Compound reference
Tesamorelin Dosage Guide 2026: Clinical Trials vs Reported Use
Short answer
What it is: tesamorelin is a synthetic growth hormone-releasing hormone (GHRH) analog. It prompts the pituitary to release more growth hormone.
The trial dose: the phase 3 trials ran a single dose: 2mg injected under the skin, once daily, for 26 weeks.
The headline number: visceral belly fat fell 15.2% on tesamorelin against a 5.0% rise on placebo in the 412 patient NEJM trial.
The catch: doses are written in milligrams. Syringes read in units.
Why it trips people: the two only agree once you know the concentration in the vial, and the approved formulations mix to different concentrations.
The rhythm: daily injections, not a weekly schedule.
The status: FDA approved for reduction of excess abdominal fat in HIV-infected patients with lipodystrophy. Other uses are off-label, and research-grade vials are not the approved product.
The sourcing: every trial figure on this page comes straight from the cited papers and the current labels, linked at the bottom.
The calculator
How it works: feed in a vial size, a water amount, a syringe type, and a dose in milligrams. It returns the concentration, the volume, and the reading in units.
Units converter
Converts the numbers you type. It does not recommend a dose.
Arithmetic only. Check the result against your own vial, your own reconstitution, and your own syringe before you trust any unit count.
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On this page
Community reports, not a protocol
Reported use: what people say they run
The source: this section is what the community reports, and it is 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 I 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 I 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.
Reports, not evidence: none of that has been studied in the population using it, as of this writing. Treat every posted schedule as an anecdote from a context the trials never studied.
Peer-reviewed trial data
What did the trials do?
The setup: two phase 3 trials 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 0.5%.
Don't merge these numbers: different studies, different timepoints. Each figure above stays attached to its own trial.
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.
The trial dose and the internet dose: same number?
The usual dodge: most sites we checked either avoid the question or publish a schedule without the trial behind it. We're doing neither.
What the trial's dose is for
What it's for: the 2mg daily dose exists to answer one research question: does tesamorelin reduce visceral fat in HIV-associated lipodystrophy, measured on CT scans. A randomized 12-month trial at the same dose also ran in people without HIV, and no approval followed for that use.
What it is: the trial dose, approved for one defined condition, in the trials' formulation. The current products deliver 1.4mg (Egrifta SV) or 1.28mg (Egrifta WR) daily. Not a starting point for anything else.
What people run online
What the posts show: community schedules 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.
We will not tell you which of those numbers is yours.
The real question: it starts with your body, your risk tolerance, and a doctor who knows your history. What we can give you is what the trials published and the math behind a dose; the rest is yours to decide with someone qualified.
How does the units math work?
The point: work the arithmetic once, generally, with no dose attached to you.
Example one: say a 2mg vial gets reconstituted with 1mL of bacteriostatic water. That's 2mg per mL, or 2,000mcg per mL.
The syringe side: the U-100 insulin syringe holds 100 units per mL, meaning each unit is 1/100th of a mL, which at this concentration works out to 20mcg, or 0.02mg. From there: 1mg is 50 units, 2mg is 100 units.
Change one thing: reconstitute the same 2mg vial with 2mL instead of 1mL. Concentration halves to 1mg per mL.
What changes: each unit now equals 0.01mg instead of 0.02mg. The same 1mg amount is now 100 units, not 50.
The forum trap: that "50 units" someone read on a forum could be 1mg at one concentration and 0.5mg at another.
| 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 |
The second trap: your syringe. Two scales exist, and the scale has nothing to do with concentration.
The two scales: U-100 reads 100 units per mL, one unit 0.01mL. U-40 reads 40 units per mL, one unit 0.025mL.
The 2.5x problem: reach for a U-40 while thinking in U-100 and every unit draws 2.5 times the volume you think it does. Same vial, same concentration, same number on the barrel.
Verify the syringe scale first, because every number after it depends on the scale.
Both halves: that is the full units-versus-mg mix-up, start to finish. The syringe reads true every time. What it cannot know is your concentration or its own scale; you can.
How many units is 2mg of tesamorelin?
The short answer: it depends on the concentration. At 2mg per mL (a 2mg vial plus 1mL of water), 2mg reads as 100 units on a U-100 syringe. At 8mg per mL (the Egrifta WR reconstitution), 2mg would read as 25 units.
The rule: a milligram amount never has one fixed units number. Concentration, then syringe type, then the arithmetic, or the calculator above does it.
What's not known yet?
The status: tesamorelin is FDA approved, and has been since 2010. 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).
What that means: every other use 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.
The real gaps:
- No phase 3 trial in people without HIV, as of our 20 July 2026 check. The approval rests on HIV lipodystrophy trials, and the newest data (a 2025 phase 2 study) still 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.
Anybody who says otherwise is guessing.
The biggest gap: in our read, one gap counts for more than any dose figure. A research-grade vial offers no independent verification of what it actually contains.
All taken on trust: identity, purity, sterility, and whatever concentration the label claims.
The quiet one: a wrong label breaks every units calculation above. The math can only be as good as the mg number it is fed.
The real worry: that is not a dosing problem, a sourcing problem, and it is what we would check before anything else.
How this page is sourced
No secondary summaries: every trial figure above comes straight from the cited papers, with review articles named as such. Not lifted from a secondary summary.
The six sources: five papers and the FDA label, with DOIs and PubMed IDs where they exist. Pull them yourself, and check our figures against theirs.
The standard: the sourcing and citation-verification standard for this whole site lives 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.
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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