Sema/L-carnitine Service Fee SPRING CREEK PHARMACY

You are requesting a service from Dr. K to provide the listed item above to be shipped to the specified address on the order. Because this requires a prescription, you must have received an *Approval Message* from Dr. K to your Push Health account prior to requesting this service. You also must also pay your New Patient Fee if applicable. Do not request this service without prior approval or your request may be refunded minus a 5% processing fee. Returning clients may request a service when ready and do not need permission to request a new service. Please message us with any questions before you request a service and we will happy to assist you.

***AVAILABLE IN AZ, CO, CT, DC, DE, FL, GA, IA, ID, IL, IN, KS, KY, LA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NY, OH, OK, PA, SD, TN, TX, UT, VA, VT, WI, and WY ***

1. This item will be shipped to you from Spring Creek Pharmacy.
2. Injection supplies are included.
3. The current shipping time is around 7 days, but your order often ships more quickly.
4. It will arrive to you cool and will need to be kept in the refrigerator.
5. The units you inject will vary depending on your dose.
6. You MUST order the dosage you intend to take.
7. Because of some pharmacy changes, the smallest vial contains 5mg. Due to BUDs, you will need to use this product only for the higher doses of 1mg and above or you risk not being able to use all of your medication before the BUD.
8. Add on the DD RX Super Lipo-B FAT BURNER SC/IM Injection at checkout and save!

DOSING

Sema/L-Carnitine 2.5mg/100mg/ml

1mg: 40units (0.4ml)
1.75mg: 70units (0.7ml)
2.5mg: 100 units (1ml)

PACKAGES:

1mg X 5 weeks: $230

1.75mg X 5 weeks: $280

2.5mg X 4 weeks: $280

New patients not previously on an injectable weight loss medication will start at the 0.25mg for the first 4 weeks (from another pharmacy). You may then move up to the 0.5mg dose for the next 4 weeks (from another pharmacy). You may then start the 1mg dose here. 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.

Patients should discard their vial after the 4th or 5th puncture and should generally use each vial within 30 days (maximum of 45 days) after first puncture.

.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.