Prescription medicine reference
Tesamorelin
trans-3-hexenoyl-GHRH(1-44) amide · a stabilised growth hormone-releasing hormone analogue
A 44-amino-acid synthetic analogue of human GHRH, modified at the N-terminus to resist enzymatic degradation.
Residues
44
Formula
C221H366N72O67S
Molecular weight
~5135.9 g/mol
Class
GHRH analogue
Clinical evidence
Unlike research peptides, Tesamorelin has phase 3 randomised trial data — but only for one indication.
Visceral adipose tissue reduction
The approved indication — significant VAT reduction versus placebo in phase 3 trials in people with HIV-associated lipodystrophy.
IGF-1 elevation
Consistent, dose-related increase.
Triglyceride reduction
Improvement observed in trial populations.
Regain on discontinuation
Visceral fat returns after treatment stops, indicating continuous administration is required for maintained effect.
Glucose tolerance
A recognised concern; GH elevation can worsen insulin sensitivity, and glucose parameters require monitoring.
NAFLD / liver fat
Investigated for hepatic fat reduction in HIV populations with promising results, but not an approved indication.
Cognition and other uses
Explored in small investigational studies; not approved and not established.
Sequence
44 residues, N-terminus to C-terminus, wrapped 11 per row on desktop with continuous numbering. Both termini are modified.
Blocks DPP-4 cleavage — the entire point of the molecule.
Hover or focus a residue to inspect. Use class filters to isolate hydrophobic, basic or acidic residues along the chain.
Sequence: YADAIFTNSYRKVLGQLSARKLLQDIMSRQQGESNQERGARARL. 44 residues, N-terminally acylated with a trans-3-hexenoyl group and C-terminally amidated.
Amino acid composition
How the 44 positions distribute across 16 unique residues.
By class
16 of 20 proteinogenic amino acids are present. Absent: Cys, His, Pro, Trp.
Arginine
Alanine
Glutamine
Leucine
Serine
Glycine
Asparagine
Aspartic acid
Glutamic acid
Isoleucine
Lysine
Tyrosine
Methionine
Phenylalanine
Threonine
Valine
Structural properties
Five readouts characterising the chain and its modifications.
Readout · 01
N-terminal hexenoyl modification
The defining feature. A trans-3-hexenoyl group blocks DPP-4 cleavage and substantially extends half-life relative to native GHRH.
Readout · 02
Net charge ≈ +4
Eight basic residues (6× Arg, 2× Lys) against four acidic. Both termini are blocked: acylated at the N-terminus, amidated at the C-terminus.
Readout · 03
No cysteine
No disulphide bridges; structure is stabilised by helical propensity rather than cross-links.
Readout · 04
No proline
Nothing interrupting the backbone, consistent with the amphipathic α-helix the central region is thought to adopt on receptor binding.
Readout · 05
Single methionine at position 27
An oxidation-sensitive residue and a known formulation stability consideration.
Mechanism of action
Well-characterised — this is a labelled prescription drug.
Regulatory status
Approved medicine.
Approved by the FDA in 2010 under the brand name Egrifta, with later reformulations (Egrifta SV, Egrifta WR). A genuine, licensed prescription drug.
Narrow indication.
Approved specifically for the reduction of excess abdominal fat in adults with HIV-associated lipodystrophy. Not approved for general fat loss, bodybuilding, anti-ageing or athletic use.
Prescription only.
Requires prescription and medical supervision, including monitoring of IGF-1 and glucose. Material sold outside pharmacy channels is not the licensed product.
Prohibited in sport.
As a growth hormone secretagogue it is prohibited by WADA at all times under category S2 (peptide hormones, growth factors and related substances).
Contraindicated in pregnancy, in active malignancy, and in disruption of the hypothalamic-pituitary axis — this is a drug with a real risk profile, not a wellness compound.