Ozempic (semaglutide) is a human-based glucagon-like peptide-1 (GLP-1) receptor agonist prescribed as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) that is considered outside a healthy range.
Mounjaro (tirzepatide) glucagon-like peptide-1 (GLP-1) receptor agonist and a glucose-dependent insulinotropic polypeptide (GIP) receptor agonist. Since Mounjaro is not only a GLP-1 agonist, but also a GIP agonist. This dual action mechanism stimulates insulin production, so there may be a greater risk for hypoglycemia (low blood sugar).
While using either semaglutide or tirzepatide, it is highly recommended that you: eat a fibrous diet, focus on fruits and vegetables that are high in fiber, eat small high protein meals as digestion is slowed down while on this medication, avoid foods high in fat as they take longer to digest, limit alcohol intake as this medication can lower blood pressure, drink at least 32oz of water a day to avoid constipation. L-Carnitine is an adjunctive ingredient to assist with wellness and weight loss and may be compounded with semaglutide depending on the pharmacy used.
Do not take L-carnitine if you have a history of seizures or epilepsy. Limited studies have shown a possible increased incidence of seizure activity in patients who are at risk.
During GLP-1 animal trials, there was an increase in a type of thyroid cancer called Medullary Thyroid Carcinoma (MCT), which was seen specifically in rodents. Early GLP-1 animal trials with primates did not suggest any increased risk for MCT and clinical trials in humans could not conclude there was any association between GLP-1 medications and MCT. Regulatory authorities are currently monitoring for any increase in the annual incidence of MCT over the next 15 years. However, as a precaution, patients with a personal or family history of MCT or Multiple Endocrine Neoplasia Type 2 (MEN2) are not permitted to take GLP-1 medications for any reason.
The most commonly reported side effects are GI related such as nausea or constipation. Many patients report any side effects experienced improve or resolve after the first 1-2 weeks, however every person and their response to medication is unique. Side effects or adverse reactions can occur when starting the medication as well as at each dose adjustment. These weight loss agents are started at a low dose to make sure the patient can tolerate the medication and then titrated up monthly. If you experience any nausea or constipation, your medical provider may recommend therapies or prescribe medications to help mitigate these side effects.
Nausea, diarrhea, vomiting, constipation, abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, belching, hypoglycemia, flatulence, gastroenteritis, and gastroesophageal reflux disease. Speak with your provider if you have concerns about any side effects, you may be experiencing once you have started the medication.
Subcutaneous Injection Adverse Reactions can include but are not limited to: itching, burning at site of administration with or without thickening of the skin (welting). It is important that you clean your injection site with an alcohol swab prior to administering your dose to reduce to risk of infection.
If you notice other side effects not listed above, contact your doctor or pharmacist immediately. Very serious allergic reactions to this drug are rare, however, get medical help right away if you notice any symptoms of a serious allergic reaction, including rash, itching or swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing, chest pain, significant and persistent epigastric abdominal pain, intractable vomiting. Report adverse side effects to your doctor or pharmacist. In the event of any emergency, call 911 immediately.
IF YOU HAVE ANY QUESTIONS AS TO THE RISKS OR HAZARDS OF THIS TREATMENT, OR ANY QUESTIONS WHATSOEVER CONCERNING THIS PROPOSED TREATMENT OR OTHER POSSIBLE TREATMENTS, SPEAK WITH YOUR MEDICAL PROVIDER BEFORE TAKING SEMAGLUTIDE OR TIRZEPATIDE.
When talking to the patient coordinator request a visit for Weight Management. Make sure to provide your cellphone number and email. You will need to access your patient protal for pre-visit questionnaires.
830.792.5800 option 3
Prior to each visit you will recive an email or text message to complete a questionnaire. These questions will be asked for each visit.
We encourage patients to use any pharmacy of their choosing, however we understand the out-of-pocket costs for GLP-1 medications at standard retail pharmacies can be incredibly expensive and a major barrier to weight management treatment.
One way many patients have been able to pay out-of-pocket for semaglutide is through the use of compounding pharmacies which can provide more affordable and expedient service.
During the initial appointment, patients should speak with their healthcare provider about these low-cost compound pharmacy options.
Please understand, it is the patient’s responsibility to work with the pharmacy and their insurance plan to review preferred formulary options and ensure coverage for the medication.Although not absolute, it has been our experience that many insurances do not cover the cost of these medications for weight management. Occasionally, some insurances will cover the medication if the specific indication is for uncontrolled diabetes, however this may require a prior authorization asking for specific details about a patient’s diabetic type, history, and status.
If a patient is NOT established with Franklin Clinic for primary care and wishes to use their insurance and normal local pharmacy, we will not be able to complete any prior authorization paperwork if the initial prescription is denied. If this occurs, we recommend considering a compounding pharmacy option. Otherwise, please follow up with your regular primary care provider to discuss GLP1 medications, for weight management or diabetes management. Your regular primary care provider will be the office responsible for handling prescription denials/prior authorization paperwork as they are most familiar with your diabetic history and status.
If a patient has already established with Franklin Clinic for primary care and has been receiving diabetic management from our providers, we will make every attempt to satisfy the prior authorization requirements so patients can get their medication from their regular pharmacy. If these attempts are unsuccessful or if a patient requests, we can avoid further delays by redirecting the prescription to a compounding pharmacy.