Important Safety Information

Compounded Semaglutide (GLP-1)

Compounded medications may be prescribed by licensed medical providers but are not evaluated by the FDA for safety, effectiveness, or quality. FDA-approved medications containing semaglutide are available.‍

WARNING

Contact your medical provider immediately or seek medical care if you experience:

• Severe nausea or vomiting leading to dehydration
• Kidney problems or kidney failure, which may occur due to dehydration
• Symptoms of thyroid tumors, including difficulty swallowing, hoarseness, neck swelling, or shortness of breath
• Pancreatitis, including severe abdominal or back pain that does not resolve
• Gallbladder problems, including upper abdominal pain, fever, yellowing of skin or eyes, or persistent nausea
• Liver concerns, including elevated liver enzymes or jaundice
• Vision changes, particularly in individuals with diabetic retinopathy
• Severe gastrointestinal disease symptoms
• Symptoms of low blood sugar, such as dizziness, shakiness, sweating confusion, or rapid heartbeat
• Increased heart rate
• Mood or behavioral changes, including worsening depression or suicidal thoughts

Never share prescription medication with another person.

Drug Interactions

Semaglutide may interact with alcohol, prescription medications, over-the-counter medications, and herbal supplements.

Important considerations include:

• Increased risk of hypoglycemia when used with insulin or sulfonylurea medications
• Delayed gastric emptying, which may affect the absorption of certain oral medications
• Possible interactions with medications requiring precise blood levels (such as warfarin)
• Patients taking thyroid medications should discuss dosing timing with their prescribing provider.

Patients should inform all healthcare providers, including surgeons, that they are taking semaglutide, as it may impact care decisions around procedures or surgery.

For a complete list of warnings and side effects, refer to pharmaceutical packaging or consult your provider.

BLACK BOX WARNING

GLP-1 medications are contraindicated in individuals with:

• A personal or family history of medullary thyroid carcinoma (MTC)
• Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

In animal studies, semaglutide caused thyroid tumors, including thyroid cancer. It is not known whether these effects occur in humans.

Notify your provider immediately if you experience:

• Difficulty swallowing
• Persistent hoarseness
• A lump or swelling in the neck
• Shortness of breath

Additional precautions:

• Do not use while pregnant, breastfeeding, or planning pregnancy
• Discontinue at least 2 months before attempting pregnancy
• Avoid alcohol while taking this medication
• Inform your provider of any kidney, liver, or pancreatic conditions

Stop using the medication and seek medical care if you experience severe abdominal pain or symptoms of a serious allergic reaction such as swelling, breathing difficulty, or severe rash. consult your provider.

Compounded NAD+

Mild Side Effects

NAD+ injections are generally well tolerated by many patients, but, as with any injectable therapy, side effects are possible. Mild effects may include:

• Mild redness, soreness, or swelling at the injection site
• Headache
• Fatigue
• Nausea or stomach discomfort

More Serious Side Effects (less common)

• Allergic reaction (e.g., rash, swelling, shortness of breath, dizziness, or fainting—particularly shortly after injection.)
• Flu-like symptoms
• Flushing
• Rapid heartbeat

If you experience signs of an allergic reaction or have severe discomfort, stop product use and seek medical care immediately.

Contraindications (not recommended for)

• Individuals with known hypersensitivity to NAD+ or any formulation components
• Individuals with unstable cardiovascular disease, active malignancy, or poorly controlled anxiety or panic disorder
• Individuals who are currently pregnant, breastfeeding, or planning to become pregnant in the near future
• Individuals with an active infection, uncontrolled chronic illness, or ongoing cancer treatment should not use the product without prior approval from their primary care physician or specialist
• Use caution in individuals taking medications that affect energy metabolism, including but not limited to insulin, metformin, or corticosteroids; all medications, supplements, and herbal products should be disclosed to a medical provider prior to use
• Use caution in patients with autonomic sensitivity or prior intolerance to injectable therapies, significant arrhythmia history, unstable angina or severe vasovagal episodes with injections

Other important safety information

• Store in the refrigerator
• Do not exceed the dose indicated on your product packaging
• Keep out of reach of children
• Do not use expired product

Hormone Replacement Therapy (HRT)

BLACK BOX WARNING

Estrogen therapy carries important risks including:

• Cardiovascular disorders
• Breast cancer
• Endometrial cancer
• Dementia in women age 65 and older

Estrogen used alone in women with a uterus increases the risk of endometrial cancer. Adding progesterone helps reduce this risk.

Hormone therapy should be used at the lowest effective dose for the shortest duration appropriate for treatment goals.

Possible Risks

When hormone therapy is started near the time of menopause and delivered as transdermal estradiol, current evidence suggests the overall risk profile is low for most healthy women. Transdermal therapy may carry lower risks of blood clots and cardiovascular events than older oral estrogen formulations, though these conditions can still occur in rare cases.

Potential risks that have been studied include:

• Blood clots
• Stroke
• Heart attack
• Breast cancer
• Gallbladder disease

Research has shown that risk varies depending on age, timing of therapy, and the type of hormone used. In some studies, starting estrogen therapy earlier in menopause has been associated with neutral or favorable cardiovascular outcomes, and estrogen-only therapy in women without a uterus has not been shown to increase breast cancer risk and in some analyses was associated with a lower incidence.

Seek medical attention immediately if symptoms such as severe chest pain, vision changes, or sudden weakness occur.

Common Side Effects

• Estradiol Topical
  • Skin irritation at application site
  • Breast tenderness
  • Bloating
  • Headache
  • Mood changes

• Estradiol Vaginal
  • Vaginal irritation
  • Discomfort
  • Spotting

• Progesterone
  • Drowsiness
  • Dizziness
  • Breast tenderness
  • Bloating
  • Mood changes

Contraindications (not recommended for)

Do not use hormone therapy if you have:

• Breast or estrogen-dependent cancers
• Active blood clots or clotting disorders
• Liver disease
• Unexplained vaginal bleeding
• Individuals who are currently pregnant, breastfeeding, or planning to become pregnant in the near future

General Disclaimer

Some medications and therapies offered through Options Medical may include compounded formulations prescribed by licensed medical providers.

Compounded drug products are not approved or evaluated for safety, effectiveness, or quality by the U.S. Food and Drug Administration (FDA).

Prescription medications and treatments may only be used by those for whom they are prescribed. 

Statements on this page have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease.

Patients should always consult their medical provider with questions regarding treatment, dosing, side effects, or risks.