Important Safety Information
Please review this important safety information carefully before starting any treatment plan. This page is not a substitute for medical advice from your licensed healthcare provider.
Important Safety Information
Compounded semaglutide and compounded tirzepatide are not FDA-approved medications. Compounded drugs are prepared by a state-licensed pharmacy pursuant to a prescription written for an individual patient following a medical evaluation by a licensed provider. Compounded medications have not undergone the FDA review process for safety, efficacy, or quality that applies to FDA-approved drug products.
Eligibility for treatment is determined by a licensed medical provider based on a review of your medical history, current health status, and clinical appropriateness. Not everyone who applies will qualify for treatment. nouri does not guarantee that any individual will be prescribed a compounded medication.
Individual experience varies. Treatment outcomes depend on adherence, dosage, individual physiology, lifestyle factors, and other medical conditions. Past patient experience is not predictive of future results.
GLP-1 receptor agonists, including compounded semaglutide and compounded tirzepatide, may cause side effects including but not limited to nausea, vomiting, diarrhea, constipation, abdominal pain, fatigue, injection site reactions, headache, and dizziness. Serious side effects, including thyroid C-cell tumors, pancreatitis, gallbladder disease, acute kidney injury, severe gastrointestinal disease, hypoglycemia (particularly when used with insulin or sulfonylureas), and allergic reactions, have been reported with GLP-1 medications.
Do not use if you or any family member has a history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2. Not for use during pregnancy or breastfeeding. Disclose all medications, supplements, and medical conditions to your provider before starting treatment.
All prescribing decisions are made by licensed, independent physicians. nouri facilitates access to care and does not practice medicine or diagnose any medical condition. This page is not medical advice and does not establish a provider-patient relationship. For medical questions, consult a licensed healthcare professional.
About nouri
nouri is a telehealth platform that connects people with licensed, independent physicians. nouri does not provide medical advice, diagnose conditions, prescribe medication, or fulfill prescriptions. nouri is not a pharmacy and is not licensed as a medical provider. All treatment decisions are made solely by licensed providers based on individual clinical evaluation.
About Compounded Medications
Some treatment plans available through nouri may include compounded medications. Compounded medications are prepared by state-licensed compounding pharmacies based on a valid prescription from a licensed healthcare provider. Nouri's compounded medications are prepared by F&F Pharmacies Inc. dba Jungle Jim's Pharmacy, a state-licensed 503A pharmacy in Fairfield, OH.
Important: Compounded medications are not approved by the FDA for safety, effectiveness, or manufacturing quality. They are not therapeutically equivalent to FDA-approved medications. Compounded medications may be appropriate when a patient has a specific clinical need that an FDA-approved product cannot meet — for example, a required dose strength not commercially available, or an allergy to an excipient in the brand formulation. Your physician will evaluate and document the individual clinical need that supports a compounded prescription.
FDA-approved semaglutide and tirzepatide products are commercially manufactured under FDA oversight for safety, effectiveness, and manufacturing quality. Compounded semaglutide and tirzepatide prepared for Nouri patients are prepared by a state-licensed 503A pharmacy and have not undergone the same FDA review process. Your provider will discuss the differences with you during your consultation.
Boxed Warning — Thyroid C-Cell Tumors
WARNING: RISK OF THYROID C-CELL TUMORS
In animal studies, GLP-1 receptor agonists (including semaglutide and tirzepatide) caused thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). It is unknown whether GLP-1 receptor agonists cause thyroid C-cell tumors, including MTC, in humans. GLP-1 receptor agonist medications are contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
Tell your healthcare provider immediately if you develop a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath. These may be symptoms of thyroid tumors. If medullary thyroid carcinoma is suspected, your provider will discontinue your treatment and refer you for further evaluation.
Semaglutide — Safety Information
Semaglutide is a GLP-1 receptor agonist. The following safety information applies to both FDA-approved semaglutide products and compounded semaglutide formulations.
Contraindications
Do not use semaglutide if you have:
- A personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- A known hypersensitivity to semaglutide or any product components
Warnings and Precautions
Tell your healthcare provider before starting treatment if you have or have had:
- Pancreatitis or a history of pancreatitis
- Kidney problems or kidney disease
- Diabetic retinopathy (if you have type 2 diabetes)
- Gallbladder problems
- Depression, suicidal thoughts, or mental health conditions
- Allergic reactions to any GLP-1 receptor agonist
Common Side Effects
The most common side effects include:
- Nausea
- Diarrhea
- Vomiting
- Constipation
- Abdominal pain
- Headache
- Fatigue
- Decreased appetite
- Dizziness
- Injection site reactions
Most side effects are mild to moderate and tend to improve over time as your body adjusts to the medication. Side effects are often most pronounced during dose escalation.
Serious Side Effects
Seek immediate medical attention if you experience:
- Signs of thyroid tumors: A lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath
- Pancreatitis: Severe, persistent abdominal pain that may radiate to the back, with or without vomiting
- Allergic reactions: Swelling of the face, lips, tongue, or throat; difficulty breathing; rapid heartbeat; rash or itching
- Hypoglycemia: Dizziness, blurred vision, anxiety, irritability, sweating, slurred speech, or confusion — especially if taking insulin or sulfonylureas
- Kidney injury: Changes in urination, swelling in legs or ankles
- Gallbladder problems: Upper stomach pain, fever, clay-colored stools, yellowing of skin or eyes (jaundice)
- Gastroparesis (stomach paralysis): GLP-1 medications slow gastric emptying. In rare cases, severe gastroparesis has been reported. Contact your physician immediately if you experience prolonged nausea, vomiting, or inability to keep food down.
- Mental health changes: Monitor for new or worsening depression, anxiety, or suicidal thoughts during treatment. If you experience these symptoms, contact your physician immediately or call the 988 Suicide & Crisis Lifeline. Do not stop your medication without consulting your physician.
Drug Interactions
Semaglutide may interact with other medications. Tell your provider about all medications you are taking, including:
- Insulin or sulfonylureas: Risk of hypoglycemia may increase; dose adjustments may be needed
- Oral medications: Semaglutide slows gastric emptying, which may affect the absorption of oral medications. Discuss timing of doses with your provider
- Warfarin or other anticoagulants: Monitor INR more frequently when starting or changing semaglutide dosing
The above safety information is provided for educational purposes and does not cover all possible uses, warnings, precautions, drug interactions, or adverse effects. This information has not been evaluated by the Food and Drug Administration. Compounded semaglutide is not FDA-approved. Consult your licensed healthcare provider for complete information.
Tirzepatide — Safety Information
Tirzepatide is a dual GIP and GLP-1 receptor agonist. The following safety information applies to both FDA-approved tirzepatide products and compounded tirzepatide formulations.
Contraindications
Do not use tirzepatide if you have:
- A personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- A known hypersensitivity to tirzepatide or any product components
Warnings and Precautions
Tell your healthcare provider before starting treatment if you have or have had:
- Pancreatitis or a history of pancreatitis
- Kidney problems or kidney disease
- Type 1 diabetes (tirzepatide has not been studied in type 1 diabetes)
- Diabetic retinopathy
- Gallbladder problems
- Severe gastrointestinal disease
- Depression, suicidal thoughts, or mental health conditions
Common Side Effects
The most common side effects include:
- Nausea
- Diarrhea
- Decreased appetite
- Vomiting
- Constipation
- Abdominal pain
- Indigestion (dyspepsia)
- Injection site reactions
- Fatigue
- Heartburn (gastroesophageal reflux)
- Belching
- Hair loss
Most side effects are mild to moderate and tend to improve over time as your body adjusts to the medication. Side effects are often most pronounced during dose escalation.
Serious Side Effects
Seek immediate medical attention if you experience:
- Signs of thyroid tumors: A lump or swelling in the neck, hoarseness, trouble swallowing, or shortness of breath
- Pancreatitis: Severe, persistent abdominal pain that may radiate to the back, with or without vomiting
- Allergic reactions: Swelling of the face, lips, tongue, or throat; difficulty breathing; severe rash; rapid heartbeat
- Hypoglycemia: Dizziness, blurred vision, anxiety, sweating, slurred speech, or confusion — especially if taking insulin or sulfonylureas
- Kidney injury: Decreased urination, swelling in legs or ankles, fatigue
- Gallbladder problems: Upper stomach pain, fever, clay-colored stools, yellowing of skin or eyes (jaundice)
- Severe gastrointestinal reactions: Persistent, severe nausea, vomiting, or diarrhea leading to dehydration
- Gastroparesis (stomach paralysis): GLP-1 medications slow gastric emptying. In rare cases, severe gastroparesis has been reported. Contact your physician immediately if you experience prolonged nausea, vomiting, or inability to keep food down.
- Mental health changes: Monitor for new or worsening depression, anxiety, or suicidal thoughts during treatment. If you experience these symptoms, contact your physician immediately or call the 988 Suicide & Crisis Lifeline. Do not stop your medication without consulting your physician.
Drug Interactions
Tirzepatide may interact with other medications. Tell your provider about all medications you are taking, including:
- Insulin or sulfonylureas: Risk of hypoglycemia may increase; dose adjustments may be needed
- Oral medications: Tirzepatide slows gastric emptying, which may affect the absorption of oral medications. This is particularly important for medications with a narrow therapeutic window. Discuss timing with your provider
- Oral hormonal contraceptives: Effectiveness may be reduced due to delayed gastric emptying. Use a non-oral backup contraceptive method for 4 weeks after initiation and for 4 weeks after each dose escalation
The above safety information is provided for educational purposes and does not cover all possible uses, warnings, precautions, drug interactions, or adverse effects. This information has not been evaluated by the Food and Drug Administration. Compounded tirzepatide is not FDA-approved. Consult your licensed healthcare provider for complete information.
Pregnancy and Breastfeeding
Do not use GLP-1 receptor agonist medications if you are pregnant, plan to become pregnant, or are breastfeeding.
- Animal studies have shown that GLP-1 receptor agonists may cause harm to a developing fetus. There is insufficient data in humans to determine the risk during pregnancy.
- Semaglutide: Discontinue at least 2 months before a planned pregnancy due to its long half-life.
- Tirzepatide: Discontinue at least 1 month before a planned pregnancy.
- Notify your provider immediately if you become pregnant during treatment. Consult your physician for guidance specific to your situation.
- It is not known whether semaglutide or tirzepatide passes into breast milk. Due to the potential for adverse effects in a nursing infant, breastfeeding is not recommended during treatment.
- If you are of childbearing potential, discuss appropriate contraceptive methods with your provider before starting treatment.
Storage and Handling
- Before first use: Store in a refrigerator at 36°F to 46°F (2°C to 8°C). Do not freeze. Do not use if the product has been frozen.
- After first use: May be stored at room temperature below 86°F (30°C) or refrigerated. Use within the timeframe specified on your product label (typically 21–28 days, depending on formulation).
- Protect from light and excessive heat.
- Do not use if the solution is discolored, cloudy, or contains particles.
- Keep out of the reach of children.
- Dispose of needles and syringes in an FDA-cleared sharps container. Do not dispose of loose needles in household trash.
When to Contact Your Provider
Contact your provider if you experience:
- Side effects that are severe, persistent, or worsening
- New or unusual symptoms after starting or changing a dose
- Difficulty administering your medication
- Questions about drug interactions with new medications
- Changes in your health status or medical history
For medical emergencies, call 911 immediately. Do not wait to contact your provider in an emergency.
Reporting Adverse Events
If you experience a serious adverse event or side effect, you are encouraged to report it to:
FDA MedWatch — The FDA Safety Information and Adverse Event Reporting Program
Online: www.fda.gov/medwatch
You should also report any adverse events to your provider and to the dispensing pharmacy.
Consult Your Provider
This page is provided for informational purposes only and does not constitute medical advice. It does not cover all possible uses, warnings, precautions, drug interactions, or adverse effects. Always consult with your licensed healthcare provider before starting, stopping, or changing any treatment. Your provider will review your complete medical history and current medications to determine if a treatment plan is appropriate for you.
Last updated: April 2, 2026