SEMA/GLYCINE 2.5mg/7.5mg/ml Injection Service Fee WP PHARMA

***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.

1. This ships from WP PHARMA, a Wells Pharmacy affiliate.
2. Injection supplies are included.
3. Please allow up to 2 weeks for shipping.
4. After the 7-week starter package, you may skip the 4th week using the 0.5mg dose and go straight to the 1mg dose if you are doing well with minimal side effects. Or, you may stay on the 0.5mg dose with the next order.
   
5. Each vial has the same concentration of TZ/Glycine (2.5mg/7.5mg/ml), so the number of units you inject will change based on your dosing.

*SHIPPING DISCLAIMER: This pharmacy ships via UPS or 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 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.*

DOSING: Each dose is used for 4 weeks before moving up to the next dose*

0.25mg dose: 10 units/0.1ml

0.5mg: 20 units/0.2ml

1mg: 40 units/0.4ml

1.75mg: 70 units/0.7ml

2.5mg: 100 units/1ml

PACKAGES:

1. 0.25mg X 4 weeks PLUS 0.5mg X 3 weeks
   *Because of the way this package works out, I will allow you to jump to the 1mg dose after only 3 weeks on the 0.5mg dose (as long as any side effects are minimal).
2. 0.5mg X 5 weeks
3. 1mg X 5 weeks
4. 1mg X 4 weeks PLUS 1.75mg X 4 weeks
5. 1.75mg X 6 weeks
6. 2.5mg X 6 weeks

***As long as you stay on a particular dose for at least 4 weeks, you are welcome to move up after that. For instance, patients on the 0.25 mg dose may decide to remain on that dose after they complete the first 4 weeks. If after an additional 2 weeks on the 0.25mg dose you feel like you want to move up to the 0.5 mg dose, you are more than welcome to do so. You do not have to complete an entire additional 4-week course. This is what is great about the multidose vials. Again, as long as you complete at least a 4-week course of each dose, you may move up after that.

**If you are having a lot of side effects with a particular dose, I would recommend not moving up until the side effects lessen. You may also try going back down a dose for a few weeks, then try moving back up again in a few weeks.

***Although many people like to stick to the same pharmacy when they reorder, you may order from any pharmacy available for your state. However, please note that the formulations are different across pharmacies, and the units you use for a particular dose may change drastically with a new pharmacy. Please pay careful attention to your vial and refer here for correct dosing.

Joint Commission guidelines for proper use of many multi-dose vials include the recommendation to discard the vial 4 weeks after first puncture, even though the Beyond Use Date (BUD) may be longer. These guidelines are generally followed in office and hospital settings, particularly when the vial is used for multiple different patients. However, this same suggestion is made for vials punctured several times a day or only once a week. With certain vial sizes/doses/packages, using all of the medication in the vial without wasting any could result in a patient using the vial for longer than 28 days after first puncture. If you choose to use your vial longer than 28 days after first puncture due to package size or maintenance dosing, you must acknowledge that you understand the Joint Commission recommendations to discard the vial 28 days after first puncture, even if you only puncture the vial once a week. You will be using the vial at your own discretion.

If you have any concerns about this issue and for best safety practices, please choose a 4-week package and discard any medication leftover 28 days after first puncture.