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Safety information

The label facts, with the labels.

Prescription medicine has real risks, and marketing pages are a bad place to learn them. This page collects the key safety facts for every treatment we offer, drawn from FDA labeling, with each source linked so you can read the original.

If it feels like an emergency, treat it like one. Chest pain, trouble breathing, signs of a severe allergic reaction, or thoughts of self-harm are 911 problems, not portal messages. For everything non-urgent, your provider is the right first call about symptoms or side effects.

GLP-1 weight loss · semaglutide & tirzepatide

Boxed warning: thyroid C-cell tumors

Semaglutide and tirzepatide labels carry a boxed warning based on thyroid C-cell tumors in rodents. They are contraindicated for people with a personal or family history of medullary thyroid carcinoma or MEN 2 syndrome.

Common and serious side effects

Nausea, vomiting, diarrhea, and constipation are common, especially while increasing dose. The labels also warn of pancreatitis, gallbladder disease, kidney injury from dehydration, and hypoglycemia when combined with insulin or sulfonylureas.

Not for pregnancy

GLP-1 medications should be stopped at least two months before a planned pregnancy per labeling, and are not for use during pregnancy.

Source: FDA label · Wegovy (semaglutide) · FDA label · Zepbound (tirzepatide)

Compounded medications are not FDA-approved

Compounded medications, including compounded semaglutide and compounded tirzepatide, are not FDA-approved as compounded products. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. A licensed provider will determine whether a compounded or brand-name medication is appropriate for you.

Metformin

Boxed warning: lactic acidosis

Metformin's label carries a boxed warning for lactic acidosis, rare but serious, with risk concentrated in significant kidney impairment, liver disease, heavy alcohol use, and acute illness with dehydration.

Common side effects

GI effects, diarrhea, nausea, stomach upset, are the most common, usually early in treatment. Long-term use can lower vitamin B12 levels, which labeling recommends monitoring.

Source: DailyMed · metformin hydrochloride labeling

Testosterone therapy

Class-wide label changes

FDA requires class-wide labeling on testosterone products, including a warning about blood pressure increases, and a limitation of use: testosterone is approved for men with specific medical conditions causing low testosterone, not simply for aging.

Fertility suppression

Testosterone therapy suppresses sperm production while you're on it. Men who want to preserve fertility should raise it in the visit, alternatives like enclomiphene exist for that reason.

Monitoring is part of treatment

Labels call for monitoring of hematocrit (blood counts), and clinical practice includes blood pressure and PSA follow-up. That's why our protocol starts with labs and includes ongoing provider oversight.

Source: FDA · class-wide labeling changes for testosterone products

Compounded medications are not FDA-approved

Compounded medications, including compounded semaglutide and compounded tirzepatide, are not FDA-approved as compounded products. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. A licensed provider will determine whether a compounded or brand-name medication is appropriate for you.

Menopause hormone therapy

Boxed warnings on estrogen products

Estrogen labeling carries boxed warnings: endometrial cancer risk with unopposed estrogen in women with a uterus (why progesterone is co-prescribed), and cardiovascular and breast cancer findings from the Women's Health Initiative trials.

Individualized risk-benefit

FDA guidance for menopause medicines is to use the lowest effective dose for the shortest duration consistent with treatment goals, a decision made with a provider who knows your history, not by a checkout page.

Source: DailyMed · estradiol labeling · FDA · Menopause: Medicines to Help You

Compounded medications are not FDA-approved

Compounded medications, including compounded semaglutide and compounded tirzepatide, are not FDA-approved as compounded products. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. A licensed provider will determine whether a compounded or brand-name medication is appropriate for you.

Sexual health · PDE5 inhibitors

Never with nitrates

Sildenafil and tadalafil are contraindicated with nitrate medications (including nitroglycerin and recreational "poppers"), the combination can cause a dangerous blood pressure drop.

Heart health matters

Sexual activity itself carries cardiac demand; labeling advises evaluation of cardiovascular status before treatment. Your provider reviews heart history in the visit.

Stop signs

Labeling warns to seek immediate care for priapism (an erection lasting more than 4 hours), sudden vision loss, or sudden hearing loss.

Source: DailyMed · sildenafil labeling

Compounded medications are not FDA-approved

Compounded medications, including compounded semaglutide and compounded tirzepatide, are not FDA-approved as compounded products. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. A licensed provider will determine whether a compounded or brand-name medication is appropriate for you.

Hair loss · finasteride & minoxidil

Finasteride, plainly

Oral finasteride's FDA label lists sexual side effects (decreased libido, erectile dysfunction) in a small percentage of men, and depression and mood changes have been reported. Topical use is designed to limit absorption, but the honest position is that risk isn't zero.

Keep it away from pregnancy

Finasteride can harm a developing male fetus. Women who are or may become pregnant should not handle the formula.

Minoxidil, plainly

Scalp irritation, unwanted facial hair growth near application areas, and a temporary early shed are the common effects. Stopping treatment means regrown hair is typically lost again within months.

Source: DailyMed · finasteride labeling

Compounded medications are not FDA-approved

Compounded medications, including compounded semaglutide and compounded tirzepatide, are not FDA-approved as compounded products. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. A licensed provider will determine whether a compounded or brand-name medication is appropriate for you.

Longevity protocols

Rapamycin (sirolimus)

Sirolimus is an FDA-approved immunosuppressant; its label warns of increased infection risk, mouth ulcers, elevated lipids, and impaired wound healing. Longevity dosing is off-label and uses much lower, intermittent doses, but the label's risks are the starting point for the conversation.

Methylene blue

FDA labeling for methylene blue warns of serious CNS reactions (serotonin syndrome) when combined with serotonergic drugs like SSRIs and SNRIs. Tell your provider about every psychiatric medication you take.

Compounded peptides and injectables

NAD+, sermorelin, glutathione, and similar compounded products are not FDA-approved drugs; they're prepared by licensed compounding pharmacies under provider prescription. Evidence for longevity endpoints is early, your provider is candid about that.

Source: DailyMed · sirolimus labeling · FDA label · ProvayBlue (methylene blue)

Compounded medications are not FDA-approved

Compounded medications, including compounded semaglutide and compounded tirzepatide, are not FDA-approved as compounded products. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are marketed. A licensed provider will determine whether a compounded or brand-name medication is appropriate for you.

Continuous glucose monitors

A device, not a drug

CGMs are prescription medical devices. The common issues are skin-level: adhesive irritation and sensor placement problems. Readings can occasionally differ from fingerstick values, confirm with a meter when a reading doesn't match how you feel.

Data needs context

If you take insulin or other glucose-lowering medication, never adjust dosing based on CGM data without guidance from the clinician managing that medication.

Source: FDA · continuous glucose monitoring devices overview

This page is educational and doesn’t replace your provider’s guidance or the full prescribing information. A licensed provider reviews every request and prescribes only when clinically appropriate, including telling you when a treatment isn’t right for you.