Tesamorelin (Egrifta) is a synthetic peptide injection approved by the U.S. Food and Drug Administration (FDA) to reduce excess abdominal fat, known as lipodystrophy, in individuals infected with HIV. Lipodystrophy involves the abnormal redistribution of body fat, often resulting in the accumulation of deep belly fat, or visceral adipose tissue. Tesamorelin is not a general weight-loss drug and is not approved for the treatment of obesity. This analysis reviews the drug’s function, effectiveness, and practical considerations.
Understanding How Tesamorelin Works
Tesamorelin functions as an analog of the naturally occurring Growth Hormone-Releasing Factor (GRF), a peptide hormone produced in the hypothalamus. It binds to and stimulates specific receptors on the pituitary gland’s somatotroph cells. This stimulation causes the pituitary gland to increase the synthesis and pulsatile release of the body’s own growth hormone (GH).
The released growth hormone travels through the body, triggering various metabolic effects, most notably lipolysis, which is the breakdown of fat. This mechanism is distinct from injecting synthetic human growth hormone directly. Tesamorelin works upstream to increase GH production, which elevates levels of Insulin-like Growth Factor-1 (IGF-1) and influences fat metabolism to target visceral adipose tissue.
Patient Reported Outcomes
The primary objective of Tesamorelin treatment is the measurable reduction of visceral adipose tissue (VAT), the deep fat surrounding internal organs. Clinical trials have consistently demonstrated this effect, with patients receiving Tesamorelin showing a statistically significant reduction in VAT compared to placebo groups. Across studies, the relative reduction in VAT at six months ranged from approximately 12% to 20%.
Patient reports often focus on the subjective improvement in body image and overall well-being resulting from the reduction in waist circumference. This measurable decrease in VAT translates to a noticeable change in abdominal profile, addressing a major source of distress for those with HIV-associated lipodystrophy. The treatment can also lead to modest reductions in liver fat, which improves the patient’s overall metabolic health.
Safety Profile and Adverse Reactions
Tesamorelin treatment is generally well-tolerated but is associated with specific adverse reactions. Injection site reactions are the most common adverse events, including redness, itching, pain, swelling, or irritation where the shot is administered. These localized reactions are typically mild and often resolve with time or proper injection site rotation.
Systemic side effects relate to the increased growth hormone and IGF-1 levels induced by the drug. Patients may experience fluid retention symptoms, such as peripheral edema (swelling in the hands or feet), joint pain (arthralgia), or muscle pain (myalgia). These musculoskeletal complaints are usually transient and may lessen with continued use or resolve upon discontinuation of the medication.
A more serious consideration is the potential for effects on glucose metabolism, as the drug can cause transient elevations in blood glucose and a slight reduction in insulin sensitivity. Healthcare providers must monitor a patient’s glucose status before and during therapy. Tesamorelin is contraindicated for use in patients with active malignancy or a history of certain pituitary gland disorders due to its growth-promoting properties. Rare hypersensitivity reactions, such as rash or urticaria, are also possible.
Practical Usage and Storage
Tesamorelin is administered as a subcutaneous injection, typically once daily. The standard dose is 2 mg, though newer formulations may vary. The injection site should be in the abdominal area, and patients must rotate the exact location daily to prevent localized skin irritation.
The medication is supplied as a lyophilized powder and requires reconstitution (mixing) with a sterile diluent. The unmixed powder is usually stored at room temperature, protected from light. Once reconstituted, some formulations must be used immediately, while others may be stored at room temperature for up to seven days. Refrigeration or freezing of the reconstituted solution is generally not recommended.