Read before starting
Important safety information.
This page covers semaglutide and tirzepatide, the two medications prescribed through New Tides. It is a plain-language summary, not a substitute for the conversation you will have with your physician — who reviews your full history before anything is prescribed and stays available throughout treatment.
Boxed warning — both medications
Possible thyroid tumors, including thyroid cancer
In rodent studies, these medications caused thyroid C-cell tumors. It is not known whether they cause them in humans. Do not use semaglutide or tirzepatide if you or a family member has had medullary thyroid carcinoma (MTC), or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your physician right away about any lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.
What these medications are
Semaglutide is a GLP-1 receptor agonist. Tirzepatide acts on two receptors — GIP and GLP-1. Both are once-weekly injections used for chronic weight management alongside a reduced-calorie diet and increased activity, in adults with a BMI of 30 or higher, or 27 or higher with at least one weight-related condition such as high blood pressure, type 2 diabetes, or high cholesterol.
New Tides prescribes compounded semaglutide and tirzepatide, prepared for you individually by a licensed US pharmacy. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality.
Who should not use them
- Anyone with a personal or family history of medullary thyroid carcinoma (MTC), or with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
- Anyone who has had a serious allergic reaction to these medications.
- Anyone pregnant, planning to become pregnant, or breastfeeding. Semaglutide should be stopped at least two months before a planned pregnancy; discuss timing for tirzepatide with your physician.
Tell your physician before starting
Share your full history, especially: problems with your pancreas or kidneys; slowed stomach emptying (gastroparesis) or other severe digestive problems; diabetic retinopathy; a history of depression or suicidal thoughts; and every medication you take — particularly insulin or sulfonylureas, which raise the risk of low blood sugar when combined with these medications.
Serious side effects
Uncommon, but you and your physician should watch for them — especially when starting or changing dose:
- Pancreatitis — severe stomach-area pain that will not go away, with or without vomiting. Stop and contact your physician immediately.
- Gallbladder problems — upper-stomach pain, fever, yellowing skin or eyes, clay-colored stools.
- Low blood sugar — especially with type 2 diabetes or diabetes medications: dizziness, blurred vision, sweating, shakiness, fast heartbeat.
- Kidney problems — dehydration from nausea, vomiting, or diarrhea can worsen kidney function; keep drinking fluids.
- Severe allergic reactions — swelling of face, lips, tongue, or throat; trouble breathing; severe rash. Seek medical attention immediately.
- Stomach paralysis (gastroparesis) — feeling full shortly after starting a meal or long after it, with nausea and vomiting.
- Vision changes — in people with type 2 diabetes.
- Mood changes — new or worsening depression or thoughts of suicide. Contact your physician immediately.
Common side effects
Mostly gastrointestinal, and usually strongest in the first weeks or after a dose increase: nausea, diarrhea, vomiting, constipation, stomach pain, indigestion, bloating, belching, heartburn, fatigue, dizziness, headache, and injection-site reactions. Tirzepatide can also cause hair loss. Most ease as your body adjusts — and your physician can slow your dose schedule if they do not.
If something feels wrong
For a medical emergency, call 911 or go to the nearest emergency department. For anything else, message your physician through the portal — that is what it is for. You can also report side effects of prescription products to FDA MedWatch at 1-800-FDA-1088 or fda.gov/medwatch, and to the pharmacy that dispensed your medication.
This summary is not comprehensive. Your physician will review the risks and benefits with you before you start, and you can raise questions at any time during treatment. Do not change or stop your dosing schedule without talking to your physician first.
Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality.