GH Secretagogues
Tesamorelin
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Label-verified Label-verified Label-verified GH Axis Metabolic
Educational reference only. Read the full disclaimer.
The protocols below are not automatically an FDA-approved or clinically verified regimen unless
explicitly marked as label-verified or clinical-trial above.
Overview
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
Unverified protocol notes
Standard Protocol
| Timeframe | Dose | Notes |
|---|---|---|
| Weeks 1-8 | 1mg to 2mg daily | Typically administered right before bed on an empty stomach. |
Unverified protocol note; not label dosing unless graded otherwise on this page.
Alternative: Split Dosing
| Timeframe | Dose | Notes |
|---|---|---|
| Weeks 1-8 | 1mg twice daily | Administered morning (fasted) and pre-bed (fasted). |
Unverified alternative protocol; not an approved-label regimen unless graded otherwise on this page.
Protocol logic check
Protocol context: GH-axis protocols are not 'more is better.' The logic is pulse quality, recovery time, IGF-1/glucose monitoring, and avoiding receptor desensitization, edema, appetite spikes, numbness, or blood-pressure strain. Entry context: target (GHRH); route Subcutaneous; timing Pre-Bed Fasted. Label/trial anchors carry more weight than forum-style escalation. Compatibility is conditional: a reasonable solo compound can become inappropriate once a contraindicated partner is added. GH-axis stacking should be filtered for total IGF-1/glucose burden, not just expected synergy.
Independent evidence
Approved label dosing: Egrifta SV dose is 1.4 mg SC once daily into the abdomen after reconstituting a 2 mg vial with 0.5 mL sterile water and administering 0.35 mL immediately.
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 (limited evidence)
- Active malignancy of any type: GH and IGF-1 elevation accelerates tumor cell proliferation. Limited / unverified
- History of malignancy: exercise caution; tesamorelin should not be initiated without careful oncology risk assessment. Limited / unverified
- Disruption of the hypothalamic-pituitary axis: pituitary tumors, pituitary surgery, head trauma, cranial radiation, or hypopituitarism from any cause. Limited / unverified
- Concurrent use with CJC-1295 No DAC, CJC-1295 DAC, sermorelin, or HGH 191aa: direct GHRH receptor redundancy and additive GH/IGF-1 overstimulation. Limited / unverified
- Concomitant glucocorticoid therapy: inhibits GH secretion and IGF-1 production. Limited / unverified
- Uncontrolled diabetes mellitus or significant insulin resistance: tesamorelin produces the most pronounced blood glucose effects of the GHRH analogs in this database. Limited / unverified
- Diabetic ketoacidosis. Limited / unverified
- Known hypersensitivity to tesamorelin, mannitol (excipient), or any formulation components. Limited / unverified
- Pregnancy: teratogenicity not established; avoid. Limited / unverified
- Breastfeeding: safety not established; avoid. Limited / unverified
- Pediatric use with open growth plates: risk of disproportionate bone growth stimulation. Limited / unverified
- Severe carpal tunnel syndrome: GH-mediated fluid retention worsens nerve compression. Limited / unverified
- Active proliferative or severe non-proliferative diabetic retinopathy: IGF-1 elevation may worsen retinal vasculopathy. Limited / unverified
Side effects (limited evidence)
- 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. Limited / unverified
- Injection site pain and irritation: discomfort at administration site; rotate sites to minimize. Limited / unverified
- Water retention and peripheral edema: GH-mediated sodium and fluid retention; more prominent in the first 4 weeks. Limited / unverified
- Joint pain and arthralgia: GH-related periarticular fluid accumulation; common. Limited / unverified
- Joint stiffness: particularly wrists, hands, and knees. Limited / unverified
- Myalgia (muscle pain): GH-mediated; typically transient. Limited / unverified
- Tingling or numbness in extremities: paresthesia from GH-related fluid shifts. Limited / unverified
- Carpal tunnel syndrome: GH-mediated median nerve compression; more likely at higher doses and in predisposed subjects. Limited / unverified
- Mild to moderate blood sugar elevations: transient fasting glucose increases; monitor glycemic status throughout. Limited / unverified
- Nausea: reported in phase 3 data. Limited / unverified
- Vomiting: less common. Limited / unverified
- Headache: vasodilation-related; transient. Limited / unverified
- Fatigue: early-cycle adaptation. Limited / unverified
- Dizziness. Limited / unverified
- Elevated IGF-1: supraphysiologic IGF-1 levels possible at higher doses; monitor with blood work on extended cycles. Limited / unverified
- Hypersensitivity reactions: urticaria, rash, pruritus, flushing; more commonly reported than with other GHRH analogs; likely related to the trans-3-hexenoic acid modification. Limited / unverified
- Anaphylaxis: rare but documented. Limited / unverified
- Injection site antibody formation: anti-tesamorelin antibodies develop in some subjects with prolonged use; may reduce efficacy. Limited / unverified
- Pituitary downregulation: risk with cycles beyond 12 weeks without washout. Limited / unverified
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: