Overview
Tesamorelin is a synthetic stabilized analog of GHRH composed of the full 44-amino acid sequence of GHRH, conjugated with a trans-3-hexenoic acid modification that dramatically extends its half-life to 26-38 minutes. It is the most potent GHRH analog commercially available and is FDA-approved for reducing visceral adipose tissue (VAT) in HIV-associated lipodystrophy. Tesamorelin is also being explored for cognitive enhancement, metabolic health, and longevity applications.
Mechanism of Action
Tesamorelin binds directly to GHRH receptors in the anterior pituitary, triggering potent GH secretion through cAMP/PKA signaling. This leads to rapid increases in serum GH and IGF-1. The trans-3-hexenoic acid modification prevents dipeptidyl peptidase IV (DPP-IV) degradation, extending the active half-life. A 2010 NEJM clinical trial demonstrated significant reduction in visceral adipose tissue and improved lipid profiles, establishing its clinical effectiveness for metabolic applications.
Potential Benefits
- FDA-approved for visceral fat reduction in HIV lipodystrophy
- Significant IGF-1 elevation within 2 weeks of administration
- Greater visceral fat reduction than other GHRH analogs
- Improved lipid profiles and metabolic markers
- Emerging evidence for cognitive enhancement
- Cardiovascular risk factor improvement
- Longer half-life than sermorelin enables more sustained GH stimulation
Dosage Protocols
The following reflects doses used in published research studies. This is not medical advice. Consult a qualified healthcare professional.
| Typical Range | 1-2 mg/day |
| Beginner | 1 mg/day at bedtime |
| Intermediate | 2 mg/day at bedtime (FDA-approved dose) |
| Advanced | 2 mg/day combined with Ipamorelin |
| Cycle Duration | Ongoing for approved indication; 12-26 weeks for off-label use |
| Cycle Off | Off-label users typically cycle 12-24 weeks on, 8-12 weeks off |
FDA-approved at 2 mg/day subcutaneously at bedtime for HIV-associated lipodystrophy. Effects on visceral adipose tissue apparent at 26 weeks. IGF-1 elevation occurs within 2 weeks. Rotate injection sites.
Use our Reconstitution Calculator to determine exact syringe units for your protocol.
Routes of Administration
Subcutaneous Injection High
Only approved route; once-daily injection at bedtime; abdominal subcutaneous tissue preferred; rotate injection sites
Read our full Routes of Administration Guide for detailed comparison of all delivery methods.
Stacking Protocols
Popular research stacks involving Tesamorelin:
FDA-Approved Metabolic Stack
Enhanced GH axis stimulation combining GHRH analog with selective GHRP
Off-label combination used in anti-aging clinics; GHRH+GHRP synergy amplifies GH pulse beyond either alone.
Cognitive and Metabolic Stack
Metabolic improvement with cognitive support
Tesamorelin's emerging evidence for mild cognitive impairment combined with NAD+ for mitochondrial and neurovascular health.
Explore our complete Peptide Stacking Guide for more combinations and safety considerations.
Reconstitution
| Typical Vial Size | 1mg (Egrifta SV), 2mg (Egrifta) |
|---|---|
| BAC Water | Supplied with diluent (sterile water for injection); reconstitute per package insert |
| Storage | Refrigerate reconstituted solution at 2-8°C; use within 24 hours of reconstitution |
| Shelf Life | 24 hours post-reconstitution; lyophilized vials: 24 months at 2-8°C |
Need exact syringe measurements?
Amino Acid Sequence
Trans-3-hexenoic acid conjugated GHRH 1-44
Side Effects & Safety
- Potential water retention and joint pain
- Insulin resistance risk (GH effect)
- Headache
- Injection site reactions
- Glucose tolerance reduction at high doses
Synergistic Compounds
The following compounds have been studied alongside Tesamorelin for potential complementary or synergistic effects:
Learn More
References & Further Reading
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