Tesamorelin: A Prescription Treatment for HIV-Associated Lipodystrophy

Tesamorelin is a prescription peptide medication and a synthetic analogue of growth hormone–releasing factor (GHRF). It works by stimulating the pituitary gland to release growth hormone, which can increase levels of insulin-like growth factor 1 (IGF-1). Tesamorelin is marketed in the United States under the brand names EGRIFTA SV and EGRIFTA WR for a specific FDA-approved medical use. [79][81]

Its FDA-approved indication is the reduction of excess abdominal fat in adults living with HIV who have lipodystrophy. HIV-associated lipodystrophy can involve an accumulation of visceral fat, which is fat located deep within the abdomen around internal organs. Tesamorelin is not approved as a general weight-loss medication or as a treatment for obesity. [79][86]

How Tesamorelin Works

Tesamorelin acts on the pituitary gland and supports the body’s release of its own growth hormone. This pathway may influence visceral adipose tissue, also called VAT. Unlike subcutaneous fat, which sits directly beneath the skin, visceral fat surrounds organs within the abdominal cavity and is associated with metabolic health risks.

In clinical studies involving adults with HIV-associated lipodystrophy, tesamorelin reduced visceral abdominal fat compared with placebo. One study reported a statistically significant reduction in visceral adipose tissue and a modest reduction in liver fat among people with HIV. Individual response varies, and treatment should be evaluated by a clinician experienced in HIV care and endocrine monitoring. [76][78]

Approved Use and Treatment Approach

Tesamorelin should only be used for its prescribed purpose and under the supervision of a qualified healthcare professional. The current EGRIFTA WR prescribing information lists a recommended dose of 1.28 mg injected subcutaneously once daily. The appropriate product, preparation, injection technique, monitoring plan, and duration of treatment must be determined by the prescribing clinician. [81]

Do not use tesamorelin for cosmetic fat loss, anti-aging, athletic performance, or general body-composition goals. It is not a substitute for a balanced eating plan, physical activity, HIV treatment, or routine medical care.

Potential Side Effects

Reported side effects may include joint pain, muscle pain, pain in the arms or legs, swelling in the hands or feet, tingling or numbness, injection-site reactions, nausea, and rash. Tesamorelin can raise IGF-1 levels and may affect blood glucose, so periodic clinical and laboratory monitoring may be needed. [79][87]

Contact a healthcare professional promptly for persistent or severe symptoms, swelling, signs of an allergic reaction, or symptoms of high blood sugar. People using diabetes medications may require additional blood-glucose monitoring and individualized treatment adjustments.

Important Safety Information

Tesamorelin is contraindicated in people with disruption of the hypothalamic-pituitary axis, active malignancy, known hypersensitivity to tesamorelin or its ingredients, and pregnancy. People with a history of cancer, diabetes, pituitary disease, or other endocrine conditions should have a thorough medical evaluation before treatment. [79]