Pinc PeptideThe girly peptide research blog

Tesamorelin · Dose evidence · updated 8 October 2026

Tesamorelin dosage: what studies actually used

The short answer

The current FDA labels give tesamorelin as one injection under the skin once a day: 1.28 mg of Egrifta WR or 1.4 mg of Egrifta SV78. Both are approved only to reduce excess belly fat in adults with HIV who have lipodystrophy (abnormal changes in where the body stores fat)78. The trials behind the labels used 2 mg once a day of the original Egrifta, and completed trials in other groups used 1 or 2 mg a day191011. This page reports those doses and is not dosing advice. Vials sold online are another matter: of the 191 completed tests among Finnrick’s latest 200 for tesamorelin, from May to September 2026, 83 failed12.

Not dosing advice. This page reports doses that studies and approved labels used, with their sources. It does not recommend a dose, and we do not give mixing, injection or unit-conversion instructions. Gray-market vials often do not contain what their label says. How we report doses.

Every dose studied in people

StudyWhoPeopleDose and routeWhat happened
Phase 3 Study 1 (Falutz 2007), randomized trial with extension Adults with HIV and excess belly fat on HIV treatment; 86% men 412 2 mg once daily, or placebo; at week 26, people on tesamorelin were re-randomized to 2 mg or placebo
Injection under the skin · 26 weeks, then a 26-week extension		 Visceral fat (the deep fat around the organs) fell 15.2% on tesamorelin and rose 5.0% on placebo, and IGF-1 (a growth factor driven by growth hormone) rose 81.0%9. In people kept on 2 mg the drop held at 18% over 52 weeks, and the fat came back in those switched to placebo2.
Phase 3 Study 2 (Falutz 2010), randomized trial with extension Adults with HIV and excess belly fat on HIV treatment 404 2 mg once daily, or placebo (2 to 1); at 6 months, people on tesamorelin were re-randomized to 2 mg or placebo
Injection under the skin · 6 months, then a 6-month extension		 Visceral fat fell 10.9% on tesamorelin versus 0.6% on placebo, and by about 18% in people who stayed on it for 12 months10. The early gains were rapidly lost in those switched to placebo10.
Older-adult thinking trial (Baker 2012), randomized trial Adults aged 55 to 87, healthy or with mild cognitive impairment (early memory and thinking problems) 152 1 mg once daily, 30 minutes before bedtime, or placebo
Injection under the skin, self-given · 20 weeks		 Thinking-test scores improved more than on placebo (P=.03), IGF-1 rose 117% and percent body fat fell 7.4%11. Mild side effects were reported by 68% on tesamorelin and 36% on placebo11.
HIV thinking trial (Ellis 2025), randomized open-label trial Adults with HIV, a suppressed virus, belly obesity and neurocognitive impairment 73 2 mg once daily, versus usual care with no placebo (3 to 2)
Injection under the skin · 6 months		 The change in thinking-test scores did not differ significantly from usual care (P = .673)13. Waist size fell more on tesamorelin, by a median difference of 2.7 cm (P = .015)13.
HIV fatty-liver trial (Stanley 2019), randomized trial Adults with HIV and fatty liver (liver fat fraction of 5% or more) 61 2 mg once daily, or placebo; then 2 mg for everyone in an open-label phase
Injection under the skin · 12 months, then 6 months open label		 Liver fat fraction fell by an absolute 4.1% more than on placebo, a 37% relative drop, and 35% versus 4% ended with liver fat under 5%14. Fasting glucose and HbA1c did not differ between the groups at 12 months14.
Dose-ranging trial (Falutz 2005), randomized trial Adults with HIV and belly fat gain (a large waist and waist-to-hip ratio) 61 1 mg or 2 mg once daily, or placebo
Injection under the skin · 12 weeks		 IGF-1 rose 48% on 1 mg and 65% on 2 mg3. Trunk fat fell 9.2% on 2 mg, significantly more than on placebo, and 4.6% on 1 mg; visceral fat changes were not significant versus placebo3.
Belly-obesity trial without HIV (Makimura 2012), randomized trial Adults aged 18 to 55 with belly obesity and reduced growth hormone output; people with HIV were excluded 60 2 mg once daily, cut to 1 mg if IGF-1 rose above the normal range for age; or placebo
Injection under the skin, self-given · 12 months		 Visceral fat fell 16 cm² on tesamorelin and rose 19 cm² on placebo (P = 0.003), a net effect of 19%, while weight did not change significantly1. There were no serious side effects and no changes in fasting glucose, 2-hour glucose or HbA1c1.
Type 2 diabetes safety trial (Clemmons 2017), randomized trial Adults aged 50 or older with type 2 diabetes 53 1 mg or 2 mg once daily, or placebo
Injection under the skin · 12 weeks		 Insulin response, fasting glucose and HbA1c did not differ from placebo, and no one stopped because of lost diabetes control15.
Obesity fatty-liver trial (NCT03375788), randomized trial, registry results only Adults aged 18 to 65 with obesity and fatty liver, without diabetes 51 Once daily, listed in the registry as 2 mg of Egrifta and as the 1.4 mg newer formulation; or placebo
Injection under the skin · 12 months, then 6 months open label		 The registry reports a median change in liver fat fraction of -5.3% on tesamorelin and +3.6% on placebo at 12 months, with no statistical test posted4. As of 7 October 2026, the registry lists no journal paper4.
HIV visceral and liver fat trial (Stanley 2014), randomized trial Adults with HIV and belly fat gain on HIV treatment 50 2 mg once daily, or placebo
Injection under the skin · 6 months		 Visceral fat fell 42 cm² more than on placebo (P = .005), and liver fat, measured as the lipid-to-water percentage, fell by a net 2.9 percentage points16. Fasting glucose rose more on tesamorelin at 2 weeks, but changes at 6 months were not significant16.
Older-adult pilot (Stewart 2026), randomized trial Adults aged 55 to 85 with normal thinking or mild cognitive impairment 22 1 mg once daily, half the standard 2 mg dose, or placebo
Injection under the skin, self-given · 10 weeks		 Treatment was not directly linked with significant changes in body composition, fatigue, sleep, physical performance, glucose tolerance, thinking tests or standard brain-scan measures; an exploratory machine-learning analysis flagged possible differences in brain areas linked to thinking5.
Healthy-men growth hormone study (Stanley 2011), uncontrolled study Healthy men, mean age 45 13 2 mg once daily
Injection under the skin · 2 weeks		 Overnight growth hormone rose, and IGF-1 rose by 181 µg/L17. Fasting glucose and insulin-stimulated glucose uptake did not change significantly17.
COPD muscle-wasting trial (NCT01388920), randomized trial stopped early, registry results only Adults aged 40 to 75 with stable COPD (a long-term lung disease) and muscle wasting 2 2 mg or 3 mg a day, or placebo; 1 person started on each dose and none on placebo
Not stated in the registry · Planned 6 months; stopped about 1 month after enrollment		 The company stopped the trial for a reason unrelated to safety, so no results were analyzed6. The registry reports no serious or other side effects in the two people treated6.

The approved schedule (Egrifta WR and Egrifta SV (FDA labels))

The Egrifta WR label (revised March 2025) and the Egrifta SV label (revised February 2024) are each approved only to reduce excess belly fat in adults with HIV and lipodystrophy78. Both say tesamorelin is not for weight loss, because its effect on weight is neutral, and that long-term heart safety has not been established78. The Egrifta WR label says the two forms have different recommended doses and are not substitutable7. The labels name no time of day for the dose, and the steps on continuing or stopping come from their limits of use and warnings78.

WhenDose on the labelNote
Every day, Egrifta WR1.28 mg injected under the skin once dailyFrom the 11.6 mg vial form
Every day, Egrifta SV1.4 mg injected under the skin once dailyFrom the 2 mg vial form
If visceral fat has not fallenWeigh the risks and benefits of continuingLong-term heart safety is not established
If IGF-1 stays highConsider stoppingFor example above 3 SDS (standard deviation scores, a measure of distance from the average), especially if the response is not robust

Studies, animals and users: kept apart

Doses below are what studies used or what a label says. They are not advice, and gray-market products may not contain what their label says.

In human studies

Approved doses: Egrifta SV 1.4 mg or Egrifta WR 1.28 mg injected under the skin of the abdomen once daily. Both give blood levels comparable to the original product’s 2 mg once daily7819. The Phase 3 trials used 2 mg once daily for 26 to 52 weeks910. Other trials used 2 mg daily for 6 to 12 months (liver fat in HIV; belly fat in obesity without HIV), 1 or 2 mg daily for 12 weeks (type 2 diabetes), 1 mg nightly for 20 weeks (older adults) and 2 mg daily for 2 weeks (healthy men)11114151617. A trial in COPD that assigned people to 2 or 3 mg daily was stopped by its sponsor, for a reason unrelated to safety, after 2 people had started6. We found no completed trial that tested a higher dose, on-off cycles or blends with other peptides620.

In animal studies

Not applicable or not reported.

What users report Anecdotal · not validated · not a recommendation

A bodybuilding-oriented source compiled in a 2026 medical review describes 2 mg under the skin once a day, used for body composition rather than for HIV lipodystrophy18.

Half-life and how it is taken

Half-life
About 11 minutes (Egrifta WR)7Mean elimination half-life in healthy adults after one under-the-skin dose of 1.28 mg Egrifta WR. The Egrifta SV label gives 8 minutes after 1.4 mg. The original 2010 label gave 26 minutes in healthy people and 38 minutes in people with HIV after 14 daily 2 mg doses. Less than 4% of an injected dose reaches the bloodstream.
Routes
  • Subcutaneous injection (the approved route; all human data)

Why trials used 1 mg or 2 mg

Before the Phase 3 trials, a 12-week dose-ranging trial in 61 people with HIV compared 1 mg and 2 mg a day with placebo3. Trunk fat fell significantly more than on placebo with 2 mg, and IGF-1 rose more on 2 mg than on 1 mg3. The authors called for longer and larger studies, and both Phase 3 trials then used 2 mg once a day3910.

Some later trials chose 1 mg on purpose. In older adults, 1 mg a day raised IGF-1 by 117%, which the authors say stayed within the normal range11. A 2026 pilot gave 1 mg as half the standard daily dose, to look for direct effects on the brain while keeping growth hormone and IGF-1 effects small5. The trial without HIV cut the dose from 2 mg to 1 mg for anyone whose IGF-1 rose above the normal range for their age1.

In type 2 diabetes, IGF-1 rose more on 2 mg than on 1 mg but stayed within normal reference ranges, and blood sugar control did not change over 12 weeks15.

Staying on it and stopping

On the original 2 mg dose, IGF-1 often ran high: after 26 weeks, 47% of people on Egrifta had IGF-1 above 2 SDS and 36% were above 3 SDS, the example the labels give for when to consider stopping7. Among those who stayed on it for 52 weeks, 34% were above 2 SDS and 23% above 3 SDS at the end7.

The fat loss did not last beyond the treatment: when people stopped, visceral fat came back2. In the Study 1 extension, visceral fat rose 25 cm² (22%) over 26 weeks in people switched to placebo, versus 3 cm² (0%) in those who stayed on 2 mg7. In Study 2, it rose 24 cm² (16%) after switching, versus a fall of 11 cm² (5%) on 2 mg7.

Why gray-market vials make doses unreliable

FDA says biological products cannot be compounded under the pharmacy compounding rules, and Egrifta is on its list of products regulated as biologics2122. In warning letters dated 24 August 2026, FDA told five online sellers that their ‘research’ tesamorelin products are unapproved new drugs2324252627.

Lab results suggest that what is in a vial may not match its label12. Finnrick lists 706 tesamorelin tests from 106 vendors between 7 May 2025 and 24 September 202612. Of the latest 200, from 5 May 2026 on, 108 passed, 83 failed and 9 were incomplete12. Finnrick’s default pass mark needs purity of at least 99.5% and a measured amount within 35% of the label12. Its public page does not say which of these each failed sample missed12. People choose which samples to send, so this is not a random survey12.

Questions people ask

How much tesamorelin should I take?

The labels give 1.28 mg of Egrifta WR or 1.4 mg of Egrifta SV once a day, for adults with HIV and lipodystrophy only78. For any other use no dose is established, though trials used 1 or 2 mg a day111. Ask a prescriber whether any dose fits you.

What dose of tesamorelin is used for people without HIV?

No dose is approved for them78. Trials outside HIV used 2 mg a day for 12 months in adults with belly obesity (people with HIV were excluded), 1 or 2 mg a day for 12 weeks in type 2 diabetes, and 1 mg a day in older adults151115.

What is the highest dose of tesamorelin?

The published trials on this page used at most 2 mg a day39. A company trial in COPD planned to compare 2 mg and 3 mg a day, but it was stopped for a reason unrelated to safety about a month after enrollment, when 1 person had started on each dose6.

How long does it take for tesamorelin to work?

In healthy men, 2 mg a day raised growth hormone and IGF-1 within 2 weeks17. The belly-fat trials judged their main result at 26 weeks, when visceral fat had fallen 15.2% in Study 19.

What happens when you stop taking tesamorelin?

The visceral fat comes back: the effects did not last beyond the treatment2. In Study 1, visceral fat rose 22% over 26 weeks in people switched to placebo, versus 0% in those who stayed on 2 mg7.

Is tesamorelin taken at night or in the morning?

The labels say once a day and name no time of day78. One trial in older adults gave it 30 minutes before bedtime, and another let people pick their own time and keep it the same each day511.

Go deeper

Sources

  1. 1Metabolic effects of a growth hormone-releasing factor in obese subjects with reduced growth hormone secretion: a randomized controlled trial The Journal of Clinical Endocrinology & Metabolism, Dec 2012. pubmed.ncbi.nlm.nih.gov
  2. 2Long-term safety and effects of tesamorelin, a growth hormone-releasing factor analogue, in HIV patients with abdominal fat accumulation AIDS, 12 Sep 2008. pubmed.ncbi.nlm.nih.gov
  3. 3A placebo-controlled, dose-ranging study of a growth hormone releasing factor in HIV-infected patients with abdominal fat accumulation AIDS, 12 Aug 2005. pubmed.ncbi.nlm.nih.gov
  4. 4Growth Hormone Releasing Hormone Analog to Improve Nonalcoholic Fatty Liver Disease and Associated Cardiovascular Risk (NCT03375788), record with posted results ClinicalTrials.gov, 20 Nov 2025. clinicaltrials.gov
  5. 5The effect of growth hormone-releasing hormone on cognition and brain connectivity in adults with cognition ranging from normal to mild cognitive impairment eNeurologicalSci, Sep 2026. pubmed.ncbi.nlm.nih.gov
  6. 6Efficacy and Safety Study of Tesamorelin in Chronic Obstructive Pulmonary Disease (COPD) Subjects With Muscle Wasting (NCT01388920) ClinicalTrials.gov, 18 Mar 2022. clinicaltrials.gov
  7. 7EGRIFTA WR (tesamorelin) for injection: prescribing information (revised 3/2025) Theratechnologies via DailyMed (U.S. National Library of Medicine), Mar 2025. dailymed.nlm.nih.gov
  8. 8EGRIFTA SV (tesamorelin) for injection: prescribing information (revised 2/2024) Theratechnologies via DailyMed (U.S. National Library of Medicine), Feb 2024. dailymed.nlm.nih.gov
  9. 9Metabolic effects of a growth hormone-releasing factor in patients with HIV New England Journal of Medicine, 6 Dec 2007. pubmed.ncbi.nlm.nih.gov
  10. 10Effects 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, Mar 2010. pubmed.ncbi.nlm.nih.gov
  11. 11Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial Archives of Neurology, Nov 2012. pubmed.ncbi.nlm.nih.gov
  12. 12Tesamorelin: safety testing results and vendor ratings Finnrick, 24 Sep 2026. finnrick.com
  13. 13Effects of tesamorelin on neurocognitive impairment in persons with HIV and abdominal obesity Journal of Infectious Diseases, 2 Jun 2025. pubmed.ncbi.nlm.nih.gov
  14. 14Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial The Lancet HIV, Dec 2019. pubmed.ncbi.nlm.nih.gov
  15. 15Safety and metabolic effects of tesamorelin, a growth hormone-releasing factor analogue, in patients with type 2 diabetes: a randomized, placebo-controlled trial PLoS One, 2017. pubmed.ncbi.nlm.nih.gov
  16. 16Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial JAMA, 23 Jul 2014. pubmed.ncbi.nlm.nih.gov
  17. 17Effects of a growth hormone-releasing hormone analog on endogenous GH pulsatility and insulin sensitivity in healthy men The Journal of Clinical Endocrinology & Metabolism, Jan 2011. pubmed.ncbi.nlm.nih.gov
  18. 18The emerging landscape of performance-enhancing peptides modulating GH-IGF1 axis: bridging the gap between clinical evidence and patient self-administration Frontiers in Endocrinology, 18 Jun 2026. frontiersin.org
  19. 19EGRIFTA (tesamorelin for injection) prescribing information, original 2010 label U.S. Food and Drug Administration (Drugs@FDA), Nov 2010. accessdata.fda.gov
  20. 20ClinicalTrials.gov search: tesamorelin (24 studies) ClinicalTrials.gov, accessed 8 Oct 2026. clinicaltrials.gov
  21. 21Compounding and the FDA: Questions and Answers U.S. Food and Drug Administration, 16 Sep 2025. fda.gov
  22. 22List of Approved NDAs for Biological Products That Were Deemed to be BLAs on March 23, 2020 U.S. Food and Drug Administration, accessed 1 Oct 2026. fda.gov
  23. 23Warning letter to Royal Peptides LLC (MARCS-CMS 734884) U.S. Food and Drug Administration, 24 Aug 2026. fda.gov
  24. 24Warning letter to NuScience Peptides LLC (MARCS-CMS 733652) U.S. Food and Drug Administration, 24 Aug 2026. fda.gov
  25. 25Warning letter to Peak Performance Peptides (MARCS-CMS 735127) U.S. Food and Drug Administration, 24 Aug 2026. fda.gov
  26. 26Warning letter to Peptide Partners LLC (MARCS-CMS 735063) U.S. Food and Drug Administration, 24 Aug 2026. fda.gov
  27. 27Warning letter to TXP Innovations LLC dba Tex Peptides (MARCS-CMS 735067) U.S. Food and Drug Administration, 24 Aug 2026. fda.gov

Not medical advice. Talk to a licensed clinician before using any drug. Report an error.