Follow Up Appointments:

You can do Virtual or In-Person Visits for your follow up appointments!

Every 6 weeks initially so we can make sure you’re reaching your goals and comfortable with medication administration. For patients who are taking medication for extended periods of time (i.e. longer than 6 months) we do follow ups every 2-3 months.
Your first follow up appointment is recommended to do in person, so that we can dispense a vial of medication to you and teach you how to draw up your medication to administer at home safely and properly.
Each vial of Semaglutide is a total of 10mg in a 2 mL vial. Typically this vial lasts approximately 8 weeks (the higher the dose required to see progress, the faster you will use up the medication)
We provide you with syringes and instructions on dosing
Refills of medication can be arranged to be picked up in our office or sent to Strive pharmacy located on Stapley & Baseline. Strive Pharmacy does offer delivery to your home for a fee of $14.99 (subject to change by Strive).

o Follow up visits are $150 each

o Semaglutide vials are $250 each

o Tirzepatide vials are $225 each

The average cost per month breaks down to approximately $200-250/monthly. We recommend patients stay on the medication for at least 3 months to ensure success with reaching your goals and keeping the weight off. We do not recommend taking this medication if you have a normal BMI.

Here is the info to the compound pharmacy we use:

Strive Pharmacy 480-626-4366

Located on Stapley/Baseline 1275 E. Baseline Rd #104 Gilbert, AZ 85233

Semaglutide Guide

What is Semaglutide? Semaglutide is a modified molecule our bodies make, called a GLP-1 analog. It works by increasing insulin production and lowers glucagon secretion as well as targets areas in the brain that regulate appetite and food intake. A small change in the molecule allows the drug to last weeks in our bodies rather than the natural version our bodies make, which lasts minutes.

How Does Semaglutide Work? Semaglutide acts in the following ways:

Delays how quickly our stomachs digest food. Leading to a feeling of fullness and satisfaction with smaller meal sizes.
Slows intestinal motility so you will feel fuller longer after meals.
Lowers blood sugars, in part by reducing the production of sugar in the liver.
Stimulates insulin secretion by the pancreas.

Benefits of Semaglutide:

Decreased appetite and cravings
Weight loss
Improved blood glucose control

Side Effects/Contraindications:

The most common side effects include nausea and constipation.

*Patients also report acid reflux, stomach pain, vomiting, and diarrhea.

The risk of serious side effects increases in patients with severe hypoglycemia, kidney disease, chronic pancreatitis, history of bowel obstruction, and/or chronic gallbladder disease.

DO NOT TAKE SEMAGLUTIDE IF:

You are pregnant or breastfeeding.
Risk of thyroid of c-cell tumors
You have Type 1 diabetes
- ** This medication is not insulin and should not be used if you have type 1 diabetes or if you develop diabetic ketoacidosis. Semaglutide should not be used with any other GLP-1 medications.
  RISK OF THYROID C−CELL TUMORS

If you or any family members have been diagnosed with Multiple Endocrine Neoplasia Syndrome Type 2 or Medullary thyroid cancer you should not take Semaglutide. If you have ever had pancreatitis consult with your medical provider as using Semaglutide can increase the risk of developing pancreatitis.

Storing Semaglutide

Keep your medication refrigerated at all times. DO NOT FREEZE. When you are ready to inject your medication, you may keep it out at room temperature for 5-10 minutes if you are sensitive to cold, otherwise, you can take the semaglutide out of the refrigerator and inject immediately.

If your medication is cloudy/opaque or discolored, do not use it. It should be a reddish pink color due to the B12.

Where to Inject:

Abdomen 1-2 inches away from the belly button

Outer Thigh

Back of arm

If you can "grab the flab", this is a good area to inject.

Wash your hands
Disinfect the injection site with an alcohol swab or cotton ball soaked in rubbing alcohol, let it air dry
Pinch the area with your non-dominant hand
With the cap off, inject the needle directly into the skin with your dominant hand and push the plunger of the syringe all the way down. Pull directly out of the skin once medication has been administered.
Dispose of your sharps in a plastic container (an empty milk jug or other plastic container is OK)
Per Arizona law, you can throw your sharps container away as long as the lid is secure and taped with duct tape. Write "DO NOT RECYCLE" with a permanent marker on the tape and dispose in your regular trash. DO NOT place it in a recycling bin.

If you experience rash/itching at the injection site, make sure you are rotating the site every week. You may take an OTC antihistamine like Zyrtec, Allegra, or Claritin to relieve any itching. If it worsens or persists, please contact me directly.

If you think you are having a true allergic reaction and experiencing trouble breathing, facial swelling, tongue swelling, please call 911 or go to the ER.

Semaglutide Dosing Tips:

You will receive pre-drawn syringes at your first visit. Please feel free to reference this dosing guide for the future.

Semaglutide Dosing Cheat Sheet:

Semaglutide 10mg vial (5mg/1mg strength):

0.25mg = 5 units

0.5 mg = 10 units

1mg = 20 units

1.5 mg = 30 units

2 mg = 40 units

2.4 mg = 50 units

Make sure to complete any labs ordered at your initial consult. The results should be faxed directly to me and I will notify you once they have been reviewed. If you do not hear back about your results after 1-2 weeks, please contact me so I can verify they were received.

Follow up appointments are every 6 weeks in the first 3 months. Depending on your progress, follow up appointments may be spaced every 6-12 weeks thereafter. Make sure to set up your follow up appointment online if you did not already pre-book.

You can do so by logging into the Patient Portal here

If you have not created a Patient Portal, you can sign up via the link above.

If you have any questions or concerns, contact your provider directly or notify the office by calling or texting us at 602-600-8796 and we will make sure to notify them for you.

Patient Portal

Tirzepatide Info

What is Tirzepatide?

Tirzepatide is a once-weekly injectable dual glucagon-like peptide 1 (GLP-1) receptor and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist. It works by increasing insulin production and lowering glucagon secretion as well as targeting areas in the brain that regulate appetite and food intake. A small change in the molecule allows the drug to last weeks in our bodies rather than the natural version our bodies make, which lasts minutes.

It works in the following ways:

1 . Delays how quickly the stomach digests food, leading to a feeling of fullness and satisfaction with smaller meal sizes.

2 . Slows intestinal motility so you will feel fuller longer after meals.

3. Dual action receptors allow for lower blood sugars, in part by reducing the production of sugar in the liver.

4 . Stimulates insulin secretion by the pancreas.

5. GIP increases energy expenditure, resulting in weight loss reductions

Side Effects/Contraindications:

The most common side effects include nausea and constipation.
- Patients also report acid reflux, stomach pain, vomiting, and diarrhea.
  - The risk of serious side effects increases in patients with severe hypoglycemia, kidney disease, chronic pancreatitis, history of bowel obstruction, and/or chronic gallbladder disease.

DO NOT take Tirzepatide if:

You are pregnant or breastfeeding
You have Type 1 diabetes

** This medication is not insulin and should not be used if you have type 1 diabetes or if you develop diabetic ketoacidosis. Semaglutide should not be used with any other GLP-1 medications.

RISK OF Thyroid C−Cell Tumors:

If you or any family members have been diagnosed with Multiple Endocrine Neoplasia Syndrome Type 2 or Medullary thyroid cancer you should not take tirzepatide. If you have ever had pancreatitis consult with your medical provider as using tirzepatide can increase the risk of developing pancreatitis.

Tirzepatide Start Up Instructions

Inject 10 units for 2 weeks, then increase the dose to 25 units for weeks 3-6. Some people may be sensitive to the medication, but common side effects are nausea, diarrhea, gas/bloating, belching, constipation, and are usually mild and temporary as you adjust to the medication.

Storing Tirzepatide:

Keep your medication always refrigerated. DO NOT FREEZE.

If your medication is cloudy/opaque or discolored, do not use it. It should be a reddish pink color due to the B12.

Where to Inject:

Abdomen 1-2 inches away from the belly button

Outer Thigh

Back of arm

If you can "grab the flab", this is a good area to inject.

Wash your hands
Disinfect the injection site with an alcohol swab or cotton ball soaked in rubbing alcohol, let it air dry
Pinch the area with your non-dominant hand
With the cap off, inject the needle directly into the skin with your dominant hand and push the plunger of the syringe all the way down. Pull directly out of the skin once medication has been administered.
Dispose of your sharps in a plastic container (an empty milk jug or other plastic container is OK)
Per Arizona law, you can throw your sharps container away as long as the lid is secure and taped with duct tape. Write "DO NOT RECYCLE" with a permanent marker on the tape and dispose of it in your regular trash. DO NOT place it in a recycling bin.

If you experience rash/itching at the injection site, make sure you are rotating the site every week. You may take an OTC antihistamine like Zyrtec, Allegra, or Claritin to relieve any itching. If it worsens or persists, please contact me directly.

If you think you are having a true allergic reaction and experiencing trouble breathing, facial swelling, tongue swelling, please call 911 or go to the ER.

Tirzepatide Dosing Guide:

You may have received pre-drawn syringes at your initial visit and given instructions by your provider on weekly dosing.

*If you received a vial and needles to draw up your dosage at home, please see below for calculating dose. Your provider will give you instructions on how quickly you increase your dose. Typically, doses are increased every 4-6 weeks for the desired effect and weight loss progress. Do not exceed the max dose your provider recommended at each visit.

Sample Dosing of Tirzepatide/Glycine/B12 10mg/5mg/500mcg per 1 mL (2 mL vial):

WEEKS WEEKLY DOSE # OF UNITS

1-4 2.5mg 25

5-8 5mg 50

9-12 7.5mg 75

13-16 10mg 100

17-20 12.5mg 125

21-24 15mg 150