Tesamorelin Dosage Guide
Written by Alejandro Reyes
Founder & Lead Researcher
Reviewed by Peptide Nerds Editorial · Updated July 2026
Dosage overview
| Typical dose | 2 mg per injection |
| Frequency | Once daily subcutaneous injection |
| Cycle length | Ongoing for approved indication; 20-26 weeks for off-label study periods |
Dosing notes
The FDA-approved dose for HIV-associated lipodystrophy is 2 mg subcutaneously once daily, injected into the abdomen. Rotation of injection sites within the abdominal region reduces local reactions. The pivotal Phase 3 trials used this dose over 26-week periods, with responders continuing through 52 weeks (PMID: 20395564). The cognitive health trial used 1 mg daily in older adults over 20 weeks, suggesting the off-label dose range may be lower than the HIV indication (PMID: 22869065). Bedtime administration is the standard recommendation. GH secretagogues amplify the body's natural nocturnal GH pulse during slow-wave sleep, and administering tesamorelin before bed aligns with this physiologic pattern. Administration on an empty stomach is recommended to avoid the GH-blunting effect of carbohydrates and dietary fats. A minimum 2-hour post-meal fast before injection is widely recommended. Reconstitution: tesamorelin is supplied as a lyophilized (freeze-dried) powder. The commercial product (Egrifta SV) uses a 2 mg/mL concentration with a separate diluent vial. Reconstituted solution should be stored refrigerated and used within the timeframe specified in product labeling. Compounded tesamorelin from specialty pharmacies uses bacteriostatic water for reconstitution. Inject the water against the vial wall, not directly onto the powder. Swirl gently, never shake. Tesamorelin costs approximately $1,000-1,500 per month at commercial pharmacy pricing for the HIV lipodystrophy indication. Insurance coverage is sometimes available for the approved indication with appropriate documentation. Off-label compounded versions through specialty telehealth providers typically cost $200-400 per month. Tesamorelin is not FDA-approved for any off-label indication and all anti-aging or cognitive uses are investigational.
FDA-approved indications
Tesamorelin is FDA-approved for: HIV-associated lipodystrophy (Egrifta, Egrifta SV).
Off-label use should only be pursued under the guidance of a licensed healthcare provider.
Important safety information
Dosage ranges listed above are based on published clinical trial protocols. Individual dosing should be determined by a qualified healthcare provider based on your specific health profile, goals, and response to treatment.
- Start at the lowest effective dose and titrate up gradually
- Monitor for side effects, especially during dose increases
- Do not exceed researched dose ranges without medical supervision
Interactive protocol guide
Step-by-step: your dosing schedule with exact syringe units, what supplies to buy, how to mix, and how to inject.
Tesamorelin Protocol Overview
Goal
GH/fat reduction
Duration
12 weeks
Route
subcutaneous
Important before you start:
- Must be taken on an empty stomach. Food intake blunts the GH pulse.
- Do not use if you have active pituitary tumors or a history of hypothalamic-pituitary disease.
- May increase IGF-1 levels. Monitor with bloodwork at 6 and 12 weeks.
Your dosing schedule
Based on a 2 mg vial mixed with 2 mL bacteriostatic water (1.00 mg/mL concentration). Using a U-50 insulin syringe.
Draw to here
100 units
on 50-unit syringe
1-12: 2 mg
| When | Dose | Syringe units | Frequency | What to expect |
|---|---|---|---|---|
| 1-12 | 2 mg | 100 units | Once daily | Inject at bedtime on an empty stomach. FDA-approved for HIV lipodystrophy. |
1-12: 2 mg
Inject at bedtime on an empty stomach. FDA-approved for HIV lipodystrophy.
What you need for a 12-week Tesamorelin protocol
Tesamorelin vials (2 mg each)
Quantity: 84
Bacteriostatic water (30 mL vial)
Quantity: 6
Insulin syringes (U-50, 29ga)
Quantity: 84+ (one per injection, never reuse)
Alcohol prep pads
Quantity: 168+ (one for vial, one for skin)
Sharps container
Quantity: 1
Quantities based on 12-week protocol using 2 mg vials reconstituted with 2 mL BAC water each.
How to mix your Tesamorelin
Your concentration:
2 mg peptide + 2 mL water = 1.00 mg/mL (1000 mcg/mL)
- 1
Wash your hands
Wash with soap and water for 30 seconds. Dry completely.
- 2
Clean the vial tops
Wipe the rubber stopper on your Tesamorelin vial AND your bacteriostatic water vial with an alcohol swab. Let air dry for 10 seconds.
- 3
Draw 2 mL of bacteriostatic water
Using an insulin syringe, draw 2 mL (100 units on a U-50 syringe) of bacteriostatic water.
- 4
Inject water into the Tesamorelin vial
Hold the peptide vial at a 45-degree angle. Point the needle at the WALL of the vial, NOT directly onto the powder. Push the plunger slowly over 10-15 seconds. Let the water run down the inside wall.
- 5
Swirl gently to dissolve
Swirl the vial in a slow circular motion for 30-60 seconds. NEVER shake. If not fully dissolved, let it sit for 2-5 minutes and swirl again.
- 6
Refrigerate immediately
Store reconstituted peptide at 36-46 degrees F (2-8 degrees C). Good for 4-6 weeks refrigerated. Label the vial with the date you mixed it.
Common mistakes that ruin your peptide:
- Shaking the vial (breaks peptide bonds, reduces potency 30-50%)
- Spraying water directly on the powder (damages the peptide)
- Using sterile water instead of bacteriostatic water (no preservative, short shelf life)
- Leaving mixed peptide at room temperature (loses 10-20% potency per day)
How to inject Tesamorelin
Timing: Bedtime, at least 2 hours after last meal
- 1Choose your injection site and rotate each time (at least 1 inch from the last site).
- 2Wipe the injection site with an alcohol prep pad. Let air dry completely.
- 3Draw your dose (check the dosing schedule above for exact syringe units).
- 4Pinch a fold of skin at the injection site.
- 5Insert the needle at a 45-90 degree angle into the pinched skin fold.
- 6Push the plunger slowly and steadily.
- 7Release the skin fold, then withdraw the needle.
- 8Do NOT rub the injection site. Light pressure with a cotton ball is fine if there is any blood.
- 9Dispose of the syringe immediately in your sharps container. Never recap or reuse.
Site rotation tip
Divide your preferred injection area into a mental grid. Move to a new spot each injection. For Abdomen injections, alternate between sides (left/right) each time.
Research references
- Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat — Journal of Clinical Endocrinology & Metabolism (2010) [PubMed]
- Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial — Archives of Neurology (2012) [PubMed]
- Tesamorelin effects on muscle morphology and gene expression in HIV-associated lipodystrophy — Journal of the Endocrine Society (2019) [PubMed]
- Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults — Journal of Clinical Endocrinology & Metabolism (2006) [PubMed]
- The Safety and Efficacy of Growth Hormone Secretagogues — Sexual Medicine Reviews (2018) [PubMed]
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