Weight Management & GLP-1 Medications

Warning: Risk of Thyroid C-Cell Tumors

• In rats, Zepbound caused thyroid tumors, including thyroid cancer. It is not known if Zepbound will cause thyroid tumors or MTC in people. Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.
• Do not use Zepbound if you or your family have ever had MTC or if you have MEN 2.

What is the FDA-approved use of Zepbound?

Zepbound is used along with a reduced-calorie diet and increased physical activity for chronic weight management in adults with obesity or with overweight plus a weight-related condition. Limitations of Use: it should not be used with other tirzepatide-containing products or any other GLP-1 receptor agonist.

Who should not use Zepbound?

Do not use Zepbound if you or your family have ever had MTC or have MEN 2, or if you have a known allergic reaction to tirzepatide.

How should I take Zepbound?

Zepbound is available as a single-dose pre-filled autoinjector pen, as a single-dose vial with separate syringe and needle, or as a multi-dose KwikPen with separate needle. It is administered as a subcutaneous injection in the stomach, thigh, or upper arm once a week on the same day every week, with or without food. Do not change your dose or stop without discussing with your provider first. Your providerIf you are pregnant: Saxenda should not be used during pregnancy; there is no benefit to weight loss during pregnancy.

• If you are breastfeeding: it is not known if liraglutide passes into breast milk; talk to your provider about benefits and risks.

Withholding or providing inaccurate health information to obtain treatment may result in harm, including death.

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What are the most serious side effects to monitor for when taking liraglutide?
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

• Thyroid C-Cell Tumors.
• Inflammation of the Pancreas (Acute Pancreatitis).
• Acute Gallbladder Disease.
• Low Blood Sugar (Hypoglycemia).
• Increase in Heart Rate.
• Acute Kidney Injury — stay hydrated.
• Serious Allergic Reactions. may increase your dose every four weeks.

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What should I tell my Allara-affiliated provider before using Zepbound?

Watch out for: diabetes medications including insulin or sulfonylureas; other oral medications (delayed gastric emptying affects absorption); hormonal birth control — Zepbound may decrease oral contraceptive efficacy, especially after the first dose, so switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase until you reach maintenance; other GLP-1 medications (Mounjaro, Wegovy, Ozempic, Saxenda, Victoza, Byetta, Bydureon); and other weight-loss products. Share your full medical history, especially type 1 or type 2 diabetes, thyroid cancer, gastrointestinal disease, pancreatitis, kidney disease, or diabetic retinopathy.

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Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding.

• If you are pregnant: Zepbound should not be used during pregnancy.
• If you are of reproductive potential: Zepbound may reduce oral contraceptive efficacy; use a non-oral or barrier method as described above.
• If you are breastfeeding: it is not known if Zepbound passes into breast milk; talk to your provider about benefits and risks.

Pregnancy registry: contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979). Withholding or providing inaccurate health information to obtain treatment may result in harm, including death.

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What are the most serious side effects to monitor for when taking Zepbound?
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

• Thyroid C-Cell Tumors.
• Severe Gastrointestinal Disease — not studied in and not recommended for patients with severe GI disease.
• Acute Kidney Injury — stay hydrated.
• Acute Gallbladder Disease.
• Inflammation of the Pancreas (Acute Pancreatitis).
• Allergic Reactions.
• Low Blood Sugar (Hypoglycemia).
• Diabetic Retinopathy Complications in patients with a history of diabetic retinopathy.
• Pulmonary Aspiration during general anesthesia or deep sedation.
• Never share a pen or needle — poses a risk of infection.

What are the most common side effects of Zepbound?

Nausea, diarrhea, vomiting, constipation, stomach pain, indigestion, injection site reactions, feeling tired, allergic reactions, belching, hair loss, and gastroesophageal reflux disease (heartburn).

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Report negative side effects to the FDA: visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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This information is not comprehensive. Please see the full Prescribing Information for complete safety information.

Zepbound® is a registered trademark of Eli Lilly and Company.

Warning: Risk of Thyroid C-Cell Tumors

• In rats, tirzepatide (the active ingredient in Mounjaro and Zepbound) caused thyroid tumors, including thyroid cancer. It is not known if Mounjaro will cause thyroid tumors or MTC in people. Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.
• Do not use Mounjaro if you or your family have ever had MTC or if you have MEN 2.

What is the FDA-approved use of Mounjaro?

Mounjaro is a GLP-1 and GIP receptor agonist used along with diet and exercise to improve blood sugar (glucose) in adults with type 2 diabetes mellitus. Limitations of Use: Mounjaro is not for use in people with type 1 diabetes and has not been studied in patients with a history of pancreatitis or severe gastrointestinal disease. Your Allara-affiliated provider may recommend Mounjaro for metabolic and weight management.

Who should not use Mounjaro?

Do not use Mounjaro if you or your family have ever had MTC or have MEN 2, or if you have a known serious allergic reaction to tirzepatide or any of its ingredients.

How should I take Mounjaro?

Mounjaro is administered as a subcutaneous injection in the stomach, thigh, or upper arm once a week on the same day every week, with or without food. Do not change your dose or stop Mounjaro without discussing with your provider first. Your provider may increase your dose over time.

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What should I tell my Allara-affiliated provider before using Mounjaro?

Watch out for: diabetes medications including insulin or sulfonylureas (risk of hypoglycemia); other oral medications (delayed gastric emptying affects absorption); hormonal birth control — Mounjaro may reduce oral contraceptive efficacy, so switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase; and other GLP-1 medications. Share your full medical history, especially type 2 diabetes, thyroid cancer, pancreatitis, gallbladder disease, gastrointestinal disease, kidney disease, or diabetic retinopathy.

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Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding.

• If you are pregnant: Mounjaro may harm an unborn baby; tell your provider if you are pregnant or plan to become pregnant.
• If you are of reproductive potential: Mounjaro may reduce oral contraceptive efficacy; use a non-oral or barrier method as described above.
• If you are breastfeeding: it is not known if Mounjaro passes into breast milk; talk to your provider about benefits and risks.
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Pregnancy registry: contact Eli Lilly and Company at 1-800-LillyRx (1-800-545-5979). Withholding or providing inaccurate health information to obtain treatment may result in harm, including death.

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What are the most serious side effects to monitor for when taking Mounjaro?
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

• Thyroid C-Cell Tumors.
• Inflammation of the Pancreas (Acute Pancreatitis).
• Low Blood Sugar (Hypoglycemia).
• Serious Allergic Reactions.
• Acute Kidney Injury — stay hydrated.
• Severe Gastrointestinal Disease.
• Acute Gallbladder Disease.
• Diabetic Retinopathy Complications in patients with type 2 diabetes.
• Pulmonary Aspiration during general anesthesia or deep sedation.
• Never share a pen or needle — poses a risk of infection.

What are the most common side effects of Mounjaro?

Nausea, diarrhea, decreased appetite, vomiting, constipation, indigestion (dyspepsia), and stomach (abdominal) pain.
Report negative side effects to the FDA: visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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This information is not comprehensive. Please see the full Prescribing Information for complete safety information.

Mounjaro® is a registered trademark of Eli Lilly and Company.

Warning: Risk of Thyroid C-Cell Tumors

• In studies with rodents, liraglutide (the active ingredient in Saxenda and Victoza) caused thyroid C-cell tumors, including MTC. It is not known if liraglutide will cause these tumors in people. Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.
• Do not use liraglutide if you or your family have ever had MTC or if you have MEN 2.

What is the FDA-approved use of liraglutide?

Saxenda is used along with a reduced-calorie diet and increased physical activity for chronic weight management in adults with obesity or with overweight plus a weight-related condition, and in certain adolescents. Victoza is used with diet and exercise to improve blood sugar in adults and children 10 years and older with type 2 diabetes, and to reduce major cardiovascular events in adults with type 2 diabetes and known heart disease. Limitations of Use: do not use with other liraglutide-containing products or any other GLP-1 receptor agonist.

Who should not use liraglutide?

Do not use liraglutide if you or your family have ever had MTC or have MEN 2, if you are pregnant, or if you have a known serious allergic reaction to liraglutide or any of its ingredients.

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How should I take liraglutide?

Liraglutide is administered once daily as a subcutaneous injection in the stomach, thigh, or upper arm, at any time of day, with or without food. Your provider will guide a dose-escalation schedule to reduce gastrointestinal side effects. Do not change your dose or stop without discussing with your provider first.

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What should I tell my Allara-affiliated provider before using liraglutide?

Watch out for: diabetes medications including insulin or sulfonylureas (risk of hypoglycemia); other oral medications (delayed gastric emptying affects absorption); and other GLP-1 medications. Share your full medical history, especially type 2 diabetes, thyroid cancer, pancreatitis, gallbladder disease, kidney disease, or diabetic retinopathy.

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Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding.

• If you are pregnant: Saxenda should not be used during pregnancy; there is no benefit to weight loss during pregnancy.
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• If you are breastfeeding: it is not known if liraglutide passes into breast milk; talk to your provider about benefits and risks.
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Withholding or providing inaccurate health information to obtain treatment may result in harm, including death.

‍

What are the most serious side effects to monitor for when taking liraglutide?
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

• Thyroid C-Cell Tumors.
• Inflammation of the Pancreas (Acute Pancreatitis).
• Acute Gallbladder Disease.
• Low Blood Sugar (Hypoglycemia).
• Increase in Heart Rate.
• Acute Kidney Injury — stay hydrated.
• Serious Allergic Reactions.
• Suicidal behavior and ideation — monitor for changes in mood, behavior, or thoughts of self-harm.

What are the most common side effects of liraglutide?

Nausea, diarrhea, vomiting, constipation, low blood sugar, headache, fatigue, and decreased appetite.
Report negative side effects to Novo Nordisk Inc. at 1-833-934-6891, or FDA MedWatch at 1-800-FDA-1088 or www.fda.gov/medwatch.

This information is not comprehensive. Please see the full Prescribing Information for complete safety information.

Saxenda® and Victoza® are registered trademarks of Novo Nordisk A/S.

Warning: Risk of Thyroid C-Cell Tumors

• In rats and mice, certain GLP-1 medications caused thyroid C-cell tumors. Foundayo did not produce these tumors in rats and mice; however, it is unknown whether Foundayo causes these tumors in people. Tell your provider if you get a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.
• Do not use Foundayo if you or your family have ever had MTC or if you have MEN 2.

What is the FDA-approved use of Foundayo?

Foundayo is used along with a reduced-calorie diet and increased physical activity to reduce and maintain weight in adults with obesity or with overweight plus a weight-related condition. Limitations of Use: it should not be used in combination with other GLP-1 receptor agonists.

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Who should not use Foundayo?

Do not use Foundayo if you or your family have ever had MTC or have MEN 2, or if you have a known allergic reaction to Foundayo.

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How should I take Foundayo?

Take one Foundayo tablet by mouth every day. Swallow the tablet whole — don't cut, crush, or chew it. You can take Foundayo with or without food, and there are no restrictions on water or other liquid intake. Do not change your dose or stop without discussing with your provider first. Your provider may increase your dose every four weeks.

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What should I tell my Allara-affiliated provider before using Foundayo?

Watch out for: Zocor (simvastatin) — do not take more than 20 mg a day while taking Foundayo; diabetes medications including insulin or sulfonylureas; other oral medications (delayed gastric emptying affects absorption); hormonal birth control — Foundayo may decrease oral contraceptive efficacy, so switch to a non-oral method or add a barrier method for 4 weeks after starting and after each dose increase; and other GLP-1 medications. Share your full medical history, especially thyroid cancer, type 1 or type 2 diabetes, gastrointestinal disease, pancreatitis, liver disease, kidney disease, or diabetic retinopathy.

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Tell your provider if you are pregnant, planning to become pregnant, or breastfeeding.

• If you are pregnant: Foundayo should not be used during pregnancy.
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• If you are of reproductive potential: Foundayo may reduce oral contraceptive efficacy; use a non-oral or barrier method as described above.
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• If you are breastfeeding: Foundayo is not recommended for breastfeeding women; talk to your provider about benefits and risks.

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Pregnancy registry: contact the manufacturer at 1-800-LillyRx (1-800-545-5979). Withholding or providing inaccurate health information to obtain treatment may result in harm, including death.

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What are the most serious side effects to monitor for when taking Foundayo?
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.

• Thyroid C-Cell Tumors.
• Inflammation of the Pancreas (Acute Pancreatitis).
• Severe Gastrointestinal Disease — not recommended in patients with severe gastroparesis.
• Acute Kidney Injury — stay hydrated.
• Low Blood Sugar (Hypoglycemia).
• Allergic Reactions.
• Diabetic Retinopathy Complications.
• Acute Gallbladder Disease.
• Pulmonary Aspiration during general anesthesia or deep sedation.

What are the most common side effects of Foundayo?

Nausea, constipation, diarrhea, vomiting, indigestion, stomach pain, headache, bloating, fatigue, belching, gastroesophageal reflux disease, flatulence, and hair loss.
Report negative side effects to the FDA: visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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This information is not comprehensive. Please see the full Prescribing Information for complete safety information.

Important Safety Information — Metformin

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Indication

Metformin is used along with diet and exercise to improve blood sugar control in adults and certain children with type 2 diabetes. Your Allara-affiliated provider may also recommend metformin to support insulin resistance and metabolic health, including cycle regulation in conditions such as PCOS.

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Boxed Warning

Lactic Acidosis. Postmarketing cases of metformin-associated lactic acidosis have resulted in death, hypothermia, hypotension, and resistant bradyarrhythmias. The onset is often subtle, accompanied only by nonspecific symptoms such as malaise, myalgias, respiratory distress, somnolence, and abdominal pain.

Contraindications

• Severe renal impairment (eGFR below 30 mL/min/1.73 m²).
• Known hypersensitivity to metformin.
• Acute or chronic metabolic acidosis, including diabetic ketoacidosis.

Warnings & Precautions

• Vitamin B12 deficiency.
• Hypoglycemia when used with insulin or insulin secretagogues.

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Drug & Alcohol Interactions

• Use caution with carbonic anhydrase inhibitors, certain diuretics, and drugs that reduce kidney function or are cleared by the kidneys, as they can increase the risk of lactic acidosis.
• Temporarily stop metformin before procedures using iodinated contrast or major surgery, as directed by your provider.
• Excessive alcohol intake increases the risk of lactic acidosis and low blood sugar; limit alcohol while taking metformin.

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Use in Specific Populations

• Pregnancy/breastfeeding: tell your provider if you are pregnant, planning to become pregnant, or breastfeeding.
• Renal/hepatic impairment: not recommended in significant kidney or liver disease. Use with caution in older adults, in whom kidney function declines.

Common Side Effects

Diarrhea, nausea, vomiting, flatulence, asthenia, indigestion, abdominal discomfort, and headache.

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Storage & Missed Dose

Store at room temperature, away from moisture and heat. Take with food to reduce stomach upset. If you miss a dose, take it with food when you remember unless it is close to your next dose — do not double up. Do not stop or change your dose without talking to your provider.

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Read your Medication Guide

Read the Patient Information provided with your prescription before you start taking this medication and each time you get a refill.
You are encouraged to report negative side effects of prescription products to the FDA: visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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This information is not comprehensive. Please see the full Prescribing Information for complete safety information.

Indication

Contrave is used along with a reduced-calorie diet and increased physical activity for chronic weight management in adults with obesity, or with overweight plus at least one weight-related condition.

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Boxed Warning

Suicidal Thoughts and Behaviors. Contrave contains bupropion, an antidepressant. Antidepressants increased the risk of suicidal thinking and behavior in children, adolescents, and young adults in short-term studies. Monitor for worsening mood, behavior changes, or thoughts of suicide.

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Contraindications

• Uncontrolled hypertension.
• Seizure disorder.
• Use of other bupropion-containing products.
• Eating disorders (bulimia or anorexia nervosa).
• Chronic opioid use, or acute opioid withdrawal.
• Pregnancy.
• Abrupt discontinuation of alcohol, benzodiazepines, barbiturates, or antiepileptic drugs.
• Use of MAO inhibitors within 14 days.

Warnings & Precautions

• Neuropsychiatric symptoms and suicide risk.
• Seizures.
• Increases in blood pressure and heart rate.
• Hepatotoxicity; angle-closure glaucoma.

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Drug & Alcohol Interactions

• Do not take with MAO inhibitors, other bupropion products, or opioids. Use caution with drugs that lower the seizure threshold and with CYP2D6 substrates.
• Minimize alcohol use; sudden reduction of heavy alcohol use can increase seizure risk, and alcohol can add to side effects.

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Use in Specific Populations

• Pregnancy: contraindicated — weight loss offers no benefit during pregnancy and may harm the unborn baby.
• Breastfeeding: not recommended.
• Use with caution in older adults and in patients with renal or hepatic impairment; dose adjustment may be required.

Common Side Effects

Nausea, constipation, headache, vomiting, dizziness, insomnia, and dry mouth.

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Storage & Missed Dose

Store at room temperature. Swallow tablets whole — do not cut, chew, or crush. Avoid high-fat meals. If you miss a dose, skip it and resume your normal schedule — do not take two doses at once.

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Read your Medication Guide

Read the Medication Guide and Patient Information provided with your prescription before you start taking this medication and each time you get a refill.
You are encouraged to report negative side effects of prescription products to the FDA: visit www.fda.gov/medwatch or call 1-800-FDA-1088.

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This information is not comprehensive. Please see the full Prescribing Information for complete safety information.

Contrave® is a registered trademark of Currax Pharmaceuticals LLC.

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