Tesamorelin dosage:
2 mg daily subcutaneous, 26-week protocol.
The standard tesamorelin dosage is 2 mg administered as a single subcutaneous injection once daily, typically into the abdomen, for a continuous period of at least 26 weeks. This is the exact dosing regimen validated in the Phase III Falutz trials and adopted by the FDA in 2010 as the approved protocol for reducing excess abdominal fat in HIV-associated lipodystrophy. At 2 mg/day, tesamorelin peptide produces a 15–20% reduction in visceral adipose tissue (VAT) over 26 weeks, with continued benefit through 52 weeks of treatment. This guide covers the complete tesamorelin dosage protocol: the 2 mg daily standard, reconstitution math for 10 mg, 5 mg, and 2 mg vials, injection technique, cycle length, timing, storage, and the off-label tesamorelin dosage patterns used for body composition, fat loss, and weight loss outside the HIV indication.
Tesamorelin dosage calculator.
Select your vial size, bacteriostatic water volume, desired dose, and syringe — the calculator returns the exact draw volume, concentration, and number of doses per vial.*
*This calculator performs simple reconstitution math based on the values you enter and is provided for educational and reference purposes only. It does not account for dead volume in syringes, peptide purity variations, or reconstitution loss. Calculator output does not constitute medical advice, a dosing recommendation, or a prescription. Tesamorelin is a prescription medication — any dosing protocol should be determined by a licensed healthcare provider. Always verify reconstitution math independently before use.
Tesamorelin dosage: the 2 mg daily FDA-approved standard.
Tesamorelin is dosed at 2 mg once daily by subcutaneous injection. This is the regimen used in every Phase III trial and the only dose that has been prospectively validated for the visceral fat reduction indication. Dosing below 2 mg has not been shown to produce clinically meaningful VAT reduction; dosing above 2 mg has not been shown to produce proportionally greater benefit while it does increase the rate of side effects, particularly IGF-1 elevation, fluid retention, and arthralgia.
The 2 mg tesamorelin dose is administered as a single injection, not split across the day. Because tesamorelin has a short plasma half-life of 26–38 minutes, the entire daily dose produces a single GH pulse followed by a return to baseline — which is actually the goal. Physiologic GH secretion is pulsatile; sustained elevation of GH or IGF-1 is associated with the adverse effects of acromegaly, not the beneficial effects of restored youthful GH signaling. The short tesamorelin half-life is a feature, not a bug, and is why once-daily dosing is preferred over multiple smaller doses.
Morning administration is typical but not strictly required. Some protocols prefer evening dosing to align with the natural nocturnal GH pulse; others prefer morning dosing to minimize sleep disruption from transient GH-related effects. The clinical trials did not mandate a specific time of day, and there is no published evidence that one time is superior. What matters more than timing is consistency — the tesamorelin dosage should be taken at approximately the same time each day to maintain predictable IGF-1 levels.
Tesamorelin is intended as a daily protocol, not an as-needed injection. Skipping doses reduces cumulative GH exposure and the resulting VAT reduction proportionally. In the Phase III trials, participants who discontinued tesamorelin saw rapid regain of visceral fat over the subsequent months, indicating that the effect is dependent on continuous GHRH receptor stimulation rather than a one-time metabolic reset.
Tesamorelin reconstitution: how to mix 10 mg, 5 mg, and 2 mg vials.
Tesamorelin is supplied as a lyophilized (freeze-dried) white powder that must be reconstituted with bacteriostatic water or sterile water for injection before use. The reconstitution volume determines the final concentration, which in turn determines how many units (on an insulin syringe) deliver a 2 mg tesamorelin dose. The math is simple but matters — dosing errors from reconstitution miscalculation are one of the most common sources of under- or over-dosing in research peptide use.
10 mg tesamorelin vial
A 10 mg tesamorelin vial reconstituted with 2 mL of bacteriostatic water yields a concentration of 5 mg/mL, or 5 mg per 100 units on a U-100 insulin syringe. At that concentration, a 2 mg dose is delivered by drawing 0.4 mL, which equals 40 units on the syringe. A single 10 mg vial provides five 2 mg daily doses — roughly five days of therapy per vial at the standard protocol. Reconstitution volumes can be varied (1 mL yields 10 mg/mL and requires 20 units per dose; 2.5 mL yields 4 mg/mL and requires 50 units per dose), but 2 mL is the most common choice because 40 units is an easy read on any insulin syringe.
5 mg tesamorelin vial
A 5 mg vial reconstituted with 1 mL of bacteriostatic water yields 5 mg/mL, the same concentration as the 10 mg vial done with 2 mL, and uses the same 40-unit draw for a 2 mg dose. A single 5 mg tesamorelin vial therefore provides two-and-a-half 2 mg doses — enough for roughly two-and-a-half days of therapy. The 5 mg vial is common in research peptide sourcing because it reduces the risk of reconstitution spoilage if a vial is used slowly.
2 mg tesamorelin vial
A 2 mg vial reconstituted with 0.4 mL of bacteriostatic water yields a concentration of 5 mg/mL, matching the larger vials, and the entire reconstituted volume is a single 2 mg dose (40 units). The 2 mg vial format is used in the pharmaceutical supply chain specifically to match the daily-dose format and eliminate reconstitution math — one vial, one day, one dose. This is the cleanest presentation but typically the most expensive on a per-mg basis.
All reconstituted tesamorelin should be stored refrigerated (2–8°C / 36–46°F) and protected from light. Bacteriostatic water–reconstituted tesamorelin is generally considered stable for 14–28 days under refrigeration, though the exact stability window depends on the specific peptide lot and storage conditions. Sterile water (non-bacteriostatic) reconstitution shortens the stable window significantly and is generally not recommended for multi-day vials.
Tesamorelin injection: subcutaneous administration to the abdomen.
Tesamorelin is administered subcutaneously — into the layer of fat just beneath the skin — most commonly using an insulin syringe with a 29- or 31-gauge needle at 5/16" or 1/2" length. The abdomen is the preferred injection site because it was the site used in Phase III trials and because it minimizes the risk of inadvertent intramuscular injection. Rotating between the left and right sides of the abdomen, and varying the specific injection point within each side, reduces the risk of local lipohypertrophy or lipoatrophy at repeated sites.
The injection technique follows the standard subcutaneous protocol: clean the site with an alcohol swab, pinch a fold of abdominal skin and fat between thumb and forefinger, insert the needle at a 45–90 degree angle depending on body composition, draw back briefly to confirm no blood return (optional but reduces the rare chance of intravascular injection), and inject the full reconstituted volume slowly over 2–5 seconds. Withdraw the needle and apply brief pressure with a clean gauze if any bleeding occurs. Minor injection site erythema, pruritus, or small bruises are common and resolve on their own.
Tesamorelin peptide can also be injected into the thighs or outer upper arms if abdominal injection is not feasible, though the clinical trial data is specifically based on abdominal injection and absorption kinetics may vary slightly by site. What matters most is consistency — once a site pattern is established, maintaining it supports predictable pharmacokinetics day to day.
Tesamorelin cycle length: how long is a tesamorelin protocol?
A standard tesamorelin cycle is 26 weeks — the exact duration of the primary Phase III trial endpoint — because 26 weeks is where the VAT reduction effect has clearly established itself and is most of what will be achieved. Extending beyond 26 weeks produces additional but diminishing VAT reduction: the 52-week extension data showed 18% reduction vs 15% at 26 weeks, so a roughly 3-percentage-point additional gain over a doubled treatment duration.
In clinical practice, continuous indefinite use is common under the FDA-approved indication, with periodic reassessment every 6–12 months. In off-label research use, tesamorelin protocols often run in "on-off" cycles — 26 weeks on, followed by a break of 12–26 weeks, followed by another cycle. The rationale for cycling rather than continuous use is partly cost-related and partly based on the concern that sustained IGF-1 elevation for years may carry unknown long-term risks (though no signal of such risk has appeared in the published safety data to date).
Discontinuation of tesamorelin produces gradual VAT rebound over 3–6 months back toward baseline if no other body composition interventions are in place. For long-term maintenance, many protocols transition to lower-dose or every-other-day tesamorelin, or shift to a sermorelin or CJC-1295/ipamorelin stack for general GH support. The tesamorelin and ipamorelin stack is commonly used either concurrently with or as a follow-on to pure tesamorelin monotherapy.
Tesamorelin dosage for fat loss, weight loss, and body composition.
Off-label tesamorelin dosage for fat loss and body composition generally follows the same 2 mg daily FDA standard, because this is the dose that the clinical efficacy data supports. The most common variation is a modestly lower starting dose — 1 mg daily for the first 1–2 weeks — to assess tolerability (particularly fluid retention and injection site reactions) before titrating up to the full 2 mg dose. Some protocols also use 1 mg daily as a long-term maintenance dose after an initial 26-week 2 mg protocol.
Tesamorelin dosage for weight loss specifically should come with the caveat that tesamorelin is not primarily a weight-loss drug. Phase III trials showed mean scale-weight changes of only a few pounds, with the benefit concentrated in body composition (VAT down, lean mass slightly up) rather than total mass. Anyone targeting significant scale-weight reduction should understand that tesamorelin is complementary to — not a substitute for — GLP-1 agonists, dietary intervention, and resistance training. See the tesamorelin for weight loss guide for a detailed comparison.
Bodybuilding-oriented tesamorelin dosage patterns sometimes push to 3–4 mg daily in the belief that higher doses produce greater IGF-1 elevation and therefore greater anabolic effect. Published evidence for this is weak: the GH response curve flattens above the 2 mg dose, and higher doses predominantly elevate side effect rates rather than efficacy. For body composition goals, the 2 mg standard is the floor, not the ceiling — additional gains come from longer cycle duration and complementary peptides, not from increasing the daily tesamorelin dosage.
Tesamorelin dosage quick reference.
| Protocol | Daily dose | Frequency | Duration | Use case |
|---|---|---|---|---|
| FDA standard | 2 mg | Once daily SC | 26+ weeks | HIV lipodystrophy, visceral fat reduction |
| Off-label body comp | 2 mg | Once daily SC | 16–26 weeks | Non-HIV visceral fat, NAFLD, recomp |
| Conservative start | 1 mg → 2 mg | Once daily SC | 1–2 wk titration | Tolerability assessment |
| Maintenance | 1 mg | Once daily SC | Ongoing | Post-initial-cycle maintenance |
| Every-other-day | 2 mg | Alternating | Variable | Cost-reduction, limited efficacy data |
Tesamorelin dosage FAQ.
What is the standard tesamorelin dose?
The standard tesamorelin dosage is 2 mg administered by subcutaneous injection once daily. This is the FDA-approved dose, the only dose validated in Phase III trials, and the dose used throughout the published clinical literature for visceral fat reduction. Dosing below 2 mg has not been shown to produce clinically meaningful VAT reduction. Dosing above 2 mg increases side effect rates without a proportional increase in efficacy.
What is the tesamorelin peptide dosage for fat loss?
The tesamorelin peptide dosage for fat loss is 2 mg daily subcutaneous — the same as the FDA-approved protocol. Off-label fat loss applications use this dose because it is the dose the clinical efficacy data supports. Some users start at 1 mg daily for 1–2 weeks to assess tolerability before titrating to the full 2 mg. Tesamorelin produces body recomposition (visceral fat reduction plus slight lean mass increase) rather than large scale-weight losses, so expectations should be set accordingly.
How do I reconstitute a 10 mg tesamorelin vial?
Reconstitute a 10 mg tesamorelin vial with 2 mL of bacteriostatic water to yield 5 mg/mL. At that concentration, a 2 mg daily dose is 0.4 mL, which equals 40 units on a U-100 insulin syringe. The reconstituted vial provides five 2 mg doses (approximately five days of therapy). Store reconstituted tesamorelin refrigerated at 2–8°C protected from light; bacteriostatic water reconstitution is generally stable for 14–28 days.
How many units is 2 mg of tesamorelin?
2 mg of tesamorelin equals 40 units on a U-100 insulin syringe when reconstituted at 5 mg/mL (10 mg vial + 2 mL bacteriostatic water, or 5 mg vial + 1 mL, or 2 mg vial + 0.4 mL). Other concentrations change the unit count proportionally — at 10 mg/mL (1 mL reconstitution of a 10 mg vial), 2 mg equals 20 units; at 4 mg/mL (2.5 mL reconstitution), 2 mg equals 50 units.
How long should a tesamorelin cycle last?
A tesamorelin cycle is typically 26 weeks, matching the primary Phase III endpoint. At 26 weeks, approximately 15% VAT reduction has been achieved; extending to 52 weeks produces roughly 18% VAT reduction — additional benefit but diminishing. Continuous indefinite use is the FDA-approved pattern; off-label cycling (26 weeks on, 12–26 weeks off) is common to manage cost and to avoid concerns about indefinite IGF-1 elevation. Visceral fat rebounds gradually over 3–6 months after discontinuation.
Can tesamorelin be taken every other day?
Every-other-day tesamorelin dosing is used in some cost-reduction or maintenance protocols but has limited clinical efficacy data. All Phase III studies used once-daily 2 mg dosing, so deviation from that protocol is extrapolation rather than evidence-based dosing. The short half-life of tesamorelin (26–38 minutes) means that every-other-day dosing produces GH pulses on only half the days, which likely reduces cumulative VAT reduction proportionally.
What time of day should I take tesamorelin?
Tesamorelin is typically taken in the morning but the time of day is not strictly prescribed. Phase III clinical trials did not mandate a specific time. Morning dosing is common to minimize any sleep disruption from the GH pulse; evening dosing is sometimes preferred to align the tesamorelin-induced GH pulse with the natural nocturnal pulse. Consistency day to day is more important than the specific time chosen.
Should tesamorelin be taken with food?
Tesamorelin is injected subcutaneously, so it is not affected by food intake in the same way oral medications are. However, the GH pulse produced by tesamorelin is blunted by simultaneous carbohydrate intake — elevated insulin suppresses GH release. For maximum efficacy, tesamorelin is generally taken in a fasted or semi-fasted state, at least 1–2 hours after a carbohydrate-containing meal and 30 minutes before the next meal. This is a theoretical optimization; the clinical trials did not control for meal timing.