Sermorelin vs Tesamorelin
Sermorelin and tesamorelin are both synthetic GHRH analogs that stimulate the pituitary to release growth hormone — but they differ in regulatory standing, evidence depth, and cost profile. Tesamorelin (Egrifta) retains an active FDA approval for a specific indication; sermorelin's original FDA approval for pediatric GH deficiency was withdrawn from the commercial market but it remains widely available as a compounded drug. Both are WADA-prohibited in competitive sport.
Side-by-side comparison
| Property | Sermorelin | Tesamorelin |
|---|---|---|
| Mechanism class | GHRH analog — first 29 amino acids of endogenous GHRH; pituitary GHRH-R agonist | Synthetic GHRH analog (palmitoyl-modified); pituitary GHRH-R agonist |
| FDA status | Original approval withdrawn commercially; widely compounded | FDA-approved (Egrifta) for HIV-associated lipodystrophy |
| Evidence tier | Tier 3 (small human studies; historically FDA-approved category) | Tier 2 (Phase 3 RCTs, active FDA label) |
| Typical dosing | 100–300 mcg/day SC (compounded) | 2 mg/day SC |
| Half-life | ~10–20 minutes | ~26–38 minutes |
| Common side effects |
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|
| Common stacks | Ipamorelin, GHRP-2 | Resistance training (for lean mass preservation) |
| Approx. cost | ~$100–300/month (compounded) | ~$3,000–8,000/month brand (Egrifta); substantially lower compounded |
Key differences
- 1
Tesamorelin has an active FDA approval (Egrifta) for HIV-associated lipodystrophy with Phase 3 RCT support; sermorelin's original approval for pediatric GH deficiency was commercially withdrawn, leaving it in compounded-only status with a thinner human evidence base for adult use.
- 2
Tesamorelin has a stronger RCT-backed evidence base specifically for visceral fat reduction; sermorelin's evidence for body composition effects in adults is limited to smaller, older studies.
- 3
Sermorelin's half-life (~10–20 min) is shorter than tesamorelin's (~26–38 min); both require daily SC injection.
- 4
Brand tesamorelin (Egrifta) is substantially more expensive than compounded sermorelin; compounded tesamorelin is available off-label at a fraction of brand cost and is increasingly used in anti-aging contexts.
- 5
Both are prohibited by WADA as GHRH analogs and are not appropriate for competitive athletes subject to drug testing.
Which might be better for…
HIV-associated lipodystrophy
Tesamorelin is the evidence-based, FDA-approved choice for this specific indication. Phase 3 trial data demonstrate significant reduction in visceral adipose tissue in HIV-positive patients on ART. Sermorelin has no specific evidence for this condition and is not an appropriate substitute in this context.
General adult GH support and anti-aging protocols
Both are used off-label in compounded form for GH-axis support in otherwise healthy adults. Sermorelin's longer history of compounded use, lower cost, and established prescribing infrastructure make it the more common starting point. Tesamorelin is increasingly used when visceral fat reduction is the primary research goal, given its Phase 3 data.
Athletes and WADA-tested individuals
Both sermorelin and tesamorelin are prohibited by WADA in and out of competition as GHRH analogs. Neither is appropriate for competitive athletes subject to anti-doping testing, regardless of the medical rationale.