Sermorelin Reconstitution: Water per Vial, mg/mL and Units

How 5 mg and 10 mg sermorelin vials convert to mg/mL and U-100 units for the 200 to 500 mcg figures pharmacies state, beside the withdrawn label's 30 mcg/kg.

Medibact Guides · Published 2026-09-18

Illustration: A vial of lyophilized powder next to a vial of sterile water on a white surface. — Illustration

Sermorelin is a 29-amino-acid fragment of growth-hormone-releasing hormone, the shortest sequence with the full activity of the parent hormone. It is the one compound on this hub with a real, if withdrawn, label: Geref, approved in 1997 for children with growth hormone deficiency and discontinued a decade later. Today it exists as a compounded prescription and as a research powder in 5 mg and 10 mg vials, the sizes the sermorelin calculator is built around. This page reports the water volumes and concentrations the sources state and what the microgram figures they quote come to on a U-100 syringe. It reports and does not recommend. The figures and their provenance are on the sermorelin dosage page; the index of every compound's arithmetic is the reconstitution hub.

What the sources state

Source	What it states	Kind of source	Opened
Drugs@FDA, NDA 020443	Geref, sermorelin acetate, EMD Serono, approved 1997-09-26, 0.5 mg and 1 mg base per vial, discontinued; "Label is not available on this site"	Regulator database	2026-09-18
DailyMed search, "sermorelin"	Zero labels	Regulator database	2026-09-18
Federal Register, 2013-03-04	Geref 0.5 mg and 1.0 mg vials and the 0.05 mg ampoule "were not withdrawn from sale for reasons of safety or effectiveness"	Regulator notice	2026-09-18
Prakash and Goa, BioDrugs 1999	Once-daily subcutaneous 30 mcg/kg at bedtime in prepubertal children; 1 mcg/kg intravenously as a diagnostic	Peer-reviewed drug review	2026-09-18
Empower Pharmacy	Adult "0.2 to 0.3 mg ... once daily at bedtime"; pediatric 0.03 mg/kg; 6, 9 and 15 mg vials; mixed gently with bacteriostatic water, no shaking; refrigerated 2 to 8 °C once mixed	Compounding pharmacy	2026-09-18
Olympia Pharmaceuticals	300 mcg, given as 33 units of a 0.9 mg/mL solution, once nightly, sixty to ninety minutes after the last meal; one vial for 28 days	Compounding pharmacy chart	2026-09-18
Peptide Dosing Protocols	200 to 300 mcg nightly; titration 100 mcg (weeks 1 to 2) to 400 to 500 mcg (week 9 on); 10 mg in 3 mL, 3,333 mcg/mL, 200 mcg is 6 units; "never validated by a large modern RCT"	Protocol site, last reviewed August 2026	2026-09-18
ClinicalTrials.gov, sermorelin as intervention	27 records, dominated by tesamorelin (TH9507) trials and GHRH-arginine diagnostic tests; no adult sermorelin dose-finding study among the titles	Trial registry	2026-09-18

The adult figures are consistent across the pharmacies and the protocol page, 200 to 300 mcg nightly, and none of them descends from a trial. The only trial-derived figure is the pediatric 30 mcg/kg, which for a 20 kg child is 600 mcg. The protocol page says as much about its own numbers.

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Water per vial and the concentration it gives

The calculator works both research vials at 1, 2 and 3 mL; the protocol page's 10 mg in 3 mL is one of those rows. One U-100 unit is a hundredth of a millilitre (MedlinePlus, "Giving an insulin injection", reviewed 2024-07-21), so the micrograms in one unit are the concentration in mcg/mL divided by 100.

Vial	Water added	Concentration	Micrograms per unit
5 mg	1 mL	5 mg/mL	50 mcg
5 mg	2 mL	2.5 mg/mL	25 mcg
5 mg	3 mL	1.67 mg/mL	16.7 mcg
10 mg	1 mL	10 mg/mL	100 mcg
10 mg	2 mL	5 mg/mL	50 mcg
10 mg	3 mL	3.33 mg/mL	33.3 mcg
Olympia's dispensed solution	as supplied	0.9 mg/mL	9 mcg

The pharmacy's 0.9 mg/mL sits far below anything a research vial reaches at the calculator's volumes; a 5 mg vial would need 5.56 mL of water to match it. That is why a units figure quoted from a pharmacy chart cannot be carried across to a research vial: 33 units of Olympia's solution is 300 mcg, and 33 units of a 5 mg vial in 2 mL is 825 mcg.

The stated microgram amounts in syringe units

The amounts the sources state are 100, 200, 300 and 500 mcg (the protocol page's titration range and the pharmacies' figures) and, for scale, the 600 mcg that the pediatric label figure comes to for a 20 kg child.

Concentration	100 mcg	200 mcg	300 mcg	500 mcg	600 mcg
10 mg/mL (10 mg in 1 mL)	1 unit	2 units	3 units	5 units	6 units
5 mg/mL (5 mg in 1 mL, 10 mg in 2 mL)	2 units	4 units	6 units	10 units	12 units
3.33 mg/mL (10 mg in 3 mL)	3 units	6 units	9 units	15 units	18 units
2.5 mg/mL (5 mg in 2 mL)	4 units	8 units	12 units	20 units	24 units
1.67 mg/mL (5 mg in 3 mL)	6 units	12 units	18 units	30 units	36 units
0.9 mg/mL (Olympia)	11 units	22 units	33 units	56 units	67 units

The 10 mg in 1 mL row shows the reason the sources add more water: a 1-unit draw is at the limit of what the syringe's graduations resolve, and a half-unit reading error is half the amount. The protocol page's 3 mL configuration and the pharmacy's dilute solution both move the same amounts into a range of six to thirty-three units, where a half-unit error is a small fraction. This is a property of the arithmetic and says nothing about which amount, if any, is appropriate.

The mixing steps, as the pharmacy and a GHRH-analogue label describe them

The Geref label is no longer published, so the label-side description here is the current one for another lyophilized GHRH analogue supplied with bacteriostatic water, EGRIFTA WR (tesamorelin, revised March 2025): the powder is reconstituted with the stated volume of the supplied Bacteriostatic Water for Injection; the vial is moved in a circle to mix and is not shaken; the solution is inspected and not used if particles appear or it is cloudy or coloured. Empower's pharmacy page describes the compounded product the same way: reconstituted with the provided diluent, usually bacteriostatic water, and mixed gently until dissolved, avoiding shaking, which the page says can denature the peptide. The general procedure for any lyophilized vial, step by step, is on Medibact's how to reconstitute peptides page and is not repeated here.

Storage after mixing

The withdrawn Geref label cannot be quoted because it is no longer published; the pharmacy page opened states refrigeration at 2 to 8 °C once mixed, and what labels and manufacturers state about reconstituted peptides is on Medibact's how to store peptides page.

What this page does not do

It does not state an amount of sermorelin to use, a time, a frequency or a titration. The 200 to 500 mcg figures are reported because compounding pharmacies and a protocol page state them, and the protocol page's own words are that the adult dosing was never validated by a large modern trial; the 30 mcg/kg figure is reported because it was the labelled pediatric dose of a product that no longer exists. The arithmetic converts stated inputs exactly and says nothing about whether any input is appropriate for anyone. Medibact's Sermorelin guide covers the compound; Peptifact's tesamorelin and sermorelin dosage page sets the two GHRH analogues' labels side by side. Decisions about administering anything to a person belong with a clinician.

Sources and dates

Opened 2026-09-18: the Drugs@FDA application page for NDA 020443; the DailyMed SPL search API for "sermorelin" (zero records); the Federal Register API record for document 2013-04827; PubMed through the NCBI E-utilities for the abstract of PMID 18031173 (Prakash and Goa, BioDrugs 1999) and the counts for sermorelin[tiab] (24) and sermorelin[tiab] AND humans[mh] AND clinical trial[pt] (0); the ClinicalTrials.gov v2 API for sermorelin as an intervention (27 records, titles reviewed); Empower Pharmacy's sermorelin acetate injection page; Olympia Pharmaceuticals' sermorelin dosage chart; the Peptide Dosing Protocols sermorelin guide (last reviewed August 2026); the EGRIFTA WR prescribing information (revised 3/2025, section 2.2); MedlinePlus, "Giving an insulin injection" (reviewed 2024-07-21). Corrections go to the contact page.

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Medibact Guides facts

Sermorelin's approved product, Geref (NDA 020443, EMD Serono, approved 1997-09-26, 0.5 mg and 1 mg base per vial), is listed as discontinued on Drugs@FDA and its label is no longer published there ('Label is not available on this site', checked 2026-09-18); a DailyMed search for sermorelin on the same day returned zero labels.
FDA published on 2013-03-04 its determination that Geref 0.5 mg and 1.0 mg vials and the 0.05 mg diagnostic ampoule were not withdrawn from sale for reasons of safety or effectiveness (Federal Register document 2013-04827), the finding that allows pharmacies to compound it.
The labelled treatment dose was pediatric and weight-based: once-daily subcutaneous sermorelin 30 mcg/kg at bedtime in prepubertal children with idiopathic growth hormone deficiency, and 1 mcg/kg intravenously as a diagnostic test (Prakash and Goa, BioDrugs 1999, abstract opened 2026-09-18). For a 20 kg child, 30 mcg/kg is 600 mcg.
No adult sermorelin dose has a label. The compounding pharmacy pages opened on 2026-09-18 state 0.2 to 0.3 mg subcutaneously once daily at bedtime (Empower Pharmacy, which sells 6, 9 and 15 mg vials) and 300 mcg once nightly as 33 units of a 0.9 mg/mL solution, one vial covering 28 days (Olympia Pharmaceuticals).
The protocol page opened the same day states 200 to 300 mcg nightly with a titration from 100 mcg up to 400 to 500 mcg, works a 10 mg vial in 3 mL of bacteriostatic water at 3,333 mcg/mL so that 200 mcg is 6 units, and states that adult anti-aging dosing 'was never validated by a large modern RCT' (Peptide Dosing Protocols, last reviewed August 2026).
At the calculator's water volumes a 5 mg vial gives 5, 2.5 and 1.67 mg/mL in 1, 2 and 3 mL, so a 200 mcg amount is 4, 8 and 12 units on a U-100 syringe; a 10 mg vial gives 10, 5 and 3.33 mg/mL, so the same amount is 2, 4 and 6 units.
Olympia's 0.9 mg/mL dispensed solution puts 300 mcg at 33.3 units, which the pharmacy rounds to 33; a 5 mg research vial would reach 0.9 mg/mL at 5.56 mL of water, a volume no research-vial page opened for this page uses.
A ClinicalTrials.gov search for sermorelin as an intervention returned 27 records on 2026-09-18; the titles are dominated by tesamorelin (TH9507) trials and GHRH-arginine diagnostic tests, and none of the 27 titles describes a dose-finding study of sermorelin in adults. PubMed held 24 records with sermorelin in the title or abstract, none tagged as a human clinical trial.
Empower states that the lyophilized powder is mixed gently with the bacteriostatic-water diluent, avoiding shaking, and kept refrigerated at 2 to 8 °C once mixed; the current label of another lyophilized GHRH analogue (EGRIFTA WR, tesamorelin, revised 3/2025) describes the same steps: diluent in, swirl, do not shake, inspect for particles.

Frequently asked questions

How much water goes into a 5 mg vial of sermorelin?

No current label sets it, and the pharmacies dispense their own presentations rather than a 5 mg research vial. The protocol page opened on 2026-09-18 uses 3 mL in a 10 mg vial (3,333 mcg/mL). The calculator works a 5 mg vial at 1, 2 and 3 mL, which gives 5, 2.5 and 1.67 mg/mL, and a 10 mg vial at 10, 5 and 3.33 mg/mL. The volume decides how many units a given microgram amount occupies and nothing else; the mass in the vial is unchanged.

How many units is 200 mcg of sermorelin on an insulin syringe?

It depends on the concentration. At 5 mg/mL (a 5 mg vial in 1 mL or a 10 mg vial in 2 mL) one unit carries 50 mcg, so 200 mcg is 4 units; at 2.5 mg/mL it is 8 units; at 3.33 mg/mL, the protocol page's configuration, it is 6 units; at 1.67 mg/mL it is 12 units. On Olympia's 0.9 mg/mL solution it is 22 units, and the pharmacy's own 300 mcg figure is 33 units. The same 200 mcg, five different draws.

What was the labelled sermorelin dose?

Pediatric and weight-based. The review of the product's clinical use reports once-daily subcutaneous sermorelin at 30 mcg/kg given at bedtime for prepubertal children with idiopathic growth hormone deficiency, and 1 mcg/kg intravenously as a diagnostic test. For a 20 kg child, 30 mcg/kg is 600 mcg, roughly twice the adult figures pharmacies state. There was never an adult treatment label; the adult convention grew up in compounding after the product left the market in 2008.

Is sermorelin FDA approved?

Not any longer. Geref was approved in 1997 for pediatric growth hormone deficiency and as a diagnostic, in 0.5 mg and 1 mg vials and a 0.05 mg ampoule; the manufacturer discontinued it, Drugs@FDA lists it as discontinued, and in March 2013 FDA determined that it was not withdrawn for reasons of safety or effectiveness. That determination is why compounding pharmacies can prepare it today. No compounded product carries an FDA-reviewed label.

How is sermorelin reconstituted, according to the pharmacies?

Empower states that the lyophilized powder is reconstituted with the provided diluent, usually bacteriostatic water, mixed gently until dissolved while avoiding shaking, and kept refrigerated at 2 to 8 °C once mixed. Olympia dispenses a ready 0.9 mg/mL solution, so no mixing is involved there. The general procedure for any lyophilized peptide, step by step, is on Medibact's reconstitution page; this page carries only the arithmetic.

Why do pharmacy vials differ from research vials?

Because they are different presentations of the same peptide. Empower sells 6, 9 and 15 mg vials that are reconstituted by the patient; Olympia dispenses a 0.9 mg/mL solution already made up; research vendors sell 5 mg and 10 mg lyophilized vials. The arithmetic is identical in every case, mass divided by volume, and a units figure quoted from one presentation is wrong for another unless the concentration happens to match.