Safety Information for Compounded Semaglutide

Compounded semaglutide belongs to a class of medications called glucagon-like peptide-1 agonists, or GLP-1’s. Compounded semaglutide is used in addition to a healthy diet and exercise program to help people lose excess weight.

GLP-1 is a naturally occurring hormone that is released as a response to eating. It’s heavily involved in regulating your appetite and weight.

Compounded semaglutide mimics the effects of this hormone, and works by:

• Enhancing insulin secretion and inhibiting glucagon release.
• Slowing the movement of food through the gut.
• Reducing appetite.
• Signaling a feeling of fullness.

As a result, you feel fuller faster, which can ultimately lead to sustained weight loss.

Compounded semaglutide is injected subcutaneously (under the skin) in the stomach (abdomen), thigh, or upper arm. Please watch our How to inject video to learn how to administer your medication.

Your doctor will likely start by prescribing a lower dose and you will be guided to gradually increase your dose based on side effects and total weight loss. This can help to ensure safe, sustainable results. Please remember the goal is NOT to be on the highest dose of medication. The goal is to have appetite and/or craving suppression.

Your dose and titration will vary based on your personal health history. Check the dosing instructions in your clinician chat carefully to confirm your personalized dosing instructions from your doctor.

In an ideal world, you’ll never miss a dose. But sometimes life gets in the way. If you skip or miss a dose of your medication, here’s what to do:

• If your next dose is more than 2 days away: Take your missed dose as soon as possible.
• If your next dose is less than 2 days away: Just skip the missed dose and take your next dose on the regularly scheduled day.
• If you’ve skipped 2 or more consecutive weeks: Contact your Noom Med doctor for guidance.
• Do not administer double doses of compounded semaglutide.

Store your compounded semaglutide in the refrigerator, away from heat, moisture, and direct sunlight. Do not freeze.

Don’t use compounded semaglutide if it has been frozen, exposed to direct sunlight or temperatures above 107°F for more than four days, or out of the refrigerator for more than 60 days, if sealed.

Your vial can provide up to 5 doses if you take your medication on the same day each week and have medication remaining (you’ll need to discard your vial 28 days after it’s been punctured).

Once your compounded semaglutide vial is punctured, it will need to be discarded after 28 days—even if there’s some medication left. You can follow these FDA-approved steps to dispose of your medication in the trash.

• Mix your medication with an unappealing substance like dirt or used coffee grounds.
• Place the mixture in a sealed container, like a plastic bag.
• Remove all personal information on the prescription label.

Risks

Medications in the GLP-1 family have caused thyroid tumors in lab mice. It is not yet known if medications in the GLP-1 family will cause thyroid tumors or medullary thyroid carcinoma (MTC) in people.

No studies have confirmed a linkage between GLP-1 medications and thyroid tumors in humans, but if you have a history of family thyroid cancer you may want to discuss taking a GLP-1 with your primary care doctor.

If you develop any of the following while taking semaglutide, please immediately notify your Noom Med clinician and stop taking the medication.

• Sudden vision changes (medications that alter blood sugar can have various effects on vision and should be evaluated promptly by an eye doctor)
• Mass or swelling in the neck
• Persistent pain or difficulty with swallowing
• Persistent hoarseness

Do not use compounded semaglutide if:

• You have or had an eating disorder such as binge eating disorder, anorexia nervosa or bulimia.
• You have a personal or family history of the following conditions:
  • Medullary thyroid cancer (MTC)
  • Multiple endocrine neoplasia type 2 syndrome (MEN-2)
• You have a personal history of the following conditions:
  • Diabetic retinopathy
  • Chronic pancreatitis
  • Gallbladder disease (this does not include does not include gallbladder removal/cholecystectomy)
  • Severe GI disease, such as ulcerative colitis.
• You are currently pregnant or breastfeeding, or are planning to become pregnant.
• You have a history of drug or alcohol abuse.
• You have undergone recent bariatric surgery.

Interactions

Compounded semaglutide can interact with other medications, including insulin and insulin-releasing medications, which can result in low blood sugar. Consult with your Noom Med clinician before starting or stopping any medication.

GLP-1s and fertility

GLP-1s can increase fertility and may make oral contraceptives less effective. You should not take a GLP-1 if you are currently pregnant or breastfeeding. If you become pregnant, please stop taking the medication and notify me immediately.

Surgery

If you have an upcoming surgery or other medical procedure, you should talk to your surgeon about what is safe. You may need to temporarily stop using compounded semaglutide to avoid complications.

Side effects

Potential side effects include nausea, vomiting, diarrhea, headache, fatigue, dizziness, and constipation. If you experience these or other side effects, the Noom app has tips for how to manage them in the ‘Manage your side effects’ section of our Success Kit. Report any severe or troublesome side effects to your Noom Med clinician immediately.

Rare side effects

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Signs of an allergic reaction (eg, rash, chest tightness, trouble breathing, swelling of mouth, throat
• Signs of severe dehydration (eg, dizziness or passing out, fast heartbeat)
• Signs of kidney problems (eg, change in how much urine is passed, blood in the urine, or leg swelling).
• Signs of gallbladder problems (eg, pain in your belly, right shoulder area, or between the shoulder blades; pale colored stools; dark urine; yellow skin or eyes; fever or chills)
• Signs of low blood sugar (eg, dizziness, feeling sleepy or weak, shaking, confusion, hunger, or sweating)
• Call your doctor right away if you have severe stomach pain, severe back pain, or throwing up which may be a sign of severe pancreas problems
• Sudden change in vision (medications that alter blood sugar can have various effects on vision and should be evaluated promptly by an eye doctor)
• Mood changes like depression or thoughts of suicide.

• Maintain a healthy lifestyle: Combine medication with a balanced diet and regular exercise through engagement in the Noom app.
• Stay hydrated: To prevent dehydration, you should drink enough fluids so that your urine is clear to light yellow in color, which is usually at least half a gallon or eight glasses of water per day.
• Communicate with your Noom Med doctor: Regular communication helps us monitor your progress and adjust treatment as needed.
• Connect with your primary care provider: Let your primary care provider know that you are now taking compounded semaglutide.