Somapacitan vs Tesamorelin (compounded)
A once-a-week growth hormone shot that replaces daily shots. Controlled trials show it works as well as daily doses. It is a shot sold by clinics to burn belly fat. It is approved only for people with HIV who have extra belly fat, and for others it rests on one trial of 60 people.
Somapacitan has the stronger evidence, grade A (strong human evidence) against grade B for Tesamorelin (compounded). Somapacitan: FDA approved. Tesamorelin (compounded): Not approved.
Evidence
AStrong human evidence
BSome human evidence
Human studies cited
Animal or cell studies cited
Why the grade
The adult approval rested on REAL 1, a randomized, double-blind, placebo-controlled and active-controlled trial of 301 adults with growth hormone deficiency, and the pediatric approvals on randomized trials against daily somatropin, the most recent being the REAL8 basket trial across three indications. The question these trials answer is whether weekly somapacitan matches daily growth hormone, and they show it does.
For the approved HIV indication the evidence would be A: two phase 3 placebo-controlled trials (412 and 404 patients, pooled 806) showed visceral fat fell about 15% over 26 weeks. For the use compounded tesamorelin is actually sold for, belly fat in people without HIV, there is one randomized trial of 60 abdominally obese adults with low GH secretion, and a 61-person trial in HIV-related fatty liver. That is B.
FDA
FDA approved
Somapacitan is FDA-approved as Sogroya (Novo Nordisk), a once-weekly injection, for adults with growth hormone deficiency (August 2020), children aged 2.5 and older with growth hormone deficiency (2023), and, since February 27, 2026, children aged 2.5 and older with idiopathic short stature, short stature after being born small for gestational age, or growth failure from Noonan syndrome.
Not approved
Tesamorelin is FDA-approved as Egrifta (Egrifta SV, and since March 2025 Egrifta WR) only for reducing excess abdominal fat in adults with HIV who have lipodystrophy. Compounded tesamorelin sold for fat loss, muscle or anti-ageing in people without HIV is not an FDA-approved product and that use has no approved indication.
Sold for
Somapacitan is the once-a-week growth hormone that replaces daily injections for children and adults who lack the hormone.
Compounded tesamorelin is sold by longevity and body-composition clinics as the approved, cleaner alternative to CJC-1295 for burning visceral fat and raising growth hormone.
Studies say
Randomized trials show weekly somapacitan reduces body fat in adults with growth hormone deficiency as well as daily growth hormone does and produces equivalent growth in children, which supports an A for its approved uses.
It reliably cuts visceral fat by about 15% in HIV lipodystrophy, one 60-person trial suggests a similar selective effect in obese adults without HIV, and the fat returns within months of stopping, so the off-label use rests on a single small trial.
Class
Long-acting GH analog
GHRH analog
Route
Injection
Injection