Important Safety Information

About This Information

Last updated: October 12, 2026

Clinical care for Liv Health patients is provided by licensed clinicians of the OpenLoop Affiliated Covered Entity. This page summarizes key safety information for the compounded medications your Liv provider may prescribe. It does not include every possible risk or side effect, and it is not a substitute for advice from your provider.

Compounded medications are not FDA approved. Federal law allows licensed pharmacies to prepare compounded medications for individual patients, but the FDA does not review them for safety, effectiveness, or quality. Your provider may recommend a compounded medication and a personalized dose based on your medical evaluation.

Compounded semaglutide contains semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.

Compounded tirzepatide contains tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist.

Either may be prescribed to adults for weight management alongside a reduced-calorie diet and increased physical activity, generally for people with a body mass index (BMI) of 27 kg/m² or higher. Safety and effectiveness have not been established for people under 18.

Warning: Risk of Thyroid C-Cell Tumors

In studies of mice and rats, semaglutide and tirzepatide caused thyroid C-cell tumors, including thyroid cancer. It is not known whether these medications cause thyroid tumors, including a type of thyroid cancer called medullary thyroid carcinoma (MTC), in people. Cases of MTC have been reported in people taking liraglutide, a related medication, after it came to market.

Tell your provider right away if you notice a lump or swelling in your neck, hoarseness that doesn't go away, trouble swallowing, or shortness of breath. These may be signs of thyroid cancer.

Who Should Not Use These Medications

Do not use compounded semaglutide or compounded tirzepatide if:

  • You or anyone in your family 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, tirzepatide, or any ingredient in the medication
  • You are pregnant

Limitations of Use

  • Do not use either medication with any other product containing semaglutide or tirzepatide, or with any other GLP-1 or GIP/GLP-1 medication.
  • Safety and effectiveness with other weight-loss products, including prescription, over-the-counter, and herbal or dietary supplements, have not been established.
  • These medications have not been studied in people with a history of pancreatitis.

Current or recent prescriptions. If you have a current or recent prescription for any brand-name or compounded weight-loss medication, tell your provider before starting. Do not take two at once; using more than one GLP-1 or GIP/GLP-1 medication at the same time raises the risk of serious side effects. You may be asked to provide details of that prescription, including the dose.

Before You Start: What to Tell Your Provider

Share your complete medical history and every medication you take, including prescriptions, over-the-counter drugs, vitamins, and herbal or dietary supplements. Withholding or giving inaccurate health information to obtain treatment can cause serious harm, including death.

Medications to mention

  • Diabetes medications, especially insulin or sulfonylureas such as glimepiride (Amaryl) or glipizide (Glucotrol XL). Taking these together can raise your risk of low blood sugar.
  • Other GLP-1 or GIP/GLP-1 medications, including Wegovy® or Ozempic® (semaglutide), Zepbound® or Mounjaro® (tirzepatide), Saxenda® or Victoza® (liraglutide), and Byetta® or Bydureon® (exenatide).
  • Any other weight-loss products, including supplements.
  • Medications taken by mouth. These medications slow stomach emptying, which can change how other oral medications are absorbed. Your provider can help you time them.

Health history to mention

Tell your provider if you have ever had:

  • Type 1 or type 2 diabetes, or diabetic retinopathy
  • Thyroid cancer
  • Pancreatitis or gallbladder problems
  • Kidney disease
  • Severe stomach problems, such as slowed stomach emptying (gastroparesis) or trouble digesting food
  • Depression, or suicidal thoughts or behavior

Pregnancy, breastfeeding, and birth control

  • Pregnancy. Do not use these medications while pregnant. Animal studies suggest possible risk to an unborn baby, and weight loss offers no benefit during pregnancy. Tell your provider right away if you become pregnant.
  • Planning a pregnancy. Stop at least 2 months before a planned pregnancy, because these medications stay in the body for a long time.
  • Breastfeeding. It is not known whether these medications pass into breast milk. Talk with your provider before starting if you are breastfeeding or feeding with breast milk.
  • Birth control pills (tirzepatide). Oral birth control may not work as well while taking compounded tirzepatide. Your provider may recommend a non-oral or backup method for 4 weeks after you start and for 4 weeks after each dose increase.

Side Effects

If you are having a medical emergency, call 911 or get emergency care right away.

Common side effects

The most common side effects are usually mild and often ease after the first few weeks or after a dose change. They include nausea, vomiting, diarrhea, constipation, stomach pain or bloating, indigestion or reflux, headache, tiredness, and dizziness. You may also have redness, swelling, or itching where you inject.

Vomiting or diarrhea that doesn't stop can lead to dehydration. Contact your provider if you have signs of dehydration, such as unusual thirst, dry mouth, or feeling lightheaded. Tell your provider if any side effect lasts or gets worse.

Serious side effects

Watch closely for these, especially when you first start and after any dose change:

  • Thyroid tumors. A lump or swelling in your neck, lasting hoarseness, trouble swallowing, or shortness of breath. See the warning above.
  • Pancreatitis. Severe stomach pain that won't go away, with or without vomiting, sometimes spreading to your back. Stop the medication and get medical help right away.
  • Gallbladder problems. Pain in your upper stomach, yellowing of your skin or eyes (jaundice), fever, or clay-colored stools. Some gallbladder problems need surgery.
  • Low blood sugar. Sweating, shakiness, fast heartbeat, hunger, blurred vision, dizziness, mood changes, or tingling in your hands or feet. Risk is higher if you also take insulin or a sulfonylurea.
  • Kidney problems. Changes in how much you urinate. Dehydration from vomiting or diarrhea can worsen kidney function, so drink plenty of fluids.
  • Serious allergic reactions. Swelling of your face, lips, tongue, or throat; severe rash or itching; trouble breathing or swallowing; very fast heartbeat; fainting or severe dizziness. Stop the medication and get emergency help.
  • Vision changes if you have type 2 diabetes. Tell your provider right away.
  • Increased heart rate. Tell your provider if your heart races while you are at rest.
  • Mood changes or suicidal thoughts. Call your provider right away about any new, worsening, or worrying changes in mood, behavior, thoughts, or feelings. If you are in crisis, call or text 988.

This is not a complete list of possible side effects. Call your provider for medical advice about side effects.

How to Use

  • Use your medication exactly as your provider prescribes, and read the instructions that come with it.
  • Inject under the skin (subcutaneously) of your stomach, thigh, or upper arm once a week, on the same day each week, with or without food.
  • Rotate your injection site each week; don't use the same spot twice in a row.
  • Never share a vial, needle, or syringe. Sharing can spread infection.
  • Don't change your dose or stop the medication without talking to your provider first.
  • If you take too much, call your provider or Poison Control at 1-800-222-1222 right away.

Typical Dosing

Treatment usually starts at a low dose and increases about every 4 weeks. Your provider may personalize your schedule, and your ongoing (maintenance) dose may be lower than the highest dose shown. Always follow your provider's instructions.

Weeks

Compounded semaglutide (once weekly)

Compounded tirzepatide (once weekly)

1–4

0.25 mg

2.5 mg

5–8

0.5 mg

5 mg

9–12

1 mg

7.5 mg

13–16

1.7 mg

10 mg

17–20

2.4 mg

12.5 mg

21–24

—

15 mg

Other forms, if prescribed: Oral compounded semaglutide is typically 5–10 mg daily, and oral compounded tirzepatide 3–6 mg daily. Lower-dose (microdose) tirzepatide typically starts at 1.25 mg injected once or twice weekly, or 1.5 mg daily by mouth.

Reporting Side Effects

Call your provider for medical advice about side effects. You can also report side effects to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Compounded semaglutide and compounded tirzepatide are not approved by the FDA. The FDA does not evaluate compounded products for safety, effectiveness, or quality. Compounded medications are not the same as, or generic versions of, any FDA-approved brand-name product.

This information is a summary only and is not medical advice. Clinical services are provided by licensed clinicians of the OpenLoop Affiliated Covered Entity. Liv Health LLC does not provide medical care.

Wegovy®, Ozempic®, Saxenda®, and Victoza® are registered trademarks of Novo Nordisk A/S. Zepbound® and Mounjaro® are registered trademarks of Eli Lilly and Company. Byetta® and Bydureon® are registered trademarks of their respective owners. Liv Health is not affiliated with these companies.

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