigerator (2–8°C).
Protocol Overview
- Tesamorelin is FDA-approved (2010, Theratechnologies) for reducing visceral fat in patients with HIV-lipodystrophy.
- It is the only GHRH analog with clinical approval — results are supported by Phase III clinical studies.
- It stimulates the pituitary for natural, pulsatile GH secretion, preserving the negative feedback mechanism.
- Studies show an average reduction in visceral fat of ~18% over 26 weeks of treatment.
- It does not increase the risk of hypoglycemia in non-diabetic individuals.
Dosing Protocol
- Weeks 1–2: 1mg/day — introductory phase to assess tolerance.
- Weeks 3+: 2mg/day — full therapeutic dose (corresponds to the FDA dose).
- Administer before bedtime on an empty stomach (≥2 hours fasting).
- Cycle: 3–6 months active, followed by a washout.
- Evaluate results at 12 weeks — if no improvement is observed, re-evaluate.
- Break between cycles: After the cycle (3–6 months), a pause of 4–8 weeks is recommended. Tesamorelin stimulates endogenous GHRH receptors — the pause prevents tolerance (down-regulation) and allows for sensitivity restoration. During the washout, maintain exercise and diet to preserve results.
Washout & Cycle Restart
When can I restart?
After the cycle (3–6 months), a pause of 4–8 weeks is recommended. Tesamorelin stimulates endogenous GHRH receptors — the pause prevents tolerance (down-regulation) and allows for sensitivity restoration. During the washout, maintain exercise and diet to preserve results.
Minimum wait period: 4 weeks
Storage Instructions
- Lyophilized powder: 2–8°C or room temperature (up to 25°C), away from light.
- Reconstituted solution: Must be kept at 2–8°C, use within 21 days.
- Do not freeze after reconstitution — crystallization destroys the molecule.
- Avoid exposure to direct light or temperatures >25°C.
Important Notes
- Tesamorelin is the most clinically-documented GHRH compound, with Phase III clinical studies.
- Contraindicated in active neoplasia or a history of GH-dependent malignancies.
- Monitor IGF-1 every 4–6 weeks and fasting glucose monthly.
- Report immediately: persistent edema, severe arthralgias, or carpal tunnel syndrome.
- The use of this protocol is for informational purposes only.
Potential Benefits & Side Effects
Potential Benefits:
- Visceral fat reduction — average reduction of ~18% in 26 weeks (FDA-approved indication)
- Increased GH and IGF-1 — physiological pulsatile secretion without axis suppression
- Improved body composition — increased lean mass, reduced abdominal circumference
- Improved lipid profile — reduction in triglycerides, improved HDL/LDL ratio
- Neuroprotective action — studies show a reduction in brain amyloid-beta deposition
- Improved sleep quality — through enhancement of nocturnal GH secretion
Potential Side Effects:
- Injection site reactions — redness, itching, swelling (most common, ~10%)
- Arthralgias — joint pain, usually mild and transient (~5%)
- Peripheral edema — fluid retention, especially in the extremities (~4%)
- Transient increase in fasting glucose — usually within normal limits
- Headache — in some patients during the first few weeks
- Rare: carpal tunnel syndrome, myalgias
⚠️ Serious Warnings & Long-Term Risks
The following warnings are based on published literature, FDA labels, and post-marketing surveillance. They do not constitute medical advice. Consult a healthcare professional.
Theoretical neoplasia risk (IGF-1 elevation)
Tesamorelin increases GH/IGF-1. Contraindicated in active neoplasia. No significant signal observed in clinical trials.
📄 FDA Label — Egrifta®References
- FDA Approval — Tesamorelin — Dhillon S. Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy. Drugs. 2011;71(8):1071-1091.
View Source - Visceral Fat Reduction RCT — Falutz J, et al. Effects of tesamorelin on body composition and visceral fat in HIV-infected patients with abdominal fat accumulation. JAMA. 2007;298(7):761-769.
View Source - Long-term Efficacy & Safety — Falutz J, et al. Long-term safety and efficacy of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS. 2008;22(14):1719-1728.
View Source - Neuroprotective Effects — Stanley TL, et al. Effects of tesamorelin on neuroimaging markers of brain aging. Ann Neurol. 2023;93(4):808-816.
View Source - Metabolic Effects Review — Stanley TL, Grinspoon SK. Effects of growth hormone-releasing hormone on visceral fat, metabolic, and cardiovascular indices in human studies. Growth Horm IGF Res. 2015;25(2):59-65.
View Source
Recommended Supplements
L-Arginine + L-Ornithine
ZMA (Zinc + Magnesium + B6)
External Sources & Regulatory Status
Regulatory Approvals
Egrifta® · HIV lipodystrophy (2010)
Egrifta® · HIV lipodystrophy (2015)
FDA + Health Canada approved
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
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