SEMAGLUTIDE

Semaglutide is a human-based glucagon-like peptide-1 receptor agonist prescribed as an adjunct to a reduced calorie diet and increased physical activity for chronic weight management in adults with an initial body mass index (BMI) considered outside a healthy range.

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Do not take this medication if:

♣ You have a personal or family history of medullary thyroid carcinoma (Thyroid Cancer)

♣ Multiple Endocrine Neoplasia syndrome type 2

♣ You are pregnant or plan to become pregnant while taking this medicine.

♣ You are diabetic and/or taking any medications related to lowering your blood sugar levels without speaking with your endocrinologist.

♣ Specifically, if you are prescribed Insulin because the combination may increase your risk of hypoglycemia (low blood sugar) and dosage adjustments by your provider may be necessary.

♣ You have a history of Pancreas.

♣ You are allergic to BPC-157, Semaglude or any other GLP-1 agonist such as: Adlyxin®, Byeta®,

Bydureon®, Ozempic®, Rybelsus®, Trulicity®, Victoza®, Wegovy®;

♣ If you have other allergies. This product may contain inactive ingredients, which can cause allergic eacons or other problems. Talk to your pharmacist for more details. Before using this medicaon, tell your doctor/pharmacist your medical history.

Possible drug interactions: Antidiabetic agents, specifically Insulin and Sulfonylureas (e.g., glyburide, glipizide, glimepiride, tolbutamide) due to the increased risk of hypoglycemia (low blood sugar). Do not take with other GLP-1 agonist medicines such as: Adlyxin®, Byeta®, Bydureon®, Ozempic®, Rybelsus®, Trulicity®, Victoza®, Wegovy® (THIS IS NOT AN ALL-INCLUSIVE LIST). For other medications used in diabetes, please tell your provider about any medications that may lower your blood sugar.

Possible side eﬀects: Nausea, diarrhea, vomiting, constant abdominal pain, headache, fatigue, dyspepsia, dizziness, abdominal distension, belching, hypoglycemia, flatulence, gastroenteritis, and gastroesophageal reflux disease. Subcutaneous Injections: common injection site reactions characterized by itching and burning at the administration site with or without skin thickening (well). Contact your doctor or pharmacist if you see other side eﬀects not listed above.

A very serious allergic reaction to this drug is rare. However, get medical help immediately if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, or trouble breathing. Report adverse side eﬀects to your doctor or pharmacist. In the event of any emergency, call 911 immediately.

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IF YOU HAVE ANY QUESTIONS AS TO THE RISKS OR HAZARDS OF THIS TREATMENT OR ANY QUESTIONS CONCERNING THIS PROPOSED TREATMENT OR OTHER POSSIBLE TREATMENTS, ASK THE STAFF NOW BEFORE SIGNING THIS CONSENT FORM.By signing, I certify that I have read and understand the contents of this form. I acknowledge having a proper laboratory /CBC done before starng treatment. I am aware of the possible side eﬀects anda proper laboratory /CBC done before starng treatment.I am aware of the possible side eﬀects anddrug interacons and give my consent for treatment. I have informed the medical staﬀ of any knownallergies to drugs or other substances, and any past adverse reacons I’ve experienced.I have informedthe medical staﬀ of all medicaons and supplements I’m currently taking.I understand there are otherways and programs that can assist me in my desire to decrease my body weight and acknowledge thatno guarantees have been made to me concerning my results.

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