The labelled tesamorelin dosage fits on a single line, which can come as a surprise if you arrived with a chart from a forum. Everything that seems to vary around that line isn't a different dose for a different goal but a prescriber's judgement about your labs and your response, and that's the part no chart can do for you.
What is the standard tesamorelin dosage?
The standard dose is one subcutaneous injection a day at the amount set by the product's label, which is 1.4 mg for Egrifta SV and 1.28 mg for Egrifta WR. The phase 3 trials used an earlier 1 mg per vial formulation at 2 mg a day, and the current labels state that their lower doses give comparable exposure, which is why "2 mg" still circulates online. The WR label is explicit that SV and WR differ in dose, mixing and storage and aren't substitutable, so the right number depends on which product is actually in your hand.
| Label detail | Egrifta SV | Egrifta WR |
|---|---|---|
| Vial strength | 2 mg | 11.6 mg |
| Dose | 1.4 mg (0.35 mL) once daily | 1.28 mg (0.16 mL) once daily |
| Mixing | 0.5 mL of the supplied sterile water, used right away, leftover discarded | 1.3 mL of the supplied bacteriostatic water, one vial covers 7 daily doses |
| After mixing | Single use | Room temperature, discarded 7 days after mixing |
| Where to inject | Abdomen, rotating sites | Abdomen, rotating sites |
Where do you inject tesamorelin?
Both labels say to inject into the abdomen and to rotate to a different area of it each time, avoiding scar tissue, bruises and the navel. Rotation matters because injection site reactions were common in the trials, affecting 25% of people on tesamorelin against 14% on placebo in the first 26 weeks, and the label names rotation as the way to reduce them. Your prescriber or pharmacist will show you the technique, and the product's own instructions for use walk through each step.
What time of day, and what if you miss a dose?
Neither current label specifies a time of day or gives instructions for a missed dose, so there's no official answer to either question. Both are worth settling with your prescriber before you start, so that if a dose slips you're following their plan rather than improvising on the day.
Why do online tesamorelin dosing charts differ?
Online charts differ because many of them aren't describing the FDA approved product at all. They're written for off-label use, often for belly fat in people without HIV, and for compounded or "research use" tesamorelin whose strength, purity and concentration aren't standardized, and none of those products are FDA approved. The FDA doesn't review compounded drugs for safety or effectiveness, and research peptides aren't made for people, so a milligram figure on a chart can't be checked against anything. If even the two FDA approved products can't be swapped milligram for milligram, a chart built for a different product entirely tells you very little about what you'd be injecting.
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Explore peptide therapyWhat does a clinician monitor on tesamorelin?
A clinician watches IGF-1, blood sugar, your skin at the injection sites and any signs of fluid retention, because those are the areas the label flags. IGF-1 is the clearest example: by week 26 of the trials, 47% of people on tesamorelin had IGF-1 above 2 standard deviation scores, and the label says to consider stopping in anyone whose IGF-1 stays persistently high, particularly if their visceral fat response isn't strong. Blood sugar gets checked before starting and at intervals afterward, since 5% of people on tesamorelin reached an HbA1c of 6.5% or higher against 1% on placebo.
Common reasons a prescriber may pause or stop include:
- IGF-1 that stays well above the normal range
- New glucose intolerance or diabetes without a clear visceral fat response
- Signs of an allergic reaction such as rash, hives or flushing
- Swelling, joint pain or carpal tunnel symptoms from fluid retention, which the label says are transient or resolve when the drug is stopped
- Any sign of a recurring cancer, or a serious acute illness
How long before tesamorelin shows results?
The trials measured their main result after 26 weeks of daily use, when visceral fat on CT had fallen by about 15% more than on placebo. People who continued to a year held that reduction, while those switched to placebo saw visceral fat climb back by 22% and 16% over the following 26 weeks, and the label asks prescribers to reconsider continuing in anyone whose visceral fat hasn't dropped. So the timeline is measured in months, it depends on staying on the medication, and results vary from person to person.
Frequently Asked Questions
Where to go from here
The dose itself is the simplest part of tesamorelin, one number on one label, injected once a day. The part that varies, and the part that matters, is a clinician reading your IGF-1, glucose and response and deciding whether it's still earning its place, which is also how Ivologist approaches sermorelin, another GHRH analogue, and the wider hormone optimization program.
Explore Ivologist's peptide therapy options and a licensed clinician will review your history and labs before recommending whether any peptide is right for you.
Medical disclaimer. This article is for informational purposes only and doesn't constitute medical advice or individual dosing guidance. Tesamorelin is FDA approved only to reduce excess abdominal fat in adults with HIV and lipodystrophy; other uses are off-label, and compounded medications aren't FDA approved. Results vary. Always consult a qualified healthcare provider before starting, changing, or stopping any treatment.
