TZ/B12 (cyano) 4-Week Supply with Service Fee STRIKER 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 currently ships to all of my patients!***

1. This medication will be shipped to you from STRIKER PHARMACY.
2. Injection supplies are included.
3. This item usually ships within 4-5 business days, often more quickly. Because this medication ships very quickly, you may not receive any shipping notification, so you will want it delivered to a place where you will be able to check your mail daily. We are not responsible if you do not receive a shipping notification before your medication is delivered. If you absolutely must receive tracking information, then order from another pharmacy.
4. It will arrive to you cool and will need to be kept in the refrigerator.
5. Your medication may have a pink or red tint due to the B12 in the vial. This is normal. I love it because it helps me see the medication better when drawing it up!
6. Each vial contains 4 weeks of either the 2.5mg, 5mg, 7.5mg, 10mg, 12.5mg, or 15mg dose of tirzepatide plus B12 in 2ml of fluid (200 units total).
7. Your injection dose with these vials is ALWAYS 0.5ml (50 units), no matter your TZ dose for that week.
8. You MUST order the dosage you intend to take, as these vials are to be used for 4 punctures only and generally should be used within 28 days. However, these vial have a long BUD if left in the refrigerator unpunctured.
9. If you are injecting WEEKLY with no gaps, you may order up to THREE vials at once (12 week supply). Those injecting less frequently may order up to TWO vials at once.

VIAL CONCENTRATIONS

• 2.5mg Dose: TZ with B12 2.5mg/1mg/0.5ml (2ml vial)
• 5mg Dose: TZ with B12 5mg/1mg/0.5ml (2ml vial)
• 7.5mg Dose: TZ with B12 7.5mg/1mg/0.5ml (2ml vial)
• 10mg Dose: TZ with B12 10mg/1mg/0.5ml (2ml vial)
• 12.5mg Dose: TZ with B12 12.5mg/1mg/0.5ml (2ml vial)
• 15mg Dose: TZ with B12 15mg/1mg/0.5ml (2ml vial)

Sometimes your medication may be printed as a dose PER ML instead of your dose PER 0.5ML. For instance, the 2.5mg dose may be written on your vial as 2.5mg/0.5ml OR 5mg/ml. These are the EXACT same concentrations, just expressed differently. Another example is if your 15mg dose is written as 30mg/ml instead of 15mg/0.5ml. These are both the exact same concentration, only printed a little differently on your vial. Just remember to ALWAYS INJECT 50 units (0.5ml).

*Note that with the first vial, there is 2.5mg TZ / 1mg Vitamin B12 / per 0.5ml (50 units) of medication. You can see above that as you move up in dosage, the amount of TZ in each 0.5ml (50 units) increases to match that dose, but the amount of Vitamin B12 remains the same at 1mg. Each vial has a total of 2ml (200 units) so your dose is always 50 units. DO NOT INCREASE THE NUMBER OF UNITS YOU INJECT WHEN YOU MOVE UP FROM ONE DOSE TO THE NEXT.

DOSING

The standard dose with these vials is always 50units (0.5ml) SC once a week, no matter the dose. The higher the dose, the higher the concentration of medication in those 50 units.

New patients not previously on an injectable weight loss medication will start at the 2.5mg for the first 4 weeks. You may then move up to the 5mg dose for the next 4 weeks, then 7.5mg 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.

***AGAIN, YOU WILL ALWAYS INJECT 50 UNITS NO MATTER WHAT DOSE OF TZ YOU ARE ON.***

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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.