Tesamorelin Dosage: The Only GH Peptide With a Real Labeled Dose

Tesamorelin is the one growth-hormone peptide on clinic menus that actually has an FDA-labeled dosage, and here it is plainly: Egrifta SV is 1.4 mg injected subcutaneously once daily; Egrifta WR is 1.28 mg once daily; and the pivotal trials that earned the approval used 2 mg once daily of the original formulation. Three different numbers, one drug — because the dose is formulation-specific, and the label itself says the formulations are not substitutable¹². The approval is for exactly one condition: reducing excess abdominal fat in HIV-infected adults with lipodystrophy. The label states that tesamorelin is not indicated for weight-loss management, that it has a weight-neutral effect, and that its long-term cardiovascular safety has not been established¹. Every fat-loss, recovery, or anti-aging use sold to healthy adults is off-label, and in tested sport tesamorelin is prohibited at all times.

That paragraph is the answer most people searching "tesamorelin dosage" are looking for. The rest of this page unpacks the two questions hiding inside it: what the label actually establishes — which dose, for whom, with what monitoring — and what the number means on a syringe, because a gray-market vial arrives as a powder, and 2 mg only becomes a mark on a barrel after you decide how much water goes in. Our tesamorelin dosage calculator does that second conversion from your own vial's numbers; this article explains everything around it.

What Is the FDA-Approved Tesamorelin Dosage?

Tesamorelin is a stabilized analog of growth-hormone-releasing hormone (GHRH). It is sold as the brand-name drug Egrifta, and unlike sermorelin, ipamorelin, or CJC-1295, it went through the full approval process — so its dose is not clinic folklore, it is printed in FDA labeling.

The current labeling covers two formulations, and the difference matters¹²:

• •Egrifta SV — 2 mg of tesamorelin per single-dose vial. You reconstitute one vial with 0.5 milliliters of sterile water, inject 0.35 milliliters (1.4 mg) once daily, and discard the rest. Mixing happens immediately before every injection².
• •Egrifta WR — an 11.6 mg multi-dose vial reconstituted once with 1.3 milliliters of bacteriostatic water to 8 mg/mL. The dose is 1.28 mg (0.16 milliliters) once daily, one vial covers seven consecutive days, and the mixed vial stores at room temperature¹. The WR labeling was revised in March 2025, making it the newest form.

The trials behind the approval used neither number. They ran 2 mg once daily of the original formulation³⁴ — a 1 mg-per-vial product that the current labels reference as a separate prescribing document². The label is explicit that the formulations differ in dosage, vials per dose, reconstitution, and storage, and that WR and SV are not substitutable¹.

That is worth pausing on, because gray-market sellers and clinic protocols almost always quote "2 mg" — the trial figure — while the currently marketed products deliver 1.4 mg or 1.28 mg of their own formulations. None of those numbers transfers to a research-grade vial of unknown salt content and purity. A labeled dose describes a specific product, not the molecule in the abstract.

Injection technique is also on the label: subcutaneous, into the abdomen, rotating sites, never into scar tissue, bruises, or the navel¹. The general technique question is covered in how to inject peptides.

What the 2 mg Dose Was Actually Established For

The evidence base is genuinely strong — and genuinely narrow. In the first pivotal trial, 412 HIV-infected patients with treatment-associated abdominal fat accumulation received 2 mg tesamorelin or placebo daily for 26 weeks: visceral adipose tissue fell 15.2% on tesamorelin while rising 5.0% on placebo, triglycerides dropped 50 mg/dL, and IGF-1 rose 81%³. The second pivotal trial, in just over four hundred similar patients, found a 10.9% visceral-fat reduction versus 0.6% for placebo at six months, reaching roughly 18% in patients who continued to twelve months⁴.

Three details inside that record change how the dose should be read.

The effect requires continuous dosing. Patients re-randomized from tesamorelin to placebo rapidly lost the visceral-fat improvement⁴, and the long-term extension study frames tesamorelin as a maintenance therapy, not a course you complete⁵. There is no labeled "cycle" — the off-label 8-to-12-week protocols clinics sell have no counterpart in the approval.

The benefit tracked visceral fat, not weight. Responders — patients with at least an 8% visceral-fat reduction — showed improved triglycerides and preserved glucose homeostasis; non-responders did not⁶, and metabolic markers moved with the visceral-fat change⁷. Body weight itself barely moved, which is exactly why the label calls the drug weight-neutral and not indicated for weight loss¹.

The population was never healthy adults. Every trial enrolled people with HIV-associated lipodystrophy, a pathological fat pattern. A later randomized trial extended 2 mg daily to fatty liver disease — again in HIV — cutting liver fat by 37% relative to baseline⁸. Nothing in this record tests recovery, muscle, or physique outcomes in healthy people; the closest relevant data, a systematic review of growth hormone itself in fit young adults, found about 2.1 kg of lean-mass gain with no apparent improvement in strength or exercise capacity and more edema and fatigue⁹. We take that question apart fully in tesamorelin for athletes.

Visceral Fat Is Not the Fat You Pinch

The distinction the marketing blurs is the one the trials measured. Visceral adipose tissue is the deep fat packed around abdominal organs, quantified by CT scan — and it is metabolically active in a way that drives the lipid and inflammatory improvements seen in responders⁶⁷. Subcutaneous fat — the fat you can pinch, the fat that changes how you look in a mirror — is a different depot, and the second pivotal trial reported no change in limb or abdominal subcutaneous fat⁴.

So a person buying tesamorelin for cosmetic leanness is buying a drug whose trials show it shrinks a fat depot they cannot see, in a disease state they do not have, while leaving the visible depot essentially alone. That is not a technicality; it is the whole gap between the label and the sales pitch.

The Monitoring the Label Builds In

The approved use is not "inject and forget." Because tesamorelin stimulates growth-hormone production and raises IGF-1 — a growth factor whose long-term elevation has unknown effects — the label instructs clinicians to monitor IGF-1 levels during therapy and to consider stopping in patients with persistent elevations above 3 standard deviation scores. In the trials, 47% of patients exceeded 2 standard deviations by 26 weeks and 36% exceeded 3¹. Glucose gets the same treatment: evaluate before starting and monitor during, because trial patients developed an HbA1c of 6.5% or higher at 5% versus 1% on placebo¹.

The label also names the people who should not take it at all: anyone with disruption of the hypothalamic-pituitary axis (pituitary surgery or tumor, hypopituitarism, head irradiation or trauma), active malignancy, pregnancy, or known hypersensitivity¹. The most common adverse reactions — arthralgia, injection-site erythema and pruritus, pain in extremity, peripheral edema, myalgia — plus the fluid-retention and glucose signals get their own article in tesamorelin side effects.

Off-label use through a wellness clinic typically reproduces the injection and skips the surveillance. That inverts the deal the approval struck: the labeled benefit came bundled with lab monitoring, in a population whose risk justified it.

How Do You Convert a Tesamorelin Dose Into Syringe Units?

The approved products remove the arithmetic — the diluent volume is fixed and the label tells you the milliliters. A compounded or gray-market vial hands the arithmetic to you, and it is the same math as every peptide: concentration = vial strength ÷ water volume, and on a U-100 insulin syringe, 100 units span 1 milliliter.

Worked example: a 10 mg tesamorelin vial reconstituted with 2 milliliters of bacteriostatic water is 5 mg/mL. A 2 mg dose is then 0.4 milliliters — 40 units. Put 3 milliliters in the same vial instead and 2 mg becomes 60 units. A units figure copied from a forum is meaningless without the concentration that produced it, and for reference, the approved products themselves sit at different concentrations — 4 mg/mL for Egrifta SV and 8 mg/mL for Egrifta WR¹² — so even "official" volumes do not transfer between vials.

The tesamorelin dosage calculator does exactly this conversion from a dose figure plus your vial's numbers, and nothing else — it proposes no dose. The water-volume decision itself is the bac water calculator, the general-purpose version is the peptide calculator, and the underlying mg-to-units relationship is in the insulin syringe units converter. The full walkthrough, syringe choice included, is how to reconstitute peptides.

Is Tesamorelin Banned in Sport?

Yes, unambiguously. As a GHRH analog, tesamorelin falls under the WADA Prohibited List's S2 category of peptide hormones and releasing factors — prohibited at all times, in and out of competition, with no minimum dose and no therapeutic carve-out short of a formal exemption. Anti-doping laboratories have published validated urine assays that detect tesamorelin by name at concentrations down to the low picogram-per-milliliter range¹⁰¹¹. A positive test does not require the drug to have worked; it requires it to be present.

You can confirm the status yourself in our WADA prohibited checker, see how the whole peptide category maps onto the list in WADA prohibited list peptides, and read what testing actually detects in do peptides show up on drug tests.

What Off-Label Clinic Pricing Actually Looks Like

Branded Egrifta is a specialty HIV drug, so nearly all "tesamorelin for wellness" runs through compounded or research-chemical channels — where both the dose and the price deserve the same skepticism. Two patterns from our verified provider checks, as of August 2026: Live Vital advertises tesamorelin at $166 a month, but its own FAQ concedes prices are built on 10-week protocols — ten weeks is 2.3 calendar months, and the site divides the protocol total by three, so the real monthly figure is higher than the label on it. ElitePhysiqMD prices tesamorelin at $274.50 a month — but every displayed price is already 10% off for enrolling in a recurring subscription, and the one-time rate is never shown. The sellers in this category overlap heavily with the sermorelin market, which is why the sermorelin provider board is the relevant comparison surface, with the dosing counterpart in sermorelin dosage.

On the product itself: compounded tesamorelin is not an FDA-approved drug, its regulatory position is tracked compound-by-compound in the peptide FDA status tracker, and a research-grade vial's identity and content are only as good as its testing — how to verify a peptide COA covers what real third-party verification looks like, and peptide vendor red flags covers the sellers who skip it. The legal frame for the whole category is in are GH peptides safe and legal, and the evidence frame in GH peptides and recovery.

Bottom Line

Tesamorelin genuinely is different from the rest of the GH-peptide menu: it has an FDA approval, pivotal trials, and a real labeled dose. But the labeled dose is formulation-specific — 1.4 mg daily as Egrifta SV, 1.28 mg daily as Egrifta WR, 2 mg daily in the trials that earned the approval — and it comes attached to a narrow indication, IGF-1 and glucose monitoring, and named contraindications¹²³. The approval is for deep visceral fat in HIV-associated lipodystrophy; the trials showed no change in the subcutaneous fat people can see⁴, the drug is weight-neutral by its own label¹, and the effect reverses when dosing stops⁴⁵. In tested sport it is prohibited at all times, with published detection methods waiting¹⁰¹¹.

If a clinician has prescribed tesamorelin and you are converting milligrams into syringe units, the tesamorelin dosage calculator does the arithmetic from your vial's own numbers. What it will not do — what no calculator can do — is turn a labeled dose for one disease into a validated dose for anything else.

This page is educational and not medical advice. Tesamorelin is a prescription drug with labeled contraindications and monitoring requirements; decisions about using it belong with a licensed clinician who knows your history.