Tesamorelin Dosing and Reconstitution Explained

Last updated: June 2026

Tesamorelin (brand name Egrifta SV) is dosed at 1.4 mg injected subcutaneously once daily, drawn from a 2 mg vial that you reconstitute with 0.5 mL of sterile water to give a 2 mg/0.5 mL solution. At that concentration the 1.4 mg dose is exactly 0.35 mL — which reads as 35 units on a U-100 insulin syringe.

Have a vial and a target dose? Convert any tesamorelin reconstitution to exact mL and syringe units in seconds.

Peptide reconstitution calculator →

TL;DR — key takeaways

FDA dose. Egrifta SV is 1.4 mg once daily, subcutaneously into the abdomen. This replaced the original Egrifta 2 mg/day formulation, which needed two 1 mg vials.
One vial, one diluent. A 2 mg vial reconstituted with 0.5 mL sterile water gives 4 mg/mL; you draw 0.35 mL (35 units) and discard the rest.
Units follow concentration. The same 1.4 mg dose is 35 units at 4 mg/mL but 70 units if you used 1 mL of water instead — the milligrams never change, the volume does.
Narrow approval. Tesamorelin is FDA-approved only to reduce excess visceral abdominal fat in people with HIV-associated lipodystrophy. Other uses are off-label and not FDA-evaluated.

What tesamorelin is and what it is approved for

Tesamorelin is a synthetic 44-amino-acid analogue of growth hormone-releasing hormone (GHRH). It binds GHRH receptors in the pituitary and prompts the gland to release the body's own growth hormone in its natural pulsatile pattern, which in turn raises insulin-like growth factor-1 (IGF-1). Because it works upstream — nudging endogenous secretion rather than flooding the body with exogenous growth hormone — it preserves more of the normal feedback rhythm.

Its only FDA-approved indication is reducing excess abdominal fat in HIV-infected patients with lipodystrophy, a condition tied to antiretroviral therapy. In the pivotal trials, 26 weeks of treatment reduced visceral adipose tissue by roughly 15–18% versus placebo. Any use outside that indication — general fat loss, “anti-aging,” or physique goals — is off-label, often relies on compounded product of variable quality, and has not been evaluated by the FDA for safety or effectiveness. This page explains the dose arithmetic; it is not a recommendation to use the drug.

The official Egrifta SV reconstitution, step by step

The label is precise, and the maths is the same two-step routine behind every peptide vial: find the concentration, then convert your dose to volume.

Worked example 1 — the FDA Egrifta SV dose

One vial holds 2 mg tesamorelin. Add 0.5 mL sterile water.

Concentration = 2 mg ÷ 0.5 mL = 4 mg/mL. Dose 1.4 mg ÷ 4 mg/mL = 0.35 mL. 0.35 mL × 100 units/mL = 35 units.

Draw 35 units on a U-100 syringe, inject into the abdomen, discard the rest.

The label is emphatic that the SV formulation is reconstituted with the supplied Sterile Water for Injection and used immediately — you do not store the mixed solution, and you do not freeze or refrigerate it. That is different from many compounded or research vials, which are mixed with bacteriostatic (BAC) water so a multi-dose vial can be kept for several weeks. If you are using a compounded vial, the discard rules come from that pharmacy, not from the Egrifta SV label.

What changes the syringe units

The single most common confusion is treating “units” as if they were milligrams. They are not. A unit is a volume mark — a U-100 syringe has 100 units per 1 mL — so the units you draw depend entirely on how much water you reconstituted with.

Worked example 2 — more water, more units, same dose

Same 2 mg vial, but reconstituted with 1 mL instead of 0.5 mL.

Concentration = 2 mg ÷ 1 mL = 2 mg/mL. Dose 1.4 mg ÷ 2 mg/mL = 0.7 mL = 70 units.

Twice the water halves the concentration and doubles the units — for the identical 1.4 mg dose.

Worked example 3 — a compounded 5 mg vial

A compounded 5 mg vial reconstituted with 2 mL BAC water gives 5 ÷ 2 = 2.5 mg/mL.

A 1 mg dose = 1 ÷ 2.5 = 0.4 mL = 40 units; a 2 mg dose = 0.8 mL = 80 units.

Worked example 4 — a compounded 10 mg vial

A 10 mg vial + 2 mL = 5 mg/mL. The FDA 1.4 mg dose would be 1.4 ÷ 5 = 0.28 mL = 28 units.

Higher concentration means fewer units for the same milligrams — and a much smaller margin for a misread mark.

Worked example 5 — does it fit your syringe?

The 35-unit official dose does not fit a 0.3 mL (30-unit) syringe. You need a 0.5 mL or 1 mL U-100 syringe.

At 2 mg/mL (1 mL recon) the 70-unit draw needs a full 1 mL syringe — check capacity before you choose a concentration.

Reconstitution reference chart

The 1.4 mg Egrifta SV dose drawn at several reconstitution volumes for a 2 mg vial. Always confirm against your own vial label and pharmacy instructions.

Water added	Concentration	Volume for 1.4 mg	U-100 units
0.5 mL (FDA)	4 mg/mL	0.35 mL	35 units
0.7 mL	2.86 mg/mL	0.49 mL	49 units
1 mL	2 mg/mL	0.70 mL	70 units
2 mL	1 mg/mL	1.4 mL	over 1 mL — too dilute

Notice the last row: at 1 mg/mL the dose no longer fits a 1 mL syringe. More water is not “safer” — past a point it just makes the dose impractical to draw.

The 35-unit draw, visualised

On a 1 mL (100-unit) U-100 syringe, the official 1.4 mg dose at 4 mg/mL fills just over a third of the barrel.

How this is calculated

Every number on this page uses two facts and nothing else: a U-100 syringe holds 100 units per millilitre, and concentration is milligrams divided by millilitres. To get units, divide your milligram dose by the concentration to find the volume in mL, then multiply by 100. There is no drug-specific constant — the same arithmetic applies to tesamorelin, any GHRH peptide, or a reconstituted vial of anything. The calculator on this site automates exactly this and lets you check the result against the chart above. None of this is medical advice; it is the maths behind a dose your prescriber sets.

Frequently asked questions

Why is Egrifta SV 1.4 mg when the old Egrifta was 2 mg?

The SV formulation is a more concentrated, reformulated product, so a 1.4 mg dose delivers a comparable amount of active drug to the original 2 mg/day Egrifta while needing only one vial and one injection. Follow the dose printed on the product you actually have.

Do I use bacteriostatic water or sterile water?

The FDA Egrifta SV kit supplies Sterile Water for Injection and the dose is used immediately. Compounded or research vials are often reconstituted with bacteriostatic water so a multi-dose vial can be stored; in that case follow the pharmacy's concentration and discard date, not the Egrifta SV label.

How many units is the 1.4 mg dose?

At the official 4 mg/mL concentration (2 mg in 0.5 mL water), 1.4 mg is 0.35 mL, which is 35 units on a U-100 syringe. At any other concentration the unit count changes — run your own numbers or use the calculator.

Is tesamorelin approved for weight loss or bodybuilding?

No. Its only FDA approval is to reduce excess visceral abdominal fat in people with HIV-associated lipodystrophy. Using it for general fat loss or physique goals is off-label and has not been evaluated by the FDA.

Sources

This guide is for general educational purposes only and does not constitute medical advice. Always follow your prescriber’s specific instructions and consult a qualified clinician before changing any protocol.