# Tesamorelin

> Source: https://peptidestogo.com/peptides/tesamorelin/
> Last updated October 25, 2026 · PeptidesToGo Editorial Team · Educational, not medical advice

GHRH analog

**Status:** FDA-approved for HIV lipodystrophy · Prescription only

**How it is delivered:** Injection — once daily.

Tesamorelin is a synthetic analog of growth hormone-releasing hormone, the peptide your hypothalamus uses to signal the pituitary to release growth hormone. It’s modified at the N-terminus with a fatty-acid group that slows degradation, giving it a viable half-life after subcutaneous injection — long enough to work, short enough to preserve the body’s natural pulsatile GH release pattern.

The clinical consequence: your pituitary releases growth hormone in bursts, IGF-1 rises from the liver and peripheral tissues, and visceral adipose tissue — the metabolically active fat around your organs — responds preferentially. Subcutaneous fat stays largely unchanged. That selectivity is what made tesamorelin viable as a drug for HIV-associated lipodystrophy, and it’s what drives the off-label interest in metabolic health and body composition.

> “Tesamorelin is the only GHRH analog with phase 3 imaging data and an FDA approval — the rare peptide where you can point to a label, a trial registry, and hard endpoints.”

Unlike direct growth hormone replacement, tesamorelin works upstream. The pituitary’s negative-feedback loops stay intact, which is part of the safety argument for the whole secretagogue category. The deeper mechanistic story — GHRH receptor binding, cAMP signaling, the downstream IGF-1 effects on neurogenesis and synaptic plasticity — lives on our PeptideWellness deep-dive.

Last updated October 25, 2026 · PeptidesToGo Editorial Team ·
[Educational, not medical advice](https://peptidestogo.com/legal/medical-disclaimer/)

## Who it's for (or who should avoid)

### What it's aimed at

Tesamorelin protocols are most commonly prescribed for:

- **HIV-associated lipodystrophy** — the FDA-approved indication, where phase 3 data showed meaningful visceral fat reduction with preserved lean mass
- **Visceral adiposity in non-HIV adults** — used off-label when central fat is the primary metabolic concern and GLP-1 therapy isn’t an option or hasn’t worked
- **Non-alcoholic fatty liver disease (NAFLD)** — early phase 2 data showed liver fat reduction in both HIV and non-HIV populations
- **Cognitive support in older adults** — based on one well-designed RCT showing improved executive function and verbal memory over 20 weeks
- **Metabolic syndrome** — when insulin resistance and central adiposity are the driving features

In the trial’s extension, visceral fat built back up once tesamorelin was stopped, so the effect lasts only as long as treatment does.

### Who should avoid it

- Anyone with active malignancy — tesamorelin is absolutely contraindicated; IGF-1 elevation carries a theoretical tumor-promotion risk
- People with pituitary dysfunction, hypophysectomy, pituitary tumor, or history of head irradiation or trauma — the drug won’t work and may cause harm
- Anyone pregnant, breastfeeding, or planning a pregnancy — no controlled human data
- Patients with pre-existing diabetes or prediabetes — glucose tolerance can worsen modestly; closer monitoring is required
- Personal or family history of malignancy without active disease — individualized risk-benefit assessment needed

Tesamorelin elevates IGF-1 by design. The long-term implications of sustained upper-normal IGF-1 in healthy adults are genuinely uncertain, particularly for cancer risk. That’s a conversation to have with your provider before starting, not after.

## Route, dose and course

**Used for:** Visceral (abdominal) fat reduction

**How it’s taken:** Daily subcutaneous injection into the abdomen, sites rotated. Branded versions come as a lyophilised powder you reconstitute.

**Label dose:** 1.28 mg daily (Egrifta WR, the current product); 1.4 mg daily (Egrifta SV); 2 mg daily (original Egrifta)

**Cycle:** Continuous daily dosing, as used in phase 3. Baseline and quarterly IGF-1, fasting glucose and lipids.

**Legal status:** FDA-approved for excess abdominal fat in HIV-associated lipodystrophy, under three brand names in sequence: Egrifta (2010, superseded), Egrifta SV (2019), and Egrifta WR (2025), which the maker says now replaces SV. Any other use is off-label. Compounded tesamorelin is not FDA-approved, and FDA says biologics, tesamorelin among them, are not eligible for 503A or 503B compounding.

**What it costs:** About $150 a month — From the sellers' own pages on November 4, 2026; some sell it per vial or unit instead. Each figure, with what it leaves out, is in the table under “Can I actually get it?”. These are compounded prices. The maker of branded Egrifta posts no cash price; it is a specialty-pharmacy drug, usually reached through coverage for the approved indication.

Tesamorelin is prescribed as a subcutaneous injection, typically into the abdomen, with site rotation to minimize injection-site reactions. The branded versions (Egrifta SV, Egrifta WR) come as lyophilized powder that you reconstitute with sterile water; the WR formulation allows weekly reconstitution instead of daily.

What the label and the trials say:

- **FDA-approved dose:** 1.28 mg subcutaneous daily (Egrifta WR, 11.6 mg per vial — the current product); 1.4 mg daily (Egrifta SV, bioequivalent); 2 mg daily (original Egrifta)
- **Off-label cognitive research:** 1 mg daily, administered before bedtime to align with the physiological GH pulse
- **Monitoring:** baseline IGF-1, fasting glucose, lipid panel, and ideally CT or DXA for VAT quantification; repeat IGF-1 and glucose every three months
- **Goal:** keep IGF-1 in the upper-normal range for age, not above it; dose reduction if levels exceed the upper limit
- **Cycling:** phase 3 used continuous daily dosing

Reconstitution is straightforward; the monitoring is the part that needs a clinician.

## Stage by stage

**Read this first.** The windows below come from the phase 3 trial behind the approval, in adults with HIV and excess abdominal fat. Other groups have not been tested the same way.

Tesamorelin is measured by imaging rather than the bathroom scale: the trials tracked fat inside the abdomen on CT. The windows below come from the phase 3 trial and its extension, with a link under each.

**DAILY How it is given** The phase 3 trial gave 2 mg by injection under the skin once a day, against placebo, in adults with HIV and excess abdominal fat.

**WEEK 26 Where the trial measured** At 26 weeks, visceral fat on CT fell 15.2% on tesamorelin and rose 5.0% on placebo. The trial measured belly fat inside the abdomen, not total weight.

**AFTER STOPPING The fat comes back** In the extension, people switched from tesamorelin to placebo at week 26 saw visceral fat build back up. Those who stayed on it kept a reduction of about 18% over 52 weeks.

## Available · from about $150/mo

Every headline price in this market excludes something. These are normalized to a
 calendar month, cheapest first, with the exclusion spelled out — the published figure
 is the footnote under it.

| Provider | From, per month | What that figure excludes | Coverage | Their own site |
| --- | --- | --- | --- | --- |
| [Live Vital](https://peptidestogo.com/providers/live-vital/) — Physician-led, monthly pricing, Draper UT | $150 (read 2026-11-04) | The dose the figure buys, which is not published; sold as a 2-month subscription, $299 every 2 months. | All 50, stated | [Go to site ↗](https://livevital.io/) |
| [Defy Medical](https://peptidestogo.com/providers/defy-medical/) — Tampa clinic, physician-led | No price for this compound | Peptides are priced per vial rather than per month, and neither the consultation nor the lab work that has to precede it is priced anywhere on the site. | Not published | [Go to site ↗](https://www.defymedical.com/) |
| PeRx — Peptide-only telehealth, Wellness MD Group PC | No price for this compound | The only peptide figure on the site is a floor for the whole menu — treatment plans "starting at $199" — so there is no price for any individual compound. The provider review is included; there is no separate consultation fee. | All 50, stated | [Go to site ↗](https://www.perxpeptides.com/) |
| [RxPepsDirect](https://peptidestogo.com/providers/rxpepsdirect/) — Per-vial prices, 503A pharmacy in Texas | $200 per vial (read 2026-11-04) | The $39 telehealth visit, charged per order. | A named list | [Go to site ↗](https://rxpepsdirect.com/) |

### Will it work where you live?

Most sellers claim all fifty states or publish nothing about coverage; a few name
 the states they serve or the ones they exclude, and the Coverage column says which.
 Either way it is the seller's own claim, so we can't filter this list by state
 without inventing a fact. What we can tell you is which state-level rules decide
 access: telehealth rules, non-resident pharmacy licensing, and who is allowed to
 prescribe.

[What shapes access in your state →](https://peptidestogo.com/tools/state-checker/)

### Prices and providers change. We keep track.

## Questions we get about Tesamorelin

### Is tesamorelin FDA-approved?

Yes — for reducing excess abdominal fat in HIV-infected adults with lipodystrophy, and that is the only approved indication. The brand has changed twice for the same molecule: Egrifta (approved 2010), then Egrifta SV (2019), then Egrifta WR (2025), which Theratechnologies says replaces SV while SV stays available through the transition. Egrifta WR is the one a pharmacy is most likely to dispense now. Off-label use for general visceral fat reduction, NAFLD, or cognitive support is prescribed by clinicians but not FDA-approved for those purposes.

### Is it legal?

Branded Egrifta SV and Egrifta WR, with a prescription, yes. Compounded tesamorelin, no: it is not FDA-approved, and since March 2020 the FDA has regulated tesamorelin as a biologic; FDA's notice to compounders says biologics are not eligible for compounding under section 503A or 503B. It is sold anyway: a few telehealth sellers list compounded tesamorelin with prices, and we show who they are and what they charge. A listing is not a statement that a given seller is operating within the rules. Ask the seller which pharmacy makes it before you start, and note that availability varies by state.

### Are there side effects?

The most common are injection-site reactions — redness, itching, occasional hives. Joint pain and mild swelling occur in some patients. Hypersensitivity reactions happen in about 3–4% of users. Glucose tolerance can worsen modestly, so fasting glucose monitoring is standard. Serious adverse events were uncommon in the phase 3 trials.

### Can I take it with my current medications?

Most patients take tesamorelin without significant medication interactions, but it can affect glucose metabolism, so coordination with diabetes medications is important. Always disclose your full medication list — including supplements — to your provider, particularly if you're on insulin or other GH-axis therapies.

### How much does it cost?

In the price table on this page, the monthly figure is about $150, read on November 4, 2026. Some sellers price it per vial or unit instead, shown in the same table. Branded Egrifta SV and WR are specialty-pharmacy drugs and the manufacturer does not post a cash price; patients treated for the approved HIV indication usually reach it through a specialty pharmacy benefit and the maker's assistance program, so what you pay depends on your plan rather than a list. The prices in the table are for compounded tesamorelin, which a few telehealth sellers list although the FDA does not treat tesamorelin as eligible for compounding. Off-label use is generally not covered.

### How is tesamorelin different from sermorelin?

Both copy GHRH, the hormone that tells the pituitary to release growth hormone, and both act on the same receptor. Tesamorelin has an FDA label for one narrow use, excess abdominal fat in adults with HIV-associated lipodystrophy, backed by two Phase 3 trials. Sermorelin's brand, Geref, left the market in 2008, and adult data are thin. The legal routes run the other way: sermorelin can be compounded with a prescription, while the FDA has treated tesamorelin as a biologic since 2020, and biologics cannot be compounded. No trial has compared the two directly.

### How is tesamorelin different from ipamorelin?

Both raise growth hormone, through different receptors: tesamorelin through the GHRH receptor, ipamorelin through the ghrelin receptor. Tesamorelin is an FDA-approved drug with two Phase 3 trials behind it. Ipamorelin was never approved, and in the one trial that reported results it missed its endpoint. Under current FDA rules neither can be lawfully compounded, for different reasons. No trial has compared the two.

We publish no medical reviewer by design. Every claim on this page traces to a
 source we hold on file, and the reviewed write-up with those citations lives on our
 hub.
[Read the full research on PeptideWellness ↗](https://peptidewellnessusa.com/peptides/tesamorelin/)

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