TZ/SEMA COMBO 4-Week Supply with Service Fee CASA 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.

***SHIPS TO ALL PATIENTS***

1. This medication will be shipped to you from CASA PHARMA.
2. Injection supplies are included.
3. TZ with SEMA is a combination designed to help prevent resistance or an immune response that can develop with long-term use of medications. This may be particularly beneficial for individuals who have plateaued in their weight loss journey, offering a way to continue making progress. Studies indicate that some patients can develop antibodies against these meds, which can also lead to increased injection site reactions. Any of my patients may order this combo. Please see below for dosing recommendations if switching from TZ or SEMA.
4. Please allow 7-10 business days for shipping. This pharmacy ships via UPS and FedEx, but DOES NOT send tracking information to you. However, you may visit www.ups.com plus 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.
5. It will arrive to you cool and will need to be kept in the refrigerator.
6. Each vial has 4 doses for a 4-week supply.
7. Your dose is ALWAYS 50 units (0.5ml) no matter the vial.
8. You MUST order the dosage you intend to take.
9. Because of the longer BUDs on these vials, you may order up to three vials if injecting weekly. Patients in the weight-loss phase should be injecting weekly for best results.
10. You may order up to two vials if you are in maintenance and spreading out your doses to every 10-14 days.

DOSING

New patients not previously on an injectable weight loss medication will start at the lowest dose (2mg/0.2mg) for the first 4 weeks. You may then move up to the next dose after 4 weeks. 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.

For patients that want to switch over from TZ, I recommend the following dosing to account for the added SEMA. If you are currently on the...

• 2.5mg TZ dose: Choose the 2mg/0.2mg combo to stay where you are. Choose the 4mg/0.4mg combo if you are ready to move up.
• 5mg TZ dose: Choose the 4mg/0.4mg combo if you want to stay where you are. Choose the 6mg/0.6mg combo if you are ready to move up.
• 7.5mg TZ dose: Choose the 6mg/0.6mg combo to stay where you are. Choose the 8mg/0.8mg combo if you are ready to move up.
• 10mg TZ dose: Choose the 8mg/0.8mg combo to stay where you are. Choose the 10mg/1mg combo if you are ready to move up. If you have been on the 10mg dose for at least 12 weeks, you might consider the 12mg/1.5mg dose as well to move up if you are not sensitive to the side effects of these meds.
• 12.5mg or 15mg dose: Choose the 12mg/1.5mg dose.

Patients that want to switch over from SEMA, I recommend the following dosing to account for the added TZ. If you are currently on the...

• 0.25mg SEMA dose: Choose the 2mg/0.2mg combo to stay where you are or if sensitive to side effects. Choose the 4mg/0.4mg combo if you are ready to move up and are not sensitive to side effects.
• 0.5mg SEMA dose: Choose the 4mg/0.4mg combo to stay where you are. Choose the 6mg/0.6mg combo if you are ready to move up.
• 1mg SEMA dose: Choose the 6mg/0.6mg combo to stay where you are. Choose the 8mg/0.8mg combo if you are ready to move up.
• 1.7 mg SEMA dose: Choose the 7.5mg/0.8mg combo to stay where you are. Choose the 10mg/1mg combo if you are ready to move up.
• 2.4 mg SEMA dose: Choose the 10mg/1mg combo if you are sensitive to side effects or the 12mg/1.5mg combo if not.