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Tesamorelin Injections: Sites, Timing, and Storage

Creator: Nadia Okonjo, Health Writer
Published: 2026-09-06

Tesamorelin is injected under the skin once daily. The abdomen, site rotation, timing, device format, and storage instructions all matter—and they are not identical across branded and compounded formulations.

Nadia Okonjo, Health Writer September 6, 2026 6 min read

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The short version

Tesamorelin is a once-daily subcutaneous injection; the current Egrifta WR label specifies the abdomen and rotation to a different area with each dose.
The Egrifta WR label sets no morning, bedtime, or fasting window. Timing is a consistency and prescribing decision, not a universal clock rule.
Current Egrifta WR is a weekly-mixed vial with separate daily syringes—not a pen—while Promise's compounded tesamorelin is an injectable vial with its own pharmacy directions.
The pivotal trials assessed their primary visceral-fat endpoint at 26 weeks, so the first days are more useful for judging technique and local tolerance than visible change.
Storage is formulation-specific: current Egrifta WR stays at controlled room temperature after mixing, while a compounded vial follows its dispensing-pharmacy label.

Tesamorelin injections are given under the skin once daily, with the actual dose and schedule set by the prescriber. The current Egrifta WR label specifies the abdomen and a different spot each day. It does not require morning, bedtime, or fasting administration. Promise's compounded version comes in an injectable vial, while the current Egrifta WR kit also uses a vial and separate syringes—not a prefilled pen. The pharmacy label controls because these formats are not interchangeable.

How tesamorelin injections work in practice

A tesamorelin injection is subcutaneous: the medication enters the layer of tissue beneath the skin rather than a muscle or vein. Daily administration is not an internet convention. The pivotal 2007 randomized trial assigned 412 adults with HIV-associated abdominal fat accumulation to a daily subcutaneous injection of tesamorelin or placebo for 26 weeks (Falutz et al., New England Journal of Medicine, 2007).

That trial population matters. Egrifta WR's labeled indication is reduction of excess abdominal fat in adults with HIV and lipodystrophy; the label expressly says it is not a weight-loss-management drug. The broader uses discussed online do not turn that specific evidence into a prediction for a healthy adult.

At Promise, tesamorelin is dispensed as a compounded medication, which is different from an FDA-approved product: the formulation offered here is not FDA-approved. The current FDA label for Egrifta WR covers the approved brand, not a compounded vial. Regulatory status is one input, and a licensed provider may still prescribe a compounded formulation when appropriate; that decision belongs to the patient and provider.

Promise's tesamorelin product page describes the current compounded form and what the clinical evaluation includes.

Why the labeled injection site is the abdomen

The Egrifta WR instructions name the abdomen, not the thigh, upper arm, or buttock. They also direct patients to rotate among different abdominal areas and avoid the navel, bruises, and scar tissue. This is a product-specific instruction, not evidence that an injection locally dissolves the fat beside it. Tesamorelin is absorbed and acts systemically through the growth-hormone axis.

The abdomen offers a broad, accessible layer of subcutaneous tissue. Moving to a different point each day avoids repeatedly disturbing one small area. The label identifies injection-site redness, irritation, swelling, itching, bruising, bleeding, pain, and rash as possible reactions, and specifically connects rotation with lowering that risk. A prescriber's technique training should settle the exact boundaries for the individual rather than a generic injection map online.

The prescribed amount is a separate question. Tesamorelin dosage covers how clinicians make that decision without turning a published protocol into self-directed instructions.

Morning or night is a consistency decision

The current Egrifta WR label requires once-daily use but names no morning-versus-evening window, bedtime rule, or fasting interval. Nighttime advice commonly follows the fact that natural growth-hormone release is strongly linked to sleep. That physiologic rationale is not the same as a label requirement.

A provider may choose timing around sleep, other medications, side effects, or a routine the patient can follow reliably. The useful principle is consistency with the prescription, not a universal clock time. Changing from evening to morning, skipping days, or compensating for a missed injection changes the prescribed plan and belongs in a provider conversation.

A compounded vial and Egrifta WR are different kits

As of September 2026, there is no Egrifta WR pen in the current FDA instructions. Both Promise's compounded tesamorelin and the brand are vial-based, but the similarity stops there.

Format	What the current source describes	Which instructions control
Promise compounded tesamorelin	Injectable vial with a 35-day supply	The dispensing pharmacy's label and the prescriber's plan
Egrifta WR	One vial mixed weekly, with separate disposable syringes for daily injections	The Egrifta WR Instructions for Use
Egrifta SV	A distinct vial formulation mixed for immediate use	The Egrifta SV Instructions for Use

The FDA label says Egrifta WR and Egrifta SV are not substitutable. That warning is a useful rule for any format comparison: concentration, mixing, dose volume, and storage cannot safely be copied from one package to another merely because each contains tesamorelin.

Why tesamorelin with ipamorelin is not the same routine

The assigned related option combines tesamorelin with ipamorelin. Tesamorelin signals through the growth-hormone-releasing hormone receptor; ipamorelin works through the ghrelin receptor. Adding a second compound changes the prescription, concentration, clinical questions, and pharmacy directions. It is not a stronger version of the same vial, and the single-compound instructions do not transfer to the blend.

What the first weeks can actually tell you

The first weeks are usually more informative about the routine than the outcome. A patient learns whether the chosen time is sustainable, whether local irritation appears, and whether the pharmacy instructions are clear. Visible body-composition change is not an overnight test of whether the medication is doing anything.

The evidence was designed on a longer clock. A 2010 pooled analysis combined two phase 3 trials with 806 adults and assessed the primary visceral-fat endpoint after 26 weeks of daily subcutaneous treatment, followed by a 26-week extension (Falutz et al., Journal of Clinical Endocrinology & Metabolism, 2010). Those participants had HIV-associated abdominal fat accumulation, so the result does not forecast what a different patient will notice or when. Does tesamorelin work? examines that evidence and its limits.

Local redness or itching can happen early. Persistent or worsening reactions, swelling beyond the injection area, hives, or symptoms of a more general allergic response warrant prompt contact with the care team. The full risk discussion belongs on the tesamorelin side-effects guide.

Storage follows the exact formulation

Storage advice is one of the clearest reasons not to borrow directions from another tesamorelin package. Under the current Egrifta WR label, unmixed vials stay protected from light at controlled room temperature. After weekly mixing, that formulation also remains at controlled room temperature, is not refrigerated or frozen, and is discarded after seven days. Egrifta SV, by contrast, is used immediately after mixing.

Promise's vial is a compounded preparation, so its pharmacy label—not the branded instructions—sets refrigeration, beyond-use date, handling after first puncture, and travel requirements. Temperature-safe shipping does not by itself reveal the correct home-storage rule. If the carton, vial, and written directions appear to disagree, the dispensing pharmacy should resolve the mismatch before another injection.

The prescription is more than an injection schedule

A clinician may consider medical history, active or prior malignancy, pituitary conditions, pregnancy, glucose status, fluid retention, and IGF-1 monitoring before and during treatment. Technique and storage matter, but they do not replace that screening.

At Promise, a licensed provider reviews every request and not everyone qualifies. If treatment is prescribed, that provider sets the dose and timing; the pharmacy supplies formulation-specific directions; and follow-up is where reactions, lab results, missed doses, and changes to the routine are handled.

Common questions

Where are tesamorelin injections given?

The current Egrifta WR label specifies subcutaneous injection in the abdomen. It also calls for rotating among different abdominal areas and avoiding the navel, bruises, and scar tissue. That is a product-specific instruction. A compounded prescription may come with formulation-specific directions, so the prescriber's training and dispensing pharmacy's label control the actual routine.

What time of day should tesamorelin be injected?

There is no universal label-mandated clock time. The current Egrifta WR instructions say once daily but do not require morning, bedtime, or fasting use. Clinicians may choose timing around sleep physiology, other medications, tolerability, and consistency. The prescriber sets the schedule, and a patient should discuss a timing change rather than silently moving or skipping injections.

Does tesamorelin come in a pen?

No. The current FDA instructions describe Egrifta WR as a vial mixed weekly and supplied with separate syringes for daily injections, not a prefilled pen. Promise's compounded tesamorelin is also documented as an injectable vial. The two are still different products, and their concentration, mixing, storage, and dose-volume directions are not interchangeable.

Do tesamorelin injections need refrigeration?

It depends on the formulation. Current Egrifta WR labeling keeps both unmixed and mixed medication at controlled room temperature, protected from light, and says not to refrigerate or freeze the mixed vial. Compounded tesamorelin may carry different handling and beyond-use directions. The dispensing pharmacy's label is the controlling source for the vial actually received.

How soon do tesamorelin injections work?

They are not expected to produce a reliable visible answer in days. The pivotal research evaluated visceral abdominal fat after 26 weeks of daily treatment in adults with HIV-associated lipodystrophy. That population and endpoint cannot predict an individual's timeline outside the labeled indication. Early follow-up is more useful for technique, local reactions, adherence, and any monitoring the prescriber ordered.

Is compounded tesamorelin an approved drug product?

No. FDA-approved versions of tesamorelin exist, but the compounded formulation offered here is not FDA-approved. Egrifta WR is labeled for reducing excess abdominal fat in adults with HIV and lipodystrophy and is not indicated for weight-loss management. A licensed provider may still prescribe compounded tesamorelin when appropriate; that decision is made with the patient.