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The Peptide Effect
Dosage Guide

Tesamorelin Dosage Guide: Protocol & Administration

Educational reference covering tesamorelin dosage protocols, reconstitution instructions, and administration guidelines as discussed in research literature.

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Medical Disclaimer

This guide is for educational and informational purposes only. It is not medical advice. Dosages described reflect ranges discussed in published research and clinical practice literature — they are not recommendations. Always consult a licensed healthcare provider before using any peptide. Legality and availability vary by jurisdiction.

Overview

Tesamorelin is a synthetic growth-hormone-releasing factor (GRF) analogue that stimulates pituitary release of endogenous growth hormone. It received FDA approval under the brand name Egrifta for the reduction of excess abdominal fat in HIV-infected patients with lipodystrophy. Research literature has also explored its potential effects on visceral adipose tissue, body composition, and cognitive function in aging populations. Tesamorelin works by binding to GHRH receptors on pituitary somatotroph cells, triggering a pulsatile GH release pattern that more closely mirrors natural physiology than exogenous GH. The following dosage information is provided for educational reference only and does not constitute medical advice.

Dosing Protocols

FDA-Approved Protocol (Egrifta)

Route: Subcutaneous (abdominal)
Dose: 2 mg
Frequency: Once daily
Duration: As directed — typically assessed at 6 months

Administered via subcutaneous injection into the abdomen. Rotate injection sites to reduce lipodystrophy risk. This is the dose used in pivotal clinical trials for HIV-associated lipodystrophy.

Bodybuilding / Recomposition Protocol

Route: Subcutaneous
Dose: 1–2 mg
Frequency: Once daily, typically before bed or in the morning on an empty stomach
Duration: 8–12 weeks, followed by a break

Discussed in bodybuilding communities for its GH-releasing properties. Evening administration may complement natural nocturnal GH pulses. Not FDA-approved for this use.

GH Optimization Protocol

Route: Subcutaneous
Dose: 1 mg
Frequency: Once daily
Duration: 12–26 weeks

A lower-dose approach reported in research contexts aimed at modest GH elevation with reduced likelihood of side effects. May be combined with lifestyle factors such as fasting and exercise for additive effects.

Reconstitution & Storage

Vial sizes2 mg lyophilized powder per vial
Recommended water volume2 mL sterile water for injection (provided with Egrifta kit)
StorageStore unreconstituted vials refrigerated at 2–8 °C (36–46 °F). Do not freeze.
Stability once reconstitutedUse within 24 hours after reconstitution. Keep reconstituted solution refrigerated and protected from light.

Use our reconstitution calculator to determine exact syringe units for your dose.

Cycle Guidance

Clinical trials evaluated tesamorelin over 26-week treatment periods. In research contexts, cycling patterns of 8–12 weeks on followed by 4–8 weeks off have been discussed to reduce potential desensitization of GHRH receptors. Visceral fat reduction observed in studies tended to reverse upon discontinuation, suggesting ongoing use may be necessary for sustained effects.

Stacking Considerations

  • Sometimes discussed alongside ipamorelin or CJC-1295 for enhanced GH axis stimulation, though clinical data on such combinations is limited.
  • May be used concurrently with testosterone replacement therapy under medical supervision in the context of HIV-associated lipodystrophy.
  • Concurrent use with exogenous GH is generally not discussed in literature, as tesamorelin works by stimulating endogenous GH release.
  • Dietary strategies such as intermittent fasting are sometimes discussed alongside GHRH analogues to potentiate GH response.

Potential Side Effects

  • Injection site reactions (erythema, pruritus, pain, irritation) — reported in up to 20% of trial participants
  • Peripheral edema and fluid retention
  • Joint pain (arthralgia) and muscle pain (myalgia)
  • Paresthesia (tingling or numbness in extremities)
  • Elevated IGF-1 levels above the normal range
  • Nausea and vomiting
  • Potential for glucose intolerance or worsening of pre-existing diabetes
  • Hypersensitivity reactions (rare)

Contraindications & Cautions

  • Known hypersensitivity to tesamorelin or mannitol
  • Disruption of the hypothalamic-pituitary axis due to conditions such as hypophysectomy, pituitary tumor or surgery, or head irradiation
  • Active malignancy — GH elevation may theoretically promote tumor growth
  • Pregnancy — FDA Pregnancy Category X (Egrifta labeling)
  • Caution in patients with a history of non-malignant neoplasms
  • Pre-existing diabetes or glucose intolerance requires monitoring

Related

Tesamorelin Profilefat lossmuscle growthanti agingsermorelin dosageipamorelin dosagecjc-1295 dosage

References

  1. 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 (2010) — PubMed
  2. Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation: a randomized clinical trial (2014) — PubMed
  3. Growth hormone-releasing hormone effects on brain γ-aminobutyric acid levels in mild cognitive impairment and healthy aging (2012) — PubMed
  4. Tesamorelin, a human growth hormone releasing factor analogue, improves body composition and metabolic parameters in HIV-infected patients (2010)

Frequently Asked Questions

What is the standard tesamorelin dosage?
The FDA-approved dosage for Egrifta is 2 mg administered once daily via subcutaneous injection into the abdomen. This was the dose evaluated in the pivotal Phase III clinical trials that led to its approval for HIV-associated lipodystrophy. Lower doses of 1 mg daily have been discussed in research exploring GH optimization in non-HIV populations.
When is the best time to take tesamorelin?
The FDA labeling does not specify a particular time of day. However, many protocols discussed in the research community suggest morning administration on an empty stomach or evening dosing before bed to align with natural nocturnal GH pulses. Food intake, particularly carbohydrates and fats, may blunt the GH response, so fasted administration is often preferred.
How long does tesamorelin take to show results?
In the pivotal clinical trials (Falutz et al., 2010), statistically significant reductions in trunk fat were observed after 26 weeks of daily 2 mg dosing. IGF-1 levels typically rise within the first few weeks of treatment. Individual timelines may vary depending on the specific outcome being measured.
Does tesamorelin need to be cycled?
There is no formal cycling recommendation in the FDA labeling. In research and community discussions, some protocols suggest 8–12 weeks on followed by a break to potentially reduce GHRH receptor desensitization. Studies have noted that visceral fat reductions tend to reverse after discontinuation, so the clinical benefit depends on continued use.
What is the difference between tesamorelin and sermorelin?
Both are GHRH analogues that stimulate endogenous GH release, but they differ in structure and regulatory status. Tesamorelin is a modified full-length GHRH(1-44) with a trans-3-hexenoic acid group that increases stability and potency. Sermorelin is a truncated GHRH(1-29) fragment. Tesamorelin has current FDA approval (Egrifta), while sermorelin (Geref) was previously approved but voluntarily withdrawn from the market.
Can tesamorelin affect blood sugar levels?
Yes. Clinical trial data showed that tesamorelin can increase fasting glucose and HbA1c in some individuals. Patients with pre-existing diabetes or glucose intolerance should be monitored closely. The FDA labeling includes warnings about the potential for new-onset diabetes or worsening glycemic control.