Answers to Your GLP-1 Questions
I have a history of a certain medical condition. Am I eligible for GLP1?
|Gallstones/gallbladder attacks/biliary disease
|Hyperthyroid or hypothyroid
|Medullary thyroid cancer
|Papillary thyroid cancer
|Follicular Thyroid cancer
|Chronic Kidney disease
|Multiple Endocrine Neoplasia Syndrome 2
My relative has medullary thyroid cancer? Am I eligible?
A first-degree relative with medullary thyroid cancer is a contraindication. A strong, persistent history in multi-generations outside of a first-degree relative is also a contraindication. Please discuss with the medical provider all relatives diagnosed with medullary thyroid cancer. To date, MTC after GLP-1 administration has been observed only in rodents and not in humans.
I suffer from gastrointestinal issues. Can I begin GLP-1 medications?
Yes. Since GLP-1 slows food transit through the intestines, you may experience nausea, acid reflux, constipation, or diarrhea. We have medication at Options to help with this and can also prescribe medications to your local pharmacy. NOTE: GLP-1 medication may trigger pancreatitis, gallbladder attacks or gastroparesis. Discuss with your medical provider if you have a history of these conditions.
Is GLP-1 safe during breastfeeding?
While there have been no observable detrimental side effects noted in nursing mothers taking GLP-1 for other reasons (i.e. diabetes), there has not been enough data or studies to determine if there are long term effects on breastfeeding mothers or infants. Additionally, milk production requires an additional 500 calories per day. Currently, it is not recommended to breastfeed while taking GLP1 medications.
Is GLP-1 safe while I am trying to conceive?
If you have discussed fertility plans or treatments with your doctor, it is recommended to stop GLP-1 medications at least 2 months prior to TTC. Please speak with your physician to determine if a longer washout period is recommended.
I have needle phobia, and I am not comfortable injecting myself. Can I still take GLP-1?
Injection training handouts and videos are available to you. You may also request an injection training appointment with our Medical Provider Assistant who can do an in-person or telehealth video appointment to train you in the process.
I have a history of psychiatric illness. Is it safe for me to begin treatment with GLP-1?
Limited data has indicated a small subset patients experience mood changes after the initiation of GLP-1. Please discuss with your medical provider if you do not feel like yourself. If you are having suicidal thoughts, stop the medication immediately and call your medical provider. The Suicide & Crisis Lifeline at 988 is available by phone or text 24/7 for immediate help.
What are brand names for semaglutide?
Ozempic (FDA-approved for DM2)
Wegovy (FDA-approved for obesity)
What is the brand name for tirzepatide?
Mounjaro (FDA- approved for DM2)
Zepbound (FDA-approved for obesity)
Does your semaglutide contain salts as a base?
What is in the formulary of your GLP1 medications offered?
Semalgutide + B6/B12 + sterile water
Tirzepetide + B6 + sterile water
Semaglutide + sterile water
How much weight can I expect to lose on GLP-1?
Semaglutide: 15-20% of body weight
Tirzepatide: 20-25% of body weight
Are there other benefits for taking GLP-1 other than weight loss?
May decrease bad cholesterol (LDL)
May decreased blood pressure
May decrease hyperglycemia, Hemoglobin A1c
May decrease or slow progression of pre-diabetes into diabetes mellitus
May improve functional capacity and activities of daily living
May decrease cardiovascular mortality risk by 20%
May decrease progression of chronic kidney disease
May help with psychiatric disorders as currently being studied as a possible treatment for anxiety, depression, addiction, and PTSD
What are some side effects from GLP-1 medications?
GI upset, headache, fatigue, and dizziness. Most of these symptoms can be minimized with adequate hydration, electrolyte replacement and vitamins. Options has lipotropic injections as well as vitamins, supplements, and stool softeners to help any side effects. Rest may also be helpful. For a headache, acetaminophen or ibuprofen is useful.
Do I need to stop my other diabetes medications while on GLP-1?
Do not stop your diabetes medications right away. Talk to your primary care physician to titrate your medication doses down as your blood sugar and hemoglobin A1c improves.
PATIENT SPECIFIC QUESTIONS
I was not home/left my package outside/forgot to retrieve my package with GLP-1 medication. I put it in the refrigerator as soon as I discovered it. Is it still good to use?
All medications should be refrigerated when they are received. Guidance on specific medications is below:
Semaglutide (PQ): Useful unrefrigerated for 3 days, up to 90 degrees F.
Semaglutid (Empower): Useful unrefrigerated for 3 days, up to 140 degrees F from the time of shipping.
Tirzepatide (Empower): Useful unrefrigerated for 3 days, up to 90 degrees F.
I injected too much medication. What should I do?
You may experience some GI upset or other side effects. Please call Options so we may determine the dose you took and walk you through a plan.
My vial did not contain enough medication for the fourth dose, it spilled out or leaked from the syringe.
Please call us so we may document what happened, walk through preventive measures, and potentially dispense another vial or syringe of medication.
I missed my GLP-1 injection. What should I do?
Less than 2 days have passed: inject NOW.
More than 2 days have passed: WAIT. Take at your next scheduled weekly injection day.
I am experiencing side effects after starting GLP-1 or increasing my dose. How long will it last?
Most side effects occur after the initial dose and can last as long as the second dose. Most side effects lessen over time.
What happens if my side effects do not subside?
We may titrate your dose back down to a tolerable level that still allows weight loss and try to increase more slowly. Alternatively, your medical provider may increase the period in between injections. Options offers supplements, vitamins and hydration packs to help with side effects during dose escalation.
How long will GLP-1 last in my body?
The half-life of GLP-1 in the body is 7 days. The medication can take up to 80 days to metabolize completely out of the body.
I’m on GLP-1 and found out that I’m pregnant. What should I do?
Stop taking the medication immediately and call your physician.
I just started GLP-1 but I’m still hungry. Is the medication working?
The medication is started at a low level and titrated up slowly. This allows the body time to adapt and tolerate the medication while minimizing side effects. We can prescribe appetite suppressants or OptiFul if you are experiencing hunger at lower doses or towards the end of the 7 days when the GLP-1 has a diminishing effect and it is nearing the time of the next injection. Hydration helps tremendously.
Can I skip strengths and increase my dose of GLP-1 before the recommended time?
No. The medication is started at a low dose and titrated up slowly to allow the body to tolerate the medication while minimizing side effects. If you are already on GLP-1, we will resume your current prescribed dosing schedule.
How long will it take to receive my medication?
If you are in geographic proximity to a location, you may receive your first dose in the clinic. If you are not, drop-shipping the medication to your home takes 7-10 business days. Please schedule your next monthly medical appointment approximately 3 weeks after starting to ensure there are no gaps in your medication schedule.
My child ingested my GLP-1 medication? What should I do?
Call Poison Control at 1.800.222.1222 immediately. Have the medication vial or syringe available to provide details. Call your child’s pediatrician to see if they should go to the urgent care or emergency department. Bring the bottle of medication to the facility. NOTE: The GLP-1 drug class is FDA-approved in ages 12+.
My pet ingested my GLP-1 medication. What should I do?
Call your pet’s veterinarian immediately. Have the bottle or syringe on hand to provide details.
Can I travel on an airplane with my GLP-1 injections?
We may ship a vial to you that is more secure than individual injections. If you are taking individual injections, ask staff to cap the end of the plunger so it is not accidently dislodged ejecting the medication. Pack ice packs with your medication and carry directly onto the airplane. A travel letter to get through airport security is available by request.
I have reached my goal weight on GLP-1 or no longer meet FDA criteria. What is the next step?
Continue onto the GLP-1 maintenance program with 1-2 injections per month. We may also begin appetite suppressants approved for long term weight maintenance use such as Phentimate or Pro Novis. Studies show, patients steadily gain weight back over the years without maintenance.
I missed my GLP-1 medical exam for the next dose. What should I do?
Call Options immediately so we may reschedule your appointment and get your medication shipped out ASAP.
I have an upcoming medical procedure involving anesthesia. Should I stop my GLP-1 injections?
Yes; do not inject at least one week prior to your surgery or procedure. Check with your physician to confirm your stop date as a longer period may be recommended.
I noticed some hair loss (alopecia) since beginning GLP1 injections. Is this normal?
Telogen Effluvium is temporary with weight loss. Some patients will lose hair because of decreased caloric intake, specifically 900 calories or less. Lipotropic injection, vitamins D&E and minerals iron & zinc can help minimize hair loss. Taking a biotin supplemental may also be useful for brittle hair and nails.
I began to have headaches and/or fatigue on GLP-1? Do I need to stop the medication?
Staying hydrated is very important as many patients become dehydrated when their appetite decreases. We can prescribe anti-emetics for nausea to improve appetite. Options has shakes available if eating full meals is difficult when initiating the medications. Electrolytes are helpful. Over-the-counter analgesics such as acetaminophen or ibuprofen may help to alleviate headache.
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