Tesamorelin Dosage Guide

FDA-approved GHRH analog for visceral fat reduction — 2 mg daily protocol, reconstitution, stacking with Ipamorelin, cycling and safety. For research purposes only — not for human use.

Clean Peptides does not provide advice on dosages or usage. This guide compiles product information from Clean Peptides together with independent educational material from PeptideWiki, for research reference only. It is not medical advice and does not represent recommendations, endorsements, or instructions from Clean Peptides.

What Is Tesamorelin?

Tesamorelin (brand name Egrifta) is a synthetic analog of GHRH — the full 44 amino acids of human GHRH(1–44) with a trans-3-hexenoic acid N-terminal modification for stability. It received FDA approval in 2010 for reducing excess abdominal fat (lipodystrophy) in HIV-infected patients. Unlike exogenous HGH, it stimulates pulsatile GH release while preserving the somatostatin feedback loop, reducing supraphysiological GH/IGF-1 risk. Trials showed 15–18% reduction in visceral adipose tissue over 26 weeks.

Dosing derives from clinical studies, published research and community protocols.

Key Characteristics

  • GHRH analog (44 amino acids) — the only FDA-approved GHRH analog.
  • FDA-approved (2010) — for HIV-associated lipodystrophy (Egrifta / Egrifta SV).
  • Pulsatile GH release — preserves the somatostatin feedback loop.
  • Visceral-fat specificity — 15–18% VAT reduction over 26 weeks; minimal effect on subcutaneous fat.
  • Cognitive potential — STAY study (2019) showed preserved cognition in HIV-positive older adults.

How Dosage Is Determined

Uniquely well-established — full FDA approval process. The 2 mg daily dose was selected in Phase II and confirmed in Phase III RCTs (>800 patients; Falutz et al. 2007, 2010). VAT reduction of 15–18% vs placebo at 26 weeks. STAY study: 12-month cognitive RCT. Strength of evidence: strong.

Standard Dosage

Fixed 2 mg daily dose regardless of body weight, sex or severity.

Protocol Dose Frequency Notes
FDA-Approved (Egrifta) 2 mg SubQ Once daily Phase III trial dose; 26-week endpoint
Standard Off-Label 2 mg SubQ Once daily Body composition / anti-aging; evening injection
Conservative 1 mg SubQ Once daily Less clinical data at this dose
5-on / 2-off (Community) 2 mg SubQ 5 days/week Extends vial use; not studied in trials

Reconstitution & Dosing (with the supplied 3 mL)

Every Clean Peptides vial ships with 3 mL of bacteriostatic water (0.9% benzyl alcohol). All figures below assume you reconstitute with the full 3 mL. On a standard U-100 insulin syringe, 100 units = 1 mL.

Quick formula: concentration = vial strength ÷ 3 mL, and units to draw = dose (mg) × 300 ÷ vial strength (mg).

How to reconstitute

  1. Wash your hands and lay out the vial, the 3 mL bacteriostatic water, an insulin syringe and alcohol swabs on a clean surface.
  2. Flip off the caps and swab both rubber stoppers with alcohol; let them air-dry 10–15 seconds.
  3. Draw the full 3 mL of bacteriostatic water (in three 1 mL passes with an insulin syringe, or in one pass with a 3 mL syringe).
  4. Add the water slowly, angling the needle so it runs down the inside glass wall — never squirt it directly onto the powder cake.
  5. Dissolve gently — let the vial sit 1–2 minutes, then swirl or roll it between your palms until the solution is clear. Never shake.
  6. Label and refrigerate at 2–8 °C. Resulting concentration: 10 mg → 3.33 mg/mL.

Storage: unreconstituted powder refrigerated (2–8 °C); reconstituted solution refrigerated and used within 28–30 days; do not freeze; protect from light and heat.

Draw volumes with 3 mL — Tesamorelin

Vial (Clean Peptides) Concentration 1 mg 2 mg
10 mg 3.33 mg/mL 30 u 60 u

Dosage by Goal

  • Visceral fat reduction (FDA indication): 2 mg SubQ daily × 26 weeks minimum. CT/DEXA at baseline and 26 wk; IGF-1 at baseline, 8 wk, 26 wk. Evening/bedtime, fasted 1–2 h.
  • Body composition & anti-aging (off-label): 2 mg SubQ daily, evening/bedtime, fasted; 12–26 weeks then break.
  • Cognitive support: 2 mg SubQ daily × 12 months (STAY study); data limited to HIV-positive population.

Injection Guide

  1. Wash hands; prepare a clean workspace.
  2. Swab the vial stopper; air-dry.
  3. Draw the dose (typically the full vial for 2 mg); tap out bubbles.
  4. Choose the abdomen (FDA-approved site), 2–3 in from navel; avoid scar tissue.
  5. Clean the site; air-dry.
  6. Inject into a pinched fold at 45°.
  7. Dispose in a sharps container.

Optimal timing: evening/bedtime (synergizes with nocturnal GH surge), fasted 1–2 h. Consistent daily dosing; rotate within the abdomen.

Cycle Duration & Timing

Protocol Duration Notes
Standard (FDA trial) 26 weeks daily Phase III primary endpoint
Extended 52 weeks daily Maintained benefit; longest studied
Cyclical 26 wk on, 8–12 wk off, repeat Pituitary recovery, cost management
5-on / 2-off weekly Ongoing, 5 days/week Reduces cost ~30%; not studied

Visceral fat reaccumulates after discontinuation; IGF-1 normalizes within weeks. No PCT required (pituitary not suppressed).

Stacking Protocols

Tesamorelin + Ipamorelin — GHRH + GHRP synergy (gold standard): Tesamorelin 2 mg SubQ evening + Ipamorelin 200–300 mcg SubQ bedtime, fasted. Separate receptor pathways → synergistic GH response.

Full Ipamorelin protocols: see our Ipamorelin Dosage Guide.

Other stacks: + AOD-9604 (direct lipolysis, morning fasted); + BPC-157 (GH optimization + tissue repair).

Safety, Side Effects & Contraindications

Cancer screening required — GH/IGF-1 promote cell growth; active malignancy is an FDA-labeled contraindication. Complete age-appropriate screening before starting.

Common (Phase III): injection-site reactions (~13%), arthralgia (~13%), peripheral edema, myalgia. Less common: hyperglycemia/insulin resistance, carpal tunnel syndrome, paresthesia, nausea.

Contraindications: active malignancy; disrupted hypothalamic-pituitary axis; pregnancy (Category X); hypersensitivity (incl. mannitol); uncontrolled diabetes.

Monitor: IGF-1 (baseline, 8 wk, 26 wk), fasting glucose & HbA1c, cancer screening, thyroid panel, lipids. Do not combine with exogenous HGH. Prescription medication; WADA-prohibited.

Common Mistakes

  • Injecting after a meal instead of fasted.
  • Expecting HGH-level results from a GHRH analog.
  • Stopping before 26 weeks.
  • Skipping IGF-1 monitoring.
  • Combining with exogenous HGH.
  • Starting without cancer screening.
  • Inconsistent daily dosing.
  • Using Egrifta (sterile water) beyond 24 hours.

Key Takeaways

  • The only FDA-approved GHRH analog; strongest clinical evidence of any GH peptide.
  • Fixed 2 mg SubQ once daily (no weight-based adjustment).
  • Pulsatile GH release preserving feedback; 15–18% visceral fat reduction over 26 weeks.
  • Inject at bedtime, fasted. Top stack: Tesamorelin + Ipamorelin.
  • Cancer screening required; monitor IGF-1; do not combine with HGH.

Download & Related Resources

📄 Download the full PDF guide

Shop Tesamorelin: Tesamorelin 10 mg

Related guides: Ipamorelin Dosage Guide · MOTS-c Dosage Guide

References

  1. Falutz J, et al. “Tesamorelin on visceral fat reduction in HIV-infected patients.” N Engl J Med. 2007;357:2359-2370.
  2. Falutz J, et al. “Metabolic effects of a GH-releasing factor in patients with HIV.” J Clin Endocrinol Metab. 2010;95(9):4291-4304.
  3. Stanley TL, et al. “Tesamorelin on visceral and liver fat in HIV patients.” JAMA. 2014;312(4):380-389.
  4. Stanley TL, et al. “Tesamorelin effects on neuropsychological function in HIV older adults.” AIDS. 2019;33(7):1179-1188.
  5. Dhillon S. “Tesamorelin: a review in HIV-associated lipodystrophy.” Drugs. 2011;71(8):1071-1091.

For research purposes only — not for human use. Educational reference compiled from PeptideWiki (peptidewiki.co).

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