Tesamorelin
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Route(s): Subcutaneous
Typical vial sizes: 2, 5, 10, 12 mg
Dosing window: Pre-Bed Fasted
Receptor / target: GHRH
Properties: GH Secretagogue
Pre-mixed: No
Protocol examples
Standard Protocol
| Timeframe | Dose | Notes |
|---|---|---|
| Weeks 1-8 | 1mg to 2mg daily | Typically administered right before bed on an empty stomach. |
Protocol example from the source dataset; verify against the evidence status and listed sources.
Alternative: Split Dosing
| Timeframe | Dose | Notes |
|---|---|---|
| Weeks 1-8 | 1mg twice daily | Administered morning (fasted) and pre-bed (fasted). |
Alternative example from the source dataset; not an approved-label regimen unless marked above.
Protocol logic check
Independent evidence
Regulatory status: approved drug label available
Storage
Store 2 mg vials at room temperature 20-25 C and protect from light. After mixing, use immediately; do not store, freeze, or refrigerate after reconstitution.
Contraindications & cautions
Evidence varies by item. Some points come from labels, published literature, or regulatory context; others are mechanism-based cautions from the source dataset. Use the sources below to verify details.
- Active malignancy of any type: GH and IGF-1 elevation accelerates tumor cell proliferation.
- History of malignancy: exercise caution; tesamorelin should not be initiated without careful oncology risk assessment.
- Disruption of the hypothalamic-pituitary axis: pituitary tumors, pituitary surgery, head trauma, cranial radiation, or hypopituitarism from any cause.
- Concurrent use with CJC-1295 No DAC, CJC-1295 DAC, sermorelin, or HGH 191aa: direct GHRH receptor redundancy and additive GH/IGF-1 overstimulation.
- Concomitant glucocorticoid therapy: inhibits GH secretion and IGF-1 production.
- Uncontrolled diabetes mellitus or significant insulin resistance: tesamorelin produces the most pronounced blood glucose effects of the GHRH analogs in this database.
- Diabetic ketoacidosis.
- Known hypersensitivity to tesamorelin, mannitol (excipient), or any formulation components.
- Pregnancy: teratogenicity not established; avoid.
- Breastfeeding: safety not established; avoid.
- Pediatric use with open growth plates: risk of disproportionate bone growth stimulation.
- Severe carpal tunnel syndrome: GH-mediated fluid retention worsens nerve compression.
- Active proliferative or severe non-proliferative diabetic retinopathy: IGF-1 elevation may worsen retinal vasculopathy.
Possible side effects
Evidence varies by item. Some points come from labels, published literature, or regulatory context; others are mechanism-based cautions from the source dataset. Use the sources below to verify details.
- Injection site erythema (redness): most distinctive adverse effect of tesamorelin vs. other GHRH analogs; more frequent and pronounced than with CJC-1295 or sermorelin; reported in approximately 6.4-25% of subjects in FDA trial data.
- Injection site pain and irritation: discomfort at administration site; rotate sites to minimize.
- Water retention and peripheral edema: GH-mediated sodium and fluid retention; more prominent in the first 4 weeks.
- Joint pain and arthralgia: GH-related periarticular fluid accumulation; common.
- Joint stiffness: particularly wrists, hands, and knees.
- Myalgia (muscle pain): GH-mediated; typically transient.
- Tingling or numbness in extremities: paresthesia from GH-related fluid shifts.
- Carpal tunnel syndrome: GH-mediated median nerve compression; more likely at higher doses and in predisposed subjects.
- Mild to moderate blood sugar elevations: transient fasting glucose increases; monitor glycemic status throughout.
- Nausea: reported in phase 3 data.
- Vomiting: less common.
- Headache: vasodilation-related; transient.
- Fatigue: early-cycle adaptation.
- Dizziness.
- Elevated IGF-1: supraphysiologic IGF-1 levels possible at higher doses; monitor with blood work on extended cycles.
- Hypersensitivity reactions: urticaria, rash, pruritus, flushing; more commonly reported than with other GHRH analogs; likely related to the trans-3-hexenoic acid modification.
- Anaphylaxis: rare but documented.
- Injection site antibody formation: anti-tesamorelin antibodies develop in some subjects with prolonged use; may reduce efficacy.
- Pituitary downregulation: risk with cycles beyond 12 weeks without washout.
Compatibility
The relationships below come from the source site's internal engine and were not verified independently. Treat them as a starting point for a conversation with a clinician. They carry no safety guarantee.
Reported synergistic:
Reported contraindicated combinations: