Sermorelin guide 路 Updated November 3, 2026
Sermorelin vs tesamorelin: what is the difference?
How the two compare on FDA status, evidence, safety and use, with sources linked throughout and listed at the end.
.md Read this page as Markdown (for AI assistants)The short answer
Both signal your pituitary to release your own growth hormone, but they serve different people. Tesamorelin (Egrifta SV) is FDA-approved for one use: reducing excess abdominal fat in adults with HIV and lipodystrophy. For adults outside that use who want to explore growth hormone support, sermorelin is the option a provider can consider through Astra. Astra's sermorelin is compounded, and compounded medications are not FDA-approved.
We found no trial comparing the two directly. In a PubMed search on November 3, 2026, all 13 papers mentioning both were reviews or laboratory testing methods. So the evidence cannot tell you that either one is "better". It can tell you what each one has and has not been shown to do.
Which one fits your situation
Tesamorelin fits
Adults with HIV and lipodystrophy who want to reduce excess abdominal fat. That is where its strong trial evidence and FDA approval apply, so talk to your HIV care team.
Sermorelin fits
Adults without that diagnosis who want to support growth hormone through their own pituitary, with a provider reviewing their health first.
Astra offers sermorelin
A licensed US provider reviews your visit, and a state-licensed US pharmacy prepares it. See why people choose Astra.
Explore sermorelin with a licensed provider
Answer a few questions online. A provider decides if it suits you, with a full refund if it is not prescribed.
Start your sermorelin visitSide-by-side comparison
| Sermorelin | Tesamorelin | |
|---|---|---|
| What it is | The first 29 amino acids of growth hormone-releasing hormone, or GHRH (review) | The full 44 amino acid sequence, with an added hexenoyl group (FDA label) |
| How it acts | Signals the pituitary to release growth hormone | Signals the pituitary to release growth hormone |
| FDA status today | Compounded sermorelin is not FDA-approved. The former brand, Geref, was discontinued in 2008 (Federal Register) | Egrifta SV is FDA-approved (label). Compounded versions are not |
| FDA-approved use | Geref: growth hormone deficiency in children with growth failure, and a pituitary diagnostic test (Federal Register) | Reducing excess abdominal fat in adults with HIV and lipodystrophy (label) |
| Main human evidence | Small studies, mostly of the mechanism and of IGF-1 levels | Randomized, placebo-controlled trials in people with HIV |
| For weight loss | Not established | The label says it is not indicated for weight loss and has a weight-neutral effect (label) |
| Given by | Injection under the skin | Injection under the skin |
| At Astra | Offered after a provider's review: $120 monthly, or $546 every 6 months ($91/mo) | Not offered |
What the evidence shows
Tesamorelin
In a 2007 trial in the New England Journal of Medicine, 412 patients with HIV and excess abdominal fat received tesamorelin or placebo for 26 weeks. Visceral fat fell 15.2% with tesamorelin and rose 5.0% with placebo. IGF-1 rose 81.0% and fell 5.0%. A pooled analysis of two phase 3 trials reported a treatment effect on visceral fat of -15.4% at 26 weeks.
These results come from people with HIV. They do not show what tesamorelin does in people without HIV, so they should not be read as evidence for general belly-fat loss.
Sermorelin
The case for sermorelin rests mostly on how it works. It acts on the pituitary, and release stays under the body's normal feedback (Walker, 2006). A small study in hypogonadal men found that growth hormone secretagogue treatment raised IGF-1, which is a lab marker rather than a health outcome. GHRH enhanced non-REM sleep in a controlled study after sleep deprivation, which is not a trial of sermorelin for sleep problems.
A review of growth hormone and ageing found no definite evidence of rejuvenation with growth hormone. Our sermorelin guide covers this in more depth.
Safety differences
The two safety records are not equally documented, so the lists below cannot be compared as rates.
Tesamorelin: the FDA label rules it out in pregnancy, active cancer, a disrupted hypothalamic-pituitary axis and known allergy to its ingredients. It warns about raised IGF-1, fluid retention, hypersensitivity and injection site reactions. It also warns about glucose intolerance: raised HbA1c at week 26 occurred in 5% of patients versus 1% on placebo. Long-term cardiovascular safety has not been established.
Sermorelin: Astra's sermorelin page lists injection site redness or irritation, flushing and mild headaches as the most common effects. It is not recommended if you are pregnant or breastfeeding, have active cancer or have certain pituitary conditions. Your provider reviews your history before prescribing.
Which one fits which situation
| Your situation | What the evidence supports |
|---|---|
| Excess abdominal fat with HIV and lipodystrophy | Tesamorelin is the FDA-approved option. Ask your HIV care team about Egrifta SV |
| You want to support growth hormone signalling, without HIV-related fat | Neither has strong outcome evidence here. A provider can check whether sermorelin is appropriate, including IGF-1 testing |
| Your main goal is weight loss | Neither is established for this. See treatments studied for weight loss |
| You have active cancer or are pregnant | Tesamorelin's label rules it out, and sermorelin is not recommended. Speak with your doctor |
Common questions
Can I take sermorelin and tesamorelin at the same time?
We found no trial testing them together. Both signal the pituitary to release growth hormone, so taking both could add to effects such as raised IGF-1 without any evidence of added benefit. Do not combine them unless a prescriber who knows you are taking both advises it. Our peptide stacking guide explains why combinations are largely untested.
Which is better for fat loss, sermorelin or tesamorelin?
Tesamorelin has trial evidence for reducing visceral abdominal fat, but only in people with HIV. No trial compares the two. Tesamorelin's label also says it is not for weight loss and is weight neutral, so reducing visceral fat is not the same as losing weight.
Will I lose belly fat on sermorelin?
We did not find a trial of sermorelin itself showing this. One uncontrolled study of a different GHRH molecule reported less visceral fat in 10 postmenopausal women. Any claim of a specific result on sermorelin goes beyond what has been studied.
What peptide is better than sermorelin?
There is no evidence-based ranking, since these peptides have rarely been compared directly and have been studied in different groups for different goals. A better question is whether a treatment has been studied for your goal and is suitable for you, which a licensed provider can assess.
Is sermorelin or tesamorelin FDA-approved?
Egrifta SV (tesamorelin) is FDA-approved for its HIV-related use. The former sermorelin brand, Geref, was discontinued, and in 2013 FDA determined it was not withdrawn for reasons of safety or effectiveness. Compounded sermorelin and compounded tesamorelin are not FDA-approved.
Does Astra offer tesamorelin?
No. Astra offers sermorelin after a licensed provider's review. A provider decides whether it is appropriate for you.
Safety at a glance
Reported side effects include flushing, injection site pain or irritation and mild headache. Sermorelin is not recommended in pregnancy or breastfeeding, active cancer or certain pituitary conditions, and long-term safety in adults has not been established. It is prohibited in tested sports. Read is sermorelin safe? for sources and details.
Keep reading
- All sermorelin guides
- Does sermorelin work?: What it does, what studies measured, and who it may suit.
- Sermorelin vs CJC-1295: Same receptor, very different duration, and no head-to-head trial.
- Sermorelin and weight loss: Why it isn't an established weight loss treatment, and how it differs from GLP-1s.
- Sermorelin vs HGH: Signal versus replacement, approved uses, legal limits and safety.
More guides: FDA status and legality 路 Sermorelin online 路 Providers compared 路 Is sermorelin safe? 路 Results timeline 路 Sermorelin for women 路 Sermorelin and sleep 路 Sermorelin with GLP-1s 路 Stopping sermorelin
Sources
- Egrifta SV prescribing information, DailyMed (label effective July 29, 2026)
- Determination that Geref was not withdrawn for safety or effectiveness, Federal Register, March 4, 2013
- Falutz et al., Metabolic effects of a growth hormone-releasing factor in patients with HIV, N Engl J Med, 2007
- Falutz et al., pooled analysis of tesamorelin phase 3 trials, J Clin Endocrinol Metab, 2010
- Walker, Sermorelin: a better approach to management of adult-onset growth hormone insufficiency?, Clin Interv Aging, 2006
- Sigalos et al., Growth hormone secretagogue treatment in hypogonadal men raises serum IGF-1, 2017
- Sch眉ssler et al., GHRH and CRH enhance non-REM sleep after sleep deprivation, 2006
- Fanciulli et al., Growth hormone, menopause and ageing, 2009
Published by Astra, which offers sermorelin. This guide is educational and is not medical advice. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness or quality.
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