Tesamorelin (20mg)
The Tesamorelin (Egrifta®) 20mg is the largest available vial, ideal for 3–6 month long cycles. It provides 10 full 2mg doses, minimizing reconstitutions. Reconstitute with 2mL of bacteriostatic water for a 10mg/mL concentration (1mg per 10 units).
Reviewed by the AllPeptides.eu Editorial Team·Last reviewed: 2026-06-16
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
⚠️ For informational/educational purposes only. Not medical advice. We do not sell any products. Self-treatment carries serious risks — consult a healthcare professional. Disclaimer
Research monograph
See the full Tesamorelin encyclopedia page with mechanism, evidence tier, related variants and research context.
How It Works
Tesamorelin is a **44-amino acid synthetic analogue** of human GHRH. It binds to GHRH receptors on somatotroph cells of the **anterior pituitary**, triggering pulsatile GH secretion. This increases circulating **IGF-1** levels, mediating lipolysis — particularly in **visceral adipose tissue**. Unlike exogenous GH, it **preserves the negative feedback mechanism** via somatostatin. Recent studies highlight **neuroprotective effects** (reduced brain amyloid-β) and **cardiovascular benefits** (improved lipid profile).
Quick Start
- Typical Dose: 2mg subcutaneously, daily
- Frequency: Daily, 30–60 minutes before sleep, on an empty stomach
- Storage: 2–8°C after reconstitution, use within 28 days
- Advantage: 10 doses/vial — optimal value for long cycles
Dosing Table — Tesamorelin 20mg
Route: Subcutaneous injection | Frequency: Daily, before sleep
| Week | Dose | Units (per injection) |
|---|---|---|
| 1–2 | 1mg | 10 Units (0.10 mL) |
| 3+ | 2mg | 20 Units (0.20 mL) |
The 20mg vial is reconstituted with 2mL BAC water (concentration 10mg/mL) and yields 10 doses of 2mg (~10 days of full dosing). The high concentration means a very small injection volume (0.2mL per dose) and minimal discomfort.
Related compounds
Reconstitution Steps
- Clean vial and BAC water stoppers with an alcohol swab.
- Draw up 2mL of bacteriostatic water (BAC water).
- Slowly inject into the vial wall — do not spray directly onto the powder.
- Gently roll until fully dissolved — do not shake.
- Note reconstitution date on the vial.
- Immediately refrigerate (2–8°C).
Protocol Overview
- Largest vial — ideal for 3–6 month long cycles without frequent reconstitutions.
- FDA-approved action (2010, Theratechnologies) against visceral fat.
- Same dosage as smaller vials — only difference is quantity and concentration.
- Clinical studies: average visceral fat reduction ~18% in 26 weeks.
- Favorable long-term safety profile (studies up to 2 years).
Dosing Protocol
- Weeks 1–2: 1mg/day — initiation phase.
- Weeks 3+: 2mg/day — full therapeutic dose.
- Before sleep on an empty stomach (≥2 hours fasting).
- Cycle: 3–6 months, washout 4–8 weeks.
- Results assessment at 12 weeks.
- Break between cycles: After the cycle (3–6 months), a 4–8 week break is recommended. Tesamorelin stimulates endogenous GHRH receptors — the break prevents tolerance (down-regulation) and allows for sensitivity restoration. Maintain exercise and diet during washout.
Washout & Cycle Restart
When can I restart?
After the cycle (3–6 months), a 4–8 week break is recommended. Tesamorelin stimulates endogenous GHRH receptors — the break prevents tolerance (down-regulation) and allows for sensitivity restoration. Maintain exercise and diet during washout.
Minimum wait period: 4 weeks
Storage Instructions
- Reconstituted: 2–8°C, use within 28 days (longer duration due to larger BAC water volume).
- Powder: room temperature (up to 25°C) or refrigeration.
- Do not freeze after reconstitution.
- Avoid light exposure.
Important Notes
- Monitor IGF-1 every 4–6 weeks and fasting glucose monthly.
- Contraindicated in active neoplasia or history of GH-dependent malignancies.
- Report immediately: persistent edema, severe arthralgia, or carpal tunnel syndrome.
- The high concentration (10mg/mL) requires accurate drawing — verify units before administration.
- Use of this protocol is purely for informational purposes.
Potential Benefits & Side Effects
Potential Benefits:
- Visceral Fat Reduction — ~18% reduction in 26 weeks (FDA-approved indication)
- Increased GH/IGF-1 — pulsatile physiological secretion without axis suppression
- Improved Body Composition — increased lean mass, reduced waist circumference
- Improved Metabolic Markers — triglycerides, HDL/LDL, insulin resistance
- Neuroprotective Effects — reduced amyloid-β deposition
- Improved Sleep Quality — enhanced nocturnal GH
Potential Side Effects:
- Injection Site Irritation — redness, itching (~10%)
- Arthralgia — mild, transient (~5%)
- Peripheral Edema — fluid retention (~4%)
- Transient increase in fasting glucose
- Rare: carpal tunnel syndrome, myalgia
⚠️ Serious Warnings & Long-Term Risks
The following warnings are based on published literature, FDA labels, and post-marketing surveillance. They do not constitute medical advice. Consult a healthcare professional.
Theoretical neoplasia risk (IGF-1 elevation)
Tesamorelin increases GH/IGF-1. Contraindicated in active neoplasia. No significant signal observed in clinical trials.
📄 FDA Label — Egrifta®References
- FDA Approval — Tesamorelin — Dhillon S. Tesamorelin: a review of its use in the management of HIV-associated lipodystrophy. Drugs. 2011;71(8):1071-1091.
View Source - Visceral Fat Reduction RCT — Falutz J, et al. Effects of tesamorelin on body composition and visceral fat. JAMA. 2007;298(7):761-769.
View Source - Long-term Safety — Falutz J, et al. Long-term safety and efficacy of tesamorelin. AIDS. 2008;22(14):1719-1728.
View Source - Neuroprotective Effects — Stanley TL, et al. Effects of tesamorelin on neuroimaging markers. Ann Neurol. 2023;93(4):808-816.
View Source - Metabolic Effects — Stanley TL, Grinspoon SK. Effects of GHRH on visceral fat, metabolic indices. Growth Horm IGF Res. 2015;25(2):59-65.
View Source
Recommended Supplements
L-Arginine + L-Ornithine
ZMA (Zinc + Magnesium + B6)
External Sources & Regulatory Status
Regulatory Approvals
Egrifta® · HIV lipodystrophy (2010)
Egrifta® · HIV lipodystrophy (2015)
FDA + Health Canada approved
Educational information. Not medical advice, and no efficacy claim is implied. Regulatory approval is not a use recommendation by AllPeptides.eu.
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