Tesamorelin Dosage Calculator: Label Doses and Syringe Units

Tesamorelin dosage on the label

Egrifta is a growth hormone-releasing factor analogue approved in the US for excess abdominal fat in HIV-infected adults with lipodystrophy. The labels say it is not indicated for weight loss management and that long-term cardiovascular safety has not been established. The three products below are not interchangeable, and the WR label says it cannot be substituted for SV.

The label arithmetic is the same as any other peptide: 2 mg in 0.5 mL is 4 mg/mL, and 1.4 mg divided by 4 mg/mL is 0.35 mL. On a U-100 syringe that is 35 units. The 2 mg figure is the older story: the trials gave 2 mg daily of the 1 mg-per-vial product, and the SV label records that exposure from 1.4 mg of SV is similar to 2 mg of the original.

What the dose did in trials

Two phase 3 trials gave 2 mg daily or placebo for 26 weeks to adults with HIV and excess abdominal fat. The table gives the label's figures, which come from a statistical model and differ from the percentages in the original journal papers.

The results reverse when dosing stops. In the 26-week extension, patients who stayed on tesamorelin held their reduction and patients switched to placebo regained visceral fat.

Weight did not change in either study, which is why the labels say tesamorelin is not for weight loss. Warnings include increased risk of neoplasms, raised IGF-1, fluid retention (edema, arthralgia, carpal tunnel syndrome) and glucose intolerance. Reactions reported by more than 5% were arthralgia, injection site erythema and pruritus, pain in extremity, peripheral edema and myalgia. The side effect article, tesamorelin side effects, goes through them, and the full compound profile is in the tesamorelin guide.

Tesamorelin units on a syringe

Concentration is vial strength divided by water added, in mg/mL. The draw volume is the dose divided by that concentration, and a U-100 insulin syringe has 100 units per millilitre, so units equal the draw in mL times 100. A 10 mg vial with 2 mL of water is 5 mg/mL, so 2 mg is 0.4 mL, or 40 units. The table covers the label doses of 1.28 and 1.4 mg and the trial dose of 2 mg. Research vials have no label, so the water volume is your choice, and these figures assume the vial holds what it says.

The same 2 mg dose is 20 units in one row and 100 in another, so a unit number is meaningless without the vial and water attached. Our rule of thumb is a draw between 20 and 60 units, which is readable and leaves headroom; a very concentrated mix makes one unit of error a large share of the dose, and a very dilute one fills the barrel. The tesamorelin dosage calculator on Peptulator does the sum for any vial, and how to reconstitute peptides covers mixing without foaming.

Mistakes that give a tenfold error

Tesamorelin is dosed in whole milligrams, while most neighbours, such as ipamorelin and CJC-1295, are dosed in hundreds of micrograms. Four errors cause most serious mistakes, and the syringe looks normal afterwards:

• Assuming the water volume. Reusing a unit figure from a vial mixed differently is the most common one.
• Milligrams read as micrograms. 2 mg is 2,000 mcg; 200 mcg is a tenth of it.
• Units read as millilitres. Drawing to 0.4 on a unit-marked barrel instead of 40 is a hundredfold error.
• Trusting an unverified vial. If a 10 mg vial holds 7 mg, every figure is off by 30 percent. A batch certificate of analysis is the only practical check.

Writing the concentration in mg/mL on the vial when the water goes in prevents three of the four. Syringe barrel size matters too: a 0.5 mL (50 unit) barrel spreads the marks further apart than a 1 mL one, which helps for a 28 to 40 unit draw. The injection guide covers needles and site rotation.

Storage after mixing

Only the labels give figures. Egrifta SV is mixed and used straight away, with the remainder discarded and the solution not frozen or refrigerated, and the SV vial itself is stored at room temperature, 20 to 25 C. Egrifta WR is mixed with bacteriostatic water, kept at room temperature, and discarded 7 days after mixing. The original 1 mg vials were refrigerated at 2 to 8 C. We found no stability study of research-grade tesamorelin mixed with bacteriostatic water, so those limits do not transfer to a research vial. Treat any shelf life you read for a research vial as an assumption, and see the peptide storage guide.

Sourcing notes

A dosage calculation is only as good as the vial it points at. Pantheon and Amino Club are the two vendors we track that carry tesamorelin and publish a per-batch certificate of analysis, and Amino Club lists it under the vendor's own spelling, "tesamorlin". The published trial results are covered in tesamorelin before and after, and how it compares with other GHRH peptides in tesamorelin vs sermorelin and the tesamorelin and ipamorelin stack. Tesamorelin at Amino Club Compare at Pantheon

Bacteriostatic water is the other half of the calculation. Bacteriostatic water

Tesamorelin is a research compound outside a prescription channel. The trial figures above describe supervised use of a licensed drug in a defined patient population, and nothing on this page is a recommendation to obtain or administer anything.

Frequently asked questions

What is the tesamorelin dosage?

The FDA-labelled dose of Egrifta SV is 1.4 mg once daily by subcutaneous injection into the abdomen, which is 0.35 mL of the 2 mg vial mixed with 0.5 mL of sterile water. Egrifta WR is dosed at 1.28 mg once daily. The pivotal trials used 2 mg once daily. The labelled use is reducing excess abdominal fat in HIV-infected adults with lipodystrophy.

Why do some sources say 2 mg and the label says 1.4 mg?

The trials used an earlier 1 mg-per-vial product at 2 mg a day. The 2 mg-vial Egrifta SV was approved at 1.4 mg a day on the basis of comparable bioavailability: the label says exposure of the 1.4 mg dose is similar to the 2 mg dose of the older product. Both numbers appear in the literature, so check which product a source means.

How many units is a tesamorelin dose on an insulin syringe?

It depends on the vial and the water. The label's own mix, a 2 mg vial with 0.5 mL, is 4 mg/mL, so 1.4 mg is 0.35 mL, or 35 units on a U-100 syringe. A 10 mg research vial with 2 mL of water is 5 mg/mL, so 1.4 mg is 28 units and 2 mg is 40 units.

How long does reconstituted tesamorelin last?

The labels give product-specific limits: Egrifta SV is used straight after mixing and any remainder is discarded, and Egrifta WR is kept at room temperature and discarded 7 days after mixing. We found no stability study of research-grade tesamorelin mixed with bacteriostatic water, so we do not give a shelf life for those vials.

What happens to the fat loss when tesamorelin is stopped?

It comes back. In the 52-week trials, patients switched from tesamorelin to placebo regained visceral fat, by 22% in Study 1 and 16% in Study 2 over 26 weeks according to the label, while patients who continued held their reduction.

Is tesamorelin approved for weight loss?

No. The Egrifta labels state that it is not indicated for weight loss management, and in the label's trial results weight did not differ significantly from placebo (difference -0.4 kg, 95% CI -1.3 to 0.5, in Study 1). It is approved for abdominal fat in HIV lipodystrophy only.

Sources

1. FDA, EGRIFTA SV (tesamorelin) prescribing information, revised 02/2024
2. FDA, EGRIFTA WR (tesamorelin) prescribing information, revised 03/2025
3. FDA, EGRIFTA (tesamorelin) prescribing information and instructions for use, 2019
4. Falutz et al, metabolic effects of a growth hormone-releasing factor in patients with HIV, N Engl J Med, 2007
5. Falutz et al, long-term safety and effects of tesamorelin in HIV patients with abdominal fat accumulation, AIDS, 2008
6. Falutz et al, effects of tesamorelin in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension, J Acquir Immune Defic Syndr, 2010
7. ClinicalTrials.gov NCT00123253, tesamorelin in HIV patients with abdominal fat accumulation (Study 1)
8. ClinicalTrials.gov NCT00435136, tesamorelin in HIV patients with abdominal fat accumulation (Study 2)