Semaglutide

There are two forms of semaglutide offered: an injectable form and an oral dissolvable tablet. Unless otherwise noted, the safety information below applies to both forms.

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What is this medication used for?

• This medication is used to help with weight loss in certain people.

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What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this medication or any part of this drug. Tell your doctor about any drug allergies and what symptoms you had.
• If you have ever had pancreatitis.
• If you have or have ever had depression or thoughts of suicide.
• If you are using a similar medication or any medication that has the same ingredients.
• If you are using another medication like this one. If you are not sure, ask your doctor or pharmacist.

Tell your doctor and pharmacist about all of your medications (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medication with all of your medications and health problems. Do not start, stop, or change the dose of any medication without checking with your doctor.

‍

What are some things I need to know or do while I take this medication?

• Tell all of your health care providers that you take this medication. This includes your doctors, nurses, pharmacists, and dentists.
• Follow the diet and workout plan from the doctor if they gave you one.
• Have blood work checked as you have been told by the doctor.
• Talk with your doctor before you drink alcohol.
• If you cannot drink liquids by mouth or if you have an upset stomach, throwing up, or diarrhea that does not go away, you need to avoid getting dehydrated. Contact your doctor to find out what to do. Dehydration may lead to low blood pressure or to new or worsening kidney problems.
• If you are planning on getting pregnant, talk with your doctor. You may need to stop taking this medication at least 2 months before getting pregnant.
• If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.
• Weight loss during pregnancy may cause harm to the unborn baby. If you get pregnant while taking this drug or if you want to get pregnant, stop taking this medication and call your doctor right away.
• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

(Additional injectable-only and tablet-only instructions are listed in the sections below.)

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What are some side effects that I need to call my doctor about right away?

• Signs of an allergic reaction, such as rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of kidney problems such as inability to pass urine, changes in how much urine is passed, or blood in the urine.
• Signs of gallbladder problems such as pain in the upper right belly area, right shoulder area, or between the shoulder blades; change in stools; dark urine or yellow skin or eyes; or fever with chills.
• Severe dizziness or passing out.
• A fast heartbeat.
• Change in eyesight.
• Low blood sugar can happen. Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of these signs. Follow what you have been told to do for low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices.
• Although rare, severe pancreatitis has happened with this medication. Call your doctor right away if you have severe stomach pain, severe back pain, or severe upset stomach or throwing up.

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What are some other side effects of this drug?

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Constipation, diarrhea, stomach pain, upset stomach, or throwing up.
• Headache.
• Feeling dizzy, tired, or weak.
• Nose or throat irritation.
• Runny nose.
• Bloating.
• Burping.
• Gas.
• Heartburn.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

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Injectable Semaglutide

How is this medication best taken?

Use this medication as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• It is given as a shot into the fatty part of the skin on the top of the thigh, belly area, or upper arm.
• Take with or without food.
• Take the same day each week, or as directed by your doctor.
• Move and rotate the injection site with each shot.
• Do not use if the solution is cloudy, leaking, or has particles.
• Wash your hands before and after use.
• Keep taking this medication as you have been told by your doctor or other health care provider, even if you feel well.
• Do not share injection materials with another person. Sharing these materials may pass infections from one person to another. This includes infections you may not know you have.
• Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for disposal. Talk with a doctor or pharmacist if you have any questions.

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What do I do if I miss a dose of the injectable form?

• Take a missed dose as soon as you think about it and go back to your normal time.
• If it is less than 48 hours until your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses within 48 hours of each other.
• If you miss 2 doses, call your doctor.

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How do I store and/or throw out the injectable form?

• Refrigerate unused medication.
• After first use, discard the vial after 28 days.
• Store somewhere protected from light.
• Protect from heat.

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Oral Dissolvable Tablet Semaglutide

How is this medication best taken?

Use this medication as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take with or without food, exactly as directed by your doctor.
• Take this medication by mouth as a dissolvable tablet.
• Place the tablet on or under your tongue and let it dissolve completely. Do not chew, crush, or swallow the tablet whole.
• Do not eat or drink anything other than a small sip of water (if instructed) when taking the tablet, unless your doctor or pharmacist has told you otherwise.
• Try to take this medication at the same time each day, or as directed by your doctor.
• Keep taking this medication as you have been told by your doctor or other health care provider, even if you feel well.

‍

What do I do if I miss a dose of the oral dissolvable tablet?

• Take a missed dose as soon as you remember it.
• If it is close to the time of your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.
• If you are not sure what to do, call your doctor or pharmacist.

‍

How do I store and/or throw out the oral dissolvable tablet?

• Store at room temperature, protected from light.
• Store in a dry place. Do not store in a bathroom.
• Keep tablets in the original container until it is time to take them, unless your pharmacist tells you otherwise.
• Keep all medications in a safe place. Keep all medications out of the reach of children and pets.
• Throw away unused or expired medication. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

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Warning (applies to all forms of semaglutide)

• This medication has been shown to cause thyroid cancer in some animals. It is not known if this happens in humans. Call your doctor right away if you have a neck mass, trouble breathing, trouble swallowing, or have hoarseness that will not go away.
• Do not use this drug if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or if you or a family member have had thyroid cancer.
• Keep all medications in a safe place. Keep all medications out of the reach of children and pets.
• Throw away unused or expired medication. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

‍

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.
• Do not share your medications with others and do not take anyone else's medication.
• Some medications may have another patient information leaflet. If you have any questions about this medication, please talk with your doctor, nurse, pharmacist, or other health care provider.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

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Tirzepatide

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What is this medication used for?

• This medication is used to help with weight loss in certain people.

‍

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this medication; any part of this drug. Tell your doctor about any drug allergies and what symptoms you had.

• If you have ever had pancreatitis.

• If you have or have ever had depression or thoughts of suicide.

• If you are using a similar medication or any medication that has the same ingredients.

• If you are using another medication like this one. If you are not sure, ask your doctor or pharmacist.

‍

‍Tell your doctor and pharmacist about all of your medications (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this medication with all of your medications and health problems. Do not start, stop, or change the dose of any medication without checking with your doctor.

‍‍

What are some things I need to know or do while I take this medication?

• Tell all of your health care providers that you take this medication. This includes your doctors, nurses, pharmacists, and dentists.

• Follow the diet and workout plan from the doctor if they gave you one.

• Have blood work checked as you have been told by the doctor.

• Talk with your doctor before you drink alcohol.

• If you cannot drink liquids by mouth or if you have an upset stomach, throwing up, or diarrhea that does not go away; you need to avoid getting dehydrated. Contact your doctor to find out what to do. Dehydration may lead to low blood pressure or to new or worsening kidney problems.

• Do not share injection materials with another person. Sharing these materials may pass infections from one person to another. This includes infections you may not know you have.

• If you are planning on getting pregnant, talk with your doctor. You may need to stop taking this medication at least 2 months before getting pregnant.

• If you have high blood sugar (diabetes), you will need to watch your blood sugar closely.

• Weight loss during pregnancy may cause harm to the unborn baby. If you get pregnant while taking this drug or if you want to get pregnant, stop taking this medication  and call your doctor right away.

• Tell your doctor if you are breast-feeding. You will need to talk about any risks to your baby.

‍

What are some side effects that I need to call my doctor about right away?

• Signs of an allergic reaction, such as rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

• Signs of kidney problems such as inability to pass urine, changes in how much urine is passed, or blood in the urine

• Signs of gallbladder problems such as pain in the upper right belly area, right shoulder area, or between the shoulder blades; change in stools; dark urine or yellow skin or eyes; or fever with chills.

• Severe dizziness or passing out.

• A fast heartbeat.

• Change in eyesight.

• Low blood sugar can happen.Signs may be dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or sweating. Call your doctor right away if you have any of these signs. Follow what you have been told to do for low blood sugar. This may include taking glucose tablets, liquid glucose, or some fruit juices.

• Although rare, severe pancreatitis has happened with this medication. Call your doctor right away if you have severe stomach pain, severe back pain, or severe upset stomach or throwing up.

‍

What are some other side effects of this drug?

‍All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

‍

‍• Constipation, diarrhea, stomach pain, upset stomach, or throwing up.

• Headache.

• Feeling dizzy, tired, or weak.

• Nose or throat irritation.

• Runny nose.

• Bloating.

• Burping.

• Gas.

• Heartburn.

‍

‍These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

‍‍

How is this medication best taken?

‍Use this medication as ordered by your doctor. Read all information given to you. Follow all instructions closely.

‍

‍• It is given as a shot into the fatty part of the skin on the top of the thigh, belly area, or upper arm.

• Take with or without food.

• Take the same day each week.

• Move / rotate the injection site with each shot.

• Do not use if the solution is cloudy, leaking, or has particles.

• This drug is clear and colorless. Do not use if the solution changes color.

• Wash your hands before and after use.

• Keep taking this medication as you have been told by your doctor or other health care provider, even if you feel well.

• Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for disposal. Talk with a doctor or pharmacist if you have any questions.

‍

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it and go back to your normal time.

• If it is less than 48 hours until your next dose, skip the missed and go back to your normal time.

• Do not take 2 doses within 48 hours of each other.

• If you miss 2 doses, call your doctor.

‍

How do I store and/or throw out this drug?

• Refrigerate unused medication,

• After first use, discard vial after 28 days of first use

‍• Store somewhere protected from light.

• Protect from heat

‍

Warning

‍

• This medication has been shown to cause thyroid cancer in some animals. It is not known if this happens in humans. Call your doctor right away if you have a neck mass, trouble breathing, trouble swallowing, or have hoarseness that will not go away.

• Do not use this drug if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or if you or a family member have had thyroid cancer.

• Keep all medications in a safe place. Keep all medications out of the reach of children and pets.

• Throw away unused or expired medication. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

‍

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.

• Do not share your medications with others and do not take anyone else's medication.

• Some medications may have another patient information leaflet. If you have any questions about this medication, please talk with your doctor, nurse, pharmacist, or other health care provider.

• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

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Zofran (ondansetron)

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What is this drug used for?

• It is used to treat or prevent upset stomach and throwing up.

‍

What do I need to tell my doctor BEFORE I take this drug?

• If you are allergic to this drug; any part of this drug; or any other drugs, foods, or substances. Tell your doctor about the allergy and what signs you had.

• If you have a long QT on ECG.

• If you are taking apomorphine.This is not a list of all drugs or health problems that interact with this drug. Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take this drug with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

‍‍

What are some things I need to know or do while I take this drug?

• Tell all of your health care providers that you take this drug. This includes your doctors, nurses, pharmacists, and dentists.

• If you have phenylketonuria (PKU), talk with your doctor. Some products have phenylalanine.

• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast-feeding. You will need to talk about the benefits and risks to you and the baby.

‍

What are some side effects that I need to call my doctor about right away?

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

• Trouble passing urine.

• Dizziness.

• Sudden chest pain or tightness.

• A type of abnormal heartbeat (prolonged QT interval) has happened with this drug. Sometimes, this has led to another type of unsafe abnormal heartbeat (torsades de pointes). Call your doctor right away if you have a fast or abnormal heartbeat, or if you pass out.

• Although rare, a severe problem called serotonin syndrome can happen. The risk may be greater if you also take certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; severe diarrhea, upset stomach, or throwing up; or very bad headache.

• This drug may make it harder to see the signs of a bowel block in people who have had surgery in the stomach area or upset stomach and throwing up after chemotherapy. Call your doctor right away if you have stomach pain or swelling of the stomach area.

‍

What are some other side effects of this drug?

‍All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

‍

‍• Headache.

• Feeling tired or weak.

• Diarrhea or constipation.

• Feeling sleepy.

• Anxiety.

‍These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects. You may report side effects to your national health agency.

‍‍

How is this drug best taken?

‍Use this drug as ordered by your doctor. Read all information given to you. Follow all instructions closely.

‍

‍• Take with or without food.

• If you take this drug on a regular basis, take a missed dose as soon as you think about it.

• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.

• Do not take 2 doses at the same time or extra doses.

• Many times this drug is taken on an as needed basis. Do not take it more often than told by the doctor.

‍

How do I store and/or throw out this drug?

• Store at room temperature protected from light. Store in a dry place. Do not store in a bathroom.

• Store in original container.

• Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.

• Throw away unused or expired drugs. Do not flush down a toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

‍

General drug facts

• If your symptoms or health problems do not get better or if they become worse, call your doctor.

• Do not share your drugs with others and do not take anyone else's drugs.

• Some drugs may have another patient information leaflet. If you have any questions about this drug, please talk with your doctor, nurse, pharmacist, or other health care provider.

• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

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NAD+ (Nicotinamide Adenine Dinucleotide)

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What is NAD+

NAD+ (Nicotinamide Adenine Dinucleotide) is a natural molecule found in every cell of your body. It plays a key role in energy production, DNA repair, and healthy cell function. As we age, NAD+ levels naturally decline, which may contribute to fatigue, changes ain metabolism, changes in focus or clarity, and other signs of aging.

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What NAD+ is used for

Common goals for NAD+ therapy include:

• Boosting energy levels
• Enhancing mental clarity and focus
• Supporting metabolic processes
• Supporting cellular repair pathways tied to healthy aging
• Improving athletic recovery

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Note: NAD+ injections are not FDA-approved to treat or cure medical conditions. This compounded medication is prepared by a licensed pharmacy and has not been evaluated by the FDA for safety or effectiveness. It is provided for wellness support as directed by your healthcare provider.

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Why use injectable NAD+

Injectable NAD+ delivers the molecule directly into your body, bypassing the digestive system for faster, more effective absorption.

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Precautions

Allergies:Tell your provider if you have allergies to NAD+, niacin, or related substances.

Medical Conditions:Inform your provider if you have heart conditions, kidney disease, liver disease, or cancer.

Pregnancy & Breastfeeding:Safety has not been established; use only if directed by your provider.

Other Medications:Provide a full list of medications and supplements you are taking to your doctor.

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How is NAD+ best taken

• Use this medication as ordered by your doctor. Read all information given to you. Follow all instructions closely.
• It is given as a subcutaneous injection into the fatty tissue of the abdomen.
• Wash your hands before and after use.
• Move/rotate the injection site with each shot.
• Do not inject into swollen, bruised, infected, or painful areas.
• Do not use if the solution is cloudy, leaking, or has particles.
• Throw away needles in a needle/sharp disposal box. Do not reuse needles or other items. When the box is full, follow all local rules for disposal. Talk with a doctor or pharmacist if you have any questions.

‍

What to expect after injection

Some patients notice immediate benefits like increased energy or improved mood. Others may require multiple injections over days or weeks for full effects.

‍

Mild side effects may include:

• Soreness at the injection site
• Mild flushing or warmth
• Headache
• Temporary fatigue
• Nausea (rare)

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When to contact your healthcare provider

Call your healthcare provider immediately if you experience:

• Signs of allergic reaction (rash, itching, swelling, severe dizziness or fainting, trouble breathing)
• Persistent nausea, vomiting, severe headache or sudden vision changes
• Chest pain or irregular heartbeat

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Storage instructions

• Store NAD+ vials in the refrigerator (36°F - 46°F / 2°C - 8°C)
• Protect from light, do not freeze
• Do not use if the solution appears cloudy or discolored
• Use within the expiration date indicated on the vial

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What to do if you miss a dose

If you miss a dose, skip the missed dose and continue with your regular schedule. If you have any questions about your dosing schedule, contact your physician.

‍

General tips

• Always use a sterile needle and syringe for each injection.
• Rotate injection sites to avoid irritation.
• Never share syringes or medications with others.
• Dispose of sharps properly in a designated sharps container.
• Keep medication out of reach of children and pets.
• Contact your healthcare provider right away if you experience severe side effects or allergic reactions.

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Questions

If you have any questions or concerns about your NAD+ injections, please contact your healthcare provider.