Important Safety Information

Compounded Tirzepatide Important Safety Information

Your health and safety are important to us. Before starting compounded tirzepatide, please review the following information to understand the possible risks, side effects, and precautions associated with your medication.

Compounded tirzepatide is a prescription medication prepared by a compounding pharmacy for an individual patient's medical needs. Tirzepatide is the active ingredient in the FDA-approved brand-name medication ZEPBOUND®. Compounded products prepared with tirzepatide base contain that same active ingredient, but compounded tirzepatide is not ZEPBOUND, is not an FDA-approved generic version of ZEPBOUND, and has not been established to be equivalent to ZEPBOUND.

Compounded medications are not FDA-approved. This means the FDA has not reviewed or approved the compounded product for safety, effectiveness, quality, or consistency before it is marketed. The information below is based on known safety risks of tirzepatide, FDA-approved tirzepatide labeling, and FDA safety communications about compounded GLP-1 medications. Compounded tirzepatide does not have its own FDA-approved prescribing information.

Please review the FDA-approved ZEPBOUND Medication Guide for additional information about tirzepatide: https://uspl.lilly.com/zepbound/zepbound.html (opens in new tab)

1. Important safety warnings

Thyroid tumors, including thyroid cancer

Tirzepatide caused thyroid tumors in animal studies. It is not known whether tirzepatide causes thyroid cancer in humans. Do not use compounded tirzepatide if:

• You or a family member has had medullary thyroid carcinoma (MTC), a specific type of thyroid cancer.
• You have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• You have had a serious allergic reaction to tirzepatide or any ingredient in your compounded medication.

Contact your healthcare provider if you notice a lump or swelling in your neck, persistent hoarseness, difficulty swallowing, or difficulty breathing.

Important: FDA-approved tirzepatide products carry a boxed warning about the risk of thyroid C-cell tumors. This warning is relevant when counseling patients about compounded tirzepatide because it contains the same active ingredient.

Pancreatitis (inflammation of the pancreas)

Tirzepatide may cause pancreatitis, which can be serious. Stop taking compounded tirzepatide and contact your healthcare provider immediately if you develop severe, persistent stomach pain, especially if the pain spreads to your back. This may occur with or without nausea or vomiting.

Gallbladder problems

Tirzepatide may increase your risk of gallstones or gallbladder inflammation. Contact your healthcare provider if you experience upper abdominal pain, especially on the right side, fever, yellowing of your skin or eyes, or persistent nausea or vomiting.

Low blood sugar (hypoglycemia)

Tirzepatide can cause low blood sugar, especially in people with diabetes who also take insulin or certain diabetes medications, such as sulfonylureas. Symptoms may include shakiness, sweating, dizziness, headache, hunger, weakness, confusion, irritability, or a fast heartbeat. If you have diabetes, monitor your blood sugar as instructed. Your healthcare provider may need to adjust your other diabetes medications. Severe low blood sugar causing seizures, loss of consciousness, or inability to swallow safely requires emergency medical attention.

Kidney problems and dehydration

Nausea, vomiting, and diarrhea can cause dehydration, which may lead to kidney problems, including acute kidney injury. Drink fluids regularly, especially when experiencing stomach-related side effects. Contact your healthcare provider if you cannot keep fluids down, have persistent vomiting or diarrhea, experience dizziness, or notice significantly decreased urination.

Severe stomach or intestinal problems

Tirzepatide slows stomach emptying and may cause nausea, vomiting, diarrhea, constipation, and abdominal discomfort. Sometimes these symptoms can be severe. Tell your healthcare provider if you have severe or persistent digestive symptoms. Tirzepatide is not recommended for people with severe gastroparesis, a condition in which the stomach empties very slowly.

Serious allergic reactions

Serious allergic reactions, including anaphylaxis and swelling beneath the skin, have been reported with tirzepatide. Stop using compounded tirzepatide and seek emergency medical care if you experience swelling of your face, lips, tongue, or throat; trouble breathing or swallowing; severe rash or itching with other allergic symptoms; or fainting. Compounded formulations may contain additional ingredients that could also cause allergic reactions.

Vision changes in people with type 2 diabetes

Rapid improvements in blood sugar may worsen diabetic retinopathy, a diabetes-related eye condition. If you have type 2 diabetes, especially if you have a history of diabetic retinopathy, tell your healthcare provider about any changes in your vision. Continue recommended eye examinations.

Surgery, anesthesia, and sedation

Tirzepatide slows stomach emptying, which may increase the risk of food or liquid entering your lungs during procedures involving general anesthesia or deep sedation. Tell your surgeon, anesthesiologist, dentist, or other healthcare professional that you take compounded tirzepatide before any planned procedure. Follow their specific instructions about your medication and fasting.

2. Pregnancy, breastfeeding, and birth control

Pregnancy precautions

Tirzepatide may harm an unborn baby. There is not enough information from human pregnancies to fully determine its risks.

• If you are pregnant, planning to become pregnant, or think you may be pregnant, tell your healthcare provider.
• If you become pregnant while taking compounded tirzepatide, stop taking the medication and contact your healthcare provider promptly.
• Discuss your pregnancy plans with your healthcare provider before starting or continuing treatment.

Pregnancy exposure registry

A pregnancy exposure registry is available for patients exposed to FDA-approved ZEPBOUND during pregnancy. The registry collects information about pregnancies exposed to tirzepatide to help researchers better understand potential effects on pregnant patients and their babies.

ZEPBOUND Pregnancy Exposure Registry: 1-800-LillyRx (1-800-545-5979)

If you become pregnant while using compounded tirzepatide, contact your healthcare provider to discuss reporting the exposure and whether you are eligible to participate in the registry. Eligibility for patients using compounded products is not established.

Breastfeeding

It is not known whether tirzepatide may affect a breastfed baby or milk production. Small amounts of tirzepatide may be present in breast milk.

Birth control precautions

Tirzepatide may reduce the effectiveness of oral hormonal contraceptives, including birth control pills, because it slows stomach emptying. If you use oral hormonal birth control, you should switch to a non-oral contraceptive method or use an additional barrier method, such as condoms:

• For 4 weeks after starting compounded tirzepatide.
• For 4 weeks after every dose increase.

Non-oral hormonal contraceptives are not expected to be affected in the same way. Discuss your birth control options with your healthcare provider.

3. Other medications and drug interactions

Tirzepatide can affect how your body absorbs certain medications because it slows stomach emptying. Before starting compounded tirzepatide, tell your healthcare provider about all prescription medications, over-the-counter medications, vitamins, and supplements you take.

Do not combine compounded tirzepatide with ZEPBOUND, Mounjaro, another tirzepatide-containing medication, or other GLP-1 medications unless your healthcare provider specifically directs a change in treatment. Your healthcare provider may need to adjust or monitor certain medications, especially insulin, sulfonylureas, and oral medications requiring careful monitoring. If you take oral hormonal contraceptives, follow the additional birth control precautions described in Section 2.

4. Common side effects

Common side effects associated with tirzepatide include:

• Nausea, vomiting, or diarrhea
• Constipation, stomach pain, bloating, or gas
• Heartburn, indigestion, or burping
• Fatigue
• Injection-site reactions
• Allergic or hypersensitivity reactions
• Hair loss

Many digestive side effects occur when first starting tirzepatide or increasing the dose. Contact your healthcare provider if symptoms are severe, persistent, or interfere with eating or drinking. Because compounded products may contain additional ingredients or differ in preparation, other side effects or reactions may occur.

5. Important instructions for taking compounded tirzepatide

Compounded tirzepatide is commonly prescribed as an injection under the skin once weekly. However, compounded formulations, concentrations, and administration instructions may vary. Always follow the specific prescription and instructions provided by your healthcare provider and dispensing pharmacy.

Dosing and administration safety

Compounded tirzepatide may be supplied in a vial rather than a prefilled injection pen. Some products require patients to measure their dose using a syringe. Unlike FDA-approved products, compounded tirzepatide may be available in different concentrations. This creates a risk of dosing errors if the wrong amount of medication is drawn into the syringe.

Important precautions:

• Confirm your prescribed dose in milligrams (mg).
• Verify the concentration of your medication and the correct volume or syringe units needed for your dose.
• Use only the syringe and measuring instructions provided or approved by your healthcare provider or pharmacy.
• Do not assume that syringe units are the same as milligrams of medication.
• Do not use dosing instructions from another patient's prescription or a previous vial with a different concentration.
• Never estimate or guess your dose.
• If your prescription, concentration, syringe, or instructions change, confirm the correct dose before your next injection.
• Do not increase your dose or inject more frequently than prescribed.

If you are unsure how much medication to draw into your syringe, do not inject until you have confirmed the correct amount with your healthcare provider or pharmacist.

Safe injection practices

• Wash your hands before preparing your injection.
• Use a new, sterile needle and syringe for every injection.
• Follow your pharmacy's instructions for preparing the medication and cleaning the vial stopper.
• Inject only under the skin, as directed.
• Rotate injection sites between your abdomen, thigh, or upper arm.
• Do not inject into the exact same spot each time.
• Never share needles, syringes, or medication vials with another person.
• Dispose of used needles and syringes in an approved sharps container.

6. When to seek medical attention

Seek emergency medical attention

Call 911 or seek emergency medical care if you experience:

• Difficulty breathing or swelling of your face, lips, tongue, or throat.
• A severe allergic reaction, including fainting or loss of consciousness.
• Severe low blood sugar causing seizures, unconsciousness, or inability to swallow safely.
• Any other life-threatening symptoms.

Stop compounded tirzepatide and seek immediate medical evaluation

Stop taking compounded tirzepatide and contact your healthcare provider immediately if you experience:

• Severe or persistent abdominal pain, especially if the pain spreads to your back, which may indicate pancreatitis.
• Severe abdominal pain with or without nausea or vomiting.

If symptoms are severe or you cannot obtain prompt medical evaluation, seek emergency care.

Contact your healthcare provider promptly

Contact your healthcare provider if you experience:

• Persistent vomiting, diarrhea, or inability to keep fluids down.
• Signs of dehydration, including significantly decreased urination or severe dizziness.
• Upper abdominal pain, fever, or yellowing of the skin or eyes, which may indicate gallbladder problems.
• New or worsening changes in vision.
• A lump or swelling in your neck, persistent hoarseness, or difficulty swallowing.
• Repeated episodes of low blood sugar.
• Increasing redness, warmth, swelling, pain, or drainage at an injection site, especially with fever.
• Pregnancy or suspected pregnancy. Stop taking compounded tirzepatide and contact your healthcare provider promptly.

If you suspect a dosing error or overdose

If you believe you injected too much compounded tirzepatide, used the wrong concentration, or made an error when measuring your dose:

• Do not take another dose until you have received medical guidance.
• Contact your healthcare provider or Poison Help at 1-800-222-1222 immediately, even if you do not have symptoms.
• Seek emergency medical care if you develop severe vomiting, severe abdominal pain, confusion, loss of consciousness, or other serious symptoms.
• Keep your medication vial, syringe, and prescription information available so healthcare professionals can determine what medication and dose you received.

Compounded Semaglutide Important Safety Information

Your health and safety are important to us. Before starting compounded semaglutide, please review the following information to understand the possible risks, side effects, and precautions associated with your medication.

Compounded semaglutide is a prescription medication prepared by a compounding pharmacy for an individual patient's medical needs. Semaglutide is the active ingredient in the FDA-approved brand-name medication Wegovy®. Compounded products prepared with semaglutide base contain that same active ingredient, but compounded semaglutide is not WEGOVY, is not an FDA-approved generic version of WEGOVY, and has not been established to be equivalent to WEGOVY.

Compounded medications are not FDA-approved. This means the FDA has not reviewed or approved the compounded product for safety, effectiveness, quality, or consistency before it is marketed. The information below is based on known safety risks of semaglutide, FDA-approved semaglutide labeling, and FDA safety communications about compounded GLP-1 medications. Compounded semaglutide does not have its own FDA-approved prescribing information.

Please review the FDA-approved WEGOVY Medication Guide for additional information about semaglutide: https://www.novo-pi.com/wegovy.pdf (opens in new tab)

1. Important safety warnings

Thyroid Tumors, Including Thyroid Cancer

Important Warning: Based on the FDA Boxed Warning for Wegovy. FDA-approved semaglutide products carry a boxed warning about the risk of thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). Semaglutide caused thyroid tumors in animal studies. It is not known whether semaglutide causes these tumors in humans.

Do not use compounded semaglutide if:

• You or a family member has ever had medullary thyroid carcinoma (MTC).
• You have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• You have had a serious allergic reaction to semaglutide or any ingredient in your compounded medication.

Contact your healthcare provider if you develop:

• A lump or swelling in your neck
• Persistent hoarseness
• Difficulty swallowing
• Difficulty breathing

Pancreatitis (Inflammation of the Pancreas)

Semaglutide may cause pancreatitis, which can be serious. Stop using compounded semaglutide and contact your healthcare provider immediately if you develop:

• Severe stomach pain that does not go away
• Pain that spreads from your stomach to your back
• Severe abdominal pain with or without nausea or vomiting

Gallbladder Problems

Semaglutide may increase the risk of gallstones and gallbladder inflammation. Contact your healthcare provider if you experience:

• Pain in the upper abdomen
• Fever
• Yellowing of your skin or eyes
• Clay-colored stools

Kidney Problems and Dehydration

Nausea, vomiting, and diarrhea may cause dehydration, which can lead to kidney injury. To reduce your risk:

• Drink fluids regularly.
• Contact your healthcare provider if vomiting or diarrhea persists.
• Report difficulty drinking fluids, dizziness, or decreased urination.

Low Blood Sugar (Hypoglycemia)

Semaglutide may cause low blood sugar, especially when used with insulin or certain diabetes medications called sulfonylureas. Symptoms may include:

• Shakiness or sweating
• Dizziness or headache
• Hunger or weakness
• Confusion or blurred vision
• Fast heartbeat

If you have diabetes, follow your healthcare provider's instructions for monitoring and treating low blood sugar.

Serious Allergic Reactions

Serious allergic reactions, including anaphylaxis, may occur. Stop using compounded semaglutide and seek emergency medical attention if you experience:

• Swelling of your face, lips, tongue, or throat
• Difficulty breathing or swallowing
• Severe rash or itching
• Fainting or severe dizziness

Severe Stomach or Intestinal Problems

Semaglutide slows stomach emptying and may cause nausea, vomiting, diarrhea, constipation, and abdominal discomfort. Some symptoms may be severe. Tell your healthcare provider if you experience severe or persistent digestive problems, especially if you have gastroparesis (delayed stomach emptying).

Vision Changes

People with type 2 diabetes may experience worsening diabetic retinopathy during treatment with semaglutide. Tell your healthcare provider if you notice new or worsening vision changes.

Increased Heart Rate

Semaglutide may increase your resting heart rate. Contact your healthcare provider if you notice a racing or pounding heartbeat that lasts for several minutes while you are resting.

Surgery or Procedures Requiring Anesthesia

Semaglutide slows stomach emptying and may increase the risk of food or liquid entering the lungs during general anesthesia or deep sedation. Tell your surgeon, anesthesiologist, dentist, or other healthcare provider that you use compounded semaglutide before any planned procedure.

2. Pregnancy and Breastfeeding

Pregnancy

Semaglutide may harm an unborn baby.

• Tell your healthcare provider if you are pregnant or planning to become pregnant.
• Stop semaglutide and contact your healthcare provider if you become pregnant while using it for weight management.
• Stop semaglutide at least 2 months before a planned pregnancy, because it remains in your body for an extended period.

Pregnancy Exposure Registry

Novo Nordisk maintains a pregnancy exposure registry for people exposed to Wegovy during pregnancy.

Wegovy Pregnancy Exposure Registry. Phone: 1-877-390-2760. Website: www.wegovypregnancyregistry.com (opens in new tab)

Important: This registry is associated with the FDA-approved Wegovy product. Eligibility for individuals exposed to compounded semaglutide is not established by this guide. Ask your healthcare provider whether reporting or participation is appropriate.

Breastfeeding

It is not known whether injected semaglutide passes into human breast milk. Talk with your healthcare provider about the potential risks and benefits of breastfeeding while using compounded semaglutide. Safety information may also depend on other ingredients included in the compounded product.

3. How to Use Compounded Semaglutide Safely

Important Dosing Precautions

Compounded semaglutide may be supplied in different concentrations and containers. Dosing errors can cause serious side effects and hospitalization. Unlike Wegovy injection pens, which deliver preset doses, some compounded semaglutide products require patients to measure medication from a vial using a syringe.

• Use only the dose prescribed by your healthcare provider.
• Confirm the medication concentration and exact dose with your pharmacist.
• Have your healthcare provider or pharmacist demonstrate how to measure and inject your dose before your first injection.
• Use only the syringe and supplies provided or specifically recommended for your prescription.
• Never guess your dose or use instructions from another patient's medication.
• Never change your dose or injection volume without guidance from your healthcare provider.

Important: Milligrams (mg), milliliters (mL), and syringe units are not interchangeable. The number of syringe units needed depends on the medication concentration and syringe type.

Taking Your Medication

For prescribed once-weekly injectable compounded semaglutide:

• Inject only on the schedule prescribed by your healthcare provider.
• Follow your individualized dose-increase schedule.
• Do not increase your dose more quickly than prescribed.
• Inject into the abdomen, thigh, or upper arm as instructed.
• Rotate injection sites.
• Never share syringes, needles, or medication vials.
• Use a new sterile needle and syringe for every injection.
• Dispose of used needles in an FDA-cleared sharps container.

Missed Doses

If you miss a dose, contact your healthcare provider or pharmacist for instructions based on your specific compounded product. Do not double your dose or administer extra medication to make up for a missed dose.

Other Medications

Tell your healthcare provider about all prescription medications, over-the-counter medications, vitamins, and supplements you take. Do not combine compounded semaglutide with Wegovy, Ozempic, Rybelsus, other semaglutide-containing medications, or other GLP-1 medications unless your healthcare provider specifically directs a treatment transition. Semaglutide may affect the absorption of certain oral medications because it slows stomach emptying.

Common Side Effects

Common side effects associated with semaglutide include:

• Nausea or vomiting
• Diarrhea or constipation
• Stomach pain or bloating
• Heartburn, indigestion, or gas
• Headache or dizziness
• Fatigue
• Hair loss

Contact your healthcare provider if side effects are severe, persistent, or prevent you from eating or drinking normally.

4. When to Seek Medical Help

Seek Emergency Medical Attention

Call 911 or go to the nearest emergency department if you experience:

• Difficulty breathing or swelling of your face or throat
• A severe allergic reaction
• Loss of consciousness or seizures related to low blood sugar

Stop Semaglutide and Contact Your Healthcare Provider Immediately

• Severe, persistent stomach pain, with or without vomiting
• Stomach pain that spreads to your back
• Symptoms suggesting pancreatitis

Contact Your Healthcare Provider Promptly

• Persistent vomiting or diarrhea
• Difficulty staying hydrated or decreased urination
• Upper abdominal pain, fever, or yellowing of your skin or eyes
• New or worsening vision changes
• A lump in your neck or persistent hoarseness
• Severe or persistent digestive symptoms
• Pregnancy or suspected pregnancy
• Concerns about an incorrect dose or accidental overdose

GHK-Cu Topical Important Safety Information

GHK-Cu is a copper-containing ingredient used in some skin and hair care products. Read this guide before use to understand precautions, possible reactions, and when to get help.

Compounded GHK-Cu cream is not FDA approved. FDA does not review compounded medicines for safety, effectiveness, or quality.

Do not use a product containing an ingredient that has caused you an allergic reaction. Check the entire ingredient list, including preservatives and fragrances, rather than checking only for GHK-Cu.

Tell your provider about sensitive skin, eczema, previous reactions to skin products, and all other products you use in the same area. Ask whether you need to change your skin routine before starting.

Safety in children, during pregnancy, and while breastfeeding has not been established. Check with your clinician before use in these situations, including when planning pregnancy. Do not apply it to the nipple or an area a nursing infant could touch or lick (Empower Pharmacy, n.d.).

Skin irritation or an allergic reaction may occur. Watch for redness, itching, hives, or other new irritation. Stop applying the product if a reaction develops and contact your provider (Empower Pharmacy, n.d.). Limited reports of serious reactions do not establish long term safety or rule out an individual allergy.

Call 911 for trouble breathing, swelling of your lips, tongue, or throat, trouble swallowing, fainting, or chest pain. These symptoms may signal a severe allergic reaction or another emergency.

Stop using the product and contact your provider for persistent burning, swelling, a spreading rash, blistering, or peeling. Seek urgent care if the reaction is severe, affects your eyes, or involves widespread blistering. If someone swallows the product, contact Poison Control at 1-800-222-1222.

For external use only. Do not inject a cream, serum, or other topical product. Avoid the eyes, inside the mouth or nose, and broken skin unless your provider specifically directs otherwise. Wash your hands after application. Ask your provider before combining it with products that irritate your skin. Keep the container closed, follow the storage directions and discard date, and keep it away from children.

Tell your provider if you develop irritation or do not see the expected benefit. They can review whether the product or treatment plan should change.

This guide does not list every possible reaction.

Glutathione Important Safety Information

Read this guide before starting Glutathione injections. It explains precautions, possible reactions, and when to get help.

Glutathione is a substance made by the body that helps protect cells from damage. Injected products carry additional risks.

This is a compounded medication. Compounded medicines are not FDA approved. The FDA does not review them for safety, effectiveness, or quality. Glutathione appears on FDA’s Category 1 list. Category 1 peptides are not FDA approved. Category 1 means FDA has enough submitted information to evaluate an ingredient and has not identified significant safety risks at that stage.

Do not take glutathione if you have had an allergic reaction to it or any ingredient in your preparation. Ask your pharmacist about preservatives and other added ingredients if you have allergies (Empower Pharmacy, n.d.). Information about the long term safety of injections is limited (Empower Pharmacy, n.d.).

Tell your provider if you have kidney or liver disease, asthma, previous injection reactions, or are being treated for cancer. Give them a list of all medicines and supplements, including chemotherapy. Your treatment team should review whether glutathione is appropriate (Empower Pharmacy, n.d.).

Safety during pregnancy and breastfeeding has not been established. Avoid injections unless your treating clinician determines there is a clear medical need and reviews the possible risks with you. Tell them if you are trying to become pregnant (Empower Pharmacy, n.d.).

You may notice soreness, redness, or swelling where the injection was given. Reported symptoms also include nausea, stomach upset, flushing, gas, or loose stools. Reliable information on how often these occur is limited (Empower Pharmacy, n.d.). An allergic reaction can occur. Tell your provider about any new symptoms during treatment.

Call 911 for trouble breathing, swelling of your lips, tongue, or throat, trouble swallowing, fainting, or chest pain. These symptoms may signal a severe allergic reaction or another emergency.

Seek medical care for fever, chills, shaking, repeated vomiting, severe dizziness, or feeling suddenly very ill during or after treatment. FDA has reported serious illnesses and hospitalizations after some compounded IV glutathione products made with unsuitable ingredients. These reactions were consistent with contamination by bacterial toxins (U.S. Food and Drug Administration, 2026b).

Contact your provider promptly for worsening injection site redness, warmth, swelling, pain, or drainage. Also report yellow skin or eyes, dark urine, or much less urine than usual. These symptoms need assessment and should not be dismissed as expected side effects. Stop treatment after a suspected serious reaction until your provider has assessed you.

Follow your provider’s instructions. Contact your provider whenever your instructions are unclear. Follow your pharmacy’s storage and discard instructions. Never share needles, syringes, or medicine. Use a new sterile needle and syringe each time, and place used supplies in a sharps container. Keep medicine and supplies away from children.

This guide does not list every possible reaction. Contact your care team with new or concerning symptoms.

Sermorelin Patient Safety Information

Read this guide before starting sermorelin. It explains precautions, possible reactions, and when to get help.

Sermorelin signals a gland in the brain to release growth hormone. Treatment requires an individual medical assessment and follow up.

This is a compounded medication. Compounded medicines are not FDA approved. The FDA does not review them for safety, effectiveness, or quality. Sermorelin appears on FDA’s Category 1 list. Category 1 peptides are not FDA approved. Category 1 means FDA has enough submitted information to evaluate an ingredient and has not identified significant safety risks at that stage.

Do not use sermorelin if you have had an allergic reaction to sermorelin or any ingredient in your preparation. Ask your pharmacist about added ingredients if you have allergies.

Tell your provider about cancer or a history of cancer, any brain or pituitary tumor, an underactive thyroid, diabetes, or high blood sugar. Share all medicines and supplements, especially steroids such as prednisone, thyroid medicines, diabetes medicines, and other hormone treatments. Do not change prescribed medicines on your own (Empower Pharmacy, n.d.).

Avoid sermorelin during pregnancy or breastfeeding because safety information is inadequate. Tell your provider if you become pregnant or are trying to become pregnant (Empower Pharmacy, n.d.).

Reported reactions include pain, redness, swelling, or bruising at the injection site; headache; flushing; dizziness; nausea; or sleepiness. Some people notice a brief change in taste. How often these occur with compounded adult treatment is uncertain (Empower Pharmacy, n.d.). Report symptoms that persist or make daily activities difficult. Do not drive if you feel dizzy or sleepy.

Call 911 for trouble breathing, swelling of your lips, tongue, or throat, trouble swallowing, fainting, or chest pain. These symptoms may signal a severe allergic reaction or another emergency.

Get urgent medical care for a new severe headache, new vision changes, or repeated vomiting. These symptoms need assessment, especially if you have a history of a brain or pituitary condition.

Contact your provider promptly for a spreading rash, worsening injection site reaction, or signs of infection such as warmth, drainage, or fever. Report increased thirst, frequent urination, or unexplained fatigue, which can be signs of high blood sugar (Empower Pharmacy, n.d.). Stop treatment after a suspected serious reaction until your provider has assessed you.

Follow your provider’s instructions. Contact your provider whenever your instructions are unclear. Follow your pharmacy’s storage and discard instructions. Never share needles, syringes, or medicine. Use a new sterile needle and syringe each time, and place used supplies in a sharps container. Keep medicine and supplies away from children.

This guide does not list every possible reaction. Contact your care team with new or concerning symptoms.

NAD+ Important Safety Information

Read this information before starting NAD+ injections. It explains precautions, possible reactions, and when to get help.

NAD+ is a substance your body uses to help cells work. Having it naturally in your body does not mean injections are risk free.

This is a compounded medication. Compounded medicines are not FDA approved. The FDA does not review them for safety, effectiveness, or quality. NAD appears on FDA’s Category 1 list. Category 1 status does not mean FDA approval. Category 1 means FDA has enough submitted information to evaluate an ingredient and has not identified significant safety risks at that stage.

Studies of injected NAD+ are limited. Its benefits and long term safety for wellness or anti aging use are not established. A lack of reported problems does not prove a treatment is safe (Empower Pharmacy, n.d.).

Do not use this medicine if you have had an allergic reaction to NAD+ or any ingredient in your preparation, including preservatives. Tell your provider about previous reactions to NAD+, niacinamide, or other vitamin B3 products. Not every side effect is an allergy; your provider should review what happened (Empower Pharmacy, n.d.).

Before treatment, tell your provider about liver or kidney disease, heart problems, cancer or a history of cancer, and any other serious illness. These conditions need individual review. If you have cancer, involve your cancer specialist before considering treatment (Empower Pharmacy, n.d.). Give your provider a complete list of medicines, vitamins, and supplements. Information about possible interactions is limited.

Avoid NAD+ injections during pregnancy or breastfeeding because safety has not been established. Tell your provider if you are pregnant, trying to become pregnant, or breastfeeding (Empower Pharmacy, n.d.).

Reported symptoms include nausea, headache, tiredness, warmth or flushing, dizziness, and soreness where the injection was given. How often these occur is uncertain (Empower Pharmacy, n.d.).

Call 911 for trouble breathing, swelling of your lips, tongue, or throat, trouble swallowing, fainting, or chest pain. These symptoms may signal a severe allergic reaction or another emergency.

Seek medical care for fever, severe chills or shaking, repeated vomiting, or marked weakness during or after treatment. FDA has received reports of serious reactions after NAD+ injections that were consistent with contamination by bacterial toxins. Some patients needed medical treatment (U.S. Food and Drug Administration, n.d.-a).

Contact your provider promptly for increasing redness, warmth, swelling, drainage, or pain around an injection site, or symptoms that persist or worsen. Stop treatment after a suspected serious reaction until your provider has assessed you.

Follow your provider’s instructions. Contact your provider whenever your instructions are unclear. Follow your pharmacy’s storage and discard instructions. Never share needles, syringes, or medicine. Use a new sterile needle and syringe each time, and place used supplies in a sharps container. Keep medicine and supplies away from children.

This guide does not list every possible reaction. Contact your care team with new or concerning symptoms.