Prescription Treatment Reference Document | May 19, 2026
This document provides Important Safety Information for prescription and compounded medications that may be available through Verum Health's affiliated provider network. It covers indications, contraindications, potential side effects, drug interactions, and use in special populations. This document is for informational purposes only and does not replace the clinical judgment of your prescribing provider.
Patients are encouraged to report adverse drug reactions to their prescribing provider, their dispensing pharmacy, and the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
In case of a medical emergency, call 911 or go to the nearest emergency room immediately.
Verum Health is a managed services organization (MSO) that provides clinical infrastructure and care coordination services. Verum Health does not practice medicine, provide medical advice, or dispense medications. All prescribing decisions are made exclusively by independent, licensed healthcare providers operating through affiliated professional medical entities in the states where they are licensed to practice.
Prescription medications are only available following a completed telehealth consultation and a clinical determination of appropriateness by a licensed provider. Whether to prescribe, and what to prescribe, is entirely within the provider's independent clinical judgment and subject to applicable laws and regulations.
Some treatments available through affiliated providers may involve compounded medications prepared by licensed, USA-based compounding pharmacies. Compounded medications may be appropriate when commercially available alternatives do not meet a patient's clinical needs.
Important: Compounded medications have not been reviewed or approved by the FDA for safety, effectiveness, or quality. They are not FDA-approved drug products. Your provider will discuss the risks and benefits of compounded medications with you during your consultation.
Compounded semaglutide is not an FDA-approved drug product. FDA shortage status for branded semaglutide may affect the availability of compounded versions. Your provider will advise you on current availability.
Semaglutide and other GLP-1 receptor agonists are contraindicated in patients with a personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). In animal studies, GLP-1 receptor agonists caused thyroid C-cell tumors. The relevance to humans is unknown.
Semaglutide may interact with insulin, oral diabetes medications (especially sulfonylureas), and other glucose-lowering therapies, increasing the risk of hypoglycemia. It may also affect the absorption rate of oral medications due to effects on gastric emptying. Inform your provider of all medications, supplements, and herbal products you are taking.
Do not use during pregnancy or while breastfeeding. Use effective contraception during treatment. Safety and efficacy have not been established in pediatric patients.
Compounded tirzepatide is not an FDA-approved drug product. FDA shortage status for branded tirzepatide may affect the availability of compounded versions.
Tirzepatide has been associated with thyroid C-cell tumors in animal studies. Do not use if you or any first-degree family member has a history of medullary thyroid carcinoma or MEN 2.
Nausea, diarrhea, vomiting, constipation, abdominal pain, indigestion, injection site reactions, fatigue, belching, hair loss, and heartburn.
Increased hypoglycemia risk when combined with insulin or sulfonylureas. May reduce the effectiveness of oral contraceptives — discuss alternative contraception with your provider.
Do not use during pregnancy or while breastfeeding. Use effective contraception during treatment.
BLACK BOX WARNING — Same as compounded semaglutide above. All semaglutide-containing products carry the same class warnings.
Nausea, constipation, vomiting, diarrhea, abdominal pain, headache, indigestion, injection site reactions, dizziness, back pain, altered taste, decreased appetite, bloating, belching, fatigue, nasopharyngitis, and GERD.
Do not use if pregnant, trying to become pregnant, or breastfeeding. Use effective contraception during treatment.
Branded tirzepatide is indicated for chronic weight management (BMI ≥30, or ≥27 with weight-related comorbidity) and for the treatment of type 2 diabetes mellitus.
Use supplemental contraception for four weeks after treatment initiation and four weeks after each dose increase.
Testosterone products prescribed through this platform are intended for adult males with clinically diagnosed hypogonadism or testosterone deficiency. These statements apply to both FDA-approved and compounded testosterone preparations.
Acne, oily skin, increased body or facial hair, mood changes or irritability, injection site reactions (for injectable forms), fluid retention, headache, and decreased testicular size.
Known or suspected prostate or breast cancer. Serious cardiovascular conditions. Polycythemia. Pregnancy (females). Do not use if you are trying to father children without first discussing fertility implications with your provider.
Regular blood tests to monitor testosterone levels, hematocrit, PSA, and liver function are required throughout treatment. Your provider will establish a monitoring schedule at the initiation of therapy.
These statements apply to both FDA-approved and compounded estradiol and progesterone/progestin preparations.
Hormone replacement therapy (HRT) for women involves the use of estrogen alone (in women without a uterus) or estrogen combined with progestogen (in women with a uterus). The following risks have been associated with systemic HRT:
Known or suspected estrogen-dependent cancers (including certain breast and uterine cancers). Active or recent history of DVT, pulmonary embolism, stroke, or heart attack. Known hypersensitivity to estradiol, progesterone, or any component of the formulation. Pregnancy. Undiagnosed abnormal genital bleeding.
Breast tenderness, bloating, nausea, headaches, mood changes, and irregular spotting or bleeding (particularly in the first months of therapy). Patch or cream forms may cause local skin irritation at the application site.
Regular follow-up visits including breast exams, mammography (as appropriate), blood pressure monitoring, and gynecological evaluation are recommended throughout treatment. Your provider will establish a monitoring schedule.
Peptide therapies offered through this platform are compounded preparations and have not been reviewed or approved by the FDA for safety, effectiveness, or quality. These are prescribed at the independent clinical discretion of your provider for off-label or wellness applications. The statements in this section have not been evaluated by the FDA.
BPC-157 is a synthetic peptide derived from a protein found in gastric juice, used off-label in certain regenerative and recovery protocols. It is not FDA-approved for any indication.
Reported benefits in preclinical and limited clinical contexts include support for tissue healing, tendon and ligament recovery, and gastrointestinal protection. Clinical evidence in humans is limited and ongoing.
Common side effects reported include nausea, dizziness, and injection site reactions. No large-scale safety data in humans is available. Patients with a history of cancer should consult their oncologist before use, as some preclinical data suggests potential pro-angiogenic effects. Do not use if pregnant or breastfeeding.
Thymosin Alpha-1 is a peptide with immune-modulating properties, used off-label in certain immune support and longevity protocols. It is not FDA-approved for use in the United States.
Reported benefits include immune system support and potential anti-inflammatory effects. Clinical evidence in the United States is limited; it is approved for use in some other countries for viral hepatitis and immune deficiency conditions.
Generally well-tolerated. Common side effects include local injection site reactions. Use with caution in patients with autoimmune conditions or those taking immunosuppressive medications. Do not use if pregnant or breastfeeding.
Thymosin Beta-4 is a naturally occurring peptide with potential roles in tissue repair, wound healing, and anti-inflammatory activity. It is not FDA-approved for any indication and is not approved for use in athletic competition.
Preclinical data suggests potential benefit in wound healing and cardiac and neurological tissue repair. Human clinical evidence is very limited.
Common side effects include injection site reactions and mild fatigue. Long-term safety data in humans is unavailable. Do not use if pregnant or breastfeeding. Patients with a history of cancer should consult their oncologist before use.
NAD+ infusions and injections are not FDA-approved drug products for any indication. The statements in this section have not been evaluated by the FDA.
NAD+ is a coenzyme involved in cellular energy metabolism. It is used off-label in longevity, anti-aging, and neurological support protocols. NAD+ therapy may be administered via intravenous infusion, intramuscular injection, or subcutaneous injection depending on the clinical protocol.
Use with caution in patients with a history of cancer, autoimmune conditions, or significant cardiovascular or hepatic disease. The safety of NAD+ therapy during pregnancy and breastfeeding has not been established. Inform your provider of all medications you are taking.
Potential interactions with certain medications affecting cellular metabolism exist but are not well-characterized. Disclose all medications, supplements, and herbal products to your provider before starting NAD+ therapy.
IV micronutrient therapies and lipotropic injections are not FDA-approved drug products for any specific indication. These are provided as compounded preparations under the supervision of a licensed provider.
IV micronutrient therapies (including Myers' Cocktail and similar formulations) typically contain combinations of vitamins, minerals, and amino acids administered intravenously. MIC (Methionine, Inositol, Choline) and Lipo-B injections are lipotropic compounds sometimes used in conjunction with weight management programs.
Patients with kidney disease, heart failure, or fluid retention conditions should consult their primary care provider before receiving IV fluid-based therapies. High-dose vitamin supplementation may interact with certain medications. Disclose all medications and supplements to your provider before treatment.
Sermorelin is a growth hormone-releasing hormone (GHRH) analogue. These statements have not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.
Itching, difficulty swallowing, flushing, headache, drowsiness, hyperactivity, or restlessness. Contact your provider if any side effects are persistent or concerning.
Glucocorticoids (e.g., prednisone) may attenuate the growth hormone-stimulating effects of sermorelin. Thyroid hormone medications may alter hormonal balance and interfere with laboratory monitoring. Disclose all medications and supplements to your provider.
Finasteride is FDA-approved for the treatment of male-pattern hair loss (androgenetic alopecia) in adult men. It is not approved for use in women or children. Women who are pregnant or may become pregnant should not handle crushed or broken finasteride tablets due to the risk of fetal harm (Category X in pregnancy).
Do not use concurrently with nitrate medications (nitroglycerin, isosorbide mononitrate, isosorbide dinitrate) — may cause severe, potentially fatal hypotension. Do not use with other PDE5 inhibitors. Use with caution or avoid entirely if you have severe cardiovascular disease, have recently suffered a stroke or myocardial infarction, or have resting hypotension.
Glutathione is a naturally occurring antioxidant tripeptide used off-label in compounded IV, intramuscular, subcutaneous, and intranasal formulations for oxidative stress support, skin health, detoxification protocols, and neurological wellness. It is not FDA-approved for these indications as a compounded preparation.
Injection site reactions (pain, redness, swelling). With IV administration: transient flushing, warmth, or tingling. Intranasal formulations may cause mild nasal irritation or temporary altered sense of smell. Rare: allergic reactions including hives, facial swelling, or difficulty breathing — seek immediate medical attention if these occur.
Known hypersensitivity to glutathione or any component of the formulation. Use with caution in patients with asthma (rare cases of bronchospasm with nebulized forms reported). Safety during pregnancy and breastfeeding has not been established. Disclose all medications and supplements to your provider, as high-dose antioxidant therapy may theoretically interact with certain chemotherapy agents.
Methylene blue is used off-label in compounded oral and low-dose IV formulations for cognitive support, mitochondrial function, and neuroprotective protocols. At prescription doses it is a potent monoamine oxidase inhibitor (MAOI). It is FDA-approved only for the treatment of methemoglobinemia at higher doses. These statements have not been evaluated by the FDA for the off-label indications described here.
Methylene blue inhibits monoamine oxidase and can precipitate potentially life-threatening serotonin syndrome when combined with serotonergic medications. Do NOT use methylene blue if you are taking any of the following: SSRIs (e.g., sertraline, fluoxetine, escitalopram), SNRIs (e.g., venlafaxine, duloxetine), MAOIs, tricyclic antidepressants, tramadol, triptans, linezolid, or St. John’s Wort. Symptoms of serotonin syndrome include agitation, confusion, rapid heart rate, high blood pressure, muscle twitching, and fever — seek emergency care immediately if these occur.
Blue or green discoloration of urine and stool (expected and harmless at low doses). Nausea, vomiting, or abdominal discomfort. Headache or dizziness. Skin or mucous membrane discoloration at higher doses. With IV administration: injection site pain and transient blood pressure changes.
Known hypersensitivity to methylene blue. G6PD (glucose-6-phosphate dehydrogenase) deficiency — methylene blue may cause hemolytic anemia in G6PD-deficient patients. Concurrent use of serotonergic medications (see warning above). Pregnancy and breastfeeding — safety not established. Renal impairment — use with caution as methylene blue is renally excreted.
Listed under Peptide Therapies
GHK-Cu (glycyl-l-histidyl-l-lysine copper) is a naturally occurring copper-binding peptide used in compounded injectable and topical formulations for skin rejuvenation, wound healing, hair follicle support, and anti-inflammatory applications. It is not FDA-approved for any of these indications. The statements in this section have not been evaluated by the FDA.
Injection site reactions (redness, mild swelling, or discomfort). Topical formulations may cause transient skin irritation, redness, or tingling at the application site. Temporary blue-green skin tint at the injection site may occur due to the copper component and typically resolves within hours. Large-scale human safety data is limited.
Known hypersensitivity to copper or any peptide component. Use with caution in patients with Wilson’s disease or other copper metabolism disorders. Patients with a history of cancer should consult their oncologist before use, as some preclinical data suggests pro-angiogenic activity. Do not use during pregnancy or breastfeeding. Safety in pediatric populations has not been established.
Phentermine is an FDA-approved Schedule IV controlled substance indicated as a short-term adjunct to a reduced-calorie diet and exercise program for the treatment of obesity in adult patients with an initial BMI of 30 kg/m² or greater, or 27 kg/m² or greater in the presence of at least one weight-related comorbidity. It is a sympathomimetic amine with amphetamine-like activity. Phentermine is prescribed only through affiliated licensed providers in states where they are authorized to prescribe Schedule IV controlled substances via telehealth, in compliance with applicable DEA regulations and state law.
Cardiovascular risk: phentermine increases heart rate and blood pressure. Do not use if you have a history of cardiovascular disease, coronary artery disease, arrhythmia, stroke, or uncontrolled hypertension. Pulmonary hypertension: rare but serious cases of primary pulmonary hypertension have been reported with phentermine use. Valvular heart disease: cases of serious regurgitant cardiac valvular disease have been reported, primarily affecting the mitral, aortic, and/or tricuspid valves. Drug dependence: phentermine has potential for abuse and dependence consistent with its Schedule IV classification. Prescribing is limited to short-term use (typically up to 12 weeks).
Dry mouth, insomnia, irritability, constipation, elevated heart rate, increased blood pressure, headache, dizziness, and decreased appetite. Some patients report restlessness or nervousness.
History of cardiovascular disease, stroke, arrhythmia, or uncontrolled hypertension. Hyperthyroidism. Glaucoma. History of drug abuse. Concurrent use of MAOIs (contraindicated — risk of hypertensive crisis) or within 14 days of MAOI discontinuation. Pregnancy and breastfeeding. Agitated states.
MAOIs: concurrent use may cause hypertensive crisis — contraindicated. Serotonergic medications: increased risk of serotonin syndrome. Other stimulants or sympathomimetic amines: additive cardiovascular effects. Insulin and oral hypoglycemic agents: phentermine may alter glycemic control — dose adjustments may be needed in diabetic patients. Alcohol: may increase the risk of adverse cardiovascular effects.
Low Dose Naltrexone (LDN) refers to naltrexone prescribed at doses significantly below the FDA-approved range (typically 1.5–4.5 mg, compared to the FDA-approved 50 mg dose for opioid use disorder). LDN is used off-label in compounded formulations for immune modulation, chronic pain, inflammatory conditions, and general wellness protocols. It is not FDA-approved for these off-label indications. Naltrexone itself is not a controlled substance. These statements have not been evaluated by the FDA for the off-label indications described here.
Vivid dreams or sleep disturbances (most common, particularly in the first 2–4 weeks of treatment). Nausea, particularly when initiating treatment. Headache. Fatigue or low energy, typically transient. Most side effects resolve as the body adjusts to the medication.
Naltrexone is an opioid antagonist. Even at low doses, it will block the effects of opioid medications and can precipitate acute opioid withdrawal in patients who are opioid-dependent. Do NOT use LDN if you are currently taking any opioid medications (including prescription pain medications, buprenorphine, or methadone) or if you have taken opioids within the past 7–10 days. Acute opioid withdrawal can be dangerous and requires immediate medical attention.
Current use of opioid medications or opioid agonist therapy (buprenorphine, methadone). Acute opioid dependence or withdrawal. Acute hepatitis or hepatic failure — naltrexone is hepatically metabolized and has been associated with hepatotoxicity at higher doses; use with caution in patients with liver disease. Pregnancy and breastfeeding — safety not established. Hypersensitivity to naltrexone or any component of the formulation.
All opioid medications: blocked effect and potential precipitation of withdrawal — contraindicated. Thioridazine: combination may cause drowsiness. Disulfiram: caution advised with concurrent use, particularly in patients with hepatic concerns. Disclose all medications — including over-the-counter medications containing opioids such as cough syrups — to your provider before starting LDN.
By initiating treatment with a compounded GLP-1 medication, you acknowledge that:
To report a suspected adverse reaction to any medication, contact:
Email: legal@verumhealthmed.com
Mail: Verum Health, LLC — 3710 Kirby Drive, Suite 1196, Houston, TX 77098
This document is provided for informational purposes only. It does not constitute medical advice and is not a substitute for consultation with a licensed healthcare provider. Verum Health, as a managed services organization, does not provide medical advice. All clinical decisions are made by independent, licensed healthcare providers. The statements in this document have not been independently reviewed or approved by the FDA unless otherwise noted.