Everything you need to feel confident with your treatment.

Schedule. Semaglutide is injected once a week, on the same day each week, at any time of day, with or without food. Pick a day you will remember, such as Sunday evening, and set a recurring reminder. You can change your injection day as long as your last dose was at least 2 days ago.

Technique. Follow the step-by-step guide above. Abdomen, thigh, and upper arm are all appropriate. Rotate sites every week.

Dose changes. Providers typically start at a low dose and increase it gradually over weeks or months to let your body adjust. Never increase on your own, and never draw up more than your label states because you feel a dose "isn't working." Report side effects instead; the plan can be adjusted.

Missed dose. If your next scheduled dose is more than 2 days (48 hours) away, take the missed dose as soon as you can. If it is less than 2 days away, skip it and resume on your regular day. If you have missed two or more doses in a row, contact your provider before restarting; restarting at a lower dose may be needed.

Storage. Keep refrigerated at 36 to 46°F (2 to 8°C) unless your pharmacy label says otherwise. Do not freeze. Protect from light. Discard after the beyond-use date on the label even if medication remains.

Read the semaglutide safety information before your first dose.

Schedule. Tirzepatide is injected once a week, on the same day each week, at any time of day, with or without food. You may change your injection day as long as at least 3 days (72 hours) have passed since your last dose.

Technique. Follow the step-by-step guide above. Rotate between abdomen, thigh, and upper arm every week.

Dose changes. Tirzepatide is usually started low and increased in steps no sooner than every 4 weeks, at your provider's direction. Do not increase on your own.

Missed dose. Take it as soon as possible within 4 days (96 hours) of the missed dose. If more than 4 days have passed, skip it and resume on your regular day. Never take two doses within 3 days of each other.

Birth control. If you take birth-control pills, use a non-oral method or add a barrier method for 4 weeks after starting and for 4 weeks after every dose increase, because tirzepatide can reduce how well the pill is absorbed.

Storage. Refrigerate at 36 to 46°F (2 to 8°C) unless the label says otherwise. Do not freeze. Protect from light.

Read the tirzepatide safety information before your first dose.

Your provider selects the specific GLP-1 medicine after reviewing your intake, and your pharmacy label will name it. Once you know which medicine you received, follow the semaglutide or tirzepatide guide above for schedule, missed-dose, and storage rules, because they differ between the two. The injection technique itself is identical: once weekly, subcutaneous, rotating sites.

If your label does not clearly name the medication, do not inject; email support@vivrx.com with a photo of the label and we will confirm.

Schedule. MIC + B12 is most often prescribed once or twice a week; your label states your frequency. Many patients prefer a morning injection because B12 can feel energizing.

Technique. Follow the step-by-step guide. Your provider may specify subcutaneous or intramuscular; unless the label says intramuscular, inject subcutaneously as shown above. The solution is often pink or red from the B12 — that is normal.

What to expect. A brief stinging or warm feeling at the site is common, and some people notice a faint fishy body odor for a few hours from the choline. Injection-site soreness usually resolves within a day.

Missed dose. Take it when you remember unless your next dose is due within a day or two; in that case skip it. Do not double up.

Storage. Follow your label. Many MIC + B12 preparations are refrigerated and protected from light, because B12 degrades with light exposure.

Read the MIC + B12 safety information.

Schedule. Frequency varies widely by protocol; follow your label exactly. Some plans begin with smaller, more frequent doses and build up.

Go slowly. This is the single most important point for NAD+. Injecting quickly can cause flushing, nausea, cramping, chest tightness, or lightheadedness. Press the plunger over the time your provider specified, often 30 to 60 seconds or longer for larger volumes. Sit or lie down for your first several doses, and have water nearby.

If symptoms start mid-injection, pause with the needle in place, breathe, and wait for the feeling to pass before continuing more slowly. If chest tightness or faintness does not pass within a few minutes, withdraw the needle and seek care.

Technique. Subcutaneous, abdomen or thigh. Rotate sites. Some patients find splitting a larger volume across two sites more comfortable; ask your provider before doing so.

Storage. NAD+ is sensitive to heat and light. Keep refrigerated and protected from light unless your label directs otherwise. Discard if the solution darkens or turns cloudy.

Read the NAD+ safety information.

Timing matters. Sermorelin is normally injected at bedtime, on an empty stomach, at least 90 minutes to 2 hours after your last meal. The body's own growth-hormone release peaks in early deep sleep, and food, especially carbohydrates and fat, blunts the response. Follow the frequency on your label; many plans are nightly, sometimes with rest days.

Technique. Subcutaneous, using the step-by-step guide above. Abdomen and thigh are typical sites. Rotate nightly.

What to expect. Mild redness or a small itchy bump at the site is common and fades within hours. Some people feel flushed or notice vivid dreams early on. Report joint pain, hand or foot swelling, or tingling fingers to your provider.

Missed dose. Skip it and take your next dose at the usual time. Do not double up.

Storage. Refrigerate and protect from light unless your label says otherwise. Do not freeze.

Read the sermorelin safety information.

Schedule. Follow the frequency on your label; one to three times a week is a common range.

Technique. Subcutaneous, using the step-by-step guide. Inject slowly. Rotate between abdomen and thigh. Glutathione can occasionally sting more than other injections; a room-temperature vial and a fully dry site help.

What to expect. Mild cramping, bloating, or loose stools within a day of a dose happen in some people and usually pass. Tell your provider about any wheezing or shortness of breath immediately, particularly if you have asthma.

Missed dose. Take it when you remember unless your next dose is close; then skip. Do not double up.

Storage. Glutathione oxidizes with heat, light, and air. Refrigerate, protect from light, and discard if it discolors or clouds.

Read the glutathione safety information.

A drop of blood means you nicked a tiny surface vessel; press for 30 seconds with gauze. Bruises are cosmetic and fade in a week. To reduce them: let alcohol dry fully, insert quickly, do not rub afterwards, and avoid injecting near visible veins. Persistent large bruises, or bruising with easy bleeding elsewhere, should be mentioned to your provider.

A tiny bead at the surface is normal and does not need making up. If a noticeable amount leaked, do not re-inject — you cannot know how much went in, and a double dose is riskier than a slightly low one. Note it, continue your usual schedule, and email us if it keeps happening. Holding the needle in for 5 seconds and releasing the pinch before pressing the plunger both reduce leaks.

In a subcutaneous injection a small bubble is harmless; it simply means your dose is a fraction low. Do not stress about it. If the bubble is large, push the medication back into the vial, redraw, and tap again with the syringe vertical, needle up.

A firm pea-sized lump or a warm, itchy red patch that appears within a day and fades within a few days is a common local reaction. A cool compress helps. Rotate away from that area until it resolves. Contact your provider if redness spreads, the area becomes hot and increasingly painful, you see pus, or you develop a fever — those can be signs of infection.

Common causes: injecting cold medication (let the vial warm 10 to 15 minutes), injecting through wet alcohol, inserting slowly, tensing the muscle beneath the site, or injecting into a scarred or overused area. Numbing the spot with an ice cube for 30 seconds before cleaning it also helps. Pain that is sharp, radiating, or lingers for hours should be reported.

Discard that syringe in your sharps container and start over with a new one. A bent needle can break, and a touched needle is no longer sterile. Never try to straighten or clean a needle.

If the glass is intact and the stopper is still sealed, wipe it and inspect the liquid for particles before using. If it cracked or leaked, wrap it in paper towel, place it in your sharps container or a sealed bag, and email us for a replacement. Do not draw up from a cracked vial.

You are not alone; this is one of the most common things new patients tell us. What helps: watch the whole step list once so nothing is a surprise, exhale as you insert, use the abdomen where the skin is least sensitive, use an ice cube to numb the site, and reward yourself afterwards. Most patients say the second injection is dramatically easier than the first. If you are still struggling after a few weeks, tell your provider — there may be options.

Go to patient.vivrx.com and enter the email address you used when you enrolled. Follow the prompts to verify your identity. If you cannot sign in or no longer have access to that email, contact support@vivrx.com from your new address and we will verify you and update your account.

Every VIV RX plan is a monthly subscription at the price shown when you enrolled. It renews automatically each month until you cancel, and each renewal includes your medication, provider oversight, and shipping. There are no separate consultation or membership fees. Your first order of a GLP-1 weight-loss plan is eligible for the $50 introductory discount with code VIV50; renewals and all other treatments bill at the standard price.

Your first order ships after a licensed provider reviews your intake and approves a prescription; nothing is charged for medication before that. Refrigerated medications ship in insulated packaging with cold packs, and a tracking link is emailed when the parcel leaves the pharmacy. If a delivery is late, damaged, or arrived warm, email us the same day so we can arrange a replacement.

Sign in to patient.vivrx.com to update your address and payment details before your next renewal date. If the option is not visible for your plan, email support@vivrx.com and we will update it for you. Because medication is prescribed to you personally, we cannot ship to a different person or to a state where the service is not available.

Email support@vivrx.com from the address on your account and tell us whether you want to pause or cancel. There is no cancellation fee. To avoid being billed for the next month, send your request before your renewal date; orders that have already shipped cannot be recalled. See the Refund Policy for how refunds are handled.

Dose changes and treatment switches are medical decisions made by your provider. Email your care team describing what you are experiencing (side effects, plateau, schedule problems) and your provider will review and respond, usually within one business day. Never adjust your own dose from the vial.

Refills are sent automatically with each renewal after your provider's ongoing review. If you are running short because a dose was changed, a vial was damaged, or a shipment was lost, email us and we will coordinate with the pharmacy. Include a photo of the label where relevant.

Your medical information is handled under our Notice of Privacy Practices and Privacy Policy. To request a copy of your records or ask a privacy question, email support@vivrx.com. California residents have additional rights described on our California Residents page.

VIV RX is available to adults 18 and older located in the United States. Availability varies by state and by treatment. Your intake confirms eligibility for your state before any charge for medication.

How they work. GLP-1 is a hormone your gut releases after eating. Medicines like semaglutide mimic it: they slow how quickly food leaves the stomach so you feel full longer, act on appetite centers in the brain so you feel less hungry and less preoccupied with food, and help the pancreas release insulin in response to meals. Tirzepatide additionally activates GIP, a second gut hormone. The result for most people is eating less without feeling deprived.

The first weeks. Providers start low and increase gradually. Early on, the most noticeable effects are usually reduced appetite and mild nausea, especially after a dose increase. Weight change in the first month is often modest; the medication's effect builds over months, and the dose you settle on is more important than how fast you get there.

Managing nausea. Eat smaller meals, stop when you feel satisfied rather than full, avoid greasy or very sweet foods, keep bland snacks handy, and stay upright after eating. Ginger and peppermint help many people. Nausea typically fades within days of each dose step; if it does not, or if you are vomiting, tell your provider.

Constipation and reflux. Slower digestion makes both common. Drink water steadily through the day, aim for fiber from vegetables and whole grains, walk after meals, and ask your provider about a gentle over-the-counter option if needed. For reflux, avoid large late meals and lying down soon after eating.

Protein and muscle. When appetite drops, protein is the nutrient most easily neglected. Prioritize it at every meal and add resistance exercise two or three times a week. Losing weight without maintaining muscle leaves you weaker and can slow your metabolism.

Hydration and alcohol. Dehydration from reduced intake, vomiting, or diarrhea is the most common route to kidney problems on these medicines, so keep fluids up even when you are not thirsty. Alcohol hits harder on a slowed stomach, worsens nausea, and increases the risk of low blood sugar; keep it minimal.

When to contact your provider. Nausea or vomiting that stops you keeping fluids down, any severe stomach pain, signs of low blood sugar, changes in vision or mood, or anything that worries you. Call 911 for symptoms of a severe allergic reaction, severe persistent abdominal pain, or chest pain.

Procedures and other doctors. Tell every clinician you take a GLP-1, especially before any surgery or sedation, because a slowed stomach changes anesthesia planning. Other prescriptions, such as blood-pressure and diabetes medicines, may need adjusting as you lose weight.

Semaglutide is a once-weekly GLP-1 receptor agonist. It is the same active molecule as the FDA-approved products Wegovy® and Ozempic®; the compounded version is prepared by a licensed pharmacy for your prescription and is not FDA-approved or reviewed. Your provider will discuss whether an FDA-approved option is appropriate for you.

What to expect. Appetite reduction is usually noticeable within the first one to two weeks. Stomach-related side effects cluster around dose increases and usually fade. Most people's dose is increased in steps over several months to reach the level that works for them.

Who it may not suit. People with a personal or family history of medullary thyroid cancer or MEN 2, a history of pancreatitis, severe stomach or bowel disease, or who are pregnant, planning pregnancy, or breastfeeding. Semaglutide should be stopped at least 2 months before trying to conceive. Full details are in the safety information.

Injecting. See how to inject semaglutide.

Tirzepatide is a once-weekly dual GIP and GLP-1 receptor agonist. It is the same active molecule as the FDA-approved products Zepbound® and Mounjaro®; the compounded version is not FDA-approved or reviewed. Your provider will discuss whether an FDA-approved option is appropriate for you.

What to expect. Appetite and food-related thoughts usually decrease within the first weeks. Nausea, diarrhea, and constipation are the most common side effects and are most likely after a dose step. Some people notice hair shedding during rapid weight loss, which typically resolves.

Birth control. Tirzepatide can reduce how well birth-control pills are absorbed. Use a non-oral method, or add a barrier method, for 4 weeks after starting and after each dose increase.

Who it may not suit. The same thyroid, pancreatitis, gastrointestinal, and pregnancy cautions as other GLP-1 medicines apply. Full details are in the safety information.

Injecting. See how to inject tirzepatide.

Both are weekly injections that reduce appetite through gut-hormone pathways. Semaglutide acts on the GLP-1 receptor alone; tirzepatide acts on both GLP-1 and GIP receptors. In the manufacturers' clinical trials of the FDA-approved products, both produced meaningful weight loss, with tirzepatide producing more on average, and the side-effect profiles are broadly similar. Your provider weighs your history, other medications, prior experience with either medicine, tolerance, and cost. Individual results vary, and the right medicine is the one you can take consistently and tolerate well. If you are prescribed Compounded GLP-1, your provider has made that selection for you and your label names it.

MIC + B12 combines three "lipotropic" compounds, methionine, inositol, and choline, with vitamin B12. Lipotropics are involved in how the body processes fat in the liver; B12 supports energy metabolism and red-blood-cell formation. The combination is compounded and is not FDA-approved for weight loss or any other use, and published evidence that it changes weight on its own is limited. It is best thought of as a supportive addition to nutrition, activity, and, where prescribed, a GLP-1 plan.

What to expect. Some patients report more energy within a few days, particularly if their B12 was low. Injection-site soreness and a brief fishy body odor from choline are the most common complaints.

Who should be cautious. Anyone allergic to cobalt or B12, people with Leber's disease, and those with kidney, liver, or heart disease. See the safety information and how to inject MIC + B12.

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every cell, central to converting food into energy and to DNA repair. Levels decline with age. Injected NAD+ is a compounded product, is not FDA-approved, and the human evidence for benefits such as energy, focus, or longevity is limited and mixed; your provider will be candid about what is and is not established.

What to expect. Experiences vary widely. Some patients describe steadier energy or clearer focus over several weeks; others notice little. The most consistent short-term effects are the injection-related ones: flushing, nausea, or a tight chest if it is injected quickly, which is why the technique guide emphasizes going slowly.

Who should be cautious. Pregnant or breastfeeding people, anyone with active cancer or serious heart, liver, or kidney disease, and anyone already taking NAD-precursor supplements such as NMN, nicotinamide riboside, or high-dose niacin. See the safety information and how to inject NAD+.

Sermorelin is a synthetic fragment of growth-hormone-releasing hormone. Rather than supplying growth hormone directly, it prompts your own pituitary gland to release it in its natural nightly pulse, which is why it is taken at bedtime. The FDA-approved product was discontinued in 2008 for commercial reasons; today's sermorelin is compounded, is not FDA-approved, and is not approved for recovery, sleep, body composition, or anti-aging. Evidence in healthy adults is limited.

What to expect. Any effects build slowly over weeks to months, not days. Patients most often mention sleep quality and recovery first. Early side effects are usually limited to the injection site, flushing, or headache.

Who should be cautious. Anyone with a history of cancer, untreated thyroid disease, diabetes, or sleep apnea, and anyone taking corticosteroids. Report joint pain, hand or foot swelling, or tingling fingers, which can signal too much growth-hormone activity. See the safety information and how to inject sermorelin.

Glutathione is the body's principal intracellular antioxidant, made from three amino acids, and is involved in neutralizing reactive molecules and in liver detoxification pathways. Injected glutathione is compounded and is not FDA-approved for any use; evidence for benefits in healthy adults is limited. VIV RX positions it as antioxidant support only and does not make claims about skin, complexion, or disease.

What to expect. Most people feel nothing acute. Mild cramping or loose stools after a dose occur in some. Because glutathione oxidizes readily, storage and prompt use matter more than with most treatments.

Who should be cautious. People with asthma, anyone receiving cancer treatment, and pregnant or breastfeeding people. The FDA has cautioned about injectable glutathione compounded from non-sterile powder, so ask how yours is prepared. See the safety information and how to inject glutathione.

Build each meal around protein (eggs, fish, poultry, Greek yogurt, tofu, legumes), then vegetables, then whole grains or fruit. Eat slowly and stop at satisfied; a slowed stomach punishes overeating with nausea. Drink water through the day, more if you are exercising or the weather is hot. Keep fiber up to counter constipation. Limit alcohol, fried food, and very sweet food, the three most reliable nausea triggers. Move daily and lift something twice a week to protect muscle. Rapid weight loss with very low intake is not a goal; if you are struggling to eat enough, tell your provider.

Your provider reviews your progress and side effects at renewal and whenever you message. Depending on your history and treatment, they may ask for blood-pressure readings, weight logs, or lab work from a local laboratory before continuing or increasing a dose. Keeping a simple weekly log of weight, injection date and site, and any side effects makes these check-ins faster and your care better.

Call 911 or go to the nearest emergency room for swelling of the face, lips, tongue, or throat; trouble breathing or swallowing; severe persistent stomach or back pain, with or without vomiting; chest pain; fainting; or thoughts of harming yourself. Contact your provider the same day for vomiting or diarrhea that prevents you keeping fluids down, a lump in the neck or hoarseness, yellowing of the skin or eyes, changes in vision, signs of low blood sugar, or a fever with an injection site that is hot, spreading, or leaking. VIV RX is not an emergency service.

Add your VIV RX medications to the list you give every doctor, dentist, pharmacist, and anesthesia team. GLP-1 medicines in particular change how oral medicines are absorbed and require specific planning before procedures with sedation. If you become pregnant or plan to, tell your VIV RX provider immediately.