tesamorelin tesamorelin tesamorelin (inn) (trade name egrifta sv) is a synthetic form of growth-hormone-releasing hormone (ghrh) which is used in the treatment of hiv-associated lipodystrophy, approved initially in 2010. it is produced and developed by theratechnologies, inc. of canada. the drug is a synthetic peptide consisting of all 44 amino acids of human ghrh with the addition of a trans-3-hexenoic acid group. tesamorelinclinical datatrade namesegrifta svahfs/drugs.commultum consumer informationmedlineplusa611035routes ofadministrationsubcutaneous injectionatc codeh01ac06 (who) legal statuslegal status us: ℞-only in general: ℞ (prescription only) pharmacokinetic databioavailability≤4%metabolismproteolysiselimination half-life26–38 minexcretionrenal/proteolysisidentifierscas number218949-48-5 yas salt: 901758-09-6 ypubchem cid16137828chemspider34982925uniimqg94m5eeoas salt: lgw5h38ve3 ykeggd09015 ychebichebi:63626comptox dashboard (epa)dtxsid00583207 chemical and physical dataformulac221h366n72o67smolar mass5135.86 g·mol−13d model (jsmol)interactive image smiles ccc(c(=o)n)nc(=o)(cccnc(=n)n)nc(=o)(c)nc(=o)(cccnc(=n)n)nc(=o)(c)nc(=o)cnc(=o)(cccnc(=n)n)nc(=o)(ccc(=o)o)nc(=o)(ccc(=o)n)nc(=o)(cc(=o)n)nc(=o)(co)nc(=o)(ccc(=o)o)nc(=o)cnc(=o)(ccc(=o)n)nc(=o)(ccc(=o)n)nc(=o)(cccnc(=n)n)nc(=o)(co)nc(=o)(ccsc)nc(=o)((c)cc)nc(=o)(cc(=o)o)nc(=o)(ccc(=o)n)nc(=o)(cc(c)c)nc(=o)(cc(c)c)nc(=o)(ccccn)nc(=o)(cccnc(=n)n)nc(=o)(c)nc(=o)(co)nc(=o)(cc(c)c)nc(=o)(ccc(=o)n)nc(=o)cnc(=o)(cc(c)c)nc(=o)(c(c)c)nc(=o)(ccccn)nc(=o)(cccnc(=n)n)nc(=o)(cc1ccc(cc1)o)nc(=o)(co)nc(=o)(cc(=o)n)nc(=o)((c)o)nc(=o)(cc2ccccc2)nc(=o)((c)cc)nc(=o)(c)nc(=o)(cc(=o)o)nc(=o)(c)nc(=o)(cc3ccc(cc3)o)nc(=o)c/c=c/cc inchi inchi=1s/c220h364n72o67s/c1-24-28-30-54-162(307)259-144(92-119-55-59-121(298)60-56-119)197(342)254-115(20)178(323)275-149(96-168(315)316)198(343)255-116(21)179(324)290-171(110(15)26-3)213(358)283-146(91-118-44-31-29-32-45-118)205(350)292-173(117(22)297)214(359)284-148(95-161(229)306)204(349)288-154(104-296)209(354)279-145(93-120-57-61-122(299)62-58-120)202(347)267-130(52-41-84-247-219(239)240)186(331)266-126(47-34-36-79-222)196(341)289-170(109(13)14)211(356)282-140(87-105(5)6)182(327)251-100-165(310)257-133(64-71-156(224)301)189(334)277-143(90-108(11)12)201(346)287-151(101-293)207(352)256-114(19)177(322)263-129(51-40-83-246-218(237)238)185(330)265-125(46-33-35-78-221)188(333)276-142(89-107(9)10)200(345)278-141(88-106(7)8)199(344)272-137(67-74-159(227)304)194(339)281-150(97-169(317)318)206(351)291-172(111(16)27-4)212(357)274-139(77-86-360-23)195(340)286-152(102-294)208(353)268-131(53-42-85-248-220(241)242)187(332)270-135(65-72-157(225)302)191(336)269-132(63-70-155(223)300)181(326)250-99-164(309)258-134(68-75-166(311)312)190(335)285-153(103-295)210(355)280-147(94-160(228)305)203(348)273-136(66-73-158(226)303)192(337)271-138(69-76-167(313)314)193(338)264-124(48-37-80-243-215(231)232)180(325)249-98-163(308)252-112(17)175(320)261-127(49-38-81-244-216(233)234)183(328)253-113(18)176(321)262-128(50-39-82-245-217(235)236)184(329)260-123(43-25-2)174(230)319/h28-32,44-45,55-62,105-117,123-154,170-173,293-299h,24-27,33-43,46-54,63-104,221-222h2,1-23h3,(h2,223,300)(h2,224,301)(h2,225,302)(h2,226,303)(h2,227,304)(h2,228,305)(h2,229,306)(h2,230,319)(h,249,325)(h,250,326)(h,251,327)(h,252,308)(h,253,328)(h,254,342)(h,255,343)(h,256,352)(h,257,310)(h,258,309)(h,259,307)(h,260,329)(h,261,320)(h,262,321)(h,263,322)(h,264,338)(h,265,330)(h,266,331)(h,267,347)(h,268,353)(h,269,336)(h,270,332)(h,271,337)(h,272,344)(h,273,348)(h,274,357)(h,275,323)(h,276,333)(h,277,334)(h,278,345)(h,279,354)(h,280,355)(h,281,339)(h,282,356)(h,283,358)(h,284,359)(h,285,335)(h,286,340)(h,287,346)(h,288,349)(h,289,341)(h,290,324)(h,291,351)(h,292,350)(h,311,312)(h,313,314)(h,315,316)(h,317,318)(h4,231,232,243)(h4,233,234,244)(h4,235,236,245)(h4,237,238,246)(h4,239,240,247)(h4,241,242,248)/b30-28+/t110-,111-,112-,113-,114-,115-,116-,117+,123-,124-,125-,126-,127+,128-,129-,130-,131-,132-,133-,134-,135-,136-,137-,138-,139-,140-,141-,142-,143-,144-,145-,146-,147-,148-,149-,150-,151-,152-,153-,154-,170-,171-,172-,173-/m0/s1key:vqfdkkwxorfbdi-vavvjcqzsa-n mechanism of action tesamorelin is the n-terminally modified compound based on 44 amino acids sequence of human ghrh. this modified synthetic form is more potent and stable than the natural peptide. it is also more resistant to cleavage by the dipeptidyl aminopeptidase than human ghrh. it stimulates the synthesis and release of endogenous gh, with an increase in level of insulin-like growth factor (igf-1). the released gh then binds with the receptors present on various body organs and regulates the body composition. this regulation is mainly because of the combination of anabolic and lipolytic mechanisms. however, it has been found that the main mechanisms by which tesamorelin reduces body fat mass are lipolysis followed by reduction in triglycerides level. contraindication tesamorelin therapy may cause glucose intolerance and increase the risk of type 2-diabetes, so it is contraindicated in pregnancy. it is also contraindicated in pregnancy (category x) because it may cause harm to fetus. it is also contraindicated in patients affected by hypothalamic-pituitary axis disruption due to pituitary gland tumor, head irradiation and hypopituitarism. adverse effects injection site erythema, peripheral edema, injection site pruritus and diarrhea.