Artisan Drug Pharmacy (Plano)

Renown Weight Loss Location Patient Attends*

These products may be compounded pursuant to an identified individuals need / shortage

Products*

Semaglutide with B6 0.25mg/5mg/0.5ml, 1ML vial (Price includes shipping)

SIG: DIRECTIONS: INJECT .25ML SUBCUTANEOUSLY WEEKLY ALTERNATE SITE OF INJECTION (COST = $70 + $15 SHIPPING)

$85.00 Quantity

Semaglutide with B6 0.5mg/5mg/0.5ml, 2ML vial (Price includes shipping)

SIG: DIRECTIONS: INJECT .5ML SUBCUTANEOUSLY WEEKLY ALTERNATE SITE OF INJECTION (COST = $90 + $15 SHIPPING)

$105.00 Quantity

Semaglutide with B6 1 mg/ 5mg/ 0.5ml, 2ML vial (Price includes shipping)

SIG: DIRECTIONS: INJECT 1ML SUBCUTANEOUSLY WEEKLY ALTERNATE SITE OF INJECTION (COST = $110 + $15 SHIPPING)

$125.00 Quantity

ORAL SEMAGLUTIDE TABLETS 4ML AND VITAMIN B6 10MG / ML , 2ML IN VIAL 3 (Price includes shipping)

SIG: DIRECTIONS: TAKE 1 TABLET ORALLY 3 X WEEKLY (COST = $70 + $15 SHIPPING)

$85.00 Quantity

Tirzepatide 2.5mg with L- Carnitine 0.5mg/0.5ml , 2 ML vial (Price includes shipping)

SIG:DIRECTIONS: DIRECTIONS; INJECT AS DIRECTED

$165.00 Quantity

Tirzepatide 5mg with L- Carnitine 0.5mg/0.5ml , 2 ML vial (Price includes shipping)

SIG:DIRECTIONS: DIRECTIONS; INJECT AS DIRECTED

$205.00 Quantity

Tirzepatide 7.5mg with L- Carnitine 0.5mg/0.5ml , 2 ML vial (Price includes shipping)

SIG:DIRECTIONS: DIRECTIONS; INJECT AS DIRECTED

$245.00 Quantity

KISSPEPTIN 200 MCG/ ML , 4 ML IN VIAL (Price includes shipping))

SIG:DIRECTIONS: DIRECTIONS; INJECT AS DIRECTED

$80.00 Quantity

Total

$0.00

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Patient Email (For prescription status notifications only)*

Patient's Delivery Address *

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Consultant's Email for Status of Delivery Notification

Medically Necessary Statement*

Semaglutide, Inject 0.25 ml (25 units) Subcutaneously Once a Week (Same Day Each Week) Discard Vial After 4th InjectionTirzepatide, Inject 0.5ml (50 units) Subcutaneously Once a Week (Same Day Each Weeks) Discard Vial After 4th InjectionFollow Custom Dosing Below

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Known Allergies: Type NKDA if "No Known Drug Allergies"*

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Artisan Drug Compounding Pharmacy