Egrifta WR
Label- Dose
- 1.28 mg
- How often
- Once daily
- How long
- Ongoing; trials ran 26 weeks plus a 26-week extension
Current form. One vial mixed weekly gives seven daily doses. Not interchangeable with Egrifta SV.
Draw 25.6 units10 mg + 2 mL
Approved drugGHRH analog
Tesamorelin
Egrifta SV, Egrifta WR
- Common dose
- 1–2 mg daily
- Cycle
- Continuous
- Vial sizes
- 5, 10, 20 mg
- Typical draw
- 40 units10 mg with 2 mL, 2 mg
A stabilized analog of full-length GHRH that raises natural growth hormone release and IGF-1.
Evidence. FDA-approved to reduce excess abdominal fat in adults with HIV-associated lipodystrophy.
Status
- Approval
- Approved in the US as Egrifta WR and Egrifta SV, to reduce excess abdominal fat in adults with HIV and lipodystrophy.
- Sport (WADA 2026)
- Banned in sportS2.2.4 growth hormone releasing factors: GHRH and its analogues, with tesamorelin named. Banned at all times.
Sport status follows the WADA Prohibited List in force since January 1, 2026; athletes should confirm with their anti-doping organization. Checked October 5, 2026. Status of every compound.
How it works
Tesamorelin binds the GHRH receptor on the pituitary with about the same strength as the body’s own growth-hormone-releasing hormone, so the pituitary releases more of its own growth hormone, in pulses. Growth hormone breaks down fat and builds tissue, partly through IGF-1 made in the liver. In the trials, belly (visceral) fat fell and IGF-1 rose.
LabelBased on the product label.
Not known
The label says the effects of IGF-1 staying high for a long time are unknown; the main trials lasted 26 to 52 weeks.
Protocol
Label
Egrifta WR and SV
Egrifta WR: 1.28 mg once daily. Egrifta SV: 1.4 mg once daily. The two aren’t interchangeable. The original Egrifta 1 mg vials were dosed at 2 mg daily.
Community
Research vials: 1–2 mg once daily, often following the original 2 mg label dose.
- Frequency
- Once daily
- Route
- Subcutaneous injection (abdomen)
- Cycle
- Continuous per label (the trials ran 26 weeks).
Continuous, shown over 26 weeks
Common protocols
The ways Tesamorelin is most often run, each tagged with where it comes from.
Egrifta SV
Label- Dose
- 1.4 mg
- How often
- Once daily
- How long
- Ongoing
Earlier approved form. Different strength, so doses don’t transfer between forms.
Draw 28 units10 mg + 2 mL
Research vials
Community- Dose
- 1–2 mg
- How often
- Once daily
- How long
- Varies; no standard cycle
Often copies the original 2 mg label dose. Vial strength differs from the approved forms.
Draw 20–40 units10 mg + 2 mL
Taking it
Where it goes
Subcutaneous injection into the abdomen, rotating sites. Avoid scars, bruises, hard bumps, the navel and the 2 inches around it.
If you miss a dose
The Egrifta WR label and patient leaflet give no missed-dose rule. Don’t double up; ask the prescriber how to resume.
What to expect
- By week 26
Belly (visceral) fat fell 14–18% in the two main trials, vs about no change on placebo (within 2%).
Label - By week 26
IGF-1 rose above the normal range (over 2 SDS) in 47% of patients, and over 3 SDS in 36%.
Label - After stopping
Patients switched to placebo at week 26 regained belly fat by week 52; the effect lasts only while taking it.
Label
Side effects and what to do
Injection-site reactions (label: 25% vs 14% on placebo)
Redness, itching, pain or swelling. Rotate sites across the abdomen.
Joint pain (label: 13% vs 11%)
Linked to fluid retention. Tell the prescriber if it persists.
Swelling, tingling or numbness (label: edema 6%, paresthesia 5%)
Fluid retention; hand numbness can mean carpal tunnel. Report it.
Higher blood sugar (label: HbA1c 6.5%+ in 5% vs 1%)
Label: check glucose before and during; consider stopping if diabetes develops without a clear benefit.
Allergic reactions (label: 4%)
Rash or hives can be the first sign. Label says stop and seek prompt care.
Stop and get medical help
Hives, rash with swelling of the face or throat, fast heartbeat or trouble breathing: stop and get prompt care (label). Stop if pregnant.
Who should avoid it
What its label rules out or warns about, most important first.
- Anyone with active cancer
- LabelRuled out by the label, because it raises growth hormone, a known growth factor. A past cancer should be inactive and fully treated first, and the label says to stop if it comes back.
- Pregnancy
- LabelRuled out by the label. In rats it caused hydrocephaly in offspring at 2 to 4 times the human exposure.
- A damaged pituitary
- LabelRuled out after pituitary surgery or a pituitary tumor, head radiation or head trauma, or with hypopituitarism.
- Allergy to tesamorelin
- LabelRuled out; allergic reactions, including rash and hives, occurred in the trials.
- Diabetes or high blood sugar
- LabelNot ruled out, but the label warns it can cause glucose intolerance or diabetes and says to check glucose before and during treatment.
- Children and teens
- LabelNot approved for them. With open growth plates it may speed up growth, the label says.
- Critical illness
- LabelThe label advises considering stopping it in critically ill patients, citing more deaths with growth hormone in acute critical illness.
Interactions
Only interactions stated on a product label or measured in a human study are listed.
- Glucocorticoid replacement (such as cortisone acetate or prednisone)
- LabelGrowth hormone slows the enzyme that activates these drugs, so people on replacement for adrenal insufficiency may need a higher dose after starting.
- Drugs cleared by liver CYP450 enzymes (such as corticosteroids, sex steroids, seizure drugs and cyclosporine)
- LabelGrowth hormone may change how fast these are cleared, so the label advises monitoring. In a study, simvastatin levels didn’t change.
Label: a product label rules it out, warns about it or lists the interaction. This isn’t a complete list: a pharmacist or doctor can check a specific medicine or condition.
Tracking and pairing
Worth tracking
- IGF-1 (label: consider stopping if persistently over 3 SDS)
- Fasting glucose and HbA1c
- Waist or belly-fat response
- Swelling, joint pain or hand numbness
Often paired with
- Ipamorelin
Sold premixed as a blend (GHRH analog plus ghrelin-receptor agonist). Never tested together.
Human studies
5 key published human studies, with how many people took part. Animal studies aren’t listed here.
-
Visceral fat fell 15.4% more than placebo at 26 weeks; IGF-1 rose by 108 ng/mL; no meaningful change in glucose.
- Design
- Pooled analysis of two Phase 3 randomized, placebo-controlled trials in people with HIV and excess abdominal fat
- Dose
- 2 mg subcutaneous daily
- Length
- 26 weeks, plus 26-week extension
Falutz et al., J Clin Endocrinol Metab 2010, PMID 20554713
-
Visceral fat fell 15.2% vs a 5.0% rise on placebo; triglycerides fell 50 mg/dL and IGF-1 rose 81%.
- Design
- Phase 3 randomized, placebo-controlled trial in people with HIV and abdominal fat gain
- Dose
- 2 mg subcutaneous daily
- Length
- 26 weeks
Falutz et al., N Engl J Med 2007, PMID 18057338
-
Visceral fat fell 10.9% vs 0.6% on placebo, and about 18% by 12 months; the gain was rapidly lost after switching to placebo.
- Design
- Second Phase 3 randomized, placebo-controlled trial with blinded extension
- Dose
- 2 mg subcutaneous daily
- Length
- 6 months, plus 6-month extension
Falutz et al., J Acquir Immune Defic Syndr 2010, PMID 20101189
-
Liver fat fraction fell 4.1 points more than placebo (37% relative drop); 35% vs 4% reached under 5% liver fat.
- Design
- Randomized, double-blind, placebo-controlled trial in people with HIV and fatty liver
- Dose
- 2 mg subcutaneous daily
- Length
- 12 months
Stanley et al., Lancet HIV 2019, PMID 31611038
-
Visceral fat fell 34 cm2 vs an 8 cm2 rise on placebo and liver fat fell modestly; fasting glucose rose at 2 weeks but not at 6 months.
- Design
- Randomized, double-blind, placebo-controlled trial in people with HIV and abdominal fat
- Dose
- 2 mg subcutaneous daily
- Length
- 6 months
Stanley et al., JAMA 2014, PMID 25038357
Limits of the evidence
Tesamorelin’s evidence comes from two 26-week Phase 3 trials and their extensions in about 800 adults with HIV and excess belly fat, plus smaller trials in HIV-related fatty liver. It hasn’t been tested for weight loss, muscle or aging in people without HIV, which is how research vials are often used. Belly fat came back within months of stopping.
Mixing your vial
| Vial | Water | Common dose | Draw | Strength | Action |
|---|---|---|---|---|---|
| 5 mg | 1 mL | 2 mg | 40 units (0.40 mL) | 5 mg/mL | |
| 10 mg | 2 mL | 2 mg | 40 units (0.40 mL) | 5 mg/mL | |
| 20 mg | 2 mL | 2 mg | 20 units (0.20 mL) | 10 mg/mL |
Egrifta SV is mixed with sterile water and used right away. Egrifta WR is mixed with bacteriostatic water and kept at room temperature for up to 7 days.
Dose chart
Syringe units for common doses at different water volumes. Select a cell to open it in the calculator.
| Dose | Water added | ||
|---|---|---|---|
| 1 mL | 2 mL | 3 mL | |
| 1 mg | |||
| 1.5 mg | |||
| 2 mg | |||
U-100 insulin syringe: 100 units is 1 mL. Draws over 100 units show in mL. Faded values are under 2 units, which is hard to measure. Check that your vial holds the larger volumes.
Datasheet
- Half-life
- about 8 to 11 minutes LabelSingle subcutaneous dose in healthy adults: 11 minutes for Egrifta WR 1.28 mg, 8 minutes for Egrifta SV 1.4 mg.
- Type
- Peptide, 44 amino acids
- Molecular weight
- 5,135.9 g/mol
- Formula
- C221H366N72O67S
- Sequence
- (hex-3-enoyl)-YADAIFTNSYRKVLGQLSARKLLQDIMSRQQGESNQERGARARL-NH2
- Storage before use
- Room temperature, 20–25 °C, in the original box to protect from light (Egrifta WR and SV).
- After mixing or opening
- Egrifta WR: keep at room temperature and discard 7 days after mixing; do not refrigerate or freeze. Egrifta SV: inject right away and discard the rest.
- Half-life: Egrifta WR and Egrifta SV labels, section 12.3 (DailyMed)
- Molecule: PubChem CID 16137828; Egrifta WR label (5135.9 Da as free base)
- Storage: Label Egrifta WR label (revised March 2025) and Egrifta SV label, DailyMed
Every compound side by side: the half-life chart and the storage chart.
Cautions
- Not for use in pregnancy, active cancer, or after pituitary surgery or head radiation.
- Raises IGF-1; the label advises monitoring.
- Fluid retention, joint pain and carpal tunnel symptoms.
- Can raise blood sugar.
Questions
What is tesamorelin?
A stabilized analog of full-length GHRH that raises natural growth hormone release and IGF-1.
How does tesamorelin work?
Tesamorelin binds the GHRH receptor on the pituitary with about the same strength as the body’s own growth-hormone-releasing hormone, so the pituitary releases more of its own growth hormone, in pulses. Growth hormone breaks down fat and builds tissue, partly through IGF-1 made in the liver. In the trials, belly (visceral) fat fell and IGF-1 rose. The label says the effects of IGF-1 staying high for a long time are unknown; the main trials lasted 26 to 52 weeks.
Is tesamorelin FDA-approved?
Approved in the US as Egrifta WR and Egrifta SV, to reduce excess abdominal fat in adults with HIV and lipodystrophy.
What is the usual tesamorelin dose?
From the label (Egrifta WR and SV): Egrifta WR: 1.28 mg once daily. Egrifta SV: 1.4 mg once daily. The two aren’t interchangeable. The original Egrifta 1 mg vials were dosed at 2 mg daily. From community reports, not established: Research vials: 1–2 mg once daily, often following the original 2 mg label dose. These are the amounts sources reference, not recommendations.
How much water do I mix tesamorelin with?
There’s no single right amount, because the water only sets the strength. With 2 mL of bacteriostatic water in a 10 mg vial, the strength is 5 mg/mL, so 2 mg is 40 units on a U-100 insulin syringe. More water makes small doses easier to measure. The dose chart above shows other volumes.
Who should avoid tesamorelin?
Anyone with active cancer: Ruled out by the label, because it raises growth hormone, a known growth factor. A past cancer should be inactive and fully treated first, and the label says to stop if it comes back. Pregnancy: Ruled out by the label. In rats it caused hydrocephaly in offspring at 2 to 4 times the human exposure. A damaged pituitary: Ruled out after pituitary surgery or a pituitary tumor, head radiation or head trauma, or with hypopituitarism. The “Who should avoid it” section lists 4 more groups and 2 interactions.
What is the half-life of tesamorelin?
About 8 to 11 minutes, according to the prescribing information. Single subcutaneous dose in healthy adults: 11 minutes for Egrifta WR 1.28 mg, 8 minutes for Egrifta SV 1.4 mg.
How should tesamorelin be stored?
Before mixing: Room temperature, 20–25 °C, in the original box to protect from light (Egrifta WR and SV). Egrifta WR: keep at room temperature and discard 7 days after mixing; do not refrigerate or freeze. Egrifta SV: inject right away and discard the rest.
Is tesamorelin banned in sport?
Yes. S2.2.4 growth hormone releasing factors: GHRH and its analogues, with tesamorelin named. Banned at all times.
Has tesamorelin been studied in people?
Yes. The human studies section lists 5 published studies. The largest, from 2010, included 806 people. Visceral fat fell 15.4% more than placebo at 26 weeks; IGF-1 rose by 108 ng/mL; no meaningful change in glucose.
Sources
- Egrifta WR label (DailyMed)
- Egrifta SV label (DailyMed)
- Original Egrifta label, 2 mg daily (FDA 2013)
For the protocol details
- Egrifta WR dosing and administration (HCP site)
For how it works, who should avoid it and the limits of the evidence
- Egrifta WR and Egrifta SV prescribing information, sections 4, 5, 7, 8 and 12.1 (DailyMed, rev. 07/2026)
- Falutz et al., pooled Phase 3 tesamorelin trials (J Clin Endocrinol Metab 2010) PMID 20554713
Doses tagged Community come from public dosing guides and user reports, checked against at least two of them. Those sites aren’t named here because many of them sell peptides or earn commissions on them.