Sermorelin vs tesamorelin: the two GHRH analogs that got FDA approval
Both are synthetic GHRH analogs. One (sermorelin) is the discontinued-but-compoundable historical workhorse; the other (tesamorelin) is the currently-marketed approved drug for HIV lipodystrophy.
Sermorelin and tesamorelin are two synthetic growth-hormone-releasing hormone (GHRH) analogs that reached FDA approval. Sermorelin (Geref, 1997) was approved for pediatric GH deficiency and then commercially withdrawn; it remains legally available via 503A compounding. Tesamorelin (Egrifta, 2010) was approved for reducing excess abdominal fat in HIV-infected patients with lipodystrophy and remains actively marketed. Both stimulate endogenous pulsatile GH release; they differ in approval path, indication, and current availability.
| Field | Sermorelin | Tesamorelin |
|---|---|---|
| Brand names | Geref (discontinued) | Egrifta, Egrifta SV |
| Manufacturer | Various compounding pharmacies | Theratechnologies |
| FDA approved | FDA approved 1997 (withdrawn 2008 commercially) | FDA approved 2010 |
| Indication | Pediatric GH deficiency (historical); adult off-label via compounding | HIV-associated lipodystrophy (excess abdominal fat reduction) |
| Mechanism | GHRH 1-29 fragment | Stabilized GHRH analog with protease-resistant modifications |
| Delivery | Daily subcutaneous injection | Daily subcutaneous injection |
Frequently asked
Which one is currently FDA approved?
Tesamorelin (Egrifta) — for HIV-associated lipodystrophy, still marketed. Sermorelin's original FDA approval was withdrawn commercially in 2008 though compounded sermorelin remains legally available under Section 503A.
Which one is better for adult GH decline or anti-aging?
Neither is FDA approved for that indication. The clinical trial evidence for adult anti-aging or body-composition benefits in healthy adults is weak for both. Tesamorelin's evidence base in HIV lipodystrophy doesn't directly extrapolate; sermorelin's adult-use data is largely observational.
Why is tesamorelin so expensive?
Narrow approved indication (HIV lipodystrophy), specialty manufacturing, and no generic competition. List price runs $3,000-4,000/month. Insurance coverage is typically limited to the on-label indication.
Can I get tesamorelin off-label for general body composition?
Legally, yes — with a prescription. Practically, insurance coverage is essentially nonexistent outside HIV lipodystrophy, so the out-of-pocket cost is prohibitive for most. Compounded sermorelin is the cheaper off-label option in the GHRH-analog category.