TZ/B12 4-Week Supply 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, TN, TX, UT, VA, VT, WA, WI, WV, WY***

1. Red Rock is now compounding their TZ with glycine or B12. Please see separate listing for the glycine version. You MUST order the dosage you intend to take, as these vials are good for 4 punctures only and are best discarded after 28 days. For those in maintenance, please do not spread your doses out further than every 10 days.
2. Please store your medication in the refrigerator.
3. This product ships from RED ROCK PHARMACY. Their current processing time is 7-10 business days, but sometimes ships sooner. They ship FedEx 2-day. Creating an account with Fedex.com can also help make sure you get notifications.
4. The vials have a BUD of 90 days, which translates to about 75-80 days once you receive it. You may order 1-2 vials at a time. Please discard your vial 4 weeks after first puncture.
5. Please note that there are 8 DIFFERENT TYPES OF VIALS, one for each dosage. Please pay attention to your particular vial and make sure you follow the instructions. There are three different strengths, so you may use the same or even less units for one of the higher doses than you do for a lower dose depending on the vial. See the chart below and note the * and ** beside the two different vial concentrations.
6. If you have recently completed the 10mg dose of TZ from any pharmacy, you may skip the 11.04mg dose and order the 13.6mg dose.
7. You will note that Red Rock offers a 1.125mg micro-dose for patients that need flexible dosing! This is a great dose for patients that can not tolerate the normal starting dose (2-2.5mg) of TZ. It's also great for patients that have lower BMIs but are using GLP-1s for other indications such as arthritis, PCOS, IBS, etc. This also makes a great dosing option for weight loss patients who have met their goals and are in maintenance.
8. You will note that Red Rock also offers a 17mg dose for patients that feel that they have stalled on the 15mg dose. Please order this dose only after you have completed at least 2 months of the 13.6 or 15mg dose from another pharmacy and feel that you have stalled.
9. The B12 is methylcobalamin.

DOSING

Remember that a milliliter (ml) and a unit (u) are measurements of volume (how much fluid is in your vial). A gram (g) and a milligram (mg) are units of weight (the amount of medication in each dose or in your vial).

*Note the weaker vial strength of 5mg/0.5mg/ml.

1.25 mg dose = 0.25 ml (25 units)

**Note the weaker vial strength of 8.5mg/0.5mg/ml.

2.125 mg dose = 0.25 ml (25 units)

4.25 mg dose = 0.50 ml (50 units)

6.375 mg dose = 0.75 ml (75 units)

***Note the stronger vial strength of 17mg/0.5mg/ml (twice as strong as the other).

8.5 mg dose = 0.50 ml (50 units)

11.05 mg dose = 0.65 ml (65 units)

13.6 mg dose = 0.8 ml (80 units)

17mg dose = 1ml (100 units)

New patients not previously on an injectable weight loss medication generally will start at the 2.125mg for the first 4 weeks (some patients with sensitive stomachs or using TZ for micro-dosing may want to use the 1.125mg dose). You may then move up to the 4.25mg dose the next 4-weeks, then 6.375mg 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 at least on your current dose before you move up.

Your vial should be used for 4 doses only, so you must order the dose you plan to use. For those on maintenance, your vial would be best if used within 45 days (for 4 punctures only) and doses spread out no longer than every 10 days.

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.