Safety Information

Compounded tirzepatide may be prescribed by a licensed healthcare provider when appropriate and when permitted by applicable law. FDA-approved medicines containing tirzepatide are available.

Tirzepatide has a boxed warning related to the risk of thyroid C-cell tumors. In animal studies, tirzepatide caused thyroid C-cell tumors. It is not known whether tirzepatide causes thyroid C-cell tumors, including medullary thyroid carcinoma, in humans.

Do not use tirzepatide if:

• You or anyone in your family has had medullary thyroid carcinoma;
• You have Multiple Endocrine Neoplasia syndrome type 2;
• You have had a serious allergic reaction to tirzepatide or any ingredient in the medication.

Tell your healthcare provider right away if you develop a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.

Stop using tirzepatide and contact your healthcare provider immediately, or seek urgent medical care, if you experience:

• Severe or persistent stomach pain, with or without vomiting, especially if pain spreads to your back;
• Severe nausea, vomiting, diarrhea, or signs of dehydration;
• Symptoms of gallbladder problems, including upper abdominal pain, fever, yellowing of the skin or eyes, or pale/clay-colored stools;
• Symptoms of a serious allergic reaction, including swelling of the face, lips, tongue, or throat, difficulty breathing or swallowing, severe rash or itching, dizziness, fainting, or rapid heartbeat;
• Changes in vision, especially if you have type 2 diabetes or a history of diabetic retinopathy;
• Symptoms of low blood sugar, including dizziness, shakiness, sweating, confusion, blurred vision, weakness, headache, hunger, irritability, or fast heartbeat.

Common side effects may include:

• Nausea;
• Diarrhea;
• Vomiting;
• Constipation;
• Abdominal pain;
• Indigestion or heartburn;
• Belching;
• Fatigue;
• Dizziness;
• Injection site reactions;
• Hair loss;
• Allergic reactions.

These are not all possible side effects. Contact your healthcare provider if any side effect is severe, persistent, or concerning.

Tell your healthcare provider about all prescription medications, over-the-counter medications, vitamins, and supplements you take.

Tirzepatide may affect how oral medications are absorbed because it slows stomach emptying. The risk of low blood sugar may increase when tirzepatide is used with insulin, sulfonylureas, or other medications that lower blood sugar.

Oral birth control pills may not work as well while using tirzepatide. Your healthcare provider may recommend a non-oral contraceptive method or an additional barrier method for 4 weeks after starting tirzepatide and for 4 weeks after each dose increase.

Tell your healthcare provider before using tirzepatide if you:

• Have or have had pancreas problems;
• Have severe stomach problems, including gastroparesis;
• Have kidney, liver, or gallbladder problems;
• Have type 2 diabetes or diabetic retinopathy;
• Are scheduled for surgery or a procedure requiring anesthesia or deep sedation;
• Are pregnant, planning to become pregnant, breastfeeding, or planning to breastfeed.

Do not share tirzepatide, syringes, needles, pens, or injection supplies with anyone.

Nicotinamide adenine dinucleotide, commonly referred to as NAD+, is a coenzyme found in cells and involved in cellular metabolism. NAD+ injections may be used in wellness settings under the direction of a licensed healthcare provider.

NAD+ injections are not FDA-approved to diagnose, treat, cure, or prevent any disease. Safety, effectiveness, and quality have not been reviewed by the FDA.

Do not use NAD+ injection if:

• You have had an allergic reaction or hypersensitivity to NAD+ or any ingredient in the formulation;
• You have been advised by a healthcare provider to avoid injectable therapies;
• You are pregnant, planning to become pregnant, or breastfeeding, unless specifically directed by your healthcare provider;
• You have a severe or unstable medical condition unless your healthcare provider determines NAD+ is appropriate for you.

Potential side effects may include:

• Injection site pain, redness, swelling, bruising, itching, or irritation;
• Nausea, vomiting, diarrhea, or abdominal discomfort;
• Headache;
• Dizziness or lightheadedness;
• Fatigue;
• Flushing or feeling warm;
• Jitteriness or changes in energy level;
• Rash, itching, swelling, or other signs of allergic reaction.

Seek emergency medical care if you experience difficulty breathing, swelling of the face, lips, tongue, or throat, fainting, severe rash, or symptoms of a serious allergic reaction.

NAD+ injection is a sterile injectable product and should only be obtained from an appropriately licensed pharmacy or medical provider. FDA has warned that ingredients intended for food or dietary supplement use are not suitable for sterile drug compounding without appropriate processing because of contamination and endotoxin risks.

Use NAD+ injection only as prescribed. Do not use more than directed, do not self-adjust your dose, and do not use the product if it appears cloudy, discolored, contaminated, damaged, expired, or improperly stored.

Tell your healthcare provider about all medications, supplements, and medical conditions before starting NAD+ injection. This includes heart, kidney, liver, metabolic, neurologic, immune, or allergic conditions.

You may report suspected adverse reactions or product quality problems to FDA's MedWatch program at www.fda.gov/medwatch or by calling 1-800-FDA-1088.