Important Safety Information

Tirzepatide is indicated as an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) of: • 30 kg/m² or greater (obesity), or • 27 kg/m² or greater (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, dyslipidemia, obstructive sleep apnea, cardiovascular disease). This is a prescription medication and should only be used under the supervision of a licensed healthcare professional. It is not intended for cosmetic weight loss without medical supervision.

Do NOT use tirzepatide if you: • Have a personal or family history of medullary thyroid carcinoma (MTC) • Have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) • Have had a serious allergic reaction to tirzepatide or any of its ingredients • Have a history of severe pancreatitis • Are pregnant or planning to become pregnant (discontinue at least 2 months before planned pregnancy) • Are breastfeeding

The most common side effects include: • Nausea (most common, especially during dose escalation) • Diarrhea • Vomiting • Constipation • Abdominal pain or discomfort • Decreased appetite • Indigestion / dyspepsia • Injection site reactions (redness, itching, pain) • Fatigue • Hair loss These are generally mild to moderate and often improve as your body adjusts. Your physician may recommend gradual dose escalation to minimize gastrointestinal side effects.

Contact your healthcare provider immediately if you experience: • Pancreatitis: Severe, persistent abdominal pain that may radiate to the back, with or without vomiting. Discontinue tirzepatide promptly if pancreatitis is suspected. • Gallbladder problems: Upper stomach pain, fever, jaundice (yellowing of skin or eyes), clay-colored stools. • Hypoglycemia: Particularly when used with insulin or insulin secretagogues. Symptoms include shakiness, sweating, confusion, rapid heartbeat, blurred vision. • Kidney injury: Reported in patients experiencing severe gastrointestinal reactions. Monitor renal function in patients with kidney disease. • Allergic reactions: Rash, itching, swelling of face/lips/tongue/throat, difficulty breathing, rapid heartbeat, dizziness. • Diabetic retinopathy complications: If you have a history of diabetic retinopathy, monitor for changes in vision. • Suicidal behavior and ideation: Report any new or worsening depression, suicidal thoughts, or unusual changes in mood or behavior.

Tirzepatide slows gastric emptying and may affect the absorption of other oral medications. Important considerations: • Oral medications: The delay in gastric emptying may reduce the rate of absorption of concomitantly administered oral medications. Monitor patients on oral medications and adjust doses as clinically indicated. • Insulin and sulfonylureas: Increased risk of hypoglycemia. Dose reduction of insulin or sulfonylureas may be necessary. • Oral contraceptives: Efficacy may be reduced. Consider switching to a non-oral contraceptive method or a backup method for 4 weeks after initiation and each dose escalation. • Warfarin and other anticoagulants: Monitor INR more frequently when initiating or changing tirzepatide doses. Always inform your healthcare provider of all medications, supplements, and herbal products you are currently taking.

Tirzepatide is administered as a once-weekly subcutaneous injection. Your physician will determine the appropriate dosing schedule: • Starting dose: Typically 2.5 mg once weekly for 4 weeks • Dose escalation: Increased in 2.5 mg increments after at least 4 weeks at each dose (5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg) • Maintenance dose: 5 mg to 15 mg once weekly based on tolerability and clinical response • Administer on the same day each week, at any time of day, with or without food • Inject into the abdomen, thigh, or upper arm; rotate injection sites • If a dose is missed, administer as soon as possible within 4 days. If more than 4 days have passed, skip the missed dose and resume the regular schedule. Store medication in the refrigerator (36°F to 46°F / 2°C to 8°C). Do not freeze. Protect from light.

Compounded medications are not FDA-approved. They are prepared by licensed compounding pharmacies and have not undergone FDA evaluation for safety, effectiveness, or quality. RETA MD does not manufacture any medications. All prescriptions are fulfilled by state-licensed 503A compounding pharmacies in the United States. RETA MD has no direct affiliation with Eli Lilly and Company, Novo Nordisk, or any pharmaceutical manufacturer. Product names and trademarks are the property of their respective owners.