Comprehensive medication guide to Tesamorelin including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
Varies widely; classified as Tier 4–5 specialty tier on most plans. Commercial insurance patients may qualify for the THERA Co-Pay Assistance Program to reduce out-of-pocket costs. Medicare Part D covers tesamorelin with a $2,000 annual out-of-pocket maximum starting in 2025. Prior authorization is required by virtually all insurers.
Estimated Cash Pricing
$2,400–$2,800 per month for brand-name Egrifta SV or Egrifta WR at retail specialty pharmacies; compounded tesamorelin from licensed 503B facilities costs $800–$1,200 per month cash-pay. No FDA-approved generic available.
Medfinder Findability Score
40/100
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Tesamorelin is a synthetic growth hormone-releasing factor (GHRF) analog — a lab-made version of a natural hormone your hypothalamus produces to signal the pituitary gland to release growth hormone. It is the only FDA-approved medication in the United States specifically indicated for the reduction of excess abdominal fat (visceral adipose tissue) in HIV-infected adults with lipodystrophy.
Tesamorelin was first approved by the FDA in 2010 under the brand name Egrifta. It has since been reformulated twice: as Egrifta SV (approved 2019) and as Egrifta WR (approved March 25, 2025), the newest version that requires only weekly reconstitution. The manufacturer is Theratechnologies, a Canadian specialty biopharmaceutical company (NASDAQ: THTX).
Tesamorelin is not indicated for general weight loss. It has a weight-neutral effect on total body weight and specifically reduces visceral fat — the internal abdominal fat associated with cardiovascular risk and metabolic syndrome in people living with HIV.
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Tesamorelin is based on the 44-amino acid sequence of human growth hormone-releasing hormone (GHRH), but with a stabilizing chemical modification (a hexenoyl group at the N-terminus) that makes it resistant to rapid enzymatic degradation by DPP4. This modification allows tesamorelin to survive in the bloodstream long enough to reach the pituitary gland after daily subcutaneous injection.
At the pituitary, tesamorelin binds to GHRF receptors on somatotroph cells and stimulates the pulsatile release of endogenous growth hormone. GH in turn travels to the liver and other tissues, stimulating IGF-1 production. In Phase 3 clinical trials, tesamorelin increased IGF-1 by an average of 84%.
Growth hormone is both anabolic and lipolytic — it promotes the breakdown (lipolysis) of visceral fat cells. In two randomized Phase 3 trials, tesamorelin at 2 mg per day for 26 weeks reduced visceral adipose tissue by approximately 15–18% (CT-measured). These effects are not sustained after discontinuation; fat re-accumulates toward baseline when tesamorelin is stopped.
1.4 mg (Egrifta SV) — Subcutaneous injection
Daily dose from 2 mg/vial; 0.35 mL of reconstituted solution injected once daily into abdomen
1.28 mg (Egrifta WR) — Subcutaneous injection
Daily dose from 11.6 mg/vial; 0.16 mL of reconstituted solution injected once daily into abdomen; vial reconstituted weekly
Tesamorelin is a specialty-only biologic dispensed exclusively through specialty pharmacies. It is not available at standard retail pharmacies. Availability has improved in 2025-2026 following the resolution of the Egrifta SV supply disruption (April 2025) and the commercial launch of Egrifta WR (September 2025). However, patients still face significant access challenges due to specialty pharmacy requirements, mandatory prior authorization, insurance tier restrictions, and the ongoing formulation transition.
Most insurers classify tesamorelin as a Tier 4 or Tier 5 specialty medication requiring prior authorization with strict documentation — including confirmed HIV diagnosis with lipodystrophy, waist circumference measurements, and often CT or MRI imaging showing excess visceral adipose tissue. The prior authorization process typically takes 2 to 4 weeks.
If you are having trouble locating tesamorelin, medfinder can call specialty pharmacies near you to find which ones have your prescription in stock and text you the results. Enrolling in the THERA Patient Support program (1-833-23-THERA) is also essential for navigating prior authorization and specialty pharmacy access.
Tesamorelin is not a controlled substance, so there are no DEA schedule restrictions on prescribing. Any licensed prescriber with prescriptive authority in the United States can write a prescription. In practice, tesamorelin is most commonly prescribed by HIV specialists because of the clinical expertise needed to diagnose HIV-associated lipodystrophy and navigate prior authorization requirements.
Infectious Disease (ID) Physicians — most common prescribers; highest familiarity with HIV lipodystrophy and specialty pharmacy access
HIV Specialists — HIV clinic physicians and advanced practice providers
Endocrinologists — particularly those managing metabolic complications of HIV treatment
Primary Care Physicians (PCPs) — can prescribe, though may refer to ID specialist for initial evaluation
Nurse Practitioners (NPs) and Physician Assistants (PAs) — with independent or collaborative prescribing authority in applicable states
Telehealth prescribing is possible for tesamorelin since it is not a controlled substance. However, the initial evaluation typically requires in-person physical examination, baseline lab work (IGF-1, glucose, HbA1c), and documentation of lipodystrophy — which may require imaging. Follow-up visits can often be conducted via telehealth. Some HIV-focused telehealth platforms offer tesamorelin prescribing for on-label HIV lipodystrophy indications.
No. Tesamorelin (Egrifta SV, Egrifta WR) is not a controlled substance and is not scheduled by the Drug Enforcement Administration (DEA). Any licensed prescriber with prescriptive authority can write a prescription for tesamorelin without any special DEA registration or prescribing limitations.
While tesamorelin is not controlled, it is a prescription-only specialty biologic medication. Because it is FDA-approved specifically for HIV-associated lipodystrophy, prescribers typically need to document the clinical indication and comply with insurer prior authorization requirements before the prescription can be filled. There are no refill restrictions based on controlled substance status — standard specialty pharmacy refill processes apply.
The following side effects were reported in clinical trials of tesamorelin:
Injection site reactions (redness, itching, pain, irritation) — 25% of patients
Arthralgia (joint pain) and joint stiffness
Pain in extremities (arms and legs)
Peripheral edema (swelling in hands, feet, or ankles)
Myalgia (muscle pain)
Paresthesia, hypoesthesia, and carpal tunnel syndrome (numbness/tingling in hands and wrists)
Nausea and vomiting
Hypersensitivity reactions: Hives, swelling of face/throat, difficulty breathing, fast heartbeat (4% incidence in trials) — discontinue and seek emergency care immediately
Elevated blood sugar/diabetes: Tesamorelin may cause glucose intolerance; monitor glucose and HbA1c during treatment
Malignancy risk: Tesamorelin increases IGF-1 (a growth factor); contraindicated in patients with active cancer; monitor for cancer recurrence
Pregnancy (Category X): Tesamorelin is absolutely contraindicated during pregnancy; use effective contraception
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Sermorelin
GHRH analog (29 AA); compounded, off-label; gentler GH stimulation; $300–$800/mo; less evidence for HIV lipodystrophy
Somatropin (HGH)
Recombinant human growth hormone; FDA-approved for GH deficiency and HIV wasting; direct GH replacement; higher side effect profile than tesamorelin
Ipamorelin
GHRP (ghrelin mimetic); compounded, off-label; often combined with sermorelin; minimal evidence for HIV lipodystrophy
Antiretroviral regimen change
Switching from older PIs/NRTIs to newer INSTI-based regimens may reduce ongoing fat accumulation; requires careful HIV management consideration
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Cortisone
majorTesamorelin enhances conversion of cortisone to cortisol; patients on cortisone replacement therapy may need dose increases
Prednisone
majorSimilar to cortisone interaction; increased conversion to active metabolite; patients may require increased prednisone doses
Macimorelin
majorTesamorelin must be stopped at least 1 week before macimorelin diagnostic GH test; tesamorelin blunts the GH response to macimorelin
Oral Contraceptives (Estrogens)
moderateTesamorelin reduces estrogen levels via CYP3A4 induction; may reduce contraceptive effectiveness; use alternative contraception
Phenytoin
moderateTesamorelin alters phenytoin metabolism; monitor phenytoin levels and adjust dose as needed
Cyclosporine
moderateTesamorelin may alter cyclosporine metabolism via CYP enzymes; monitor cyclosporine levels
Theophylline
moderateTheophylline decreases tesamorelin levels by altering its metabolism; may reduce tesamorelin effectiveness
Ritonavir
minorTesamorelin co-administration reduces ritonavir AUC by 9% and Cmax by 11%; modest effect unlikely to compromise efficacy at standard doses
Tesamorelin occupies a unique and medically important niche: it is the only FDA-approved treatment in the United States for HIV-associated lipodystrophy and its associated excess visceral abdominal fat. With the resolution of the Egrifta SV supply disruption in April 2025 and the launch of the more convenient Egrifta WR formulation in September 2025, access has improved significantly going into 2026 — though the specialty pharmacy-only dispensing model and mandatory prior authorization continue to create access friction for patients.
The financial burden is real. Brand-name Egrifta costs $2,400–$2,800 per month at retail, with no generic available. However, the THERA Patient Support program provides co-pay assistance for commercially insured patients and free medication for qualifying uninsured patients. HIV-specific programs including Ryan White and state ADAPs may also provide coverage. Patients should exhaust all assistance options before considering discontinuation.
If you have been prescribed tesamorelin and are having trouble finding it at a specialty pharmacy near you, medfinder can help — we call specialty pharmacies on your behalf to locate available stock and text you the results.
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