Cagrilintide vs Tesamorelin

Long-acting amylin analogue; acts on amylin/calcitonin receptors to prolong satiety; synergistic with semaglutide in CagriSema combination

Cagrilintide is a long-acting synthetic amylin analogue under clinical development for obesity, designed to mimic the satiety-promoting and gastric-emptying-reducing actions of the endogenous beta-cell hormone amylin. By activating amylin receptors in the hindbrain, cagrilintide reduces caloric intake and body weight, and the drug is also being co-developed with the GLP-1 receptor agonist semaglutide (CagriSema) to target multiple appetite-regulating pathways simultaneously. Phase 2 randomized controlled trials published in The Lancet have demonstrated meaningful weight reduction in people with overweight and obesity, establishing proof of concept for both monotherapy and combination approaches. Cagrilintide is an investigational compound that has not yet received FDA approval; it remains in late-stage clinical development as of 2025.

Tesamorelin stimulates pulsatile GH secretion from the anterior pituitary by binding GHRH receptors. Its stabilisation protects it from rapid enzymatic cleavage by dipeptidyl peptidase IV, extending the effective half-life compared to unmodified GHRH. Downstream effects on visceral adiposity are mediated through elevated IGF-1 and direct lipolytic signalling.

Tesamorelin (GHRH(1-44)-trans-3-hexenoic acid; Egrifta) is a synthetic 44-amino-acid analog of endogenous growth hormone-releasing hormone conjugated with a trans-3-hexenoic acid moiety to confer resistance to DPP-IV enzymatic degradation and extend its plasma stability, developed and approved as the first GHRH analog indicated for a metabolic complication of HIV antiretroviral therapy — specifically visceral adiposity from HIV-associated lipodystrophy. Tesamorelin activates GHRH receptors on pituitary somatotrophs to stimulate pulsatile GH secretion and downstream hepatic IGF-1 production; the resulting normalization of GH pulse amplitude in treated patients reduces visceral adipose tissue through lipolytic signaling in visceral fat depots, without the risk of direct supraphysiological GH administration. A pivotal Phase 3 randomized placebo-controlled trial in HIV-infected adults on antiretroviral therapy demonstrated significant and sustained reductions in visceral adipose tissue area by MRI imaging versus placebo, with a favorable safety profile in this immunocompromised population, providing the pivotal evidence for FDA approval in 2010. Tesamorelin (Egrifta, Theratechnologies) is FDA-approved and requires a prescription; it is indicated specifically for the reduction of excess abdominal fat in HIV-infected patients with lipodystrophy and is not approved for general fat loss, body composition improvement, anti-aging, or GH deficiency applications outside the HIV-lipodystrophy indication. Tesamorelin dosage and where to get it: Tesamorelin (Egrifta) is administered as a once-daily subcutaneous injection of 2mg in its FDA-approved indication for HIV-associated lipodystrophy; this is the only dose and indication with established clinical evidence. In off-label research contexts examining body composition and GH axis support in non-HIV populations, tesamorelin has been studied at similar dose ranges, though no approved protocol exists for these applications. Where to find tesamorelin: as an FDA-approved prescription medication, tesamorelin is available through licensed pharmacies in the United States with a valid prescription. Compounding pharmacies may also prepare tesamorelin for off-label clinical use under physician supervision. Telehealth providers specializing in peptide therapy and hormone health sometimes offer tesamorelin consultations for eligible patients. PeptideBase maintains a directory of verified providers — including telehealth platforms — for those researching access to tesamorelin through supervised clinical channels.