Medication Risk Disclosure

Semaglutide

Common side effects: Nausea, vomiting, diarrhea, constipation, abdominal pain, decreased appetite, fatigue, headache, and injection site reactions.

Serious risks: Pancreatitis, gallbladder problems (gallstones, cholecystitis), acute kidney injury (from dehydration), intestinal obstruction, thyroid C-cell tumors (boxed warning based on animal studies), severe hypoglycemia when combined with insulin or sulfonylureas, and severe allergic reactions.

Contraindications: Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2), pregnancy and breastfeeding, severe gastrointestinal disease, and type 1 diabetes.

Drug interactions: Insulin and sulfonylureas (increased hypoglycemia risk), oral contraceptives (reduced absorption), and oral medications generally (delayed absorption due to slowed gastric emptying).

Tirzepatide

Common side effects: Nausea, diarrhea, decreased appetite, vomiting, dyspepsia, constipation, abdominal pain, fatigue, headache, hair loss, mild heart rate increase, and injection site reactions.

Serious risks: Thyroid C-cell tumors (boxed warning), pancreatitis, gallbladder disease, acute kidney injury, severe hypoglycemia, diabetic retinopathy worsening, tachycardia, bowel obstruction, and severe allergic reactions including anaphylaxis.

Contraindications: Personal or family history of MTC or MEN2, pregnancy and breastfeeding, severe gastrointestinal disease, and type 1 diabetes. History of pancreatitis requires clinical judgment.

Drug interactions: Insulin and sulfonylureas, oral medications (delayed absorption), warfarin (monitor INR), and oral contraceptives.

Semaglutide Microdose (Sublingual)

Common side effects: Generally milder than full-dose injectable semaglutide due to lower dosing. Possible mild nausea, decreased appetite, occasional headache, fatigue, mild GI upset (loose stools or constipation), and transient changes in taste from sublingual administration.

Serious risks: Although microdosing reduces the likelihood of severe adverse events, the same class-level risks of GLP-1 receptor agonists still apply: pancreatitis, gallbladder problems, acute kidney injury (from dehydration), thyroid C-cell tumors (boxed warning based on animal studies), severe hypoglycemia when combined with insulin or sulfonylureas, and severe allergic reactions.

Contraindications: Personal or family history of medullary thyroid carcinoma (MTC) or multiple endocrine neoplasia syndrome type 2 (MEN2), pregnancy and breastfeeding, severe gastrointestinal disease, type 1 diabetes, and known hypersensitivity to semaglutide or any excipient in the sublingual formulation.

Drug interactions: Insulin and sulfonylureas (increased hypoglycemia risk), oral contraceptives (reduced absorption), and oral medications generally (delayed absorption due to slowed gastric emptying).

Important note: Sublingual semaglutide is a compounded formulation. It is not FDA-approved and has not been evaluated by the FDA for safety or efficacy at this route of administration.

Tirzepatide Microdose (Sublingual)

Common side effects: Generally milder than full-dose injectable tirzepatide due to lower dosing. Possible mild nausea, decreased appetite, occasional dyspepsia or diarrhea, fatigue, headache, and transient taste changes from sublingual administration.

Serious risks: Microdosing lowers the likelihood of severe events, but the same class-level risks of dual GLP-1/GIP receptor agonists still apply: thyroid C-cell tumors (boxed warning), pancreatitis, gallbladder disease, acute kidney injury, severe hypoglycemia, diabetic retinopathy worsening, tachycardia, bowel obstruction, and severe allergic reactions including anaphylaxis.

Contraindications: Personal or family history of MTC or MEN2, pregnancy and breastfeeding, severe gastrointestinal disease, type 1 diabetes, and known hypersensitivity to tirzepatide or any excipient in the sublingual formulation. History of pancreatitis requires clinical judgment.

Drug interactions: Insulin and sulfonylureas, oral medications (delayed absorption), warfarin (monitor INR), and oral contraceptives.

Important note: Sublingual tirzepatide is a compounded formulation. It is not FDA-approved and has not been evaluated by the FDA for safety or efficacy at this route of administration.

GHK-Cu Peptide

Common side effects: Mild redness, irritation, or dryness at the application or injection site, temporary tingling or skin sensitivity, mild nausea, and headaches.

Serious risks: Allergic reaction or anaphylaxis, copper toxicity (abdominal pain, vomiting, chest pain, chills, tremors), and theoretical tumor promotion through angiogenesis (new blood vessel formation).

Contraindications: Known allergy to copper-based products, Wilson’s disease or copper metabolism disorders, active or suspected cancer, pregnancy and breastfeeding, and active skin infections at treatment sites.

Drug interactions: Vitamin C (copper counteracts its antioxidant properties), retinoids, and strong chemical exfoliants (AHAs, salicylic acid).

CJC-1295 / Ipamorelin

Common side effects: Injection site reactions, headache, flushing, mild nausea, fatigue, water retention, joint stiffness, tingling or numbness in hands/feet, increased appetite, and mood changes.

Serious risks: Immunogenicity and allergic reactions, cardiovascular effects (increased heart rate, vasodilation, hypotension), potential impact on cellular replication with long-term use, hormonal imbalance (gynecomastia, altered fertility), and altered insulin sensitivity. When prescribed, ipamorelin is dispensed by a US-licensed compounding pharmacy as a subcutaneous injection only, under ongoing physician supervision. Madison Meds connects patients with independent providers and pharmacies and does not dispense medication.

Contraindications: Active cancer or cancer diagnosis within the past 2 years, pregnancy and breastfeeding, uncontrolled diabetes, and certain cardiac conditions.

Drug interactions: Thyroid medications, corticosteroids, insulin and diabetes medications, and testosterone replacement therapy.

Sermorelin

Common side effects: Injection site irritation, headache, flushing, dizziness, nausea, rash, sleepiness, taste changes, and restlessness.

Serious risks: Severe allergic reaction or anaphylaxis, cancer risk (growth hormone and IGF-1 stimulation may accelerate tumor growth), and worsened insulin resistance.

Contraindications: Active cancer or recent cancer diagnosis (requires oncologist clearance), pregnancy and breastfeeding, known allergy to sermorelin, untreated hypothyroidism, and moderate to severe liver or kidney disease.

Drug interactions: Corticosteroids (reduce effectiveness), oral estrogens, insulin and sulfonylureas, somatostatin analogs, levothyroxine, aspirin, and certain beta-blockers.

Glow Peptide Stack (GHK-Cu + BPC-157 + TB-500)

Common side effects: Injection site reactions (redness, irritation, mild bruising), transient flushing, mild nausea, headache, fatigue, and minor changes in skin sensitivity. Most users tolerate the stack well at the doses used.

Serious risks: Allergic reaction or anaphylaxis, copper toxicity from GHK-Cu (abdominal pain, vomiting, chest pain, chills, tremors), theoretical tumor promotion through angiogenesis and growth-factor signaling shared by all three components, immune reactions and immunogenicity, and contamination hazards if peptides are not prepared in a sterile compounding environment. No large-scale controlled human trials exist for this specific combination.

Contraindications: Active or recent cancer, pregnancy and breastfeeding, immunocompromised state, Wilson’s disease or copper metabolism disorders, known allergy to copper-based products or any peptide component, and active skin infections at injection sites.

Drug interactions: Strong topical exfoliants (AHAs, retinoids, salicylic acid) used alongside GHK-Cu, immunosuppressants, and high-dose vitamin C (which can counteract copper’s antioxidant effects).

Important note: BPC-157 and TB-500 are not FDA-approved for human use. The Glow stack is a product name, not a clinically validated protocol, and is dispensed only by physician prescription through licensed compounding pharmacies.

BPC-157

Common side effects: Headache, mild nausea, fatigue, appetite changes, injection site irritation, sleep disruption, and mild mood shifts.

Serious risks: Theoretical cancer risk through activation of cell migration pathways (FAK-paxillin), immune reactions and immunogenicity, infection from non-sterile injection, and contamination hazards from peptide sourcing. No large-scale controlled human trials have been conducted.

Contraindications: Active cancer or history of cancer, pregnancy and breastfeeding, and immunocompromised patients.

Important note: BPC-157 has not been approved by the FDA for human use. Human safety data is limited.

Wolverine Peptide Stack (BPC-157 + TB-500)

Common side effects: Injection site reactions, nausea, headache, water retention, and fatigue.

Serious risks: Theoretical cancer risk from both components (through angiogenesis and growth factor promotion), unknown long-term effects, immune and systemic effects that are not fully understood, and contamination hazards. No clinical safety data exists for this combination.

Contraindications: Active cancer or history of cancer, pregnancy and breastfeeding, and immunocompromised patients.

Important note: Neither BPC-157 nor TB-500 is FDA-approved for human use. The “Wolverine Stack” is a product name, not a clinically validated protocol.

NAD+ Injection

Common side effects: Nausea, flushing, headache, fatigue, mild chest tightness (resolves by slowing infusion), injection site reactions, dizziness, digestive discomfort, muscle cramps, and sweating.

Serious risks: Allergic reaction or anaphylaxis, rapid heart rate, chest pain, severe vein inflammation (IV administration), elevated inflammation markers, glucose intolerance or liver toxicity signals with long-term use, and fainting.

Contraindications: Known hypersensitivity to NAD+ or niacinamide, active cancer, uncontrolled hypertension, congestive heart failure, severe liver or kidney disease, active infections, and pregnancy and breastfeeding.

Drug interactions: Mitochondria-affecting medications (metformin, statins, chemotherapy agents), glutathione and alpha-lipoic acid (when combined in infusions), and antidiabetic medications.

Glutathione Injection

Common side effects: Nausea, headache, injection site pain, mild allergic reactions (rash, itching), transient breathing discomfort (especially in asthma patients), diarrhea, and abdominal cramping.

Serious risks: Endotoxin-related reactions (fever, chills, low blood pressure, difficulty breathing), liver injury (hepatotoxicity observed in clinical studies), anaphylaxis, potential thyroid dysfunction, kidney dysfunction, cardiovascular effects (blood pressure drop, irregular heart rhythms), and altered skin photoprotection increasing UV-related skin damage risk.

Contraindications: Known allergy to glutathione, asthma or breathing disorders (bronchospasm risk), liver or kidney disease, immune compromise, and pregnancy and breastfeeding.

Drug interactions: NAD+ and alpha-lipoic acid (overlapping effects in combination infusions) and chemotherapy agents (discuss with oncologist).

MIC-B12 Injection (Methionine, Inositol, Choline + Vitamin B12)

Common side effects: Mild injection site reactions (redness, soreness, bruising), transient warmth or flushing, mild nausea or upset stomach, headache, change in urine odor (from methionine and B12), and a temporary energy boost or insomnia if injected late in the day.

Serious risks: Allergic reaction or anaphylaxis (rare, more often linked to cobalt or preservative sensitivity), low potassium (hypokalemia) with high-dose B12 in susceptible patients, exacerbation of pre-existing kidney or liver disease, and theoretical worsening of homocysteine-related cardiovascular conditions in patients with untreated B-vitamin metabolism disorders. Sterile injection technique is essential to avoid local infection.

Contraindications: Known allergy to methionine, inositol, choline, cobalt, or vitamin B12, Leber’s hereditary optic neuropathy, polycythemia vera, severe liver or kidney disease, pregnancy and breastfeeding (use only under physician supervision), and active infection at injection sites.

Drug interactions: Levodopa (B12 may alter response), chloramphenicol (may blunt hematologic response to B12), metformin and proton-pump inhibitors (long-term use can lower B12 absorption — confirm dosing with provider), and methotrexate or other folate antagonists.

Important note: MIC-B12 is a compounded lipotropic injection used as an adjunct to lifestyle changes. It is not a substitute for medically supervised weight loss or treatment of B12 deficiency, and individual responses vary.

LushLox (Oral Minoxidil 2.5mg + Biotin + Vitamin D3 + Vitamin K2)

Common side effects: Typically minimal at 2.5 mg oral minoxidil. Possible mild lightheadedness or dizziness, increased body hair (hypertrichosis), transient fluid retention or mild ankle swelling, and occasional headache. Biotin, vitamin D3, and vitamin K2 are generally well tolerated at the doses used.

Serious risks: Rare with low-dose oral minoxidil. Reports have included pericardial effusion, tachycardia, and significant fluid retention in susceptible patients. Biotin supplementation can interfere with certain laboratory assays (including some thyroid and troponin tests) — inform your lab before blood work. Very high-dose vitamin D can cause hypercalcemia; the dose in LushLox is within standard supplemental range.

Contraindications: Pregnancy and breastfeeding. Use with caution in significant cardiovascular disease, low blood pressure, pericardial effusion, or pheochromocytoma. Known hypersensitivity to minoxidil.

Drug interactions: Antihypertensive medications (additive blood pressure lowering), guanethidine, and other vasodilators. High-dose vitamin K2 may interact with warfarin — notify your provider if you are on anticoagulants.

Household safety: LushLox is an oral capsule. Keep out of reach of children and pets.

RegrowFuel (Oral Minoxidil 2.5mg + GHK-Cu 5mg + Apigenin 50mg + Fisetin 50mg)

Common side effects: Initial (temporary) shedding in the first 2–4 weeks as follicles reset into the growth phase, fine body-hair growth (hypertrichosis), mild fluid retention or ankle swelling, lightheadedness, and occasional headache. Most effects are dose-related and resolve with time or dose adjustment.

Serious risks: Uncommon at 2.5 mg. Low-dose oral minoxidil can increase heart rate or lower blood pressure, and rare cases of pericardial effusion have been reported — your provider will screen for cardiac risk before prescribing. GHK-Cu, apigenin, and fisetin are well tolerated at these doses.

Contraindications: Pregnancy and breastfeeding. Significant cardiovascular disease, uncontrolled low blood pressure, history of pericardial effusion, or known hypersensitivity to minoxidil or any active. Use caution with kidney impairment.

Drug interactions: Use caution when combined with other antihypertensives or vasodilators — may lower blood pressure further. Notify your provider of all medications during intake.

Monitoring: Your provider will check baseline blood pressure and heart rate, and may recheck during follow-up. Report any chest discomfort, shortness of breath, or sudden swelling immediately.