FDA-approvedAlso: Egrifta, Egrifta SV

Tesamorelin Dosage Chart

FDA-approved 2 mg daily protocol for HIV-associated lipodystrophy, plus the off-label visceral fat reduction schedules.

Written by
Megan Williams
Editor-in-Chief
Reviewed by
Brian Williams
Co-founder & Research Editor
Last updated
April 25, 2026

Educational tool — not medical advice. This calculator provides estimates based on population averages and published trial data. Outputs are not clinical recommendations and do not replace evaluation by a qualified prescriber. Do not start, stop, or change a peptide therapy based on the result of this tool.

Tesamorelin is a synthetic GHRH analog FDA-approved (2010) as Egrifta for HIV-associated lipodystrophy — specifically reduction of excess visceral abdominal fat. It is also used off-label in anti-aging and aesthetic medicine for visceral fat reduction in non-HIV populations. The labeled dose is 2 mg subcutaneously once daily.

Tesamorelin at a Glance

FDA-labeled dose (Egrifta SV)2 mg subQ once daily
RouteSubcutaneous, abdominal injection (rotate sites)
Best timingBedtime preferred (aligns with overnight GH pulse)
Cycle length (labeled)Continuous use approved
Off-label cycling5 days on, 2 off, for 12–26 week cycles
FDA statusFDA-approved 2010 for HIV-associated lipodystrophy
Common vial size1 mg or 2 mg lyophilized powder; pre-filled pens for Egrifta SV

Tesamorelin Reconstitution Chart

How vial size, bacteriostatic water volume, and insulin-syringe units convert for Tesamorelin. Use this to translate a prescribed mcg or mg dose into a syringe measurement.

Vial sizeBac waterConcentrationDose → insulin-syringe units (U-100)
2 mg (compounded)1 mL or per pharmacy label2 mg/mL
  • 2 mg100 units (1 mL)
Egrifta SV pre-filled penPre-filled — no reconstitution neededPer device specification
  • 2 mgSingle dose per pen click

U-100 syringe reference: 100 units = 1.0 mL. So 10 units = 0.1 mL, 25 units = 0.25 mL, 50 units = 0.5 mL. Egrifta SV is supplied as a pre-filled pen and does not require reconstitution. Compounded tesamorelin from 503A pharmacies is supplied as lyophilized powder requiring reconstitution per pharmacy instructions.

Tesamorelin Dosing by Use Case

Commonly cited protocols vary by what Tesamorelin is being used for. The table below summarizes typical ranges reported in clinical practice and published literature.

Use caseTypical doseFrequencyCycle lengthNotes
HIV-associated lipodystrophy (FDA-labeled)2 mgOnce dailyContinuous, indefiniteStandard FDA-labeled use. Reassess after 6 months — discontinue if no visceral fat reduction.
Visceral fat reduction (off-label)1–2 mgOnce daily12–26 weeks, often 5 days on / 2 offOff-label aesthetic protocols often cycle to reduce GH receptor desensitization.

Stacking Tesamorelin

Tesamorelin is sometimes stacked with ipamorelin to combine GHRH stimulation (tesamorelin) with ghrelin-receptor stimulation (ipamorelin) for stronger pulsatile GH release. The combination is used in anti-aging settings rather than HIV lipodystrophy.

Use with caution

Tesamorelin has the most extensive clinical safety data among GHRH analogs and an FDA approval, but raises GH-related metabolic concerns with long-term use.

  • Common side effects: injection-site reactions, joint pain (arthralgias), peripheral edema, mild hyperglycemia, paresthesias.
  • Increases IGF-1 levels — labeled monitoring includes periodic IGF-1 measurement; doses adjust if IGF-1 is significantly elevated.
  • Theoretical concern with chronic GH/IGF-1 elevation: facilitation of cancer growth in patients with malignancy. Contraindicated in active pituitary or non-pituitary cancers.
  • Glucose intolerance is a class effect — caution and monitoring in patients with prediabetes or T2D.
Do not use if
  • Active malignancy
  • Disrupted hypothalamic-pituitary axis (post-surgery, irradiation, trauma)
  • Pregnancy

Tesamorelin Dosing FAQ

Tesamorelin is FDA-approved as Egrifta SV for the reduction of excess abdominal fat in HIV patients with lipodystrophy. Off-label, it is used in anti-aging and aesthetic medicine for visceral fat reduction in non-HIV patients.

FDA labeling and trial data indicate visceral fat reduction is typically measurable at 6 months. Reassessment at 6 months is built into the labeled use — discontinuation is recommended if no benefit is observed by then.

Yes. Egrifta and Egrifta SV are the brand-name FDA-approved tesamorelin products. Compounded tesamorelin from 503A pharmacies contains the same active ingredient but is not FDA-approved as a finished drug.

Sources

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Medical Disclaimer: This content is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare provider before beginning any peptide therapy treatment.