Medication Safety Information

Revised 1/31/2026

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

Side Effects: Birdie provides access to care, not medical treatment itself. In an emergency, call 911 or go to the nearest emergency room. If you experience non-emergent side effects, contact your prescribing provider and dispensing pharmacy. To report serious reactions to the FDA visit fda.gov/medwatch.

Prescription Medications: All prescription treatments require a consultation with a licensed medical provider. Prescriptions are issued at the provider’s sole discretion, and access to medication is not guaranteed. Prescription medications carry risks. Review the Medication Safety Information below for intended use, risks, side effects, drug interactions, and use in specific populations before starting any prescription therapy. Please speak with your provider about potential side effects.

Compounded Medications: These products are not FDA-approved for safety or effectiveness but may be prescribed when standard FDA-approved medications aren’t suitable for a patient’s needs.

Jump to a Compounded Pharmacy Product

B12

B12 w/ Synapsin

GLP‑1 (semaglutide)

GLP‑1+GIP (tirzepatide)

Glutathione

Low Dose Naltrexone (LDN)

MIC+B12

NAD+

Sermorelin

Vitamin B12 Injection (Cyanocobalamin or Methylcobalamin)

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advice. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Contraindications

Not recommended if:

  • You have a known allergy to vitamin B12, cobalt, or any ingredients in the formulation

  • You have Leber’s disease (hereditary optic nerve atrophy)

Use caution and consult your healthcare provider if:

  • You are pregnant or breastfeeding (consult your provider)

  • You have kidney disease

  • You have low potassium levels

  • You have a history of polycythemia vera

Drug Interactions

Always tell your provider about all medications and supplements you take. Vitamin B12 may interact with:

  • Metformin

  • Proton pump inhibitors (PPIs)

  • H2 blockers

  • Chloramphenicol

  • Colchicine

  • Certain anticonvulsants

Common Side Effects

  • Mild pain, redness, or irritation at the injection site

  • Mild diarrhea

  • Nausea

  • Headache

  • Mild itching or rash

  • Feeling of warmth or flushing

  • Temporary anxiety or restlessness

More Serious, Less Common Side Effects

Serious allergic reactions: Discontinue use and seek urgent care if you develop swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; hives; or fainting.

Low potassium (hypokalemia): Rapid red blood cell production after starting B12 therapy may rarely lower potassium levels. Symptoms may include muscle cramps, weakness, irregular heartbeat, or extreme fatigue. Contact your provider if these occur.

Severe dizziness or fainting: Seek medical care if you experience persistent or severe symptoms.

Chest pain or irregular heartbeat: Seek immediate care if you develop chest pain, pressure, shortness of breath, or palpitations.

Severe or persistent headache or vision changes: Report new or worsening symptoms to your healthcare provider.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction (swelling of face/lips/tongue/throat, trouble breathing or swallowing, severe rash, fainting)

  • Chest pain, pressure, tightness, or shortness of breath

  • Irregular or rapid heartbeat with dizziness

  • Severe weakness or muscle cramps suggesting low potassium

  • Any other severe or rapidly worsening symptoms

Contact Your Provider If You Have:

  • Ongoing injection site irritation

  • Persistent nausea, diarrhea, or headache

  • New fatigue or muscle weakness

  • Palpitations without severe symptoms

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Protect from light

  • Do not freeze

  • Refrigerate if instructed

  • Keep out of reach of children

Vitamin B12 (Methylcobalamin) with Synapsin Nasal Spray

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advice. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Contraindications

Not recommended if:

  • You have a known allergy to vitamin B12, cobalt, Synapsin components, or any ingredients in the formulation

  • You have Leber’s disease (hereditary optic nerve atrophy)

Use caution and consult your healthcare provider if:

  • You are pregnant or breastfeeding

  • You have kidney disease

  • You have low potassium levels

  • You have a history of polycythemia vera

  • You have significant nasal irritation, recent nasal surgery, or frequent nosebleeds

Drug Interactions

Always tell your provider about all medications and supplements you take. Vitamin B12 may interact with:

  • Metformin

  • Proton pump inhibitors (PPIs)

  • H2 blockers

  • Chloramphenicol

  • Colchicine

  • Certain anticonvulsants

Common Side Effects

  • Mild nasal irritation or dryness

  • Sneezing

  • Runny nose

  • Mild headache

  • Nausea

  • Mild flushing or feeling of warmth

  • Temporary anxiety or restlessness

More Serious, Less Common Side Effects

Serious allergic reactions: Discontinue use and seek urgent care if you develop swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; hives; or fainting.

Low potassium (hypokalemia): Rapid red blood cell production after starting B12 therapy may rarely lower potassium levels. Symptoms may include muscle cramps, weakness, irregular heartbeat, or extreme fatigue. Contact your provider if these occur.

Severe dizziness or fainting: Seek medical care if symptoms are persistent or severe.

Chest pain or irregular heartbeat: Seek immediate care if you develop chest pain, pressure, shortness of breath, or palpitations.

Severe or persistent headache or vision changes: Report new or worsening symptoms to your healthcare provider.

Severe nasal irritation or nosebleeds: Contact your provider if you experience persistent irritation, pain, or recurrent nosebleeds.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction (swelling of face/lips/tongue/throat, trouble breathing or swallowing, severe rash, fainting)

  • Chest pain, pressure, tightness, or shortness of breath

  • Irregular or rapid heartbeat with dizziness

  • Severe weakness or muscle cramps suggesting low potassium

  • Sudden or severe vision changes

  • Any other severe or rapidly worsening symptoms

Contact your provider if you have:

  • Ongoing nasal irritation, dryness, or nosebleeds

  • Persistent nausea or headache

  • New fatigue or muscle weakness

  • Palpitations without severe symptoms

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Protect from light

  • Do not freeze

  • Refrigerate if instructed

  • Keep out of reach of children

Compounded GLP-1 (semaglutide)

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. FDA-approved semaglutide and tirzepatide products are available. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advise. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions to compounded tirzepatide, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Warnings

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 rodent studies, GLP-1 medications caused thyroid tumors, including thyroid cancer. It is not known whether this risk applies to humans. Notify your provider immediately if you develop trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath.

Contraindications

Not recommended if:

  • You have a known allergy to any ingredients

  • Have or have had thyroid cancer

  • Have a personal or family history of medullary thyroid carcinoma (MTC)

  • Have MEN 2

  • Are pregnant, trying to become pregnant, or breastfeeding. Use effective contraception while taking this medication. If planning pregnancy, stop use at least 2 months before trying to conceive.

  • Have a history of severe gastrointestinal disease

  • NOT suitable for individuals with type 1 diabetes or diabetic ketoacidosis

  • Should not be used alongside other GLP-1 receptor medications

  • Gastric emptying may be delayed, requiring caution for procedures involving sedation or general anesthesia due to aspiration risk

  • Use caution in those with a history of diabetic retinopathy

  • Consult your healthcare provider if you have a history of pancreatitis, as the medication may increase risk

Drug Interactions

Aways tell your provider about all medications and supplements you take.

  • GLP-1 medications may interact with alcohol, prescription drugs, OTC medications, and herbal supplements

  • Increased risk of hypoglycemia (low blood sugar) with insulin or sulfonylureas (e.g., glipizide, glimepiride, glyburide)

  • Delays gastric emptying and may affect absorption of oral medications

  • Thyroid hormone medications may need timing adjustments

  • Medications with narrow therapeutic windows (e.g., warfarin) require close monitoring

Common Side Effects

  • Nausea, Vomiting

  • Diarrhea, Constipation

  • Indigestion, Acid Reflux, Belching

  • Hair Loss

  • Fatigue

  • Injection Site redness/irritation (injection form)

More Serious, Less Common Side Effects

  • Serious allergic reactions: Discontinue use and seek urgent care if you have swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; or fainting.

  • Low blood sugar (hypoglycemia): Watch for dizziness, sweating, shakiness, confusion, or a fast heartbeat and seek in-person care right away if this happens. 15–20g of fast-acting sugar (juice, regular soda, or hard candy) can be taken to raise your blood sugar quickly. If you use insulin or sulfonylureas (like glipizide, glimepiride, or glyburide), talk with your provider about adjusting your dose to reduce the risk of hypoglycemia.

  • Persistent Vomiting or Dehydration: Severe or ongoing stomach pain, nausea, vomiting, or diarrhea can occur. Contact your provider if symptoms are intense or do not improve.

  • Dehydration and kidney risk: Vomiting or diarrhea may lead to dehydration, which can strain the kidneys. Drink plenty of fluids and seek care if you cannot keep liquids down.

  • Gallbladder and Liver issues: Get medical help right away for upper-right or middle abdominal pain, fever, yellowing of the skin or eyes, or pale stools.

  • Pancreatitis: Stop the medication and call your provider if you develop persistent abdominal pain, with or without vomiting.

  • Gastroparesis: Severe or ongoing stomach pain, nausea, vomiting, or diarrhea can occur. Contact your provider if symptoms are intense or do not improve.

  • Increased heart rate: Seek immediate urgent care for a high heart rate that doesn’t slow with rest or if you have chest pain, pressure or tightness, shortness of breath, fainting, or severe dizziness. For milder symptoms, notify your provider for evaluation.

  • Vision Changes: Diabetic retinopathy complications (vision changes, especially in people with diabetes): Report any new or worsening vision problems to your healthcare provider.

  • Worsening depression, mood changes, or suicidal thoughts: Monitor for worsening depression, anxiety, or suicidal thoughts and notify your provider immediately if they occur.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction: Swelling of face/lips/tongue/or throat, trouble breathing or swallowing, fainting or dizziness, very rapid heartbeat, severe rash or itching

  • Severe symptoms of low blood sugar (dizziness, shakiness, sweating, confusion, headache, rapid heartbeat) that can’t be controlled with oral sugars

  • Severe, persistent abdominal pain with or without vomiting

  • Severe dehydration and inability to keep down any food or water

  • High heart rate that doesn’t slow with rest or if you have chest pain, pressure or tightness, shortness of breath, fainting, or severe dizziness

  • Sudden vision changes

  • Immediate concern of suicide or other harmful actions

  • Any other emergent reactions

Contact your provider if you have:

  • Ongoing mild/moderate nausea, vomiting, or dehydration

  • Ongoing blood sugar dysregulation

  • Kidney, liver, or pancreas concerns

  • Elevated (non-emergent) heart rate

  • Gradual vision changes

  • Mood or behavior changes

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Keep refrigerated unless otherwise instructed

  • Protect from light

  • Do not freeze

  • Keep out of reach of children

Compounded GLP‑1+GIP (tirzepatide)

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. FDA-approved semaglutide and tirzepatide products are available. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advise. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions to compounded tirzepatide, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Warnings

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 rodent studies, GLP-1 medications caused thyroid tumors, including thyroid cancer. It is not known whether this risk applies to humans. Notify your provider immediately if you develop trouble swallowing, hoarseness, a lump or swelling in your neck, or shortness of breath.

Contraindications

Not recommended if:

  • You have a known allergy to any ingredients

  • Have or have had thyroid cancer

  • Have a personal or family history of medullary thyroid carcinoma (MTC)

  • Have MEN 2

  • Are pregnant, trying to become pregnant, or breastfeeding. Use effective contraception while taking this medication. If planning pregnancy, stop use at least 2 months before trying to conceive.

  • Have a history of severe gastrointestinal disease

  • NOT suitable for individuals with type 1 diabetes or diabetic ketoacidosis

  • Should not be used alongside other GLP-1 receptor medications

  • Gastric emptying may be delayed, requiring caution for procedures involving sedation or general anesthesia due to aspiration risk

  • Use caution in those with a history of diabetic retinopathy

  • Consult your healthcare provider if you have a history of pancreatitis, as the medication may increase risk

Drug Interactions

Aways tell your provider about all medications and supplements you take.

  • GLP-1 medications may interact with alcohol, prescription drugs, OTC medications, and herbal supplements

  • Increased risk of hypoglycemia (low blood sugar) with insulin or sulfonylureas (e.g., glipizide, glimepiride, glyburide)

  • Delays gastric emptying and may affect absorption of oral medications

  • Thyroid hormone medications may need timing adjustments

  • Medications with narrow therapeutic windows (e.g., warfarin) require close monitoring

Common Side Effects

  • Nausea, Vomiting

  • Diarrhea, Constipation

  • Indigestion, Acid Reflux, Belching

  • Hair Loss

  • Fatigue

  • Injection Site redness/irritation (injection form)

More Serious, Less Common Side Effects

  • Serious allergic reactions: Discontinue use and seek urgent care if you have swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; or fainting.

  • Low blood sugar (hypoglycemia): Watch for dizziness, sweating, shakiness, confusion, or a fast heartbeat and seek in-person care right away if this happens. 15–20g of fast-acting sugar (juice, regular soda, or hard candy) can be taken to raise your blood sugar quickly. If you use insulin or sulfonylureas (like glipizide, glimepiride, or glyburide), talk with your provider about adjusting your dose to reduce the risk of hypoglycemia.

  • Persistent Vomiting or Dehydration: Severe or ongoing stomach pain, nausea, vomiting, or diarrhea can occur. Contact your provider if symptoms are intense or do not improve.

  • Dehydration and kidney risk: Vomiting or diarrhea may lead to dehydration, which can strain the kidneys. Drink plenty of fluids and seek care if you cannot keep liquids down.

  • Gallbladder and Liver issues: Get medical help right away for upper-right or middle abdominal pain, fever, yellowing of the skin or eyes, or pale stools.

  • Pancreatitis: Stop the medication and call your provider if you develop persistent abdominal pain, with or without vomiting.

  • Gastroparesis: Severe or ongoing stomach pain, nausea, vomiting, or diarrhea can occur. Contact your provider if symptoms are intense or do not improve.

  • Increased heart rate: Seek immediate urgent care for a high heart rate that doesn’t slow with rest or if you have chest pain, pressure or tightness, shortness of breath, fainting, or severe dizziness. For milder symptoms, notify your provider for evaluation.

  • Vision Changes: Diabetic retinopathy complications (vision changes, especially in people with diabetes): Report any new or worsening vision problems to your healthcare provider.

  • Worsening depression, mood changes, or suicidal thoughts: Monitor for worsening depression, anxiety, or suicidal thoughts and notify your provider immediately if they occur.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction: Swelling of face/lips/tongue/or throat, trouble breathing or swallowing, fainting or dizziness, very rapid heartbeat, severe rash or itching

  • Severe symptoms of low blood sugar (dizziness, shakiness, sweating, confusion, headache, rapid heartbeat) that can’t be controlled with oral sugars

  • Severe, persistent abdominal pain with or without vomiting

  • Severe dehydration and inability to keep down any food or water

  • High heart rate that doesn’t slow with rest or if you have chest pain, pressure or tightness, shortness of breath, fainting, or severe dizziness

  • Sudden vision changes

  • Immediate concern of suicide or other harmful actions

  • Any other emergent reactions

Contact your provider if you have:

  • Ongoing mild/moderate nausea, vomiting, or dehydration

  • Ongoing blood sugar dysregulation

  • Kidney, liver, or pancreas concerns

  • Elevated (non-emergent) heart rate

  • Gradual vision changes

  • Mood or behavior changes

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Keep refrigerated unless otherwise instructed

  • Protect from light

  • Do not freeze

  • Keep out of reach of children

Glutathione

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advice. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Contraindications

Not recommended if:

  • You have a known allergy to glutathione or any ingredients in the formulation

Use caution and consult your healthcare provider if:

  • You are pregnant or breastfeeding

  • You have asthma (inhaled glutathione may worsen bronchospasm)

  • You have kidney or liver disease

  • You are receiving chemotherapy or other cancer treatments

  • You have a history of electrolyte imbalances

Drug Interactions

Always tell your provider about all medications and supplements you take. Glutathione may interact with:

  • Chemotherapy agents

  • Nitroglycerin

  • Activated charcoal (may reduce absorption of oral glutathione)

Common Side Effects

  • Mild injection site pain, redness, or irritation (injectable form)

  • Nausea

  • Abdominal discomfort or bloating

  • Headache

  • Mild rash

  • Temporary flushing or warmth

  • Unpleasant taste (oral or inhaled forms)

More Serious, Less Common Side Effects

Serious allergic reactions: Discontinue use and seek urgent care if you develop swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; hives; or fainting.

Bronchospasm (more common with inhaled formulations): Wheezing, shortness of breath, or chest tightness. Seek immediate care if this occurs.

Severe abdominal pain or persistent vomiting: Contact your provider if symptoms are severe or do not improve.

Low zinc levels (rare, long-term high-dose use): Symptoms may include fatigue, immune changes, or hair thinning. Monitoring may be recommended.

Chest pain or irregular heartbeat: Seek immediate care if you develop chest pain, pressure, shortness of breath, or palpitations.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction (swelling of face/lips/tongue/throat, trouble breathing or swallowing, severe rash, fainting)

  • Severe shortness of breath or wheezing

  • Chest pain, pressure, or tightness

  • Severe or persistent vomiting

  • Any other severe or rapidly worsening symptoms

Contact your provider if you have:

  • Ongoing injection site irritation

  • Persistent nausea, bloating, or headache

  • Mild shortness of breath

  • Skin rash that does not improve

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Protect from light

  • Do not freeze

  • Refrigerate if instructed

  • Keep out of reach of children

Low Dose Naltrexone (LDN)

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advice. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Contraindications

Not recommended if:

  • You are currently using opioid medications (such as morphine, oxycodone, hydrocodone, fentanyl, tramadol, or codeine)

  • You have a known allergy to naltrexone or any ingredients in the formulation

  • You have acute hepatitis or severe liver failure

Use caution and consult your healthcare provider if:

  • You are pregnant or breastfeeding

  • You have liver disease or elevated liver enzymes

  • You have kidney disease

  • You are scheduled for surgery or may require opioid pain control

  • You consume alcohol regularly

Drug Interactions

Always tell your provider about all medications and supplements you take. Low Dose Naltrexone may interact with:

  • Opioid-containing medications (including cough syrups, anti-diarrheal medications like loperamide in high doses, and certain pain medications). Low Dose Naltrexone (LDN) blocks the same receptors that opioid pain medications use to work. This means opioid medications may not work as well or may not work at all while you are taking LDN. If you take opioids while on LDN, it can also cause sudden withdrawal symptoms such as nausea, sweating, body aches, anxiety, or restlessness.

  • Buprenorphine or methadone

  • Alcohol

  • Certain liver-metabolized medication

Common Side Effects

  • Vivid dreams

  • Sleep disturbances or insomnia

  • Headache

  • Nausea

  • Mild gastrointestinal discomfort

  • Fatigue

  • Anxiety or restlessness

These side effects are often temporary and may improve with dose adjustment.

More Serious, Less Common Side Effects

Precipitated opioid withdrawal: If opioids are in your system, symptoms may include agitation, sweating, nausea, vomiting, diarrhea, muscle aches, and anxiety. Seek medical care immediately.

Liver injury (rare at low doses): Symptoms may include yellowing of the skin or eyes, dark urine, severe fatigue, abdominal pain, or persistent nausea. Contact your provider immediately if these occur.

Severe allergic reactions: Discontinue use and seek urgent care if you develop swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; hives; or fainting.

Severe mood changes: Report worsening depression, severe anxiety, or suicidal thoughts to your provider immediately.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction (swelling of face/lips/tongue/throat, trouble breathing or swallowing, severe rash, fainting)

  • Symptoms of opioid withdrawal

  • Yellowing of the skin or eyes

  • Severe abdominal pain

  • Suicidal thoughts or behaviors

  • Any other severe or rapidly worsening symptoms

Contact your provider if you have:

  • Ongoing insomnia or vivid dreams

  • Persistent nausea or headache

  • Mood changes or increased anxiety

  • Fatigue that does not improve

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Protect from light

  • Keep at room temperature unless otherwise instructed

  • Keep out of reach of children

MIC+B12 (Methionine, Inositol, Choline + Vitamin B12 Cyanocobalamin)

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advice. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Contraindications

Not recommended if:

  • You have a known allergy to methionine, inositol, choline, vitamin B12, cobalt, or any ingredients in the formulation

  • You have Leber’s disease (hereditary optic nerve atrophy)

Use caution and consult your healthcare provider if:

  • You are pregnant or breastfeeding

  • You have kidney or liver disease

  • You have low potassium levels

  • You have a history of polycythemia vera

  • You have cardiovascular disease

  • You have a history of bipolar disorder (high-dose methyl donors may affect mood in susceptible individuals)

Drug Interactions

Always tell your provider about all medications and supplements you take. MIC+B12 may interact with:

  • Metformin

  • Proton pump inhibitors (PPIs)

  • H2 blockers

  • Chloramphenicol

  • Colchicine

  • Certain anticonvulsants

  • Other methyl-donor supplements (e.g., SAMe, high-dose folate)

Common Side Effects

  • Mild injection site pain, redness, irritation or swelling

  • Nausea

  • Mild diarrhea

  • Headache

  • Feeling of warmth or flushing

  • Mild anxiety or restlessness

  • Increased energy

More Serious, Less Common Side Effects

Serious allergic reactions: Discontinue use and seek urgent care if you develop swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; hives; or fainting.

Low potassium (hypokalemia): Rapid red blood cell production after starting B12 therapy may rarely lower potassium levels. Symptoms may include muscle cramps, weakness, irregular heartbeat, or extreme fatigue. Contact your provider if these occur.

Mood changes: Report significant anxiety, agitation, insomnia, or mood swings to your provider.

Chest pain or irregular heartbeat: Seek immediate care if you develop chest pain, pressure, shortness of breath, or palpitations.

Severe or persistent headache or vision changes: Report new or worsening symptoms to your healthcare provider.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction (swelling of face/lips/tongue/throat, trouble breathing or swallowing, severe rash, fainting)

  • Chest pain, pressure, tightness, or shortness of breath

  • Irregular or rapid heartbeat with dizziness

  • Severe weakness or muscle cramps suggesting low potassium

  • Sudden or severe vision changes

  • Any other severe or rapidly worsening symptoms

Contact your provider if you have:

  • Ongoing injection site irritation

  • Persistent nausea, diarrhea, or headache

  • New or worsening anxiety or insomnia

  • Palpitations without severe symptoms

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Protect from light

  • Refrigerate if instructed

  • Do not freeze

  • Keep out of reach of children

NAD+ (Nicotinamide Adenine Dinucleotide)

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advice. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Contraindications

Not recommended if:

  • You have a known allergy to NAD+ or any ingredients in the formulation

Use caution and consult your healthcare provider if:

  • You are pregnant or breastfeeding

  • You have cancer or a history of cancer. Higher levels of NAD+ may increase cellular energy production, which could potentially help cancer cells grow.

  • You have liver or kidney disease

  • You have cardiovascular disease

  • You have a history of gout (niacin-related compounds may affect uric acid levels)

Drug Interactions

Always tell your provider about all medications and supplements you take. NAD+ may interact with:

  • Niacin or high-dose vitamin B3 supplements

  • Blood pressure medications

  • Diabetes medications

  • Blood thinners

Common Side Effects

  • Flushing or feeling of warmth

  • Injection site pain, redness, or irritation (injectable form)

  • Nausea

  • Headache

  • Dizziness

  • Fatigue

  • Mild abdominal discomfort

  • Temporary chest tightness during IV infusion

More Serious, Less Common Side Effects

Serious allergic reactions: Discontinue use and seek urgent care if you develop swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; hives; or fainting.

Low blood pressure: Symptoms may include lightheadedness, dizziness, fainting, or blurred vision. Seek medical care if severe or persistent.

Irregular heartbeat or chest pain: Seek immediate care if you develop chest pain, pressure, shortness of breath, or palpitations.

Severe nausea or vomiting: Contact your provider if symptoms are intense or do not improve.

Electrolyte imbalance (rare with high-dose IV infusions): Symptoms may include muscle cramps, weakness, or abnormal heart rhythm.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction (swelling of face/lips/tongue/throat, trouble breathing or swallowing, severe rash, fainting)

  • Chest pain, pressure, or tightness

  • Severe dizziness or fainting

  • Irregular or rapid heartbeat

  • Any other severe or rapidly worsening symptoms

Contact your provider if you have:

  • Persistent nausea or headache

  • Ongoing flushing or fatigue

  • Injection site irritation that does not improve

  • Mild lightheadedness

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Protect from light

  • Refrigerate if instructed

  • Do not freeze

  • Keep out of reach of children

Sermorelin

Disclaimer

PLEASE REFER TO THE PHARMACY PROVIDED CONSUMER MEDICATION INFORMATION (CMI) INSERT THAT COMES WITH YOUR MEDICATION. THE INFORMATION BELOW IS FOR YOUR REFERENCE AND NOT INTENDED TO REPLACE CMI.

DO NOT SHARE THIS MEDICATION WITH OTHER PEOPLE.

Compounded medications are not FDA-approved or reviewed for safety, effectiveness, or quality. This product is not intended to diagnose, treat, cure, or prevent any disease. This information is not medical advice. Consult your healthcare provider for personalized medical advice.

This is not a complete list of all possible side effects. Other side effects may occur. To report serious or unexpected reactions, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.

If you experience unusual or severe symptoms, stop use and contact your healthcare provider for guidance. In an emergency, call 911 or go to the nearest emergency room.

Contraindications

Not recommended if:

  • You have a known allergy to sermorelin or any ingredients in the formulation

  • You have active cancer

  • You have uncontrolled pituitary disorders

  • You have acute critical illness following surgery, trauma, or respiratory failure

Use caution and consult your healthcare provider if:

  • You are pregnant or breastfeeding

  • You have diabetes or impaired glucose tolerance

  • You have thyroid disease

  • You have adrenal insufficiency

  • You have a history of brain tumors or lesions

  • You have scoliosis (growth hormone changes may influence progression in some individuals)

Drug Interactions

Always tell your provider about all medications and supplements you take. Sermorelin may interact with:

  • Corticosteroids (may blunt growth hormone response)

  • Thyroid hormone medications

  • Insulin or other diabetes medications

  • Hormone replacement therapies or other growth hormone–stimulating agents

Common Side Effects

  • Injection site redness, swelling, or irritation

  • Headache

  • Flushing

  • Dizziness

  • Nausea

  • Mild fluid retention

  • Increased hunger

  • Temporary fatigue

More Serious, Less Common Side Effects

Serious allergic reactions: Discontinue use and seek urgent care if you develop swelling of the face, lips, tongue, or throat; trouble breathing; severe rash; hives; or fainting.

Elevated blood sugar: Symptoms may include increased thirst, frequent urination, blurred vision, or fatigue. Contact your provider if these occur.

Intracranial hypertension (rare): Symptoms may include severe headache, vision changes, nausea, or vomiting. Seek immediate medical care.

Joint pain or swelling: Report persistent or severe symptoms to your provider.

Carpal tunnel symptoms: Numbness, tingling, or pain in the hands or wrists should be reported.

Seek Care

Seek emergent in-person care if you have:

  • Signs of a serious allergic reaction (swelling of face/lips/tongue/throat, trouble breathing or swallowing, severe rash, fainting)

  • Severe or persistent headache with vision changes

  • Chest pain or shortness of breath

  • Sudden swelling of the face or limbs

  • Any other severe or rapidly worsening symptoms

Contact your provider if you have:

  • Ongoing injection site irritation

  • Increased thirst or urination

  • Persistent joint pain

  • Numbness or tingling in hands

  • Any other concerning non-urgent side effects

Storage

  • Store as directed on the pharmacy label

  • Refrigerate if instructed

  • Protect from light

  • Do not freeze

  • Keep out of reach of children