GHRH(1-44) analog · FDA-approved (HIV-associated lipodystrophy)

Tesamorelin (Egrifta / Egrifta SV / Egrifta WR)

Used for: reduction of excess abdominal fat in HIV-infected adults with lipodystrophy (FDA-approved indication)

Tesamorelin is a synthetic analog of human GHRH(1-44) with a trans-3-hexenoyl group attached to the tyrosine at position 1. That single N-terminal modification resists proteolytic degradation and extends in-vivo activity. It is FDA-approved as Egrifta, Egrifta SV, and Egrifta WR (Theratechnologies) for reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy.

Class
GHRH(1-44) analog · growth hormone-releasing factor (GHRF)
Manufacturer
Theratechnologies
FDA approval
Egrifta (2010) · Egrifta SV · Egrifta WR[1][2]
Approved indication
Excess abdominal fat in HIV-associated lipodystrophy[1]
Plasma half-life (Egrifta WR)
~11 minutes (SC, 1.28 mg)[1]
Plasma half-life (Egrifta SV)
~8 minutes (SC, 1.4 mg)[1]
Approved dose (Egrifta WR)
1.28 mg SC once daily[1]
Approved dose (Egrifta SV)
2 mg SC once daily[1]
Prescription medication — educational reference only. Tesamorelin is a prescription drug in the United States. The FDA prescribing information for your specific product (Egrifta, Egrifta SV, or Egrifta WR) is the authoritative source for dosing, contraindications, monitoring, and safety. Do not initiate, modify, or discontinue treatment without a qualified healthcare professional.

Last reviewed April 24, 2026 by the Enhanced Health Editorial Team. See the editorial policy.

What tesamorelin is

Tesamorelin is a 44-amino-acid synthetic peptide — specifically, a chemical analog of human growth hormone-releasing hormone, GHRH(1-44). The only structural difference from native GHRH is a trans-3-hexenoyl group attached to the tyrosine at position 1.[3] That single modification dramatically reduces proteolytic degradation by DPP-IV and other peptidases, which extends the in-vivo activity of tesamorelin relative to native GHRH despite a still-short plasma half-life of minutes rather than hours.

Tesamorelin is developed and manufactured by Theratechnologies. The original FDA approval of Egrifta was in 2010. The Egrifta SV formulation (2 mg/vial) reduced the injection volume and vial handling burden. The Egrifta WR formulation (11.6 mg/vial, "WR" for "weekly reconstitution") further simplified handling for patients — and is bioequivalent to earlier formulations per the FDA label.[1][2]

Mechanism

Tesamorelin binds GHRH receptors on somatotroph cells in the anterior pituitary gland and stimulates a pulsatile, physiologically normal release of growth hormone. Increased GH raises insulin-like growth factor 1 (IGF-1) over time.[4]

In HIV-associated lipodystrophy, where excess visceral abdominal fat accumulates despite virologic control, tesamorelin-induced restoration of a more natural GH pulse pattern reduces the volume of visceral adipose tissue. That reduction is the clinical outcome supporting the FDA-approved indication.[1]

Pharmacokinetics (from FDA label)

  • Egrifta WR plasma half-life. Approximately 11 minutes after a single subcutaneous dose of 1.28 mg in healthy subjects.[1]
  • Egrifta SV plasma half-life. Approximately 8 minutes after a single subcutaneous dose of 1.4 mg in healthy subjects.[1]
  • PD duration. Despite the short plasma half-life, daily dosing produces sustained elevation of IGF-1 and persistent pharmacodynamic effect — the GHRH receptor engagement is the trigger, not continuous drug exposure.
  • Bioequivalence. Egrifta WR has been demonstrated bioequivalent to the original Egrifta F1 formulation, with less than half the injection volume.[2]
  • Special populations. Pharmacokinetics in patients with renal or hepatic impairment, in pediatric patients, or in elderly patients has not been established per the FDA label — an important gap when prescribing.[1]

FDA-approved dosing

  • Egrifta WR: 1.28 mg (0.16 mL of the reconstituted solution) subcutaneously once daily into the abdomen, rotating injection sites.[1]
  • Egrifta SV: 2 mg subcutaneously once daily.[1]
  • Common adverse reactions. Arthralgia, injection-site reactions, pain in extremity, peripheral edema, and myalgia.[1]
  • Contraindications and monitoring. Refer to the current FDA prescribing information for your specific product. Do not derive clinical dosing from the educational math below or from research-vendor product.

Storage and handling

  • Commercial products (Egrifta / Egrifta SV / Egrifta WR). Follow the FDA prescribing information and patient instructions in the product package. These are regulated pharmaceutical products with validated storage and reconstitution procedures.
  • Compounded / research-vendor vials. Store sealed lyophilized powder refrigerated at 2–8 °C or frozen at −20 °C per the supplier's certificate of analysis. Reconstitute in bacteriostatic water (0.9% benzyl alcohol) for multi-draw use; sterile water for single-draw. Refrigerate reconstituted solution. Avoid freeze–thaw and vigorous shaking.

Reconstitution math (research-vendor context)

The math below applies to compounded tesamorelin dispensed as a lyophilized powder in a research-vendor vial. Commercial Egrifta, Egrifta SV, and Egrifta WR products come with their own FDA-validated reconstitution procedures — use those for the approved products.

Example 1 · 10 mg vial + 1 mL bac water concentration = 10 mg / 1 mL = 10 mg/mL = 10,000 mcg/mL
1 unit = 0.01 mL = 100 mcg = 0.1 mg
→ 1 mg = 10 units
→ 2 mg = 20 units
→ 5 mg = 50 units
→ 10 mg = 100 units (full syringe)
Example 2 · 10 mg vial + 2 mL bac water concentration = 10 mg / 2 mL = 5 mg/mL = 5000 mcg/mL
1 unit = 0.01 mL = 50 mcg
→ 1 mg = 20 units
→ 2 mg = 40 units
→ 5 mg = 100 units (full syringe)
Example 3 · 5 mg vial + 1 mL bac water concentration = 5 mg / 1 mL = 5 mg/mL = 5000 mcg/mL
1 unit = 0.01 mL = 50 mcg
→ 1 mg = 20 units
→ 2 mg = 40 units
→ 5 mg = 100 units (full syringe)

Frequently asked questions

What is tesamorelin?

Synthetic GHRH(1-44) analog with N-terminal trans-3-hexenoyl modification. FDA-approved as Egrifta / Egrifta SV / Egrifta WR.[1][3]

What's it FDA-approved for?

Reduction of excess abdominal fat in HIV-infected adults with lipodystrophy. Not approved for non-HIV weight management, anti-aging, or general GH deficiency.[1]

What's the half-life?

~11 minutes (Egrifta WR, SC 1.28 mg) or ~8 minutes (Egrifta SV, SC 1.4 mg). Short plasma half-life, sustained IGF-1 PD effect with daily dosing.[1]

How does it work?

GHRH receptor agonist on pituitary somatotrophs → pulsatile GH release → IGF-1 elevation → visceral fat reduction in HIV lipodystrophy.[4]

What's the approved dose?

Egrifta WR: 1.28 mg SC once daily. Egrifta SV: 2 mg SC once daily.[1]

How do I reconstitute a vial?

For FDA-approved Egrifta products, follow the product package. For compounded material: 10 mg + 1 mL bac water = 10 mg/mL → 1 unit = 0.1 mg; 1 mg = 10 units. Not a substitute for the approved product.

Primary references

  1. U.S. Food and Drug Administration. EGRIFTA WR (tesamorelin for injection) — full prescribing information. Updated label, 2025. accessdata.fda.gov — Egrifta WR label
  2. Theratechnologies Inc. FDA approves F8 formulation of tesamorelin for HIV-associated lipodystrophy (Egrifta WR). theratech.com
  3. U.S. Food and Drug Administration. EGRIFTA (tesamorelin for injection) — original prescribing information, 2010. accessdata.fda.gov — Egrifta 2010 label
  4. Ferdinandi ES, Brazeau P, High K, Procter B, Fennell S, Dubreuil P. Non-clinical pharmacology and safety evaluation of TH9507, a human growth hormone-releasing factor analogue. Basic Clin Pharmacol Toxicol, 2007.
  5. DailyMed (NIH). Label: EGRIFTA WR / EGRIFTA SV — tesamorelin kit. dailymed.nlm.nih.gov

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