Thymosin Alpha-1

Also known as · Thymalfasin · Tα1 · Zadaxin (approved outside US)

01 / Dosing schedule

Cited dosing

Thymosin Alpha-1 (Zadaxin) is approved outside the US for chronic hepatitis B, malignant melanoma, DiGeorge anomaly, and hepatocellular carcinoma. The insert lists 1.6 mg subcutaneously twice weekly for chronic hepatitis B, as monotherapy or with interferon.

Zadaxin — chronic hepatitis B

PhaseDose & frequency
Standard dose1.6 mg (900 mcg/m²) subQ twice weekly
RegimenMonotherapy or combined with interferon at labeled interferon dose
RouteSubcutaneous only — not IV
Vial1.6 mg lyophilized powder + 1 mL diluent

Source · SciClone Zadaxin (thymalfasin) prescribing information ↗

Source indication · Chronic hepatitis B (Zadaxin insert, non-US approval).

Injection frequency
Twice weekly, spaced 3–4 days apart.
Injection sites
Subcutaneous — typical rotation sites.

02 / Reconstitution

Reconstitution reference

Zadaxin is 1.6 mg lyophilized powder per vial, reconstituted with 1 mL of sterile water for injection immediately prior to use. Final concentration is 1.6 mg/mL. The full vial is the standard dose. For research-grade multi-dose vials, dilution math scales with the vial size and BAC water volume chosen.

Vial1.6 mg (labeled)
BAC water1 mL
Concentration1.6 mg/mL
Example dose1.6 mg
On a U‑100 syringe100 units on U‑100 (1 mL)
Open the reconstitution calculator →

03 / Overview

Protocol overview

Thymosin Alpha-1 is a 28-amino-acid peptide originally isolated from thymic tissue. It modulates T-cell maturation and shifts the innate/adaptive immune response.

It is approved in over 35 countries (including much of Europe and Asia) for chronic hepatitis B, malignant melanoma, DiGeorge syndrome, and hepatocellular carcinoma. It is not FDA-approved in the US and is available domestically only through compounding pharmacies.

The 1.6 mg twice-weekly subQ schedule is the label-standard for chronic hepatitis B and the dose used in the pivotal trials. Broader immunomodulation dosing in the literature ranges from 0.8–6.4 mg per dose.

The ~2 hour plasma half-life belies a longer functional effect on lymphocyte populations. Twice-weekly dosing has been the trial-standard cadence.

04 / References

References

  1. SciClone Zadaxin (thymalfasin) prescribing information ↗
  2. Costantini C et al. Thymosin alpha 1: A comprehensive review of the literature. PMC 2020 ↗