Tesamorelin keeps the complete growth hormone-releasing hormone sequence and adds a single chemical cap to stop it being cut apart. It is one of the few compounds here that went all the way through clinical trials.
Tesamorelin · Growth hormone-releasing hormone analogue
Growth hormone-releasing hormone (GHRH) is the brain’s instruction to the pituitary to release growth hormone. The natural hormone is destroyed within minutes by an enzyme in the blood. Tesamorelin is a copy that resists that enzyme, and it was studied in people to see whether a stronger growth hormone signal would reduce the excess abdominal fat that some HIV treatments cause. The main clinical programme was randomised trials in that population, with smaller research outside it.
Tesamorelin is a synthetic analogue of the full 44-amino-acid human GHRH. The difference is a trans-3-hexenoic acid group attached to the first amino acid, which protects the peptide from DPP-IV (dipeptidyl peptidase-4, the enzyme that normally trims and inactivates GHRH). Because it acts at the GHRH receptor on pituitary cells, it prompts the pituitary to release its own growth hormone in a pulsatile pattern, rather than supplying growth hormone directly.
It is not the only GHRH analogue to have reached approval. Sermorelin, a GHRH(1–29) fragment, was approved in the United States in the 1990s as Geref for diagnosis and treatment of growth hormone deficiency in children and later withdrawn for commercial reasons (Federal Register, 2013).
The clinical programme studied adults with HIV who had accumulated visceral fat (fat around the abdominal organs) as a side effect of antiretroviral treatment. Two randomised, placebo-controlled phase 3 trials over 26 weeks reported a reduction in visceral adipose tissue measured by CT scan, with IGF-1 rising as expected (Falutz et al., 2007); the pooled analysis with extension data confirmed that the fat reduction reversed when treatment stopped (Falutz et al., 2010). Those trials led to US FDA approval as Egrifta in 2010 for that indication.
Later trials in the same population examined liver fat. A randomised trial found reduced liver fat over six months in HIV-infected adults with abdominal fat accumulation (Stanley et al., 2014), and a subsequent trial in people with HIV and non-alcoholic fatty liver disease reported reduced liver fat fraction over 12 months (Stanley et al., 2019). Those liver-fat findings are investigational: the US approval covers the abdominal-fat indication only.
One smaller trial looked outside HIV. In 60 abdominally obese adults with reduced growth hormone secretion, 12 months of tesamorelin reduced visceral fat and lowered triglycerides and C-reactive protein compared with placebo, without changing glucose measures (Makimura et al., 2012). It is a single trial in a defined group, not evidence of a general effect.
The registered use rests on trials in adults with HIV; the trial identified outside HIV was a single small study. In both settings the findings belong to the pharmaceutical product, and the fat reduction was not maintained after treatment ended. Glucose tolerance and IGF-1 elevation were monitored throughout as safety signals, and the medicine carries prescribing restrictions accordingly. As a growth hormone-releasing factor it is prohibited in sport under WADA category S2.
Tesamorelin is approved in the United States (Egrifta SV) for the reduction of excess abdominal fat in HIV-infected adults with lipodystrophy, per the FDA label. It is not an approved medicine in Australia. Growth hormone-releasing factors are prohibited at all times in sport under WADA category S2.
Sources and status checked 2026-09-23
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