Sema/Glycine with Service Fee RED ROCK PHARMACY

THIS ITEM REQUIRES A PRESCRIPTION FROM DR.K. NEW PATIENTS MUST PAY THE NEW PATIENT FEE AND BE SENT AN *APPROVAL MESSAGE* PRIOR TO ORDERING. DO NOT ORDER PRIOR TO THIS OR YOUR ORDER WILL BE CANCELLED MINUS A 5% PROCESSING FEE. RETURNING PATIENTS MAY PLACE AN ORDER WHEN READY AND DO NOT NEED PERMISSION PRIOR TO PLACING A NEW ORDER.

***This product ONLY ships to my patients in: AZ, CO, CT, DE, FL, GA, IA, ID, IL, IN, KS, KY, MD, MI, MN, MO, MT, NC, NE, ND, NH, NV, NY, OH, OK, PA, SC, SD, TX, TN, UT, VA, VT, WA, WI, WY***

1. This product ships from RED ROCK PHARMACY. Their current processing time is 7-10 business days.
2. Red Rock requires dosing regimens that are different from what's commercially available, so you will not see the standard dosing with them. The dosing will be 0.2mg, 0.4mg, 0.8mg, 1.5mg, 2.15mg, and 2.7mg.
3. There are two different vial concentrations used for this product. The TZ/Glycine 2.5mg/5mg/ml vial is used for the 0.2mg and 0.4mg doses. The 5mg/5mg/ml vial is used for the 0.8mg, 1.5mg, 2.15mg, and 2.7mg doses.
4. The vials have a BUD of 45 days, which translates to about 35-40 days once you receive it. Please discard your vial 4 weeks after first puncture. Please order one vial at a time.
5. You will note that Red Rock offers a 2.7mg dose for patients that feel that they have stalled on the lower doses. Please order this dose only after you have completed at least 2 months of the 2mg semaglutide dose or higher an feel that you have stalled.

DOSING

The vial concentration for the first 2 doses is 2.5mg/5mg/ml. This means there is 2.5mg of sema and 5mg of glycine in each ml (100 units).

0.2mg dose = 8 units

0.4mg dose = 16 units

The vial concentration for the 4 higher doses is 5mg/5mg/ml. This means there is 5mg of sema and 5mg of glycine in each ml (100 units).

0.8mg dose = 16 units

1.5mg dose = 30 units

2.15mg dose = 43 units

2.7mg dose = 54 units

New patients not previously on an injectable weight loss medication will start at the 0.25mg dose for the first 4 weeks. You may then move up to the 0.5mg dose the next 4-weeks, then 1mg for 4 weeks, etc. If you are doing well on a certain dose, you do not have to move up until you are read. Most people move up once their weight loss stalls and side effects have resolved.

Your vial should be used for 4-5 doses only, and you must order the dose you plan to use.

***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 you are having a lot of side effects with a particular dose, I would recommend not moving up until the side effects lessen.

***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.