- What is tesamorelin?
- Tesamorelin is a 44-amino acid GHRH analog with a longer half-life than sermorelin. It binds GHRH receptors at the pituitary and stimulates endogenous growth hormone release. The molecule is FDA-approved as Egrifta for the reduction of excess abdominal fat in adults with HIV-associated lipodystrophy. It is also used off-label in age-management practices for body composition and visceral fat reduction.
- Is tesamorelin FDA-approved?
- Tesamorelin was FDA-approved as the branded product Egrifta for HIV-associated lipodystrophy. The tesamorelin Rx Peps Direct prescribes is not that branded product: the pharmacy compounds it under Section 503A of the Federal Food, Drug, and Cosmetic Act as a patient-specific prescription, which is legal but is a different regulatory pathway than FDA approval of the specific compounded preparation. Off-label use for visceral adiposity in non-HIV patients is permissible under physician judgment. Rx Peps Direct providers prescribe tesamorelin within their state's scope of practice.
- How is tesamorelin dosed at Rx Peps Direct?
- You choose between three doses when you order, all taken once at bedtime Monday to Friday with two days off each week. 2 mg is 25 units (0.25 mL) of the 8 mg/mL vial (Tesamorelin High-Dose, 24 mg in 3 mL), two vials a fill. That is the dose the Phase III visceral fat results came from. About 1 mg is 13 units (0.13 mL) of the same vial, one vial a fill. 0.75 mg is 25 units (0.25 mL) of the 3 mg/mL vial (15 mg in 5 mL), one vial a fill. Neither lower dose has been tested for visceral fat. Neither the approved label nor the trials titrate, so you can start on any of them, and your prescriber reviews the dose you choose. Your prescriber can lower the dose: for a two-week tolerance start, for side effects, or for older or smaller patients and those with diabetes. Your prescriber can also set about 1 mg on the 3 mg/mL vial (15 mg in 5 mL), which is 33 units and is not something you choose at checkout. The label states the units for the vial you have. Tesamorelin comes in those two strengths and they are not interchangeable, so check the concentration on the label before every draw: 25 units of the 8 mg/mL vial is 2 mg, and 25 units of the 3 mg/mL vial is 0.75 mg. Plan on at least 26 weeks, then your prescriber reviews whether to continue.
- Why Monday to Friday instead of every day?
- The pharmacy sends at most two vials per fill, and two vials hold 24 doses at 2 mg. On a five-day week that lasts almost five weeks; on a seven-day week it would run out in 24 days. Five days a week gives you about 71 percent of the trial's weekly amount, so results may be smaller in proportion. We state that plainly rather than hide it.
- How much does tesamorelin cost?
- The High-Dose vial is $200 at the pharmacy's price, with nothing added. At 2 mg a vial holds 12 doses and a fill is 2 vials ($400), which lasts about 4.8 weeks, or about $83 a week. A 26-week course is 11 vials, $2,200. At about 1 mg a fill is 1 vial ($200): 23 doses at 13 units, about 4.6 weeks, about $43 a week, and 6 vials ($1,200) over 26 weeks. If your prescriber sets about 1 mg on the 15 mg vial (3 mg/mL, $100), a fill is 1 vial of 15 doses: 3 weeks, about $33 a week, and 9 vials ($900) over 26 weeks. Each order also carries the $39 prescriber review.
- How do I know if tesamorelin is working?
- Measure your waist at your belly button before your first dose, at week 12, and at week 26. Sleep often improves in the first two weeks, and the earliest waist change in people who respond shows between weeks 8 and 12. About 3 in 10 people in the trials did not respond. If your waist has not changed by week 26, your prescriber will talk with you about stopping. If you stop, visceral fat tends to come back.
- Who should not take tesamorelin?
- Do not use tesamorelin with active cancer, a pituitary tumor, or during pregnancy. It is prohibited at all times in tested sport under WADA rules. Tell your prescriber about diabetes or prediabetes, carpal tunnel symptoms, or joint problems. If you have diabetes or prediabetes, send a recent HbA1c or fasting glucose from your own doctor before your first fill. We do not order lab work, and everyone else starts without a test. Joint pain, swelling in the hands or feet, tingling or numbness in the hands, rising home glucose readings, or injection-site redness usually mean the dose should come down, not that the drug should stop. Message your provider in the portal. Your prescriber can lower the dose, and the label states the units for the vial you have.
- Where do I inject tesamorelin?
- Under the skin of the abdomen, rotating sites with each injection, using a U-100 insulin syringe (a 0.3 mL barrel reads a draw of up to 30 units most accurately; a 33-unit draw is more than a 0.3 mL barrel holds and needs a larger one). Inject at bedtime. The trials allowed any time of day, so doing it every scheduled night matters more than the exact hour.
- How is tesamorelin supplied and stored?
- Compounded by a licensed U.S. 503A compounding pharmacy under a patient-specific prescription. Ships pre-reconstituted and ready to inject in cold-chain packaging. Every batch is tested by Eagle Analytical Services for sterility and bacterial endotoxin; the Certificate of Analysis is published on this product page. Keep vials in the refrigerator (36 to 46 °F), away from light, never frozen.
