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The only GHRH analogue with a current approval — a stabilised full-length GHRH used to shrink visceral fat in HIV lipodystrophy.
Also known as: Egrifta · TH9507 · TH 9507 · tesamorelin acetate
Part of the Growth hormone & IGF peptides cluster
Overview
Tesamorelin (Egrifta, TH9507) is a stabilised synthetic 44-amino-acid analogue of human growth hormone-releasing hormone (C221H366N72O67S, ≈5,136 Da). It stimulates pituitary growth hormone release and was approved by the US FDA in November 2010 to reduce excess abdominal fat in HIV-infected patients with lipodystrophy — the only GHRH analogue with a current marketing approval. It is also being studied for liver fat, cognition and physical function in people with HIV.
Source & context
Biological / chemical source: Synthetic GHRH analog
Primary research or clinical context: Approved (US FDA, November 2010; Canada) for reduction of excess visceral abdominal fat in HIV-associated lipodystrophy
What tesamorelin is
Tesamorelin is a synthetic analogue of the full 44-residue human growth hormone-releasing hormone, stabilised so that it survives longer in circulation than the native hormone. The IUPHAR/BPS Guide to Pharmacology classifies it as a stabilised synthetic peptide analogue of hypothalamic GHRH, marketed as the acetate salt; its molecular formula is C221H366N72O67S and its average mass about 5,136 Da. It was developed as TH9507 by Theratechnologies and, in November 2010, became the first — and so far only — GHRH analogue to receive a US marketing approval, as Egrifta (Grunfeld et al., Nature Reviews Drug Discovery 2011).
Sequence and structure
The one-letter backbone deposited with IUPHAR is Y-A-D-A-I-F-T-N-S-Y-R-K-V-L-G-Q-L-S-A-R-K-L-L-Q-D-I-M-S-R-Q-Q-G-E-S-N-Q-E-R-G-A-R-A-R-L — the entire GHRH(1-44) sequence, of which sermorelin is the first 29 residues. The stabilising modification sits at the N-terminus, the region where native GHRH is rapidly cleaved; the registries describe the peptide as stabilised without specifying the group, so this profile does not either. The C-terminal 15 residues (Q30 onward) are the part sermorelin and CJC-1295 lack.
Mechanism
Tesamorelin acts on pituitary somatotrophs to stimulate production and release of growth hormone, which raises IGF-1 and, downstream, promotes lipolysis in visceral fat. Because it works through the physiological GHRH receptor and pulsatile release rather than replacing growth hormone directly, the resulting IGF-1 rise is more moderate than with recombinant growth hormone; the pack's clinical reviews attribute its effect on visceral adiposity to this axis. It has major effects on glucose and lipid metabolism, per the NIH LiverTox summary, which is why glucose monitoring features in its labelling.
The approval evidence
Tesamorelin was approved on the basis of phase 3 trials in treatment-experienced adults with HIV and lipodystrophy. Canada's CADTH review (2016) records the indication precisely: treatment of excess visceral adipose tissue, as assessed by waist circumference of at least 95 cm in men or 94 cm in women and confirmed by a CT-measured VAT above 130 cm², in adults who failed to reduce VAT with diet and exercise — at a labelled dose of 2 mg subcutaneously once daily. A 2012 review concluded that tesamorelin is effective in improving visceral adiposity and body image in this population (Spooner & Olin, Annals of Pharmacotherapy 2012).
Newer trials: liver fat, cognition, function
The ClinicalTrials.gov footprint (24 registered studies) shows the drug being tested beyond its label. A phase 2 trial at Massachusetts General Hospital examined a GHRH analogue for non-alcoholic fatty liver disease in HIV (NCT03375788, completed), and a 2026 phase 2 trial is recruiting for liver-fat reduction in fatty liver disease (NCT07481734). A six-month randomised open-label phase 2 trial in 73 virally suppressed adults with HIV and abdominal obesity found that tesamorelin reduced waist circumference more than standard of care (median difference −2.7 cm, P = .015) but that the between-group difference in neurocognitive performance was not significant (Ellis et al., Journal of Infectious Diseases 2025). A trial of tesamorelin as an adjunct to exercise for physical function is recruiting (NCT06554717).
| Registration | Question | Phase / status |
|---|---|---|
| NCT00608023 | Extension study in HIV-associated lipodystrophy (Theratechnologies) | Phase 3, completed |
| NCT03375788 | GHRH analogue for non-alcoholic fatty liver disease in HIV | Phase 2, completed |
| NCT02572323 | Cognition in ageing people with HIV | Phase 2, completed |
| NCT06554717 | Adjunct to exercise for physical function in HIV | Phase 2, recruiting |
| NCT07481734 | Liver-fat reduction in fatty liver disease | Phase 2, recruiting |
Safety profile
The NIH LiverTox database notes that tesamorelin has major effects on glucose and lipid metabolism but has not been linked to serum aminotransferase elevations during therapy or to clinically apparent acute liver injury. In the 2025 neurocognition trial, IGF-1 rose as expected and the treatment was given daily for six months without the abstract reporting safety-related discontinuations. Label-level cautions (glucose intolerance, injection-site reactions, contraindication in active malignancy) are the prescriber's domain and are not detailed in the pack.
Tesamorelin vs sermorelin vs CJC-1295
All three are GHRH-receptor agonists built on the GHRH sequence. Sermorelin is the unmodified 29-residue fragment and is no longer marketed in the US; CJC-1295 is a 29-residue analogue with an albumin-binding linker that never reached approval; tesamorelin is the full 44-residue hormone, stabilised, and approved. In practice this makes tesamorelin the only one of the three with a pharmaceutical supply chain, a label and post-marketing safety data — the comparison guides linked below go through the pharmacology side by side.
Off-label demand and sport
Tesamorelin appears in the same sports-medicine and self-administration literature as the unapproved secretagogues: recent reviews list it among GHRH analogues used in online protocols (Dominikowski et al., Frontiers in Endocrinology 2026), and WADA-accredited laboratories screen for it alongside sermorelin and CJC-1295 (Coppieters et al., 2022). Unlike its neighbours, tesamorelin is a prescription medicine, so material sold outside the pharmacy channel is either diverted product or unlicensed synthesis of unknown quality. This profile is educational; it is not guidance on obtaining or using any product and it is not medical advice.
Sequence
One-letter sequence commonly cited for Tesamorelin (educational; isoforms and modifications may differ):
YADAIFTNSYRKVLGQLSARKLLQDIMSRQQGESNQERGARARL
Residues plotted ~100° apart around an α-helix — clustering of one color reveals an amphipathic face.
Structure & chemistry
Molecular identity & reference confidence
Source-supported reference
Reference values are taken from the cited molecular record or curated profile. A database match is not independent laboratory verification; modifications, counter-ions, and formulations can change the measured mass.
- Molecular form
- Full-length human GHRH(1-44) sequence, stabilised (IUPHAR: 'a stabilised synthetic peptide analogue of the hypothalamic peptide GHRH'); marketed as the acetate salt
- Species
- Not established by this molecular identity audit
- Termini (N / C)
- Not specified / Not specified
Average reference mass
Reference policy updated: 2026-10-05
- IUPHAR/BPS source snapshot · 2026-10-01
- PubChem molecular record · 2026-10-01
- Molecular formula
- C221H366N72O67S
- Average reference mass
- ≈ 5,136
- Receptors
- Growth hormone-releasing hormone receptor (GHRH-R) on pituitary somatotrophs
- Backbone
- Full-length human GHRH(1-44) sequence, stabilised (IUPHAR: 'a stabilised synthetic peptide analogue of the hypothalamic peptide GHRH'); marketed as the acetate salt
- Status
- Approved: US FDA November 2010 (Egrifta) for HIV-associated lipodystrophy; reviewed by CADTH in Canada (2016). Not approved for any other indication.
- PubChem CID: 16137828
- IUPHAR ligand: 6959
- ChEMBL: CHEMBL1237026
- DrugBank: DB08869
- CAS RN: 218949-48-5
- UNII: MQG94M5EEO
Chemistry values: curated profile, IUPHAR/BPS Guide to Pharmacology, PubChem · fetched 2026-10-01.
Clinical development snapshot
ClinicalTrials.gov lists 24 registered studies with “Tesamorelin” as an intervention (snapshot 2026-09-06). A registry footprint is not evidence of efficacy or approval.
| NCT | Title | Phase | Status | Updated |
|---|---|---|---|---|
| NCT03226821 | Body Composition and Adipose Tissue in HIV | Phase 4 | terminated | 2026-05-19 |
| NCT06554717 | Tesamorelin as an Adjunct to Exercise for Improving Physical Function in HIV | Phase 2 | recruiting | 2026-05-19 |
| NCT07481734 | Tesamorelin for Reduction of Liver Fat in Adults With Fatty Liver Disease (Mock Study) | Phase 2 | recruiting | 2026-03-19 |
| NCT02572323 | Phase II Trial of Tesamorelin for Cognition in Aging HIV-Infected Persons | Phase 2 | completed | 2026-03-12 |
| NCT03375788 | Growth Hormone Releasing Hormone Analog to Improve Nonalcoholic Fatty Liver Disease and Associated Cardiovascu | Phase 2 | completed | 2025-11-20 |
| NCT03150511 | Tesamorelin to Improve Functional Outcomes After Peripheral Nerve Injury | Phase 2 | recruiting | 2025-11-12 |
Tesamorelin — reconstitution calculator
Enter how much peptide is in the vial and how much diluent (e.g. bacteriostatic water) is added. The tool returns the resulting solution concentration — and, for any amount you type, the volume it corresponds to. This is educational arithmetic, not a dosing recommendation.
Reference form: Full-length human GHRH(1-44) sequence, stabilised (IUPHAR: 'a stabilised synthetic peptide analogue of the hypothalamic peptide GHRH'); marketed as the acetate saltAverage reference mass: 5,136 Da
Enter an amount to see the volume it corresponds to.
Educational concentration mathematics only. This tool does not recommend a dose, amount, or protocol, and nothing here is medical advice. Many peptides are not authorized by Health Canada for human use — see our reconstitution and bacteriostatic-water guides for context.
Change log
Dated observations from the data pipeline (registry flags, trial footprints, identifiers) and editorial reviews of this profile.
- EditorialProfile content reviewed and updated by the editorial team.
FAQ about Tesamorelin
What is Tesamorelin?+
Tesamorelin (Egrifta, TH9507) is a stabilised synthetic 44-amino-acid analogue of human growth hormone-releasing hormone (C221H366N72O67S, ≈5,136 Da). It stimulates pituitary growth hormone release and was approved by the US FDA in November 2010 to reduce excess abdominal fat in HIV-infected patients with lipodystrophy — the only GHRH analogue with a current marketing approval. It is also being studied for liver fat, cognition and physical function in people with HIV.
What Canadian product status is recorded for Tesamorelin?+
Canadian product status for Tesamorelin has not been verified in this profile. No verified record here does not mean no authorization exists. Status depends on the product, formulation and use; consult Health Canada's product records.
What is the typical length of Tesamorelin?+
Tesamorelin is commonly described as approximately 44 amino acids (GHRH analogue (approved medicine)).
What is tesamorelin?+
A stabilised synthetic analogue of full-length human GHRH (44 amino acids) that stimulates growth hormone release. Approved as Egrifta in 2010 for excess abdominal fat in HIV-associated lipodystrophy.
Is tesamorelin approved?+
Yes — by the US FDA in November 2010 for HIV-associated lipodystrophy, and reviewed for Canadian reimbursement by CADTH in 2016. It is not approved for weight loss, ageing or any other indication.
Does tesamorelin reduce belly fat?+
In its approved population — adults with HIV and lipodystrophy — trials showed reductions in visceral adipose tissue, and a 2025 trial found a −2.7 cm greater reduction in waist circumference than standard care over six months.
Tesamorelin vs sermorelin?+
Tesamorelin is the full 44-residue GHRH, stabilised and approved; sermorelin is the native 29-residue fragment, no longer marketed in the US. Both act at the GHRH receptor.
What is tesamorelin's half-life?+
The evidence pack does not give a figure. It is dosed once daily in its approved use.
Is tesamorelin safe for the liver?+
LiverTox reports no link to liver-enzyme elevations or clinically apparent liver injury. Its main metabolic effects are on glucose and lipids.
Further reading
- GH secretagoguesTesamorelin vs CJC-1295: Two GHRH Analogs, ComparedTesamorelin and CJC-1295 are both GHRH analogs, but one is an approved medicine and the other a research compound. Compare their design, half-life, and how the literature treats them. Educational only.
- Hormone axisGH Secretagogue Peptides Explained: CJC-1295, Ipamorelin, GHRPsEducational overview of growth hormone secretagogue peptides—GHRH analogs vs GHRPs, DAC vs no DAC, receptors, and research context.
- ComparisonCJC-1295 vs Sermorelin: Comparing GHRH AnalogsAn educational comparison of CJC-1295 and sermorelin—two GHRH-analog research compounds—covering DAC vs no-DAC design, half-life concepts, and framing. Not medical advice.
- Not a peptideIs MK-677 (Ibutamoren) a Peptide? No — It Is an Oral Small-Molecule Ghrelin Mimetic. What the Trials ShowedMK-677 (ibutamoren) is sold next to peptides and stacked with them, but it is a small synthetic molecule that activates the ghrelin receptor by mouth. This guide explains what it is, how it differs from GHRH and GHRP peptides, what its clinical trials showed — including the safety signal that stopped one — and its regulatory status.
- CanadaAre Peptides Legal in Canada? A Regulatory GuideAn educational overview of how Health Canada regulates peptides—drug authorization, DINs, the “research use only” gray area, and import ambiguity. Not legal advice.
Related peptides
References & further reading
- 1.Falutz et al. (2007). Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med
- 2.Falutz et al. (2010). Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. J Acquir Immune Defic Syndr
- 3.Stanley et al. (2014). Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial. JAMA
- 4.Stanley et al. (2019). Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV
- 5.Fourman et al. (2020). Effects of tesamorelin on hepatic transcriptomic signatures in HIV-associated NAFLD. JCI Insight
- 6.Baker et al. (2012). 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
- 7.Russo et al. (2024). Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors. AIDS
- 8.Fourman et al. (2017). Visceral fat reduction with tesamorelin is associated with improved liver enzymes in HIV. AIDS
- 9.Rahman et al. (2023). Effect of tesamorelin in people with HIV with and without dorsocervical fat: Post hoc analysis of phase III double-blind placebo-controlled trial. J Clin Transl Sci
- 10.Bedimo (2011). Growth hormone and tesamorelin in the management of HIV-associated lipodystrophy. HIV AIDS (Auckl)
- 11.Spooner et al. (2012). Tesamorelin: a growth hormone-releasing factor analogue for HIV-associated lipodystrophy. Ann Pharmacother
- 12.Stanley et al. (2012). Reduction in visceral adiposity is associated with an improved metabolic profile in HIV-infected patients receiving tesamorelin. Clin Infect Dis
- 13.Grunfeld C, Dritselis A, Kirkpatrick P (2011). Tesamorelin. Nature Reviews Drug Discovery
- 14.CADTH (2016). Clinical Review Report: Tesamorelin (Egrifta). Canadian Agency for Drugs and Technologies in Health
- 15.Ellis RJ et al. (2025). Effects of tesamorelin on neurocognitive impairment in persons with HIV and abdominal obesity. Journal of Infectious Diseases
- 16.LiverTox (2018). Tesamorelin. NIDDK
- 17.Coppieters G et al. (2022). Detection of growth hormone-releasing hormones in urine by nanoLC-HRMS/MS. Journal of Pharmaceutical and Biomedical Analysis
- 18.Dominikowski A et al. (2026). Performance-enhancing peptides modulating the GH-IGF1 axis. Frontiers in Endocrinology
- 19.PubChem — Tesamorelin (CID 16137828)