Tesamorelin Reconstitution Calculator
Tesamorelin has a published human dose, and it comes from an approved label rather than from a trial someone reinterpreted. It is FDA-approved and prescription-only for exactly one indication: reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. It is a synthetic analogue of growth hormone-releasing factor, supplied as a lyophilised powder, reconstituted with the sterile water packed alongside it, and injected subcutaneously into the abdomen once daily. The label's limitations of use are unusually blunt: long-term cardiovascular safety has not been established, and it is not indicated for weight management because its effect on weight is neutral. The calculator below converts a vial size and a mixing volume into mg/ml and U-100 syringe units, which is arithmetic about a vial rather than a dose. Two approved formulations exist, with different vial strengths and different mixing procedures, and the published range below covers both of them.
Curated by Dosavy from published literature and regulator labels. Published 11 September 2026, last reviewed 11 September 2026. No clinician reviews this page.
Enter a target dose above to see the draw.
What the evidence says
| Experience | Route | Range | Frequency |
|---|---|---|---|
| Beginner | Subcutaneous | 1.4–2 mg[1][2][3]The only labelled dose; there is no titration and no higher labelled dose. Label wording: 'The dose of EGRIFTA SV is 1.4 mg (0.35 mL of the reconstituted solution) injected subcutaneously once daily.' The equivalent dose of the older 1 mg-per-vial EGRIFTA formulation is 2 mg once daily, and the label states that systemic exposure is similar between the two. In the phase 3 programme 2 mg once daily for 6 months reduced visceral adipose tissue by 10.9% versus 0.6% on placebo; most of the effect on visceral fat is seen by 6 months and the label requires reassessing whether to continue in patients who have not responded. | Once daily |
- BeginnerSubcutaneous
Once daily
The only labelled dose; there is no titration and no higher labelled dose. Label wording: 'The dose of EGRIFTA SV is 1.4 mg (0.35 mL of the reconstituted solution) injected subcutaneously once daily.' The equivalent dose of the older 1 mg-per-vial EGRIFTA formulation is 2 mg once daily, and the label states that systemic exposure is similar between the two. In the phase 3 programme 2 mg once daily for 6 months reduced visceral adipose tissue by 10.9% versus 0.6% on placebo; most of the effect on visceral fat is seen by 6 months and the label requires reassessing whether to continue in patients who have not responded.
Published ranges, reported as the literature states them and numbered to the sources at the foot of this page. Not a recommendation.
Tesamorelin has a single labelled dose and no titration, so one range is emitted rather than a beginner/intermediate/advanced spread. The range spans 1.4 mg to 2 mg because two approved formulations exist and the label states their systemic exposure (Cmax and AUC) is similar: 1.4 mg of the 2 mg-per-vial EGRIFTA SV formulation is the current labelled dose, and 2 mg of the older 1 mg-per-vial EGRIFTA formulation is the dose used throughout the phase 3 programme. This matters practically because grey-market vials are usually sold as '2 mg' with no formulation identity, and the two label documents give different reconstitution volumes and vial counts for what is meant to be the same delivered exposure. All human efficacy data are in HIV-infected adults with lipodystrophy; a separate 12-month randomised trial in 60 abdominally obese non-HIV subjects with reduced GH secretion also used 2 mg once daily, but that population is not a labelled indication.
Tesamorelin at a glance
- Category
- GH secretagogue
- Half-life
- 0.1 h
- Routes
- Subcutaneous
- Regulatory status
- Approved
- Also sold as
- Tesamorelin, tesamorelin, TH9507, Egrifta, Egrifta SV, GHRF analogue
Mechanism
A synthetic analogue of human growth hormone-releasing factor (GHRF, also called GHRH). In vitro it binds and stimulates human GRF receptors with similar potency to endogenous GRF. GHRF acts on pituitary somatotroph cells to stimulate synthesis and pulsatile release of endogenous growth hormone, which is both anabolic and lipolytic; GH then acts on chondrocytes, osteoblasts, myocytes, hepatocytes and adipocytes, with many but not all effects mediated by IGF-1. Because it works upstream at the pituitary, GH release stays pulsatile and remains subject to normal somatostatin feedback, unlike exogenous somatropin.
Reconstitution
Supplied as a lyophilised powder. Reconstitute one 2 mg vial with 0.5 mL of the supplied Sterile Water for Injection (2 mg per 0.5 mL), mix by rolling the vial gently in your hands for 30 seconds, do not shake. Use only if the solution is clear, colourless and free of particulate matter. Inject 0.35 mL (which is the 1.4 mg dose) immediately, then discard the rest. The older 1 mg-per-vial EGRIFTA formulation has different reconstitution instructions, a different number of vials per dose and a different labelled dose; the two are not interchangeable procedures.
Storage
Store the EGRIFTA SV 2 mg vial at room temperature, 20°C to 25°C (excursions 15°C to 30°C permitted), protected from light in the original box until use. The Sterile Water for Injection diluent and injection supplies are also stored at room temperature. Do not freeze or refrigerate the reconstituted solution. Use it immediately and discard any unused portion.
Frequency in practice
Once daily, injected subcutaneously into the abdomen with site rotation.
Regulatory
FDA-approved and prescription-only, for one indication only: reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy. The label carries explicit limitations of use: long-term cardiovascular safety has not been established, it is not indicated for weight-loss management because its effect on weight is neutral, and there are no data supporting improved antiretroviral compliance. Use for body composition, anti-ageing or performance in people without HIV-associated lipodystrophy is off-label and unstudied for benefit. As a GHRH analogue, tesamorelin is prohibited at all times in sport.
What to know before anything else
CONTRAINDICATED in patients with disruption of the hypothalamic-pituitary axis (hypophysectomy, hypopituitarism, pituitary tumour or surgery, head irradiation, head trauma). The drug works by stimulating a pituitary that must be intact.
CONTRAINDICATED in active malignancy; any preexisting malignancy must be inactive and its treatment complete before starting, because tesamorelin induces release of endogenous GH, a known growth factor. Discontinue on any evidence of recurrent malignancy.
CONTRAINDICATED in pregnancy and in known hypersensitivity to tesamorelin or excipients; hypersensitivity reactions occurred in clinical trials.
Raises serum IGF-1 by design. The label states plainly that the effects of prolonged IGF-1 elevation are unknown, requires IGF-1 monitoring during therapy, and says to consider discontinuation in patients with persistent elevations.
Fluid retention (oedema, arthralgia, carpal tunnel syndrome) and glucose intolerance or new diabetes mellitus can develop; evaluate glucose before and during therapy.
Consider discontinuation in patients who become acutely critically ill. Increased mortality has been seen with GH-axis stimulation in that setting.
Injection-site reactions are common; inject into the abdomen only, rotate sites, and avoid scar tissue, bruises and the navel.
Interacts pharmacodynamically with glucocorticoid replacement (GH inhibits 11β-HSD-1, so maintenance or stress doses may need increasing) and may alter clearance of CYP450-metabolised drugs.
Tesamorelin questions
Is there an established dose for tesamorelin?
Yes, and it is unusually simple: one labelled dose, once daily, no titration, no higher labelled step. Behind it sits a 2010 randomised, double-blind, placebo-controlled phase 3 trial in 404 patients, where six months of daily treatment cut visceral adipose tissue by 10.9% against 0.6% on placebo, and a 2005 dose-ranging trial in 61 patients that selected the dose. The published range below spans two numbers only because two approved formulations exist.
How does tesamorelin work, and how is it different from injecting growth hormone?
It acts one step upstream. In vitro it binds and stimulates human GRF receptors with similar potency to endogenous growth hormone-releasing factor, and GHRF acts on pituitary somatotroph cells to stimulate synthesis and pulsatile release of the body's own growth hormone. That hormone is both anabolic and lipolytic, acting on chondrocytes, osteoblasts, myocytes, hepatocytes and adipocytes, with many but not all of its effects mediated by IGF-1. Because the pituitary is doing the releasing, output stays pulsatile and remains subject to normal somatostatin feedback, which exogenous somatropin does not.
Are EGRIFTA and EGRIFTA SV the same thing?
No, and this is the practical trap. The two approved formulations carry different vial strengths, different reconstitution volumes, different vial counts per dose and different labelled doses, even though the label states systemic exposure between them is similar. The procedures are not interchangeable. Grey-market vials are usually sold as a bare milligram figure with no formulation identity, so copied mixing instructions may belong to the other product.
Is tesamorelin approved for weight loss or anti-ageing?
No. The label says in its own limitations of use that it is not indicated for weight-loss management, because its effect on weight is neutral, and that long-term cardiovascular safety has not been established. Every human efficacy result sits in HIV-infected adults with lipodystrophy. One separate 12-month randomised trial ran in 60 abdominally obese subjects without HIV who had reduced growth hormone secretion, but that population is not a labelled indication. Use for body composition, anti-ageing or performance in people without HIV-associated lipodystrophy is off-label and unstudied for benefit. As a GHRH analogue it is also prohibited at all times in sport.
Who must not take tesamorelin?
The label lists four contraindications. It is contraindicated with any disruption of the hypothalamic-pituitary axis, including hypophysectomy, hypopituitarism, a pituitary tumour or surgery, head irradiation or head trauma, because the drug works by stimulating a pituitary that has to be intact. It is contraindicated in active malignancy, since it induces release of endogenous growth hormone, a known growth factor; any preexisting malignancy must be inactive with treatment complete before starting. It is contraindicated in pregnancy, and after known hypersensitivity to tesamorelin or its excipients.
What monitoring does the tesamorelin label require?
IGF-1 and glucose. Tesamorelin raises serum IGF-1 by design, the label states plainly that the effects of prolonged elevation are unknown, and it requires IGF-1 monitoring during therapy with discontinuation considered where elevations persist. Glucose intolerance and new diabetes can develop, so glucose is evaluated before and during therapy. Fluid retention shows up as oedema, arthralgia and carpal tunnel syndrome. Discontinuation should be considered in anyone who becomes acutely critically ill, where GH-axis stimulation has been associated with increased mortality. Growth hormone also inhibits 11-beta-HSD-1, so glucocorticoid replacement may need increasing, and clearance of CYP450-metabolised drugs may change.
How is a tesamorelin vial reconstituted and stored?
By its own label, not by peptide convention. The 2 mg vial is reconstituted with the supplied sterile water for injection, mixed by rolling the vial gently in the hands for 30 seconds and never shaken, and used only if the solution is clear, colourless and free of particulate matter. The labelled volume is injected immediately and the remainder discarded. Vials, diluent and supplies are stored at room temperature, protected from light in the original box; the reconstituted solution is neither frozen nor refrigerated. Clearance is fast, with a mean elimination half-life of about eight minutes and subcutaneous bioavailability under 4%.
Every number above, and where it came from
3 sources, numbered where they are used. Each one links to the paper or the label itself, not to a summary of it.
- [1]EGRIFTA SV (tesamorelin) for injection, for subcutaneous use: FDA prescribing information
2026 · FDA approved label
- [2]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.
Journal of acquired immune deficiency syndromes (1999) · 2010 · Randomised, double-blind, placebo-controlled phase 3 trial · n=404
- [3]A placebo-controlled, dose-ranging study of a growth hormone releasing factor in HIV-infected patients with abdominal fat accumulation.
AIDS (London, England) · 2005 · Randomised, double-blind, placebo-controlled dose-ranging trial · n=61
The rest of the math
- Reconstitution calculatorThe full version of the tool above, with syringe barrel sizes and IU conversion.
- Vial longevityHow many doses a vial holds and the date it runs out.
- Cost per doseVial price against doses drawn, so two vial sizes can be compared honestly.
- Half-life and decayFirst-order clearance, time to steady state, and what remains at a given hour.
You worked out the draw. Now log this dose.
A calculator answers once and forgets. Dosavy keeps the concentration you mixed, the doses you actually took, and a reminder for the next one, with the same evidence labels you see on this page.