People searching "tesamorelin or sermorelin" usually want to know which works better for fat loss or aging. No trial has compared them. What can be compared is the record each one carries: what FDA approved, what the trials measured and how a patient can get it. On every one of those, the two differ sharply. This page puts them side by side.
Both are GHRH analogs, but they aren't the same drug
Both peptides copy growth-hormone-releasing hormone, the brain's signal to the pituitary to release growth hormone. Neither contains growth hormone. The Egrifta label describes tesamorelin as a growth-hormone-releasing factor analog that "binds and stimulates human GRF receptors with similar potency as the endogenous GRF" [1].
Sermorelin is GRF(1-29)-NH2, the first 29 amino acids of natural GHRH, which carry its activity [10]. Tesamorelin is a modified, stabilized GHRH analog made by Theratechnologies [9]. Same target, different molecules, different makers and different approvals. Results from one are not results for the other.
Side by side: tesamorelin vs sermorelin
| Tesamorelin | Sermorelin | |
|---|---|---|
| Molecule | Stabilized GHRH analog [9] | GRF(1-29)-NH2, the active part of natural GHRH [10] |
| FDA status | Approved November 10, 2010 as Egrifta [2] | Approval withdrawn 2009, not for safety [4] |
| Labeled use | Excess belly fat in adults with HIV lipodystrophy [1] | Formerly: growth hormone deficiency in children (Geref) [4] |
| Can it be compounded? | No; a biologic since March 23, 2020 [3] | Reaches patients through compounding pharmacies |
| Largest trial | 412 adults with HIV, 26 weeks [6] | 110 children with GH deficiency, open-label [10] |
| Adult body-composition evidence | Visceral fat down 15.2% vs up 5.0% [6] | No change in 11 older men over 6 weeks [11] |
| Label warnings | Tumor risk, IGF-1, fluid retention, glucose, allergy [1] | No current FDA label |
| How patients get it | Brand Egrifta, on a prescription | Compounded product, on a prescription |
| Sport | Banned, WADA S2.2.4 [13] | Banned, WADA S2.2.4 [13] |
What tesamorelin was tested for: belly fat in people with HIV
Tesamorelin's evidence comes from large randomized trials in one population. In the main 26-week trial of 412 adults with HIV and excess abdominal fat, visceral fat fell 15.2% on tesamorelin and rose 5.0% on placebo; triglycerides fell 50 mg/dL against a 9 mg/dL rise [6]. A pooled analysis of the two phase 3 trials put the treatment effect at −15.4% for visceral fat, with no significant change in fat under the skin [7].
Two single trials explored uses outside the label. In 61 people with HIV and fatty liver, liver fat fell 37% relative to baseline more than on placebo over 12 months [8]. In older adults with and without mild cognitive impairment, 20 weeks of tesamorelin had a favorable effect on a cognitive composite score (P=.03) [9]. Both are off-label findings, not approved uses.
The label draws a firm line around the approval: Egrifta SV "is not indicated for weight loss management as it has a weight neutral effect" [1]. For more, see Does tesamorelin work?
What sermorelin was tested for: growth in children, little in adults
Sermorelin's best evidence is in children, for the use it was once approved for. In an open-label study of 110 children with growth hormone deficiency, average growth rose from 1.6 to 3.1 inches (4.1 to 8.0 cm) a year at 6 months; 74% were judged good responders [10].
Adult data are small. In 11 healthy men aged 64 to 76, 6 weeks of GHRH(1-29) raised overnight growth hormone but did not change IGF-1, weight or DEXA measures of muscle and fat; two of six strength measures improved [11]. In 19 older men and women, a closely related analog ([Nle27]GHRH(1-29)-NH2) raised 12-hour growth hormone by 107% in men and 70% in women and IGF-1 by 28% [12]. For more, see Does sermorelin work?
| Study | Drug | People | Result |
|---|---|---|---|
| Falutz 2007 [6] | Tesamorelin | 412 adults with HIV | Visceral fat −15.2% vs +5.0%; triglycerides −50 vs +9 mg/dL |
| Falutz 2010 [7] | Tesamorelin | Pooled phase 3 | Visceral fat effect −15.4%; fat under the skin unchanged |
| Stanley 2019 [8] | Tesamorelin (off-label) | 61 with HIV and fatty liver | Liver fat −37% relative, vs placebo |
| Baker 2012 [9] | Tesamorelin (off-label) | Older adults, with or without MCI | Favorable cognitive effect (P=.03) |
| Thorner 1996 [10] | Sermorelin | 110 children with GH deficiency | Growth 1.6 → 3.1 in/yr (4.1 → 8.0 cm/yr) at 6 months (open-label) |
| Vittone 1997 [11] | Sermorelin | 11 older men | No change in IGF-1 or body composition |
| Khorram 1997 [12] | Sermorelin analog | 19 older adults | GH +107% men, +70% women; IGF-1 +28% |
Safety on the record
Tesamorelin has a current FDA label with a full safety section; sermorelin does not. On the Egrifta SV label, injection-site reactions occurred in 25% of patients against 14% on placebo over 26 weeks, and HbA1c reached 6.5% or higher in 5% against 1% [1]. The label warns about tumor growth, raised IGF-1, fluid retention (swelling, joint pain, carpal tunnel), glucose intolerance and allergic reactions. It is contraindicated in pregnancy, active cancer and pituitary disruption [1].
Sermorelin's old studies reported few problems; the pediatric trial found no adverse changes in blood chemistry or hormones [10]. With no current label, though, there is no up-to-date official safety section for the compounded product. See Is tesamorelin safe? and Is sermorelin safe?
FDA status and how each is obtained
Tesamorelin. FDA approved Egrifta on November 10, 2010 [2]. On March 23, 2020, its approval was deemed a biologics license, and biologics "will not be eligible for the exemptions" that let pharmacies compound under sections 503A and 503B [3]. So the only lawful tesamorelin is the brand product. See Is tesamorelin FDA-approved?
Sermorelin. FDA approved Geref in 1990 as a diagnostic and in 1997 for children with growth hormone deficiency. The maker stopped selling it in 2008, and FDA withdrew both approvals in 2009 [5]. In 2013 FDA determined Geref was "not withdrawn from sale for reasons of safety or effectiveness" [4]. Sermorelin is not an approved drug today. It reaches patients through compounding pharmacies, and FDA has not approved any compounded version. See Is sermorelin FDA-approved?
| Date | Tesamorelin | Sermorelin |
|---|---|---|
| December 28, 1990 | Geref Diagnostic approved [4] | |
| September 26, 1997 | Geref approved for GH deficiency in children [4] | |
| May 19, 2009 | Approvals withdrawn at the maker's request [5] | |
| November 10, 2010 | Egrifta approved [2] | |
| March 4, 2013 | FDA: not withdrawn for safety or effectiveness [4] | |
| March 23, 2020 | Deemed a biologic; no compounding [3] |
Which fits which situation
The honest frame is labeled use, not goals. Tesamorelin fits one situation: an adult with HIV and excess abdominal fat, prescribed brand Egrifta. Outside that, it is off-label, and compounded "tesamorelin" has no lawful route.
Sermorelin is what most telehealth offers for general growth-hormone support, as a compounded product with a thin adult evidence base. What it costs, and which providers offer it, is on the sermorelin page. Tesamorelin's full record is on the tesamorelin page. For related pairs, see tesamorelin vs ipamorelin and CJC-1295 vs sermorelin, and for how this site reads a provider's pharmacy and claims, how we check.