SEMA/B6 SC Injection Service Fee DD RX PHARMACY

***DISCLAIMER***

You are requesting a service from Dr. K, which includes a chart review for eligibility. If approved, the listed item above will be shipped to the specified address on the order. Because this requires a prescription, you must be a registered patient under Dr. K on Push Health. If you have not registered, please click HERE to get started. Unless otherwise approved, new patients must request a 0.25mg dose package or lower of SEMA.

This service request will not be completed until all enrollment steps have been taken. New patients will receive an “Approval Message” through your Push Health account when you are approved for the program and another message once your service has been competed. Returning patients may return and place a new order request when ready and do not need prior approval. Please message us through your Push Health account with any questions before requesting a service.

**AVAILABLE TO ALL PATIENTS EXCEPT CA**

1. This product ships to you from DD RX PHARMACY.
2. Please refer to your vial for accurate dosing. Each vial contains 4 weeks of your product. Please order the dose you intend to take. The BUD on these vials is only 35 days, so you must be injecting weekly.
3. There are 6 doses to allow for a more gradual escalation: 0.25mg, 0.5mg, 1mg, 1.5mg, 2mg, and 2.5mg doses.
4. You will inject 25 units for the 0.25mg vial. You will inject 50 units for the other 5 higher doses.
5. Patients that are doing well with the 1.75mg dose from another pharmacy and want to order this product may skip the 2mg dose if desired. However, I prefer patients using the 1.5mg dose here from DD RX to order the 2mg dose before the 2.5mg dose (don't skip it).
6. The medication will need to be refrigerated after arrival, so please place it in the refrigerator when you receive it.
7. All injection supplies are included.

*SHIPPING DISCLAIMER: Please allow 7-10 days for shipping. This pharmacy ships via UPS and Fed-Ex, but DOES NOT send tracking information to you. However, you may visit www.ups.com and www.fedex.com and create a profile there with your shipping address; you should then receive shipping notifications anytime UPS or FedEx is delivering you a package from any source. Please ship to an address that you have easy access to and plan to check daily, such as your home address. We can not be held responsible if you do not receive a delivery notification of your item. If you absolutely require a delivery notification, please consider ordering from another pharmacy.*

0.25mg: Inject 25 units weekly X 4 weeks.

0.5mg: Inject 50 units weekly X 4 weeks.

1mg: Inject 50 units weekly X 4 weeks.

1.5mg: Inject 50 units weekly X 4 weeks.

2mg: Inject 50 units weekly X 4 weeks.

2.5mg: Inject 50 units weekly X 4 weeks.

New patients not previously on an injectable weight loss medication will start at the 0.25mg for the first 4 weeks. You may then move up to the 0.5mg dose for the next 4 weeks, then 1mg for 4 weeks, etc. However, you do NOT have to move up in dosing until you are ready. If you are having successful weight loss on a certain dose, you do not have to move up. Also, if you are having significant side effects on a dose, you should spend another 4 weeks on your current dose before you move up.

For patients that have been on TZ and want to switch to semaglutide either temporarily or permanently:

If you have completed:

2.5mg TZ, start with 0.5mg of sema.

5mg of TZ, start with 1mg sema.

7.5mg of TZ, start with 1.75mg sema.

10mg and above of TZ, use the max dose of 2.5mg sema.

*Please remember that although these medications act on similar receptors in your body, they are still different medications. Therefore, the side effect profile can be different for each medication. The above recommendations are just general guidelines. It can sometimes be difficult to ascertain the exact dose a patient should start with when switching from TZ because of the variations in the way the medications affect different people. If you find that the dose of semaglutide that you start on after switching from tirzepatide is too strong or causes too many side effects, please message us for dosing adjustments.