Tesamorelin

What Tesamorelin does

Tesamorelin prompts the pituitary gland to release growth hormone. It is FDA-approved for excess deep belly fat in adults with HIV-related fat changes, not general weight loss. Trials also studied liver fat and cognition, with mixed results outside its approved use. Main concerns include high blood sugar, raised IGF-1, swelling and allergic reactions.

• Tesamorelin (Egrifta) is approved to reduce excess belly fat in adults with HIV-related fat changes. (Drug label)
• In two large trials of adults with HIV, daily shots reduced deep belly fat; the effect faded after stopping. (Studied in a trial)
• In small trials of adults with HIV, it lowered liver fat, including in people with fatty liver. (Studied in a trial)
• People report fat loss and keeping muscle, usually while also changing diet, training or other peptides. (Reported by users)

Uses in the sources

• Approved for reducing excess abdominal fat in adults with HIV-associated lipodystrophy. (Drug label) (source)
• Studied for fatty liver in adults with and without HIV; not an approved liver-disease indication. (Studied in a trial) (source)
• A small trial in obesity with low GH output reduced visceral fat. General weight-loss benefit is unestablished. (Studied in a trial) (source)
• Cognition trials are mixed; the 2025 HIV trial and 2026 pilot did not show a clear between-group clinical benefit. (Studied in a trial) (source)
• Community users report recomp and muscle preservation. Selected HIV responders had imaging changes; healthy-user performance benefits are unknown. (Reported by users) (source)

Tesamorelin dosage

Typical reported dose: 1.28 mg once a day (Egrifta WR)

• Egrifta WR: 1.28 mg: 1.28 mg subcutaneously once daily once daily, under the skin. Drug label. Studied in: Adults with HIV-associated lipodystrophy and excess abdominal fat. (source)
• Egrifta SV: 1.4 mg: 1.4 mg, 0.35 mL of the reconstituted solution, injected subcutaneously once daily once daily, under the skin. Drug label. Studied in: Adults with HIV-associated lipodystrophy and excess abdominal fat. (source)
• Original Egrifta: historical 2 mg: 2 mg injected subcutaneously once daily once daily, under the skin. Drug label. Studied in: Adults with HIV-associated lipodystrophy and excess abdominal fat. (source)
• Pivotal HIV regimen: Original tesamorelin 2 mg SC daily once daily, under the skin. Studied in a trial. Studied in: Adults with HIV-associated lipodystrophy and excess abdominal fat. (source)
• 1 mg dose-finding arm: 1 mg SC once daily once daily, under the skin. Studied in a trial. Studied in: Adults with HIV-associated lipodystrophy and excess abdominal fat. (source)
• 2 mg dose-finding arm: 2 mg SC once daily once daily, under the skin. Studied in a trial. Studied in: Adults with HIV-associated lipodystrophy and excess abdominal fat. (source)

Highest studied: A 3 mg SC daily arm exposed only one COPD participant; the main efficacy trials used 2 mg daily.; Early FDA-reviewed study used 2 mg SC twice daily for 14 days..

These are doses reported in labels, trials or user reports, not a personal plan. Check the source behind each one.

Work out syringe units with the dosing calculator

How to mix Tesamorelin

Comes as: Egrifta WR: 11.6 mg lyophilized single-patient vial for seven daily doses., Egrifta SV: 2 mg lyophilized single-dose vial., Historical original Egrifta: 1 mg lyophilized vials; two per dose..

Mixed with: WR: supplied bacteriostatic water only; discard bottle 28 days after first use. SV/original: supplied sterile water only..

Common vial sizes: 11.6, 2, 1 mg. Common water amounts: 1.3, 0.5, 2.2 mL.

• WR: add 1.3 mL to one 11.6 mg vial, swirl without shaking; label concentration is 8 mg/mL. Draw 0.16 mL for 1.28 mg.
• SV: add 0.5 mL to one 2 mg vial; roll gently for 30 seconds. Draw 0.35 mL for 1.4 mg and discard the rest.
• Original: 2.2 mL supplied sterile water transfers through two 1 mg vials; withdraw 2 mL for 2 mg. Historical use only.
• WR: use the label’s concentration, not vial content divided by added water. Formulations are not interchangeable.
• Use only clear, colorless solution without particles; discard cloudy or discolored solution.

Before mixing: WR/SV: room temperature (20–25°C); short periods at 15–30°C allowed. Original: refrigerate (2–8°C). Keep all in original boxes, away from light.

After mixing: WR: room temperature (20–25°C); discard seven days after mixing. SV/original: use immediately; discard leftovers. Do not refrigerate or freeze any mixed formulation.

Egrifta WR 11.6 mg vials: store at 20-25 C in the original box, protected from light. After mixing, keep Egrifta WR at 20-25 C and discard after seven days; do not refrigerate or freeze.

Tesamorelin side effects and risks

Reported side effects

• Injection-site redness, itching or pain: All injection site reactions: 25% versus 14% placebo over 26 weeks., mild. Rotate abdominal sites; seek care for spreading redness, warmth, pus or fever. (source)
• Joint pain: 13% versus 11% placebo in the pooled 26 week adverse reaction table., moderate. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• Muscle pain: 6% versus 2% placebo., moderate. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• Swollen ankles or other fluid retention: 6% versus 2% placebo., moderate. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• Arm or leg pain: 6% versus 5% placebo., moderate. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• Tingling: 5% versus 2% placebo., moderate. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• Reduced skin sensation: 4% versus 2% placebo., moderate. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• Rash: 4% versus 2% placebo., mild. A rash with breathing trouble, facial swelling or faintness needs emergency care. (source)
• High blood sugar or new diabetes: HbA1c ≥6.5% developed in 5% versus 1% placebo by week 26., serious. Check glucose; the label advises reassessing treatment if glucose worsens without clear benefit. (source)
• Allergic reaction: 4% of tesamorelin trial participants; the warning gives no placebo rate., serious. Stop and seek prompt medical attention; use emergency care for breathing or circulation symptoms. (source)
• Carpal tunnel syndrome: 1% versus 0% placebo in the pooled adverse reaction table., moderate. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• Vomiting: 3% versus 0% placebo., moderate. Persistent vomiting needs review and assessment of hydration. (source)
• Stomach discomfort: Indigestion: 2% versus 1% placebo., mild. Discuss persistent symptoms and reassess the dose or need for treatment. (source)
• High IGF-1: IGF 1 >3 standard deviations above the age average: 36% at 26 weeks; 23% at 52 weeks among continuing patients., moderate. Monitor IGF-1; the label advises considering stopping if levels stay this high. (source)

Stop and get help if

• Trouble breathing, swelling of the face or tongue, widespread hives or faintness: Stop dosing and get emergency care now.
• New severe breathlessness, chest pain, fainting or rapidly worsening swelling: Get urgent medical care now; severe symptoms need emergency services.
• Marked thirst or frequent urination with vomiting, confusion or deep breathing: Check glucose if available and get urgent care for possible severe high blood sugar.
• New blurred vision, sudden vision loss or a curtain over vision: Get same-day eye assessment; sudden vision loss is an emergency.
• Spreading injection-site redness, heat, pus or fever: Stop using that vial and get prompt care for possible infection.

Who should avoid it

• pregnant: Contraindicated by the label. Changing pregnancy-related visceral fat has no known benefit and may harm the fetus.
• tryingToConceive: Listed as a reason to avoid it.
• breastfeeding: No human milk or infant-safety data. The product label says mothers receiving tesamorelin should not breastfeed.
• under18: Safety and effectiveness are not established; the label does not indicate pediatric use.
• activeCancer: Contraindicated because tesamorelin raises GH and IGF-1. Stop if a prior cancer recurs.
• cancerHistory: Past cancer must be inactive with treatment complete; review the possible risk of recurrence before starting.
• other: Contraindicated with pituitary-axis disruption, including pituitary tumor or surgery, head irradiation, hypopituitarism or relevant head trauma.
• other: Contraindicated after a known allergy to tesamorelin or an ingredient in the specific product.
• diabetes: New diabetes can develop. Existing diabetes needs glucose follow-up and retinal monitoring.
• diabeticRetinopathy: Raised IGF-1 may worsen retinal disease; the label calls for regular monitoring in people with diabetes.
• kidneyDisease: Drug levels and needed dose changes with kidney impairment are unknown.
• liverDisease: Drug levels and needed dose changes with liver impairment are unknown, including in advanced liver failure.
• heartCondition: Fluid retention may worsen swelling or heart-failure symptoms; long-term cardiovascular safety is unknown.
• surgeryPlanned: Critical illness after major surgery or trauma warrants reassessment; the label advises considering discontinuation in critically ill patients.
• other: Consider stopping during sudden breathing failure or severe critical illness. The warning comes from growth hormone drug treatment.
• testedAthlete: Prohibited at all times under the 2026 WADA List, section S2.2.4.

Interactions

• Insulin and sulfonylureas: Tesamorelin may raise blood sugar and change medication needs. Watch for highs or lows after diabetes medicines change.
• Glucocorticoid replacement: Growth hormone can reduce cortisone's conversion to cortisol. Clinicians may review routine or stress steroid replacement.
• Other growth hormone and IGF-1 drugs: May add to effects on blood sugar, swelling and tissue growth. Combination safety is unknown.
• Cyclosporine and some seizure medicines: Growth hormone may change drug breakdown. Clinicians can check drug effects and blood levels.
• Sex steroids: The label warns sex hormone breakdown may change. A clinician should review possible interactions.
• Simvastatin and ritonavir: Small crossover studies in healthy volunteers found no drug level changes requiring dose adjustment.
• Anticoagulants: No direct interaction is established. Injections can bruise; review medicines with a clinician if bleeding risk is high.

Product quality risks

• An FDA-approved molecule does not make an online vial an approved product. Identity, amount and injectable quality may differ.
• Poor preparation can cause contamination or too much or too little active drug; FDA describes serious injury and death from compounding failures.
• No independent tesamorelin retail-sampling study or drug-specific counterfeit-pen series was found. Do not borrow semaglutide contamination rates.
• A purity percentage alone does not establish the dose, sterility, endotoxin level or stability after mixing.

What to expect

• During daily treatment: Joint pain, swelling and injection-site reactions are common with tesamorelin treatment for HIV-related abdominal fat.
• Week 26: In HIV-related abdominal-fat trials, deep belly fat fell by about 14-18% on average, with little change in body weight.
• Weeks 27-52: Continuing tesamorelin generally kept the belly-fat benefit, while groups switched to placebo regained fat during the next 26 weeks.

Daily treatment for HIV-related abdominal fat; pivotal trials lasted 26 weeks, with extensions to 52 weeks.

63 human research records include reused data, reviews and ongoing or stopped trials. Some share participants; two large HIV trials give the strongest evidence.

Key studies

• First human dose study: FDA review documents this human study; detailed clinical results are limited. (source)
• Early seven-day doses: FDA review documents this human study; detailed clinical results are limited. (source)
• Once versus twice daily: FDA review documents this human study; detailed clinical results are limited. (source)
• SC versus IV exposure: FDA review documents this human study; detailed clinical results are limited. (source)
• Original formulation comparison: FDA review documents this human study; detailed clinical results are limited. (source)
• Two drug lots: FDA review documents this human study; detailed clinical results are limited. (source)

Tesamorelin FAQ

• Is Tesamorelin FDA-approved? Yes: Egrifta (excess abdominal fat in adults with HIV lipodystrophy; original formulation now discontinued.); Egrifta SV (excess abdominal fat in adults with HIV lipodystrophy.); Egrifta WR (excess abdominal fat in adults with HIV lipodystrophy.). Not approved for weight-loss management.
• How do people take it? Under the skin, once daily. Source: drug label.
• What's the difference between Tesamorelin and Ipamorelin? Tesamorelin: a peptide approved for deep abdominal fat in adults with HIV lipodystrophy. Ipamorelin: an experimental peptide that triggers growth hormone release. Why people pair them: reported to add another GH-release signal for sleep, recovery or recomp. No controlled combination outcome trial was found.
• Can I take it with Ipamorelin? Reported to add another GH-release signal for sleep, recovery or recomp. No controlled combination outcome trial was found. Potential additive IGF-1, swelling and glucose effects; combined safety is unknown. Source: reported by users. Ask a doctor before combining anything.
• Is it banned in sport? Yes. It is banned in and out of competition (WADA 2026). Tesamorelin is named among GHRH analogues; the 2026 list remains applicable through December 31, 2026.
• How long does a mixed vial last? WR: room temperature (20–25°C); discard seven days after mixing. SV/original: use immediately; discard leftovers. Do not refrigerate or freeze any mixed formulation.