Tesamorelin (20 mg vial) dosage protocol

1. Draw 3 mL of bacteriostatic water with a sterile syringe.
2. Inject it slowly down the inside wall of the vial, not onto the powder, to avoid foaming.
3. Swirl or roll the vial gently until the powder dissolves. Do not shake it.
4. Label it with the date and the volume of water, and refrigerate at 2-8 °C (36-46 °F), away from light.

• Reconstitute: add 3 mL of bacteriostatic water for a 6.67 mg/mL solution.
• Amounts in the chart: 2 mg each time, by subcutaneous injection, once a day.
• Easy measuring: at 6.67 mg/mL, one unit (0.01 mL) on a U-100 insulin syringe holds about 66.7 mcg.
• Storage: freeze-dried, keep it sealed, cold and away from light (frozen for long storage). Once mixed, refrigerate at 2-8 °C and avoid freezing and thawing.

Tesamorelin is a synthetic version of growth hormone-releasing hormone with a small chemical addition that makes it more stable. Sold as Egrifta, it is FDA-approved for one use: reducing excess abdominal fat in adults with HIV and lipodystrophy.

• Primary calculation: 20 mg made up to 3 mL equals 6.67 mg/mL.
• Amounts shown: 2 mg per administration. The dose escalation used in published human trials, worked out for a research vial.
• Route and frequency: subcutaneous injection, once a day.
• Evidence ceiling: 9 of the 9 studies with a dose in our library were done in people.
• Regulatory status: FDA-approved in 2010 (now sold as Egrifta SV and Egrifta WR) for one indication: reducing excess abdominal fat in adults with HIV and lipodystrophy. Research products are not the approved drug. WADA: Prohibited at all times (growth hormone releasing factors).
• Approved drug: the prescription drug has its own dosing in its FDA label. See the label dosing.

A 20 mg vial holds 20,000 mcg of Tesamorelin. Adding 3 mL gives 6.67 mg/mL, so one U-100 unit (0.01 mL) holds 66.7 mcg. To get the units for an amount, divide it by 66.7 mcg. The units are a volume mark on the syringe, not a measure of potency.

• 2 mg: 0.3 mL, or 30 U-100 units.

Vial coverage by mass: 10 full amounts of 2 mg per vial, before any handling loss.

If a different volume of water is used, every unit figure changes: recalculate with the calculator above.

The main human studies, all randomised and placebo-controlled unless stated:

• Phase 2 dose-finding: in 61 people with HIV and central fat, 2 mg daily for 12 weeks reduced trunk fat by 9.2% vs a 0.8% rise with placebo. Visceral fat fell 15.7%, but this was not statistically different from placebo (Falutz 2005).
• First phase 3 trial: 412 people; 2 mg daily for 26 weeks reduced visceral fat and improved lipid levels compared with placebo (Falutz 2007). In the 26-week extension, the reduction was maintained at about 18% over 52 weeks, but fat returned after stopping (Falutz 2008).
• Second phase 3 trial: 404 people; visceral fat fell 10.9% vs 0.6% with placebo at 6 months, with no change in glucose measures. Again, the gains were rapidly lost in those switched to placebo (Falutz 2010).
• Pooled phase 3 data: across 806 people, the placebo-adjusted reduction in visceral fat was 15.4% at 26 weeks, with no meaningful change in fat under the skin and a mean IGF-1 rise of 108 ng/ml (Falutz 2010).
• Liver fat: in 50 people with HIV, 6 months reduced visceral fat and liver fat; fasting glucose rose at 2 weeks but not by 6 months (Stanley 2014). In an NIH-funded trial in 61 people with HIV and fatty liver disease, 12 months reduced the liver fat fraction by 4.1 percentage points more than placebo (Stanley 2019).
• Type 2 diabetes: in 53 people with type 2 diabetes (without HIV), 12 weeks did not change insulin response or blood sugar control (Clemmons 2017).
• Thinking skills in older adults: in 152 adults aged 55-87, 1 mg nightly for 20 weeks had a favourable effect on a combined cognitive score, mainly executive function. Adverse events were reported by 68% on tesamorelin vs 36% on placebo (Baker 2012).

A 2026 meta-analysis of five randomised trials in people with HIV confirmed lower visceral fat, trunk fat, liver fat and waist size, and higher lean mass, with side effects such as joint pain, muscle pain, tingling and injection-site redness (Badran 2026). In short: in people with HIV, tesamorelin reliably reduces visceral fat while it is used, and the effect fades after stopping. Whether this lowers heart disease or other hard outcomes has not been shown, and the evidence outside HIV is limited to small trials.

Doses used in human studies

• Falutz J 2007: 2 mg once daily (Subcutaneous, once daily; 26 weeks)
• Falutz J 2005: 1 mg or 2 mg once daily, or placebo (Subcutaneous, once daily; 12 weeks)
• Falutz J 2008: 2 mg once daily, or placebo after re-randomisation (Subcutaneous, once daily; 26-week extension (52 weeks in total))
• Falutz J 2010: 2 mg once daily, or placebo (2:1) (Subcutaneous, once daily; 6 months, plus a 6-month blinded extension)
• Falutz J 2010: 2 mg once daily, or placebo (Subcutaneous, once daily; 26 weeks, plus a 26-week extension)
• Stanley TL 2014: 2 mg once daily (n=28), or placebo (n=22) (Subcutaneous, once daily; 6 months)
• Stanley TL 2019: 2 mg once daily, or placebo; then 2 mg daily open-label for all (Subcutaneous, once daily; 12 months, plus a 6-month open-label phase)
• Clemmons DR 2017: 1 mg or 2 mg, or placebo (Subcutaneous; 12 weeks)
• Baker LD 2012: 1 mg/day, 30 minutes before bedtime, or placebo (Subcutaneous, nightly (self-injected); 20 weeks, plus 10-week washout)

Every study dose, including animal and cell studies, is in the Tesamorelin dose table.

Tesamorelin's side effects are better documented than those of most peptides because of its approval. According to the FDA prescribing information, the most common side effects in trials were joint pain, injection-site redness and itching, pain in the arms or legs, swelling of the legs and muscle pain. More people stopped because of side effects on tesamorelin than on placebo (Falutz 2007).

• Blood sugar: the prescribing information reports that more people on tesamorelin developed diabetes-range HbA1c than on placebo (5% vs 1%). Fasting glucose rose briefly in one trial (Stanley 2014).
• Fluid retention: swelling, joint pain and carpal tunnel syndrome are listed warnings.
• IGF-1 and cancer: IGF-1 is a growth factor. The label says the effects of long-term raised IGF-1 are unknown, and it should not be used by people with active cancer.
• Allergic reactions and antibodies: hypersensitivity reactions occurred in trials, and about half of patients developed antibodies to tesamorelin.
• Who should not use it (per the label): pregnant women, people with active cancer, and people whose pituitary or hypothalamus is damaged or removed.
• Effects do not last: visceral fat came back after stopping (Falutz 2008). Long-term cardiovascular safety has not been established.
• Research products: tesamorelin sold online as a research chemical is not the approved, quality-controlled drug.
• Sport: growth hormone releasing factors are on the WADA prohibited list at all times.

• FDA: FDA-approved in 2010 (now sold as Egrifta SV and Egrifta WR) for one indication: reducing excess abdominal fat in adults with HIV and lipodystrophy. Research products are not the approved drug.
• WADA: Prohibited at all times (growth hormone releasing factors).
• Evidence limits: reported use is not evidence that a schedule works or is safe. Animal doses do not convert to people, and research products are not made or checked for use in people.
• Status checked on: Oct 26, 2026.