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Reviewed by MyPeptideMatch Editorial TeamLast reviewed February 2026Updated February 2026

Tesamorelin Dosing Protocol: 20 mg Vial — 10-Day Supply Guide

High-volume tesamorelin supply from the 20 mg vial — provides 10 daily doses at the FDA-approved 2 mg/day rate, minimizing reconstitution frequency.

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Quickstart highlights

Tesamorelin at 2 mg/day over 26 weeks produces the highest-evidence visceral fat reduction of any GHRH analogue (15.2% in Phase 3, NCT00311948 / Falutz 2010).

  • Concentration: 2 mg/mL (20 mg vial + 10 mL bacteriostatic water).
  • At 2 mg/mL: 2 mg = 100 units (1 mL) once daily — FDA-approved Egrifta SV dose.
  • One 20 mg vial provides exactly 10 daily doses at 2 mg; reconstitute every 10 days.
  • Phase 3 (NCT00311948): 2 mg/day x 26 weeks — 15.2% visceral fat reduction vs. 0.7% placebo.
  • Requires 10 mL bac water per reconstitution — use a 10 mL syringe or four 2.5 mL additions.

Dosing table

For educational reference only. Your prescribing provider may adjust doses based on your clinical profile and response.

WeekDose (µg)UnitsFrequencyNotes
1-4100050Once daily1 mg — 50 units; 20 vial provides 20 doses at this level (20 days)
5-262000100Once daily2 mg — 100 units (FDA-approved dose); 20 mg vial provides 10 daily doses (10 days per reconstitution)

Reconstitution steps

  1. Draw 10 mL bacteriostatic water (use four 2.5 mL draws from a 3 mL syringe, or a 10 mL syringe) into the vial.
  2. Inject slowly down the vial wall in divided portions to minimize foaming.
  3. Swirl gently between additions; allow to fully dissolve before drawing doses.
  4. Final concentration: 2 mg/mL (20 mg / 10 mL). Label with date; refrigerate at 2–8 °C. Use within 28 days.

Supplies needed

12-week plan

  • 6 vials
  • 84 syringes
  • 60 mL bac water
  • 84 alcohol swabs

26-week plan

  • 19 vials
  • 182 syringes
  • 190 mL bac water
  • 182 alcohol swabs
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Protocol overview & cycle notes

Optimize 26-week tesamorelin protocol logistics by using the 20 mg vial — reducing reconstitution events to every 10 days versus every 2.5–5 days with smaller vials, improving sterility management and convenience.

Cycle length: 26 weeks on.

Off-cycle: 8 weeks off; measure IGF-1 and waist circumference before resuming.

Storage & handling

Lyophilized: store below 25 °C. Reconstituted at 2 mg/mL: refrigerate 2–8 °C; use within 28 days. At 2 mg/day: one 20 mg vial provides 10 daily doses — reconstitute approximately every 10 days.

Injection & tracking tips

  • Reconstituting 20 mg requires 10 mL bac water — use a 10 mL syringe or four sequential 2.5 mL additions.
  • The 20 mg vial at 2 mg/day requires reconstitution every 10 days — reducing handling events to ~78 reconstitutions for a full 26-week protocol versus 182 with 5 mg vials.
  • Mark each dose draw on the vial label to track remaining volume.

Tracking

Logging helps you and your provider spot patterns and adjust dose or timing.

  • Measure waist circumference and weight weekly.
  • Check IGF-1 at baseline, 8 weeks, and 16 weeks.
  • Track fasting glucose and HbA1c every 8 weeks; GH elevation affects insulin sensitivity.
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How this works & references

Tesamorelin at 2 mg/day over 26 weeks produces the highest-evidence visceral fat reduction of any GHRH analogue (15.2% in Phase 3, NCT00311948 / Falutz 2010). The 20 mg vial at 2 mg/mL provides 10 mL total, enabling 10 consecutive daily 1 mL (2 mg) doses from a single reconstitution event — the most efficient vial size for the full-dose 26-week protocol.

Sources

Frequently asked questions

How many 20 mg vials do I need for a 26-week protocol?
182 total doses at 2 mg = 364 mg total. At 20 mg/vial: 364 ÷ 20 = 18.2 — approximately 19 vials for the full 26-week protocol. This is the most cost-effective per-mg option.
Is 10 mL too much bac water to add to one vial?
10 mL is a large volume for a standard lyophilized vial and may require partial dissolution technique: inject 2.5 mL, allow to dissolve, inject another 2.5 mL, etc. The vial neck should accommodate 10 mL if it is a standard 30 mL glass vial; verify vial capacity with your compounding pharmacy.
What is the shelf life concern when drawing 10 times from one vial?
Every syringe penetration introduces micro-contamination risk. Bacteriostatic water mitigates but does not eliminate this risk. Clean the stopper with a fresh alcohol swab before each draw. Use within 28 days regardless of remaining volume. Discard if cloudiness or visible particles appear.
Should I use a preservative-containing bac water?
Yes — only use bacteriostatic water (0.9% benzyl alcohol) for reconstituting the 20 mg vial, never sterile water. Bacteriostatic water extends the viable use period to 28 days by inhibiting microbial growth between draws.
Does the 20 mg vial require different storage than smaller vials?
No — the same 2–8 °C refrigeration applies. However, given the larger total volume (10 mL), the 20 mg vial has a greater surface area of solution exposed to light and temperature variations. Store upright with the stopper sealed, ideally in the main refrigerator (not the door which experiences temperature fluctuations).

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This content is for informational purposes only and does not constitute medical advice. Consult a licensed healthcare provider before starting any peptide therapy. Dosing and protocols may vary by formulation and prescriber.

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