Tesamorelin Dosage 2026

Tesamorelin has carried three label doses since its 2010 approval, and the FDA treats all three as the same dose. The phase 3 trials gave 2mg a day. The current Egrifta SV vial gives 1.4mg, and the newest version, Egrifta WR, gives 1.28mg. The two newer formulations absorb better, so a smaller number of milligrams reaches the same level in the blood.

That matters the moment a researcher holds a plain 10mg or 20mg vial of tesamorelin powder and a U-100 syringe. The milligrams have to become units, the units depend on how much water went in, and a vial that holds five doses at one setting holds twenty at another. Every figure below starts from the trials and ends on the syringe line.

2mg, 1.4mg or 1.28mg: which number goes in the syringe

The 2mg figure is the one with outcome data behind it. Both phase 3 trials, the 2005 dose-ranging study and the liver-fat trials all ran 2mg once a day (Falutz, New England Journal of Medicine, 2007). The 1.4mg and 1.28mg doses were approved later on a single finding: in healthy volunteers they produced the same blood exposure as 2mg of the original formulation, according to the Egrifta SV and Egrifta WR labels. Neither was tested for visceral fat on its own.

Those lower numbers belong to their own vials and mixing systems, and the WR label says outright that its formulation and SV are not substitutable. A research vial of tesamorelin is neither, so the unit tables below carry the 2mg trial dose and the 1mg dose from the dose-ranging and cognition trials, with the two label doses alongside for comparison.

The 2005 trial is the only head-to-head comparison of doses. Over 12 weeks, 1mg raised IGF-1 by 48% and 2mg by 65%. Trunk fat fell 4.6% on 1mg and 9.2% on 2mg, and only the 2mg result separated from placebo. Visceral fat fell 3.6% on 1mg, less than the 5.4% drop on placebo, and 15.7% on 2mg (Falutz, AIDS, 2005). The phase 3 trials that followed used 2mg.

How many units of tesamorelin from a 10mg vial

On a U-100 syringe, 100 units is 1mL, so the units for any dose are the dose divided by the vial’s strength, times 100. With 2mL of water in a 10mg vial, the strength is 5mg per mL and 2mg is 40 units. With 2.5mL it is 4mg per mL, and 1mg lands on 25 units.

The 1.28mg and 1.4mg columns are rounded to the nearest whole unit. On the WR label itself, 1.28mg is 0.16mL of an 8mg-per-mL solution, which is 16 units on the same syringe. That vial is mixed far stronger than any research setting above, which is why its dose looks so small on the barrel.

Reading the syringe backwards: units to milligrams

Many researchers already have a unit number from somewhere and need the milligrams behind it. The answer changes with the water: 20 units is 2mg in a vial mixed with 1mL and 0.67mg in one mixed with 3mL.

How many units of tesamorelin from a 20mg vial

The 20mg vial holds twice the powder, so the same water makes it twice as strong. With 2mL it runs at 10mg per mL, and 2mg is 20 units, the same reading as a 10mg vial mixed with 1mL. With 3mL it runs at 6.67mg per mL and 2mg is 30 units.

The bigger vial changes the arithmetic more than the dose. At 2mg a day it covers ten days instead of five, and it costs $158 against $95, about $7.90 per mg against $9.50. Units for any other water volume come straight out of the reconstitution calculator.

How much bacteriostatic water for 10mg of tesamorelin

Any volume from 1mL to 3mL gives the same milligrams; the water only decides how far the plunger travels. Two settings make the common doses land on round lines. For 2mg a day, 2mL puts the dose at 40 units. For 1mg a day, 2.5mL puts it at 25 units.

Less water means a smaller injection but a coarser scale. With 1mL in a 10mg vial each unit carries 100mcg, so one unit of misreading is 5% of a 2mg dose. With 2mL each unit carries 50mcg, and with 3mL about 33mcg. In a 20mg vial, 2mL gives the same 100mcg per unit as 1mL in a 10mg vial.

The WR label specifies bacteriostatic water for injection, the same type of diluent as Simms Research’s Research Water: sterile water with 0.9% benzyl alcohol, the preservative that lets one vial serve many doses. The SV label uses plain sterile water because its vial is mixed and used in a single sitting.

Mixing it the way the label does

Tesamorelin is a 44-amino-acid peptide, long enough to foam if the water is jetted onto the powder. The SV instructions angle the needle so the water runs down the inside wall of the vial, then roll the vial between the palms for 30 seconds without shaking. The WR label uses a gentle swirl, also without shaking. Both labels set the same finish line: a clear, colorless solution with no particles.

How long does a 10mg vial of tesamorelin last

Divide the vial by the dose. At 2mg a day a 10mg vial is five doses and a 20mg vial is ten. The five-days-a-week column counts from a Monday start with weekends off.

Once mixed, the vial is kept at 2–8°C and used within 28 days, the storage terms on the tesamorelin product page. Every combination above finishes inside that window. The tightest is the 20mg vial at 1mg five days a week, whose last dose falls on day 26. Sealed powder storage is covered in the refrigeration guide.

The labels run much shorter clocks because they are different products. SV is mixed and injected immediately, and WR is kept at room temperature and thrown out 7 days after mixing. Those limits belong to those formulations, not to a refrigerated research vial.

Down to the last unit: what the measured content changes

A vial labeled 10mg rarely holds exactly 10mg. The current batch, 2026-TN650, measured 11.11mg across three vials. Mixed with 2mL, that vial holds 200 units at 5.56mg per mL, so every unit carries a little more than the label math says.

Drawing 40 units, the label-math dose for 2mg, delivers 2.22mg five times. Drawing 36 units delivers 2.0mg and leaves a sixth partial dose of about 1.1mg in the bottom of the vial. The earlier batch, TN544, measured 10.19mg, close enough to the label that 39 units is 2.0mg.

How much tesamorelin for 8, 12 or 26 weeks

The phase 3 trials ran 26 weeks before their first readout. Shorter plans of 8 or 12 weeks are common in research protocols, and the 20-week cognition trial ran on 1mg. Vial counts round up, and prices are the current shelf prices of the Tesamorelin 10mg and 20mg vials.

At 2mg a day the 20mg vial costs 12% to 17% less across these plans and halves the number of vials to mix. Water adds up too: 19 vials mixed with 2mL each use 38mL, four 10mL bottles.

Every day or five days a week, morning or night

Every controlled tesamorelin trial dosed seven days a week. Five days on and two off is a clinic and research convention with no trial behind it. At 2mg a dose it delivers 10mg a week, 71% of the 14mg the trials gave.

Neither label sets a time of day. The phase 3 trials gave the dose once daily without fixing the hour. The one trial that did fix it, the 2012 cognition study, injected 1mg 30 minutes before bedtime (Baker, Archives of Neurology, 2012). That choice follows the body’s own pattern, in which the largest growth hormone pulse comes early in sleep.

Tesamorelin itself is gone fast: the labels put its half-life at 8 to 11 minutes. What lasts is the response. In 13 healthy men, two weeks of 2mg a day raised mean overnight growth hormone, the size of each pulse and the baseline between pulses, and lifted IGF-1 by 181µg/L (Stanley, Journal of Clinical Endocrinology and Metabolism, 2010).

Food timing follows the same rule as every GHRH-type peptide, since a glucose load blunts the growth hormone response. The research behind that, and a meal-timing table, are in the CJC-1295 and ipamorelin dosage guide. The same guide covers pairing a GHRH peptide with ipamorelin.

How fast tesamorelin reduces belly fat at 2mg

Tesamorelin’s measured effect is on the fat inside the abdomen, around the organs, and on IGF-1, the hormone the liver makes in response to growth hormone. IGF-1 moves within two weeks. Visceral fat takes months, and the clearest readout is at 26 weeks.

Does tesamorelin reduce subcutaneous fat?

Not in the trial data. In the 2005 study, fat under the skin of the abdomen was preserved and did not change in any group, while trunk and visceral fat fell on 2mg. The drop is concentrated in the deep abdominal fat, which is why the trials scanned it by CT rather than tracking body weight.

Why am I gaining weight on tesamorelin?

Body weight barely moves on tesamorelin, and the labels call it weight-neutral. Across the phase 3 trials weight changed by −0.4kg and +0.5kg in 26 weeks, while lean mass rose about 1.2–1.3kg and trunk fat fell 0.8–1.0kg. Lean tissue replacing fat keeps the scale flat even as the waist shrinks: waist circumference fell 3cm and 2cm.

Does fat come back after stopping tesamorelin?

Yes, the visceral fat returns. At week 26 the trials split the tesamorelin group in two. Those who kept dosing held their result, changing 0% and −5% over the next 26 weeks. Those switched to placebo saw visceral fat climb 22% and 16%, most of the way back. IGF-1 fell back the same way, down 137 and 135ng/mL after the switch.

The batch data behind every unit

Every Simms Research tesamorelin batch goes to an independent lab for identity, purity and net peptide content. The net content is the figure that feeds the unit math above.

Batch 2026-TN650 is the one used for the last-unit table: its three vials ranged from 10.84mg to 11.36mg, an average 11% over the label. The full certificates for both batches are on the tesamorelin lab results page.

Frequently asked questions

Is 2mg of tesamorelin too much?

No. 2mg is the dose every phase 3 and liver-fat trial used for 26 to 52 weeks, and the newer labels lower the milligrams only because their formulations absorb better. The marker those trials tracked was IGF-1, which rose by about 107ng/mL at 26 weeks.

Is 0.5mg of tesamorelin enough?

No trial has tested it. The lowest studied dose, 1mg, raised IGF-1 by 48% over 12 weeks but did not move visceral fat beyond placebo.

How long should a tesamorelin cycle be?

The trials ran 26 weeks, then a second 26. The visceral fat result held through 52 weeks of continuous dosing and faded after stopping. About half of participants developed antibodies to tesamorelin by week 26, and their visceral fat and IGF-1 responses matched those without antibodies. The WR label’s one rule on length is to reconsider continuing when visceral fat has not dropped.

How much tesamorelin should women take?

The same as men: the labels give one dose for both sexes. Women were 14% and 16% of the phase 3 participants and 89 of the 152 adults in the 1mg cognition trial.

Does tesamorelin make you retain water?

Most people don’t. Over 26 weeks on 2mg, peripheral swelling was reported by 6%, against 2% on placebo, and joint pain by 13% against 11%. The label ties it to the rise in growth hormone and notes that it was either transient or resolved after stopping.

Does tesamorelin keep you up at night?

The one trial that measured it found no change. In the 2012 cognition study, 20 weeks of 1mg at bedtime left sleep quality scores level with placebo.

Is tesamorelin approved?

Egrifta SV and Egrifta WR are prescription drugs, FDA-approved for one use: reducing excess abdominal fat in adults with HIV-associated lipodystrophy. Simms Research sells tesamorelin vials for laboratory research use only.