This tesamorelin dosage chart keeps two things apart that most dosing pages blend: the doses printed on the FDA labels for Egrifta, and the amounts people on Reddit say they inject from research vials. The label numbers have changed twice, and none of them is the "1 to 2 mg" figure you see on vendor charts. Tesamorelin is one of the few peptides with an approved product, but only for one condition.
Key Takeaways
- The current labels give 1.4 mg a day for Egrifta SV (2 mg vial) and 1.28 mg a day for Egrifta WR (11.6 mg vial). Both are stated to match the exposure of the original 2 mg dose, and the two products are not substitutable
- The trials behind approval used 2 mg daily for 26 weeks. We found no controlled trial of the 1 mg doses, 5-days-on schedules or 8-week cycles that dominate online charts
- Of 13 Reddit accounts that named a dose, 7 used 2 mg or titrated up to it, 3 used 1 mg and 3 used less than 1 mg. This is a small, self-selected sample, not a recommendation
- Water volume sets the unit count: a 10 mg vial with 2 mL is 5 mg/mL, so 1 mg is 20 units on a U-100 syringe
- Approval covers excess abdominal fat in adults with HIV-associated lipodystrophy. Research-vial tesamorelin is not that product, and this page is information, not medical advice
For what tesamorelin is and how it works, see our tesamorelin peptide guide. This page is the dose-focused companion, and our tesamorelin side effects page covers tolerability in depth.
Tesamorelin dosage chart: what the FDA labels say
Start with the label, because it is the only dosing source with regulatory weight. We read the current Egrifta WR prescribing information (FDA copy, revised 3/2025) and the Egrifta SV label on DailyMed (revised 2/2024). The first thing to notice is that "Egrifta" is now three different products over time, and they do not use the same milligram figure.
Tesamorelin (Egrifta) doses as written on the FDA labels
| Original Egrifta | Egrifta SV | Egrifta WR | |
|---|---|---|---|
| Vial strength | 1 mg per vial | 2 mg per vial | 11.6 mg per vial |
| Daily dose | 2 mg | 1.4 mg (0.35 mL) | 1.28 mg (0.16 mL) |
| Mixing | Older label, not checked here | 0.5 mL sterile water into one vial | 1.3 mL bacteriostatic water into one vial (8 mg/mL) |
| After mixing | Not checked | Use at once; do not refrigerate or freeze | Room temperature; one vial covers 7 daily doses, then discard |
| Label date | Superseded | Revised 2/2024 | Revised 3/2025 |
Tesamorelin was first approved as Egrifta in November 2010, in 1 mg vials with a 2 mg daily dose. A second presentation, Egrifta SV, came later (Drugs.com dates it to October 2019): one 2 mg vial per day, mixed with 0.5 mL of sterile water, with a 0.35 mL dose that delivers 1.4 mg. The newest, Egrifta WR, is an 11.6 mg vial mixed with 1.3 mL of bacteriostatic water to 8 mg/mL. One vial gives seven daily doses of 1.28 mg (0.16 mL each), so the patient mixes once a week instead of every day.
The falling milligram number is a formulation change, not a lower treatment dose. The WR label states that exposure (Cmax and AUC) at 1.28 mg is similar to that of the original 2 mg dose, and the SV label says the same for 1.4 mg. The label also reports absolute bioavailability under 4% for a subcutaneous 2 mg dose and a half-life of about 11 minutes, so small formulation changes move exposure a long way. That is how "1.4 mg" and "2 mg" can be the same dose in effect.
Three more label facts matter. The injection goes into the abdomen, rotating sites, never into scar tissue, bruises or the navel. Glucose should be checked before starting and IGF-1 monitored, with discontinuation considered if it stays high (for example above 3 SDS). And it is contraindicated with pituitary disruption, active malignancy, known hypersensitivity and pregnancy. The indication is excess abdominal fat in adults with HIV-associated lipodystrophy, and the label says it is not for weight loss management.
What the trials used to get that label
The numbers behind the label are older than the current formulations. In the pivotal trial reported in the New England Journal of Medicine in 2007, 412 people with HIV and abdominal fat received 2 mg of tesamorelin or placebo daily for 26 weeks (PMID 18057338). Visceral fat fell 15.2% on tesamorelin and rose 5.0% on placebo, and triglycerides fell by 50 mg/dL against a 9 mg/dL rise. The label's two studies show mean visceral fat changes of minus 18% and minus 14% against plus 2% and minus 2% on placebo.
A smaller 2014 JAMA trial gave 2 mg daily or placebo to 50 antiretroviral-treated people for 6 months and reported a visceral fat change of minus 34 cm2 against plus 8 cm2, with lower liver fat (PMID 25038357).
Every one of these used a single fixed dose. That is the main limit of any tesamorelin dosage chart: one dose in one population, with no dose-ranging data we could verify for the 0.5 mg or 1 mg amounts people discuss. The label also lists the adverse reactions seen at that dose: injection site reactions in 17% of treated patients against 6% on placebo, arthralgia 13% against 11%, peripheral edema 6% against 2%, and hypersensitivity in 4%. In the label's 26-week data, 47% of treated patients had IGF-1 above 2 SDS.
Research vials are not Egrifta
Reddit and vendor dosing talk is built on a different product: a lyophilized powder, usually in 5, 10, 15 or 20 mg vials, mixed by the user. There is no published exposure bridge between a research vial and the SV or WR products, and the labels say different formulations cannot be swapped milligram for milligram. Someone saying "I take 2 mg" is applying the old trial number to a vial of unknown fill.
Compounded tesamorelin is the third category. Two accounts mention a compounding pharmacy or a prescriber, one describing a doctor's instruction to draw 20 syringe units. We could not verify the current regulatory status of compounded tesamorelin, so check with a pharmacist rather than assuming. In the data, one r/PeptidePathways thread also shows a pre-filled 3 mL pen at 1 mg/mL that commenters called overpriced and badly concentrated, a reminder to check concentration before any dose.
What Reddit users report taking
We read 441 posts and comments from 19 threads across 11 subreddits. After removing bot notices, deleted comments, two vendor promotional posts, bare questions and passing mentions, 20 first-hand accounts remained, from 8 threads and 6 subreddits (11 in r/Biohackers, 3 in r/Biohacking, 2 each in r/PeptidePathways and r/Retatrutide, 1 each in r/Peptidesource and r/BodyHackGuide). Of those, 13 named a dose.
Highest regular tesamorelin dose named by 13 Reddit accounts
The pattern is that 2 mg is the center of gravity, which matches the old trial number. Seven accounts used or titrated up to it, usually starting at 0.5 mg or 1 mg for a week or two. Three stayed at 1 mg. Three used less than 1 mg, including one who injected 0.2 mg six days a week for about five weeks and one whose prescriber had them draw 20 units, which they calculated as roughly 0.6 mg and later raised to 0.9 mg. That calculation was inconsistent (they also wrote 333 mcg), which shows how often unit math goes wrong.
Of the accounts that stated a schedule, three used five or six days a week and two injected every day. Four injected at bedtime, typically about two hours after dinner, and one moved to a fasted morning dose because 1 mg at night disturbed their sleep. A r/PeptidePathways commenter (Jun 2026) wrote: "...1mg a night messed up my sleep so I do 2mg first thing in the morning..." (link). Opinions on the weekend break split. A r/Peptidesource commenter (Mar 2026) said: "...stop doing five days on two days off with gh peptides, you’re just wasting your time and lessening the long-term effects." (link). Nobody cited evidence, and no trial we found compared schedules.
On results, 5 accounts reported getting leaner and 3 reported no change. The positive claims are weakly documented: One reported losing 5% visceral fat over 12 weeks without saying how it was measured, one cited a DEXA scan with no baseline, and several ran retatrutide, tirzepatide or growth hormone at the same time, so tesamorelin cannot be credited. Three people described no visible effect, including the one on 0.6 to 0.9 mg who wondered whether the dose was too low. Water retention or bloating came up in four accounts, and one wrote: "You do hold water weight with tesa, to which I typically drop around 1.5-2kgs each weekend as I cycle off it." (link).
Reactions are the other pattern. Three accounts described itching, welts or burning at injection sites, and three described whole-body itching or hives. One went to an emergency room after hives and a tingling throat and then stopped, and another described a reaction to a restart after a break. One more user reported insomnia, breathlessness and chest "zapping" after a first 1 mg dose, with a normal EKG at urgent care. Three reported joint, back or hip pain. These are anecdotes, but they echo the label: hypersensitivity in 4%, and the label tells patients to seek prompt medical attention and discontinue if it is suspected.
Several commenters described 2 mg as the bottom end of what people take. That is peer pressure rather than evidence, and it happens to be the old trial dose delivered by a different product. The sample is small, drawn from communities that exist to discuss these products, and cannot tell you what is safe.
Reconstitution math: mg, mL and syringe units
Most dosing threads end up being arithmetic threads. The vial holds a fixed mass of powder, the water you add sets the concentration, and the volume you draw depends on both. The formula is units on a U-100 syringe = dose in mg divided by concentration in mg/mL, times 100.
A worked example: a 10 mg vial mixed with 2 mL of bacteriostatic water is 10 mg in 2 mL, or 5 mg/mL. A 1 mg dose is 1 divided by 5, which is 0.2 mL, or 20 units on a syringe where 100 units equals 1 mL. A 2 mg dose is 40 units. The label products work the same way: Egrifta WR at 8 mg/mL gives 1.28 mg in 0.16 mL, which is 16 units, and Egrifta SV's 0.35 mL is 35 units.
Syringe units for tesamorelin research vials (U-100 syringe)
| Concentration | 1 mg dose | 2 mg dose | Vial lasts (1 mg / 2 mg a day) | |
|---|---|---|---|---|
| 5 mg + 1 mL | 5 mg/mL | 20 units | 40 units | 5 days / 2.5 days |
| 5 mg + 2 mL | 2.5 mg/mL | 40 units | 80 units | 5 days / 2.5 days |
| 10 mg + 1 mL | 10 mg/mL | 10 units | 20 units | 10 days / 5 days |
| 10 mg + 2 mL | 5 mg/mL | 20 units | 40 units | 10 days / 5 days |
| 20 mg + 2 mL | 10 mg/mL | 10 units | 20 units | 20 days / 10 days |
Scaling by vial size is division. A 12-week course of 1 mg daily uses 84 mg, and 2 mg daily uses 168 mg, so Reddit accounts mostly used 10 to 20 mg vials, and one said a 15 mg vial finishes in about six days. Dilute too far and the volume gets awkward: a 2 mg dose at 1 mg/mL is 200 units, more than a standard 100-unit syringe holds, which is the mistake commenters pointed out in the pre-filled pen thread.
Two commenters raised concentration as a comfort issue: one had moved from 2 mL to 3 mL of water per vial after painful injections, and another wondered whether diluting tesamorelin would hurt efficacy. Neither had data, and neither choice changes the milligrams.
The other half of the math is the vial itself. Every number above assumes the label is true. If you want one supplier to check against, Ascension Peptides lists a 5 mg tesamorelin vial at $50.00 as of 2026-10-11, tested batch by batch by Kovera Labs (HPLC, LC-MS identity, net content, endotoxin, sterility and heavy metals), with more than 98% of batches passing and public batch certificates. Shipping is US only and all sales are final. At that price a 5 mg vial is $10 per milligram, so a 12-week course at 1 mg a day is about 17 vials. Our guide to where to buy tesamorelin covers reading certificates.
Timing, frequency and cycle length
The label dose is daily, with no cycle: the trials ran 26 weeks plus a 26-week extension. Reddit accounts reported cycles of 5 to 12 weeks, with a few pausing between runs for a month or more, and one planned a 45-day run from a bulk order. We found no study that supports an 8-weeks-on, 8-weeks-off pattern or a fixed five-day week.
On timing, users say food blunts the response and a night pulse of growth hormone is the one to restore, so they inject at bedtime about two hours after eating. That reasoning comes from commenters, not a timing trial, and the label specifies neither time of day nor fasting.
The label says to monitor IGF-1 and glucose. Only two Reddit commenters asked about IGF-1 at all, and none of the tesamorelin users reported a result, so forum dose escalation is effectively blind. Several commenters argued that tesamorelin is redundant when growth hormone is also taken, a view that is plausible but unmeasured. See our comparisons of sermorelin vs tesamorelin and tesamorelin with retatrutide for how those combinations are discussed.
What changes the dose
The product. SV, WR, the original and a research vial are four different things; a milligram figure only means something with its formulation.
Tolerance. Starting at 0.5 or 1 mg and stepping up is practice, not label instruction. Joint pain, swelling and hypersensitivity were the reasons people gave for stepping down or stopping.
IGF-1 and glucose. Both are label-monitored, so a clinician, not feel, should drive adjustments.
Other drugs. Adding growth hormone, secretagogues or a GLP-1 changes the picture, and stack reports cannot separate the contributions.
Product quality. An underfilled vial makes two people on the same "dose" report different results.
Health conditions. Active cancer, pituitary disease and pregnancy are label contraindications, not dose questions. Anyone with diabetes or a cancer history should talk to a clinician first.
Frequently Asked Questions
What is the tesamorelin dosage?
There is no single answer. The FDA labels give 1.4 mg daily for Egrifta SV and 1.28 mg daily for Egrifta WR, both subcutaneous into the abdomen, for HIV-associated abdominal fat. The older trials used 2 mg daily. The Reddit accounts we counted most often named 2 mg or a step-up to it.
How many units is 1 mg of tesamorelin?
It depends on the water you add. A 10 mg vial with 2 mL is 5 mg/mL, so 1 mg is 20 units on a U-100 syringe. With 1 mL it is 10 units, and with a 5 mg vial and 2 mL it is 40 units.
Is the tesamorelin dose 1 mg or 2 mg?
The old trials and original Egrifta used 2 mg daily. The current labels use 1.4 mg (SV) and 1.28 mg (WR) because the formulations were changed to match that exposure. A research vial has no such bridge, so neither number transfers cleanly.
How long should you take tesamorelin?
The label dose is daily without a built-in end, and the trials ran 26 to 52 weeks. Reddit cycles clustered at 5 to 12 weeks, with no study behind the break lengths. The label's extension phase re-randomized treated patients to placebo to test whether the loss held, so duration is a question for a prescriber.
Is tesamorelin FDA approved?
Yes, as Egrifta SV and Egrifta WR, for reducing excess abdominal fat in adults with HIV-associated lipodystrophy. It is not approved for general weight loss or anything else, and research-vial tesamorelin is not an approved product.
Checking a vial before you do any math
The dose arithmetic assumes the vial contains what it says, so confirm lot, purity and mass first. Ascension Peptides lists its 5 mg tesamorelin vial at $50.00 as of 2026-10-11, with per-batch Kovera Labs testing and public batch certificates, US shipping only and all sales final. New customers can use code PEPTIDEDECK for 50% off. Write units out in full, and treat every Reddit number here as an anecdote.
Medical Disclaimer: Tesamorelin is FDA-approved only as Egrifta for reducing excess abdominal fat in adults with HIV-associated lipodystrophy. Research-vial tesamorelin is sold for laboratory research use only and is not an approved product. This article reports label, published and user-reported figures for education. It is not medical advice, a dosing protocol or a recommendation for personal use. Consult a qualified healthcare professional about any treatment decision.
