No compounded medication is reviewed by FDA for safety or efficacy.
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Compounded Semaglutide information for prescribers
The expense and the relative scarcity of the injectable GLP-1 agonists have left many patients unable to begin or continue therapy uninterrupted. These patients could benefit greatly from the potential of these medications to reduce A1C and weight.
D&H Drugstore's compounding lab has a created a GLP-1 suspension for sublingual administration. This option is available for patients looking for an alternative to injectable GLP-1s.
Our compound requires a prescription in order to be dispensed.
What makes our compound different?
We only obtain Semaglutide from FDA registered sources to ensure the potency and purity of our compounded suspensions.
The vehicle to achieve absorption through the sublingual cavity is done using a base suspension, SubMagna HMW (TM). The base was researched and produced with the express purpose of carrying high molecular weight drugs, like Semaglutide, through the sublingual cavity.
Injections
Nasal Sprays
Other Sublingual
Compounds
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User Friendly
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The majority of patients prefer a sublingual route of administration over injections.
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Patient Safety
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Though there are pharmacies that can dependably compound sterile products, there are other sources on the internet without a previous reputation of quality and safety. One must choose carefully from many available sources.
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Was the Semaglutide used in the compounds sourced from an FDA-registered site? This can make a difference whether the powder is tested reliably for purity and potency.
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Efficacy
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Is the compounding entity using the salt form known as Semaglutide sodium? Although there is some evidence to suggest that the base form and the salt form have similar activity, the FDA is not recommending the use of the sodium form as a substitute
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There has been an increase in calls to poison control regarding Semaglutide injections. This is likely due to multi dose vials being dispensed to patients, resulting in larger than intended doses being injected.
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Efficacy
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The molecular weight of Semaglutide is very large at 4113 g/mol. It is very unlikely that a molecule of this size would readily penetrate the nasal mucosa to get into the blood stream
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Efficacy
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The molecular weight of Semaglutide will be a problem for absorption in the sublingual cavity without an appropriate vehicle to assist in penetration.
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Patient Safety
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Some products have been made using a powerful solvent, DMSO. This chemical is indiscriminate in what it will push through the mucosa, including substances unintended at the time of dosing. DMSO is not currently recommended for oral use.
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HOW TO PRESCRIBE
Note: This prescription is not billable to insurance.
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The suspension must be held under the tongue for a minimum 90 seconds. The longer the suspension is held under the tongue the better potential absorption
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An initial dose for GLP-1 naive patients is: Compounded Semaglutide 1mg-1ml in SubMagna™ HMW –Place 0.5ml under the tongue for minimum of 90 seconds before swallowing once daily for 1 week. Increase to 1ml once daily for 2 to 4 weeks and then contact prescriber for dosage escalation if needed. Do not eat or drink for 30 minutes after taking medication
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If higher doses are needed for clinical effect, may increase by 1ml every 2 to 4 weeks as tolerated
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Expect a range of dosages needed for clinical effect of 1mg to 2mg daily
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Daily doses greater than 1ml (1mg) may need to be split into 2 daily doses
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Note: Higher concentration suspensions may be available in the future
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Check back for updates on available formulas.
QUESTIONS? We're here to help!
If you have any questions about our pharmacy, our compounds, or the prescription writing process, feel free to give us a call or complete the contact form below. We look forward to talking with you!