Compound reference
Tesamorelin Dosage Guide 2026: Trials vs Reported Use
Short answer
A GHRH analog, working one step upstream: tesamorelin is a synthetic growth hormone-releasing hormone analog. It prompts the pituitary to release more growth hormone rather than supplying it.
One dose, tested twice: both phase 3 trials ran the same single amount, 2mg injected under the skin, once daily, for 26 weeks.
What that dose moved: visceral belly fat fell 15.2% on tesamorelin against a 5.0% rise on placebo, in the 412 patient NEJM trial.
A milligram figure still has to survive a reconstitution: the trials and the labels speak in milligrams, an insulin barrel is marked in units, and the two only agree once the concentration is known. Egrifta SV and Egrifta WR reconstitute to different ones.
Approved, for exactly one indication: reduction of excess abdominal fat in HIV-infected patients with lipodystrophy. Everything else is off-label, and a research-grade vial is not the approved product.
The sourcing: every trial figure comes straight from the cited papers and the current labels, linked at the bottom.
The calculator
What the converter needs: how much peptide the vial holds, how much water went into it, which barrel is being read, and the milligram figure to convert. It returns the concentration, the volume in milliliters, and the reading in units.
Units converter
Converts the numbers you type. It does not recommend a dose.
Arithmetic only. This is arithmetic on the numbers entered. It has no knowledge of any real vial, reconstitution, or syringe.
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On this page
Peer-reviewed trial data
What did the trials do?
Two phase 3 trials, one population: both enrolled HIV-infected patients with excess abdominal fat on antiretroviral therapy. Study 1 (Falutz et al., New England Journal of Medicine, 2007) randomized 412 people; Study 2 (Falutz et al., JAIDS, 2010) randomized 404.
The dose: both trials ran tesamorelin 2mg injected daily against placebo for 26 weeks, with a 26 week extension after.
The pooled view: a pooled analysis of the two trials (Falutz et al., Journal of Clinical Endocrinology and Metabolism, 2010) covers 806 people, 543 on tesamorelin and 263 on placebo.
| Report | Patients | Daily dose | Visceral fat at 26 weeks |
|---|---|---|---|
| Study 1, NEJM 2007 | 412 | 2mg | down 15.2% vs up 5.0% on placebo |
| Study 2, JAIDS 2010 | 404 | 2mg | down 10.9% vs down 0.6% on placebo |
| pooled, JCEM 2010 | 806 | 2mg | treatment effect -15.4% |
What moved with it: in Study 1, triglycerides fell 50mg per deciliter against a 9 point rise on placebo. The effect was specific to visceral fat; the pooled trial analysis found the fat under the skin did not move.
The IGF-1 signature: IGF-1 rose 81% on drug against a 5% fall on placebo in Study 1.
The extension: people who stayed on tesamorelin held the effect out to 52 weeks, about 17.5 to 18% down from baseline. People switched to placebo lost it fast.
The newer trial: a 2024 analysis in AIDS (Russo et al.) of a 61-person trial in people with HIV and fatty liver disease. In the 38 on integrase inhibitor regimens (31 completers with body-composition data), the same 2mg daily dose for 12 months brought visceral fat down a median 25 cm2 against a 14 cm2 rise on placebo, and liver fat down 4.2% against a 0.5% fall on placebo, each figure a median.
Each figure stays attached to its own trial: different studies, different timepoints, and no row above summarizes the row beside it.
15.2%
visceral fat down at 26 weeks, 2mg daily arm
5.0%
up on placebo in the same trial
806
people across the two pooled phase 3 trials
2mg
the single daily dose the trials tested
Phase 3 trials, Falutz et al., NEJM 2007 and JCEM 2010.
Community reports, not a protocol
Reported use: what people say they run
Whose numbers these are: the community's, reported as the community reports them, and not a protocol.
Who is talking: the guides ranking for this compound mostly address fat loss, bodybuilding, and anti-aging audiences. None of those are the approved indication.
The copied number: in our read, the 2mg daily figure circulating online traces back to the phase 3 trial dose, not to any community study.
The schedule drift: the protocols we have read keep the daily injection but add structure the trials never tested: cycles of weeks on followed by time off.
The vial difference: community vial math is written for research vials, 10mg and larger in the guides we have seen. The approved pharmacy products are a 2mg vial and an 11.6mg vial.
The goal posts: reported goals are visceral fat loss and physique change, borrowed from the HIV lipodystrophy data and applied to people without HIV.
Correction, 30 July 2026, because the untested part is not the one this page named: an earlier version said these reports came from a population the trials never enrolled. That is wrong, and the page's own reference 7 is the counterexample: a randomized, double-blind, placebo-controlled 12-month trial ran the same 2mg daily in 60 abdominally obese adults without HIV (Makimura et al., 2012). What none of the eight sources below tests is the schedule, weeks on followed by time off, drawn from a research vial rather than one of the two approved products.
The trial dose and the internet dose: same number?
The unusual thing about this comparison: the number the internet copies is not the number a pharmacy hands over. The 2mg is a trial figure that the approved products moved away from, so the two columns below disagree about the label as well as about the population.
What the trial's dose is for
What the 2mg was built to answer: one research question, and only one: does tesamorelin reduce visceral fat in HIV-associated lipodystrophy, measured on CT scans. A randomized, double-blind, placebo-controlled 12-month trial at the same 2mg daily dose also ran in 60 abdominally obese adults without HIV who had reduced growth hormone secretion (Makimura et al., Journal of Clinical Endocrinology and Metabolism, 2012), and the label's indication is still the HIV one.
And what a pharmacy actually dispenses: not that 2mg. The current products deliver 1.4mg (Egrifta SV) or 1.28mg (Egrifta WR) daily, so the figure the internet copies is one the approved route stopped handing over.
What people run online
What the community schedules do with it: they borrow the 2mg daily figure and run it in cycles for fat loss and physique goals, in people without HIV, from research vials. No trial has tested that pattern, as of our 20 July 2026 check.
The label's own line: the FDA label states tesamorelin is not indicated for weight loss and has a weight-neutral effect. The internet uses it as a weight loss tool anyway.
The 2mg belonged to a trial in HIV-associated lipodystrophy. The products that reached pharmacies deliver 1.4mg and 1.28mg.
What the label answers, and who it answers for: tesamorelin has an approved indication, a printed daily dose, and a studied population, and the community schedules above are running it outside all three at once. That is three separate extrapolations stacked on one number, and the label makes none of them.
How does the units math work?
Arithmetic on a vial, not on a person: every number below comes from a vial size and a water volume.
The 2mg vial in 1mL: a 2mg vial reconstituted with 1mL of bacteriostatic water holds 2mg per mL, which is 2,000mcg per mL.
What one unit is worth there: the U-100 scale puts 100 units in a milliliter, which makes one unit 0.01mL, or 20mcg, 0.02mg, in a 2mg per mL vial. That puts 1mg on 50 units and 2mg on the full barrel.
Twice the water, same vial: 2mg in 2mL rather than 1mL halves the concentration, to 1mg per mL.
Every mark now carries half as much: a unit is worth 0.01mg where it was worth 0.02mg, so the same 1mg reads 100 units, not 50.
Which is what makes "50 units" a bad unit of exchange: the number survives being copied and the milligram amount underneath it does not, so the same figure lands at 1mg on the first mix and 0.5mg on the second.
| Water added | Concentration | 1 unit equals | What the article works out |
|---|---|---|---|
| 1mL | 2mg per mL (2,000mcg per mL) | 0.02mg (20mcg) | 1mg is 50 units, 2mg is 100 units |
| 2mL | 1mg per mL | 0.01mg (10mcg) | 1mg is 100 units, not 50 |
| Product | Vial | Label reconstitution | Daily dose | Reads on U-100 |
|---|---|---|---|---|
| Egrifta SV | 2mg | 0.5mL sterile water (4mg per mL) | 1.4mg (0.35mL) | 35 units |
| Egrifta WR | 11.6mg | 1.3mL bacteriostatic water (8mg per mL) | 1.28mg (0.16mL) | 16 units |
One assumption is running through every unit figure above, and it is worth stating rather than leaving in the table headings: all of them are U-100 counts. The other scale in circulation, U-40, puts two and a half times the volume behind the same mark, which is a fact about the barrel rather than about tesamorelin, and so belongs on its own page instead of this one.
How many units is 2mg of tesamorelin?
It depends which vial the 2mg is sitting in: at 2mg per mL, a 2mg vial plus 1mL of water, it reads as 100 units on a U-100 syringe. At 8mg per mL, the Egrifta WR reconstitution, the same 2mg would read as 25 units.
And the second of those two vials is the only one with a label behind it: the 8mg per mL figure is Egrifta WR's own reconstitution, printed by the manufacturer. The 2mg per mL row is a research-vial mix that neither approved label specifies, which is why our dose math index keeps the water volume and the milligram amount as separate inputs rather than collapsing them into one chart.
What's not known yet?
Approved since 2010, and still for one condition: tesamorelin has held that approval throughout. The current products are Egrifta SV (1.4mg daily) and Egrifta WR (1.28mg daily), same indication: reduction of excess abdominal fat in HIV-infected adults with lipodystrophy (checked 19 July 2026).
Everything else is off-label: the label itself states the drug is not indicated for weight loss, and that long-term cardiovascular safety has not been established.
What sixteen years of approval still has not answered:
- No phase 3 trial in people without HIV, as of our 29 July 2026 check. The approval rests on HIV lipodystrophy trials, and the newest data we found, a 6-month open-label phase 2 trial in 73 participants (Ellis et al., Journal of Infectious Diseases, 2025), again studied people with HIV.
- No verified data on cycled use, the on-off pattern in community protocols, as of our 20 July 2026 check.
- No verified data on research-grade vials, which are not the approved product and were never studied, as of our 20 July 2026 check.
The approval covers none of those three, and no other dataset covers them either.
And one that lands before any of them: an Egrifta vial arrives with a reconstitution volume and a strength printed on an FDA-approved label. A research vial arrives with a label nobody approved, and identity, purity, sterility and strength all rest on it.
Which makes sourcing the first problem and dosing the second: the two Egrifta reconstitutions are printed in a document FDA reviewed, and a research vial's is not, and that is what we would check before anything else.
How this page is sourced
Every figure read off its own paper or label: nothing above was taken from somebody else's summary of the trials, and review articles are named as reviews where they appear.
Eight sources, seven papers and the labels: with DOIs and PubMed IDs where they exist. Each is listed below with its identifier, and every figure on this page traces back to one of them.
What gets checked before a number ships: the sourcing and citation-verification standard sits on the methodology page. Any correction to a number here happens there first.
Last reviewed: 19 July 2026.
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1
Falutz J, Allas S, Blot K, et al. Metabolic effects of a growth hormone-releasing factor in patients with HIV. N Engl J Med. 2007;357(23):2359-70. doi:10.1056/NEJMoa072375. PMID 18057338.
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2
Falutz J, Mamputu JC, Potvin D, et al. Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in human immunodeficiency virus-infected patients with excess abdominal fat: a pooled analysis of two multicenter, double-blind placebo-controlled phase 3 trials with safety extension data. J Clin Endocrinol Metab. 2010;95(9):4291-304. doi:10.1210/jc.2010-0490. PMID 20554713.
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3
Falutz J, Potvin D, Mamputu JC, et al. Effects of tesamorelin, a growth hormone-releasing factor, in HIV-infected patients with abdominal fat accumulation: a randomized placebo-controlled trial with a safety extension. J Acquir Immune Defic Syndr. 2010;53(3):311-22. doi:10.1097/QAI.0b013e3181cbdaff. PMID 20101189.
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4
Dhillon S. Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy. Drugs. 2011;71(8):1071-91. doi:10.2165/11202240-000000000-00000. PMID 21668043.
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5
Russo SC, Ockene MW, Arpante AK, et al. Efficacy and safety of tesamorelin in people with HIV on integrase inhibitors. AIDS. 2024;38(12):1758-64. doi:10.1097/QAD.0000000000003965. PMID 38905488.
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6
Theratechnologies Inc. Egrifta SV (tesamorelin) prescribing information, revised February 2024, and Egrifta WR (tesamorelin) prescribing information, revised March 2025. DailyMed, US National Library of Medicine. dailymed.nlm.nih.gov.
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7
Makimura H, Feldpausch MN, Rope AM, et al. Metabolic effects of a growth hormone-releasing factor in obese subjects with reduced growth hormone secretion: a randomized controlled trial. J Clin Endocrinol Metab. 2012;97(12):4769-79. Tesamorelin 2mg once daily or placebo for 12 months in 60 abdominally obese subjects without HIV. doi:10.1210/jc.2012-2794. PMID 23015655.
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8
Ellis RJ, Vaida F, Hu K, et al. Effects of Tesamorelin on Neurocognitive Impairment in Persons With HIV and Abdominal Obesity. J Infect Dis. 2025;231(5):1230-1238. Six-month open-label phase 2 trial, 73 participants randomized 3:2 to tesamorelin 2mg subcutaneously daily or standard of care. doi:10.1093/infdis/jiaf012. PMID 39813152.
The disclaimer
Every page is reviewed by medical professionals before it ships, and written with longtime biohackers who were doing this before it was a trend. Reviewed still does not mean prescribed: nothing here is medical advice.
It is research, trial data, and reported use, with the numbers intact so you can check them. For decisions about your body, see a doctor who can look at your labs.
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