What does the evidence show about Tesamorelin's effects?

Read Off Label rates the evidence for Tesamorelin as Strong and the benefit magnitude as med, producing an overall grade of B- (5.8/10). Only FDA-approved GHRH analog for metabolic indication.

What safety findings are reported for Tesamorelin?

Tesamorelin has a med-high risk profile in the database. Med-High (insulin resistance/diabetes worsening — FDA black-box; injection reactions; joint pain; expensive) Legal status: Rx (Egrifta/Egrifta SV) for HIV lipodystrophy; off-label for visceral fat reduction.

What does the low Safety score for Tesamorelin represent?

The Safety score is 3.5/10. It records the substantial harms described for one or more use contexts; the Benefit score, indication, dose, route, duration, population, and legal status remain separate parts of the evidence profile.

Rankings / Muscle & Strength

Tesamorelin

Muscle & Strength · Stabilized GHRH analog

Tier B-

High-risk evidence profile

Reviewed by Read Off Label · Last reviewed Jun 8, 2026 · How we grade

gh-axisprescription

High-risk evidence profile

5.8 / 10

Tier B-

Ev 8 Bn 5 Sf 3.5

Bottom line

Read Off Label grades Tesamorelin as B- (5.8/10) based on strong evidence, med benefit magnitude, and a med-high-risk safety profile.

Its high-risk evidence profile reflects a Safety score of 3.5/10; reported benefits and harms can differ by indication, dose, route, duration, and population.

Only FDA-approved GHRH analog for metabolic indication.

Studied, labeled, or reported-use context: 1. — Rx (Egrifta/Egrifta SV) for HIV lipodystrophy; off-label for visceral fat reduction; not individualized guidance.

High-risk evidence profile

This entry documents both reported effects and serious harms. Its composite is arithmetic, so the Benefit and Safety axes should be read separately rather than treated as a verdict.

Side-effect or harm risk is meaningful even when used as studied.
Anabolic-class compound — endocrine, cardiovascular, and hepatic risks reported even at studied doses.
Used off-label for longevity or enhancement — outside the FDA-approved indication, with evidence and monitoring requirements that vary by context.
Growth-hormone-axis modulator — reported concerns include IGF-1 elevation, insulin resistance, monitoring needs, and variable supply-chain purity.

Dose and route fields describe clinical studies, labeled practice, or reported use; they are not individualized instructions. See methodology · disclaimer.

What the evidence says

Only FDA-approved GHRH analog for metabolic indication. Stanley 2014 NEJM showed liver fat reduction in HIV patients with NAFLD. Notable worsening of insulin sensitivity limits cohort applicability. Expensive at list price; becoming more common in off-label metabolic/longevity prescribing.

Mechanism

Synthetic trans-3-hexenoic acid-modified GHRH(1-44); FDA-approved (Egrifta) 2010 for HIV-associated lipodystrophy; reduces visceral adipose tissue

Studied, labeled, or reported dose & route

1.4 mg (Egrifta SV) or 2 mg (Egrifta) subQ daily

This records doses and routes described in studies, approved labeling, clinical practice, or documented use. It is not individualized guidance and does not establish safety; context changes with indication, formulation, health history, monitoring, and other medicines.

Citations

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Common questions

What does the evidence show about Tesamorelin's effects?: Read Off Label rates the evidence for Tesamorelin as Strong and the benefit magnitude as med, producing an overall grade of B- (5.8/10). Only FDA-approved GHRH analog for metabolic indication.
What safety findings are reported for Tesamorelin?: Tesamorelin has a med-high risk profile in the database. Med-High (insulin resistance/diabetes worsening — FDA black-box; injection reactions; joint pain; expensive) Legal status: Rx (Egrifta/Egrifta SV) for HIV lipodystrophy; off-label for visceral fat reduction.
What does the low Safety score for Tesamorelin represent?: The Safety score is 3.5/10. It records the substantial harms described for one or more use contexts; the Benefit score, indication, dose, route, duration, population, and legal status remain separate parts of the evidence profile.
What doses or routes are reported for Tesamorelin?: 1.4 mg (Egrifta SV) or 2 mg (Egrifta) subQ daily This is context from studies, approved labeling, clinical practice, or documented use; it is not individualized guidance and does not establish safety.
How does Tesamorelin work?: Synthetic trans-3-hexenoic acid-modified GHRH(1-44); FDA-approved (Egrifta) 2010 for HIV-associated lipodystrophy; reduces visceral adipose tissue

This is an independent synthesis of published research by a non-clinician. Scores are opinions supported by citations, not prescriptions. See the full disclaimer and methodology for how this score was produced and what it does and doesn't mean.

Scorecard

Evidence: Strong (HIV lipodystrophy visceral fat reduction); Moderate (NAFLD liver fat — positive Ph2) (8 / 10)
Benefit: Med (5 / 10)
Safety: Med-High (insulin resistance/diabetes worsening — FDA black-box; injection reactions; joint pain; expensive) (3.5 / 10)
Legality: Rx (Egrifta/Egrifta SV) for HIV lipodystrophy; off-label for visceral fat reduction Cost and legal access vary by country, insurer, and supplier — recorded here for context, not factored into the grade.
Last reviewed: Jun 8, 2026

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