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Tesamorelin vs sermorelin

A Tesamorelin GHRH (growth-hormone-releasing factor) analog FDA-approved — Egrifta (2010) A Sermorelin GHRH receptor agonist at the anterior pituitary Approved product discontinued (Geref)

Residue Editorial Team · updated

In brief

Both are synthetic analogs of growth-hormone-releasing hormone (GHRH) that prompt the pituitary to release growth hormone1PubMedSermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency. Prakash A & Goa KL BioDrugs. 1999.,2FDAEGRIFTA SV prescribing information: Indications and Usage. FDA-approved labeling via openFDA/DailyMed, version effective 2026-07-29.. Tesamorelin is FDA-approved as Egrifta to reduce excess abdominal fat in adults with HIV and lipodystrophy2. Sermorelin was approved as Geref, now listed as discontinued, and its clinical data come mainly from children with growth hormone deficiency3FDADrugs@FDA: GEREF (NDA019863). EMD SERONO; original approval 1990-12-28; Discontinued.,4PubMedA comparative study of growth hormone (GH) and GH-releasing hormone(1-29)-NH2 for stimulation of growth in children with GH deficiency. Chen RG et al. Acta Paediatr Suppl. 1993..

How do Tesamorelin and Sermorelin compare at a glance?

Table 1. Tesamorelin and Sermorelin on the dimensions that matter most; every entry is cited.
DimensionTesamorelinSermorelin
StructureSynthetic GHRH analog2GHRH(1-29)-NH2, 29 amino acids1
FDA statusApproved: Egrifta5FDADrugs@FDA: EGRIFTA (BLA022505). THERATECHNOLOGIES; original approval 2010-11-10; Prescription.Geref approved, now discontinued3
Approved useExcess abdominal fat in HIV lipodystrophy; not for weight loss2Pediatric GH deficiency (historic)4
Key resultVisceral fat −15.4% vs placebo at 26 wk (pooled phase 3)6PubMedEffects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. Falutz J et al. J Clin Endocrinol Metab. 2010.Height velocity 9.2–9.3 vs 14.6 cm/yr on GH4
PharmacologyIGF-1 +108 ng/mL vs −7 on placebo (pooled phase 3)6Rapidly eliminated; GH raised ~3 h after IV dose7PubMedPharmacokinetics of growth hormone-releasing hormone(1-29)-NH2 and stimulation of growth hormone secretion in healthy subjects after intravenous or intranasal administration. Wilton P et al. Acta Paediatr Suppl. 1993.
Adverse eventsArthralgia, myalgia, paresthesia, injection-site reactions8PubMedBody composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials. Badran AS et al. Obes Res Clin Pract. 2026.Anti-GHRH antibodies in most treated children4
Evidence gradeAA (historic approval)

Written by Residue Editorial Team

Reviewed by Residue Editorial Team · source-by-source check,

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Registry data · How we grade · Markdown + sources

Figure 1. Size of the research record, from PubMed and ClinicalTrials.gov at the data edition. Bars are scaled to the larger value in each row; volume is not quality.
PubMed records 105 366
Trial publications 24 63
Registered studies 24 27
Phase 3 studies 2 4

Tesamorelin Sermorelin

How do their records differ?

Sermorelin is GHRH(1-29)-NH2 — the shortest synthetic peptide with the full biological activity of GHRH — and stimulates growth hormone secretion from the anterior pituitary1. Tesamorelin is also a GHRH analog2; PubChem's record gives it 44 residues, the first 29 matching sermorelin's9PubChemPubChem compound record: Tesamorelin. C221H366N72O67S · MW 5136 g/mol.,10PubChemPubChem compound record: Sermorelin. C149H246N44O42S · MW 3357.9 g/mol.. Working through the pituitary, it raised mean IGF-1 by 108 ng/mL versus a fall of 7 ng/mL on placebo in pooled phase 3 data6. The difference is in what each was tested for and what FDA approved.

What is the evidence for tesamorelin?

Tesamorelin's approval rests on two phase 3 trials in people with HIV and abdominal fat accumulation. Pooled, visceral adipose tissue fell by 24 cm² versus a 2 cm² rise on placebo at 26 weeks (a treatment effect of −15.4%), without significant change in subcutaneous fat6. The reduction was maintained at about −18% over 52 weeks, but visceral fat reaccumulated after stopping11PubMedLong-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. Falutz J et al. AIDS. 2008.. In a randomized trial of 61 people with HIV and fatty liver disease, hepatic fat fraction fell by an absolute 4.1% versus placebo12PubMedEffects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Stanley TL et al. Lancet HIV. 2019.. A 2026 meta-analysis of five RCTs reported arthralgia, myalgia, paresthesia and injection-site reactions8.

What is the evidence for sermorelin?

Sermorelin's human data are older and pediatric. A 1999 review describes a single 1 µg/kg intravenous dose as a rapid, relatively specific diagnostic test for GH deficiency, and limited data suggesting daily subcutaneous use promoted growth in some prepubertal children1. In a 1987 study of 18 GH-deficient children, height velocity rose in 1213PubMedTreatment of growth-hormone deficiency with growth-hormone-releasing hormone. Ross RJ et al. Lancet. 1987.. In a randomized study of 60 children, mean height velocity at 6 months was 9.2 and 9.3 cm/year on two GHRH doses versus 14.6 cm/year on growth hormone itself4. After an intravenous dose sermorelin is rapidly eliminated, though GH stays elevated for about 3 hours, and intranasal bioavailability was only 3–5%7. Most treated children developed anti-GHRH antibodies, without apparent effect on growth4,13.

Neither compound has published randomized evidence for anti-aging or general adult use in the sources we fetched.

Are they FDA-approved?

Egrifta (tesamorelin) is an active FDA application5, and its label notes long-term cardiovascular safety has not been established2. Both Geref (sermorelin) applications appear in Drugs@FDA as discontinued3,14FDADrugs@FDA: GEREF (NDA020443). EMD SERONO INC; original approval 1997-09-26; Discontinued..

Two identical glass beakers, one holding pale amber liquid and one clear, standing either side of a brass balance

Why do they get these evidence grades?

A Tesamorelin
FDA-approved (Egrifta) for excess abdominal fat in HIV-associated lipodystrophy, based on two phase 3 trials. Other uses are graded separately. Grade A: Approved / regulatory-grade.
A Sermorelin
Was FDA-approved (Geref, now discontinued) on pediatric data. Evidence for adult or anti-aging uses is limited and graded separately below. Grade A: Approved / regulatory-grade.

Questions readers ask

Are tesamorelin and sermorelin the same?

No. Both act like GHRH, but sermorelin is the 29-amino-acid fragment GHRH(1-29)-NH21, while tesamorelin is a separately developed GHRH analog with its own approval and label2.

Is either approved for weight loss?

No. The Egrifta SV label states tesamorelin is not indicated for weight-loss management2. Sermorelin's approval was for children with growth hormone deficiency, and Geref is discontinued3.

What happens when tesamorelin is stopped?

Visceral fat reaccumulated after discontinuation in the phase 3 extension11.

Can you take tesamorelin and sermorelin together?

No published trial among the sources we cite tested them together. Tesamorelin (Egrifta) is labeled for a specific HIV-lipodystrophy indication2; sermorelin's former Geref approval was discontinued3.

Is tesamorelin better than sermorelin for fat loss?

Tesamorelin reduced visceral fat by about 15% versus placebo in pooled phase 3 HIV-lipodystrophy trials6. Sermorelin's published record is diagnostic and short-term GH stimulation, not a fat-loss outcomes program1.

References

Every source below was retrieved from its official API or page and cached on the data-edition date. Numbers match the margin notes.

  1. 1 PubMed Prakash A, Goa KL. Sermorelin: a review of its use in the diagnosis and treatment of children with idiopathic growth hormone deficiency. BioDrugs 1999. PMID 18031173; doi:10.2165/00063030-199912020-00007.
  2. 2 FDA EGRIFTA SV prescribing information: Indications and Usage. FDA-approved labeling via openFDA/DailyMed, version effective 2026-07-29.
  3. 3 FDA Drugs@FDA: GEREF (NDA019863). EMD SERONO; original approval 1990-12-28; Discontinued.
  4. 4 PubMed Chen RG, Shen YN, Yei J, et al. A comparative study of growth hormone (GH) and GH-releasing hormone(1-29)-NH2 for stimulation of growth in children with GH deficiency. Acta Paediatr Suppl 1993. PMID 8329830; doi:10.1111/j.1651-2227.1993.tb12834.x.
  5. 5 FDA Drugs@FDA: EGRIFTA (BLA022505). THERATECHNOLOGIES; original approval 2010-11-10; Prescription.
  6. 6 PubMed Falutz J, Mamputu JC, Potvin D, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. J Clin Endocrinol Metab 2010. PMID 20554713; doi:10.1210/jc.2010-0490.
  7. 7 PubMed Wilton P, Chardet Y, Danielson K, et al. Pharmacokinetics of growth hormone-releasing hormone(1-29)-NH2 and stimulation of growth hormone secretion in healthy subjects after intravenous or intranasal administration. Acta Paediatr Suppl 1993. PMID 8329825; doi:10.1111/j.1651-2227.1993.tb12827.x.
  8. 8 PubMed Badran AS, Helal A, Shata KS, et al. Body composition, hepatic fat, metabolic, and safety outcomes of Tesamorelin, a GHRH analogue, in HIV-associated lipodystrophy: A meta-analysis of randomized controlled trials. Obes Res Clin Pract 2026. PMID 41545261; doi:10.1016/j.orcp.2026.01.002.
  9. 9 PubChem PubChem compound record: Tesamorelin. C221H366N72O67S · MW 5136 g/mol.
  10. 10 PubChem PubChem compound record: Sermorelin. C149H246N44O42S · MW 3357.9 g/mol.
  11. 11 PubMed Falutz J, Allas S, Mamputu JC, et al. Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation. AIDS 2008. PMID 18690162; doi:10.1097/QAD.0b013e32830a5058.
  12. 12 PubMed Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial. Lancet HIV 2019. PMID 31611038; doi:10.1016/S2352-3018(19)30338-8.
  13. 13 PubMed Ross RJ, Rodda C, Tsagarakis S, et al. Treatment of growth-hormone deficiency with growth-hormone-releasing hormone. Lancet 1987. PMID 2879138; doi:10.1016/s0140-6736(87)90699-4.
  14. 14 FDA Drugs@FDA: GEREF (NDA020443). EMD SERONO INC; original approval 1997-09-26; Discontinued.