Tesamorelin 5 mg vial dosage

What Tesamorelin is

Class:

GHRH analogue

Also called:

Egrifta, Egrifta WR, Egrifta SV, TH9507

Used for:

Approved for reducing excess visceral abdominal fat in people with HIV-associated lipodystrophy.

Human evidence:

Strong human evidence. Twenty-six randomised controlled trials, including a randomised trial in JAMA measuring visceral and liver fat, plus safety and metabolic studies and more recent evaluation in people taking integrase inhibitors. The rating describes the volume and design of the evidence for the approved indication; no trial has tested healthy adults for body composition.

US status:

FDA-approved · prescription only. FDA-approved for reducing excess visceral abdominal fat in people with HIV-associated lipodystrophy. Requires a prescriber. Grey-market vials carry the name without the approval, the quality control or the indication. Regulated as a licensed biologic since 23 March 2020; FDA says licensed biologics are not eligible for the 503A and 503B compounding exemptions.

The full picture, with every study: Tesamorelin guide.

How to mix a 5 mg Tesamorelin vial

For this vial: 1 mL of bacteriostatic water makes 5 mg/mL, so 1.28 mg is 25.5 units (0.26 mL) on a U-100 insulin syringe. Pick a different volume from the units table if you want bigger or smaller draws; the number of doses stays the same.

1. Wipe the rubber stoppers of both the peptide vial and the bacteriostatic water vial with an alcohol swab and let the alcohol dry. ^[2][3]
2. With a new sterile needle and syringe, draw up the amount of bacteriostatic water you have chosen for the dilution. ^[2][3][4]
3. Inject the water into the peptide vial by aiming the stream against the inside glass wall, which helps prevent foaming. ^[5]
4. Swirl or roll the vial gently until the powder has fully dissolved; do not shake it. Do not inject the solution if it is cloudy or has particles in it. ^[2][3][5]
5. Label the vial with the date and time it was mixed, the amount of water added and how long it can be used after mixing. ^[2]
6. Store the mixed vial in the refrigerator at 2-8°C (36-46°F) and do not freeze it. ^[5]

Step by step with pictures: how to reconstitute peptides. About the water itself: bacteriostatic water.

Storing Tesamorelin vials

• Freeze-dried (lyophilized) peptide keeps far longer than peptide in solution; peptide suppliers advise storing the powder at -20°C away from bright light. ^[6]
• Protect peptide vials from heat and light. ^[6][7]
• Avoid repeated freeze-thaw cycles; a prescription peptide label also says not to freeze a vial once it has been mixed. ^[5][6]
• Once a multi-dose vial, such as bacteriostatic water, has been opened (needle-punctured), date it and discard it within 28 days unless its manufacturer states another date. ^[8][9]

More detail: peptide storage and shelf life.

Injecting safely

• Clean the injection site with an alcohol swab and let the skin dry completely before injecting. ^[10][11]
• Pinch up a fold of skin and fat (not muscle) and insert the needle at a 45- to 90-degree angle: 90 degrees where there is enough fatty tissue, 45 degrees where there is little. ^[10][11][12]
• Pulling back on the plunger (aspiration) is not necessary for a subcutaneous injection, because the chance of the needle being in a blood vessel is small. ^[10]
• Inject slowly, at roughly 10 seconds per mL. ^[10]
• Common sites are the belly, the thigh and the upper arm; rotate sites, keeping each injection at least 1 inch (2.5 cm) from the last. ^[5][10][11]

Hygiene and warning signs

• Use a new sterile needle and syringe for every injection and every time you enter a vial; never reuse them. ^[4][8][11]
• Never share needles, syringes or pens with anyone, even if the needle is changed; unsafe injection practices spread hepatitis B, hepatitis C and HIV. ^[4][7][8]
• Put used needles and syringes in a sharps disposal container straight away (FDA-cleared if possible), never loose in the trash, recycling or toilet, and dispose of the container following your community's guidelines. ^[13][14]
• Contact a health care provider if the injection site shows signs of infection, such as redness, swelling, red streaks or a fever. ^[11]

Where to inject: subcutaneous injection sites.

How Tesamorelin works

• Tesamorelin is a synthetic analogue of human growth hormone-releasing factor (GHRH): the full 44-amino-acid sequence of the natural hormone with a hexenoyl group (a six-carbon chain) attached to the tyrosine at its N-terminal end. ^[1]
• In lab studies it binds and stimulates human GHRH receptors with potency similar to the natural hormone, prompting pituitary somatotroph cells to make and release growth hormone in pulses. Growth hormone in turn raises IGF-1 and IGFBP-3. ^[1]
• In clinical trials it caused no clinically significant changes in other pituitary hormones, including TSH, LH, ACTH and prolactin. ^[1]
• Absolute bioavailability after a 2 mg subcutaneous dose was under 4% in healthy adults, and peak blood levels were reached at a median of 0.15 hours. ^[1]

What the Tesamorelin research found

Human evidence: strong human evidence. Each result says what was studied.

• Human studyIn a 26-week randomised trial of 412 people with HIV and abdominal fat accumulation, visceral fat fell 15.2% on daily tesamorelin 2 mg and rose 5.0% on placebo. Triglycerides fell and IGF-I rose 81%, with no significant difference in glycaemic measures. ^[15]
• Human studyIn a second trial of 404 patients, visceral fat fell 10.9% on tesamorelin against 0.6% on placebo at 6 months, and by about 18% in those who continued for 12 months. The reduction was quickly lost in those switched to placebo. ^[16]
• Human studyIn a 6-month double-blind trial of 50 people with HIV and abdominal fat accumulation, tesamorelin reduced visceral fat (-34 cm² against +8 cm² on placebo) and liver fat, a net effect of -2.9% in liver lipid-to-water percentage. ^[17]
• Human studyIn a 12-month randomised trial of 61 people with HIV and fatty liver disease, tesamorelin reduced hepatic fat fraction by an absolute 4.1% more than placebo (a 37% relative reduction). By 12 months, 35% on tesamorelin and 4% on placebo had liver fat below 5%. ^[18]
• Human studyIn a 12-week randomised trial of 53 people with type 2 diabetes, tesamorelin 1 or 2 mg did not change insulin response, fasting glucose, HbA1c or overall diabetes control compared with placebo. ^[19]
• Human studyAmong 38 people on integrase-inhibitor HIV regimens within a 12-month randomised trial, tesamorelin reduced visceral fat, liver fat and the trunk-to-limb fat ratio compared with placebo, without worsening glycaemic control. ^[20]

Tesamorelin side effects and risks

• FDA labelThe most common adverse reactions (over 5%) were joint pain, injection-site redness, injection-site itching, pain in the arms or legs, swelling of the lower limbs and muscle pain. Over the first 26 weeks of trials, injection-site reactions occurred in 25% on tesamorelin against 14% on placebo. ^[1]
• FDA labelFluid retention linked to the rise in growth hormone can cause oedema, joint pain and carpal tunnel syndrome; these effects were transient or resolved when treatment stopped. ^[1]
• FDA labelIt can cause glucose intolerance: 5% of patients on tesamorelin against 1% on placebo developed an HbA1c of 6.5% or more (hazard ratio 3.3). ^[1]
• FDA labelIGF-1 rises and needs monitoring. After 26 weeks, 47% of patients had IGF-1 above 2 standard deviation scores and 36% above 3; the effects of prolonged IGF-1 elevation are unknown. ^[1]
• FDA labelHypersensitivity reactions, including itching, redness, flushing, hives and rash, occurred in 4% of patients in clinical trials. ^[1]
• FDA labelIt is contraindicated in active malignancy, pregnancy and disruption of the hypothalamic-pituitary axis, and the label states that long-term cardiovascular safety has not been established. ^[1]

Other things to know

• The approval and every trial concern people with HIV-associated fat redistribution. Reading across to a healthy adult wanting to lose abdominal fat is an extrapolation the evidence does not license.
• It is a growth hormone releasing factor and therefore prohibited in sport at all times.
• It appears in the same research-chemical channels as unapproved GH peptides, which means taking on grey-market risk to obtain something that exists in a controlled form.

Reported side effects and what the studies measured: Tesamorelin side effects.

Where this vial size comes from

Tesamorelin is sold as a 5 mg vial by the page below, each checked on the date shown. I list them as evidence that this size exists, not as a recommendation to buy from them.

• Core PeptidesvendorLists it as: "Tesamorelin - 5MG / 10MG" - 5mg option offered · checked 2026-09-28

The doses come from the FDA label on the Tesamorelin dosing page, and every number on this page is arithmetic on those doses and this vial size.

Other Tesamorelin vial sizes

• 5 mg
• 10 mg vial
• 20 mg vial

Questions

How much water do I add to a 5 mg Tesamorelin vial?

There is no single correct amount: water changes how many units a dose is, not how many doses the vial holds. With 1 mL the vial is 5 mg/mL and 1.28 mg is 25.5 units (0.26 mL) on a U-100 insulin syringe. The units table gives 1, 2, 3 mL.

How many doses are in a 5 mg Tesamorelin vial?

3 doses at 1.28 mg.

What does 1 unit equal in a 5 mg Tesamorelin vial?

50 mcg with 1 mL, 25 mcg with 2 mL, 16.67 mcg with 3 mL of bacteriostatic water, on a U-100 syringe.