Medications Available

Compounded Semaglutide/Tirzepatide

What are Compounded Semaglutide/Tirzepatide Drugs?

As an alternative to FDA-approved branded products (Ozempic®, Wegovy™, Mounjaro® and Zepbound®) a provider may prescribe a compounded drug with the identical Approved Active Pharmaceutical Ingredient (API), which is prepared by a USA state-licensed sterile compounding pharmacy partner. Compounded drugs are permitted to be prescribed under federal law.

Semaglutide

What is Semaglutide?

Semaglutide, the active pharmaceutical ingredient in Ozempic®, Wegovy™, and Rybelsus®, belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. It mimics the GLP-1 hormone that is released in the gastrointestinal tract in response to eating. One role of GLP-1 is to prompt the body to produce more insulin, which reduces blood glucose (sugar). GLP-1 in higher amounts also interacts with the parts of the brain that reduce appetite and signal a feeling of fullness to help patients with weight management.

How does Semaglutide work?

It slows the rate food moves through your digestive system, known as gastric emptying, which tells your brain there’s food in your stomach, and reduces your appetite and food cravings.  Smaller quantities of food keep you satisfied longer, so you’re not hungry as often as usual. You consume fewer calories than you use for your daily activities, resulting in easy and effective weight loss.

How do I use Semaglutide?

Semaglutide is a painless weekly shot that you administer from the comfort of your own home. Your medication delivery will contain specific directions on how to administer the medication to yourself subcutaneously (under the skin). If you have any questions, please reach out to your Healthcare Team to ensure you’re dispensing the medication correctly.

Is Semaglutide Right for Me?

Semaglutide is only right for some people. According to the Obesity Medicine Association (OBM), “Adults with obesity (BMI 30 or more) or overweight (BMI 27-29) with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), are eligible to receive it if there are no contraindications.”

What dose of Semaglutide will I be prescribed?

Your Healthcare Provider will personalize the dosage based on your current health status, health history, and other factors, which will be reassessed regularly. Upon approval by your Healthcare provider, you will begin using Semaglutide with the proper dose to minimize side effects. Thereafter, the doses may increase and once you reach your weight loss goal, your provider will prescribe a low-dose maintenance plan.

Tirzepatide

What is Tirzepatide?

Tirzepatide, the active pharmaceutical ingredient in Mounjaro® (tirzepatide) and Zepbound® (tirzepatide), belongs to a class of medications known as glucagon-like peptide-1 (GLP-1) receptor agonists. Tirzepatide is a prescription medicine that may help adults with obesity or excess weight (overweight) who also have weight-related medical problems, lose weight and keep it off, and improves blood sugar (glucose) in adults with type 2 diabetes mellitus.

“Obesity and overweight are serious conditions that can be associated with some of the leading causes of death such as heart disease, stroke and diabetes,” said John Sharretts, M.D., director of the Division of Diabetes, Lipid Disorders, and Obesity in the FDA’s Center for Drug Evaluation and Research. “In light of increasing rates of both obesity and overweight in the United States, today’s [tirzepatide] approval addresses an unmet medical need.” 

Approximately 70% of American adults have obesity or overweight, and many of those overweight have a weight-related condition. Losing 5% to 10% of body weight through diet and exercise has been associated with a reduced risk of cardiovascular disease in adults with obesity or overweight.

How does Tirzepatide work?

It activates receptors of hormones secreted from the intestine (glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP)) to reduce appetite and food intake to help patients with weight management. It reduces your appetite and food cravings, so you consume fewer calories than you use for your daily activities, resulting in easy and effective weight loss. 

How do I use Tirzepatide?

Tirzepatide is a painless weekly shot that you administer from the comfort of your own home. Your medication delivery will contain specific directions on how to administer the medication to yourself subcutaneously (under the skin). If you have any questions, please reach out to your Healthcare Team to ensure you’re dispensing the medication correctly.

Is Tirzepatide Right for Me?

The U.S. Food and Drug Administration approved Zepbound (tirzepatide) injection for chronic weight management in adults with obesity (body mass index of 30 kilograms per square meter (kg/ m2) or greater) or overweight (body mass index of 27 kg/m2 or greater) with at least one weight-related condition (such as high blood pressure, type 2 diabetes or high cholesterol) for use, in addition to a reduced calorie diet and increased physical activity. Tirzepatide is only right for some people.

What dose of Tirzepatide will I be prescribed?

Your Healthcare Provider will personalize the dosage based on your current health status, health history, and other factors, which will be reassessed regularly. Upon approval by your Healthcare provider, you will begin using Tirzepatide with the proper dose to minimize side effects. Thereafter, the doses may increase and once you reach your weight loss goal, your provider will prescribe a low-dose maintenance plan.

Side Effects

Let’s discuss the potential side effects of GLP-1 medications, which are important to consider when evaluating their benefits for weight loss.

  1. General Side Effects:
    • Nausea and Vomiting: Some individuals experience mild nausea or occasional vomiting when starting GLP-1 medications. However, these side effects often improve over time as your body adjusts1.
    • Stomach Pain: Abdominal discomfort or pain can occur, especially during the initial weeks of treatment. It’s essential to communicate any persistent or severe pain with your healthcare provider.
    • Headache and Fatigue: These side effects are relatively common but usually not severe. Staying well-hydrated and getting adequate rest can help manage them.
    • Changes in Vision: Tell your health care provider if you have changes in vision during treatment
    • Most Common Side Effects: Nausea, diarrhea, decreased appetite, vomiting, constipation, indigestion, and stomach (abdominal) pain. Tell your health care provider if these side effects persist.
  1. Low Blood Sugar (Hypoglycemia):
  1. Less Common Side Effects:
    • While less frequent, some individuals may experience:
      • Dizziness: If you feel lightheaded or dizzy, especially when standing up, discuss it with your doctor.
      • Constipation or Diarrhea: Changes in bowel habits can occur. Staying hydrated and maintaining a balanced diet can help.
      • Heartburn, Indigestion, or GERD: These gastrointestinal symptoms might occur, but they’re usually manageable.
  1. Rare but Serious Side Effects:
    • Although uncommon, it’s crucial to be aware of potential serious risks:
      • Pancreatitis: Some GLP-1 medications have been associated with pancreatitis (inflammation of the pancreas). Seek medical attention promptly if you experience severe abdominal pain.
      • Thyroid Cancer: There have been concerns about an increased risk of thyroid cancer, although the evidence remains inconclusive. Regular thyroid monitoring is recommended.
      • Kidney Injury: Rare cases of kidney injury have been reported. If you notice changes in urination or swelling, consult your healthcare provider.
      • Gallbladder Disease: GLP-1 medications may affect gallbladder function. Inform your doctor if you experience symptoms like abdominal pain after meals.
  1. Long-Term Use and Weight Maintenance:
    • GLP-1 medications are effective for weight loss, but maintaining that weight loss often requires long-term strategies that should be discussed with your healthcare team.
    • Remember that lifestyle changes (such as diet and exercise) remain essential for sustained success.

Always consult your healthcare provider, and don’t hesitate to share any concerns or symptoms you experience during treatment.

Disclaimer: This information is not a substitute for professional medical advice. Consult your healthcare provider before starting any new medication.

1: U.S. News: Side Effects of Ozempic, Wegovy, Mounjaro, and Zepbound 2: Mayo Clinic: GLP-1 Agonists and Byetta

Contraindications

Let’s dive into the important topic of contraindications for GLP-1 medications. These contraindications help guide healthcare providers in determining who should and should not take GLP-1 medications. Remember, always consult with your doctor before starting any new treatment. Here’s what you need to know:

  1. Hypersensitivity to GLP-1 Agonist Drugs:
    • If you’ve had an allergic reaction to GLP-1 receptor agonists (such as semaglutide), these medications may not be suitable for you. Allergic reactions can range from mild skin rashes to more severe symptoms like difficulty breathing.
  1. Previous History or Current Pancreatitis:
    • Individuals with a history of pancreatitis (inflammation of the pancreas) should avoid GLP-1 medications. Pancreatitis can be a serious condition, and these medications may exacerbate it.
  1. Family History of Medullary Thyroid Cancer:
    • Medullary thyroid cancer (MTC) is a rare but serious type of thyroid cancer. If you have a family history of MTC, your doctor will carefully consider the risks and benefits before prescribing GLP-1 agonists.
  1. Multiple Endocrine Neoplasia Syndrome Type 2 (MEN2):
    • MEN2 is a genetic disorder that predisposes individuals to various endocrine tumors, including MTC. If you have MEN2 or a family history of it, GLP-1 medications may not be appropriate.
  1. End-Stage Renal (Kidney) Disease:
    • Kidney function plays a role in how GLP-1 medications are metabolized. If you have severe kidney disease (end-stage renal disease), your doctor will assess whether these medications are safe for you.
  1. Gastroparesis or Inflammatory Bowel Disorders:
    • Gastroparesis (delayed stomach emptying) and inflammatory bowel disorders (such as Crohn’s disease or ulcerative colitis) can affect how GLP-1 medications work. In some cases, they may be contraindicated.
  1. Pregnancy:
    • GLP-1 medications are generally not recommended during pregnancy due to limited safety data. If you’re pregnant or planning to become pregnant, discuss alternative options with your healthcare provider.
  1. Pediatric Obesity:
    • GLP-1 medications are not typically used in children for weight management. Their safety and effectiveness in pediatric populations are still being studied.

Remember that individual circumstances vary, and your doctor will consider your overall health, medical history, and specific needs. Always communicate openly with your healthcare team to make informed decisions about your treatment plan.

Disclaimer: This information is not a substitute for professional medical advice. Consult your healthcare provider before starting any new medication.

1: Mayo Clinic Diet: Considering GLP-1 Medications