Important safety information

Safety information for every VIV RX treatment

Last reviewed 2026-09-18. Based on the FDA-approved labeling of the reference products where one exists, and on published cautions for compounded wellness injectables. Not a complete list of risks.

Compounded medications are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are dispensed, and a compounded preparation is not evaluated as equivalent to any FDA-approved product. Every VIV RX treatment is prescription-only and is prescribed by an independent, US-licensed provider after an online evaluation. Not everyone is a candidate.

In an emergency, call 911. To report a side effect, email support@vivrx.com and contact FDA MedWatch at 1-800-FDA-1088 or www.fda.gov/medwatch.

Weight loss

Compounded Semaglutide

GLP-1 receptor agonist

Compounded semaglutide is a compounded medication prepared by a state-licensed pharmacy for an individual prescription. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are dispensed. FDA-approved medicines containing semaglutide (Wegovy®, Ozempic®) are available; ask your provider about them. The safety information below is based on the FDA-approved labeling for those products.

Warning: risk of thyroid C-cell tumors. In rodent studies, medicines in this class caused thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). It is not known whether they cause thyroid C-cell tumors in humans. Do not use if you or any family member has ever had MTC, or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your provider right away if you notice a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath.

Do not use if

You or a family member has had medullary thyroid carcinoma (MTC), or you have MEN 2.
You have had a serious allergic reaction to semaglutide or any ingredient in the preparation.
You are pregnant, planning to become pregnant, or breastfeeding. Semaglutide may harm an unborn baby; stop it at least 2 months before trying to conceive.
You have type 1 diabetes or a history of diabetic ketoacidosis — semaglutide is not a substitute for insulin.
You have a history of pancreatitis, severe stomach or bowel disease (including gastroparesis), or diabetic retinopathy — tell your provider so the risk can be weighed.

Serious risks — get medical help

Pancreatitis — stop use and get medical help right away for severe pain in your stomach area that will not go away, with or without vomiting; the pain may spread to your back.
Gallbladder problems (gallstones, inflammation) — pain in the upper stomach, fever, yellowing of the skin or eyes, or clay-colored stools.
Low blood sugar (hypoglycemia), especially if you also take insulin or a sulfonylurea — dizziness, shakiness, sweating, confusion, fast heartbeat, or blurred vision.
Kidney injury — vomiting, diarrhea, or nausea can cause dehydration that worsens kidney function, including in people without prior kidney disease. Drink fluids.
Serious allergic reactions (anaphylaxis, angioedema) — swelling of the face, lips, tongue, or throat, trouble breathing or swallowing, severe rash, fainting, or very fast heartbeat. Stop use and call 911.
Diabetic retinopathy complications — tell your provider about any change in vision, particularly if you have type 2 diabetes.
Increased heart rate — report a racing or pounding heartbeat at rest.
Depression or suicidal thoughts — pay attention to changes in mood or behavior and tell your provider promptly.
Severe stomach or bowel problems, including slowed stomach emptying and, rarely, intestinal blockage (ileus). Not recommended if you have severe gastroparesis.
Food or liquid getting into the lungs during surgery or a procedure — tell every clinician, especially your anesthesia team, that you take this medication before any procedure that uses anesthesia or deep sedation.

Common side effects

Nausea, diarrhea, vomiting, constipation, stomach pain, headache, tiredness, indigestion, dizziness, bloating, belching, gas, heartburn, and injection-site reactions. Stomach-related effects are most common when starting and after a dose increase, and usually ease over a few weeks.

Drug interactions

Insulin and sulfonylureas (glipizide, glimepiride, glyburide) raise the risk of low blood sugar; doses may need adjusting.
These medicines slow stomach emptying, which can change how oral medicines are absorbed. Medicines with a narrow margin (for example warfarin, levothyroxine, some seizure medicines) should be monitored more closely.
Alcohol can worsen nausea and increase the chance of low blood sugar.
Do not combine with other GLP-1 medicines or other prescription weight-loss drugs unless your provider directs it.

Missed dose

Based on FDA-approved semaglutide labeling: if you miss a dose and your next scheduled dose is more than 2 days (48 hours) away, take the missed dose as soon as possible. If the next dose is less than 2 days away, skip the missed dose and take your next dose on the usual day. If you miss two or more doses in a row, contact your provider before restarting — your dose may need to be lowered.

Also important

Never share your vial, syringes, or needles with anyone, even if the needle is changed — you may give or get a serious infection.
Tell your provider about every medical condition and every medicine, vitamin, and supplement you take.
Losing weight can change how much of other medicines you need (for example blood pressure or diabetes medicines). Keep every prescriber informed.

Report side effects to your VIV RX care team at support@vivrx.com and to the FDA MedWatch program at 1-800-FDA-1088 or www.fda.gov/medwatch. If you think you are having a medical emergency, call 911 or go to the nearest emergency room.

How to inject Compounded Semaglutide → View treatment →

Weight loss

Compounded Tirzepatide

Dual GIP / GLP-1 receptor agonist

Compounded tirzepatide is a compounded medication prepared by a state-licensed pharmacy for an individual prescription. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are dispensed. FDA-approved medicines containing tirzepatide (Zepbound®, Mounjaro®) are available; ask your provider about them. The safety information below is based on the FDA-approved labeling for those products.

Do not use if

You or a family member has had medullary thyroid carcinoma (MTC), or you have MEN 2.
You have had a serious allergic reaction to tirzepatide or any ingredient in the preparation.
You are pregnant or breastfeeding, or you are planning a pregnancy — tirzepatide should not be used during pregnancy. Tell your provider before trying to conceive.
You have type 1 diabetes or a history of diabetic ketoacidosis.
You have a history of pancreatitis, severe stomach or bowel disease (including gastroparesis), or diabetic retinopathy — tell your provider so the risk can be weighed.

Serious risks — get medical help

Pancreatitis — stop use and get medical help right away for severe pain in your stomach area that will not go away, with or without vomiting; the pain may spread to your back.
Gallbladder problems (gallstones, inflammation) — pain in the upper stomach, fever, yellowing of the skin or eyes, or clay-colored stools.
Low blood sugar (hypoglycemia), especially if you also take insulin or a sulfonylurea — dizziness, shakiness, sweating, confusion, fast heartbeat, or blurred vision.
Kidney injury — vomiting, diarrhea, or nausea can cause dehydration that worsens kidney function, including in people without prior kidney disease. Drink fluids.
Serious allergic reactions (anaphylaxis, angioedema) — swelling of the face, lips, tongue, or throat, trouble breathing or swallowing, severe rash, fainting, or very fast heartbeat. Stop use and call 911.
Diabetic retinopathy complications — tell your provider about any change in vision, particularly if you have type 2 diabetes.
Increased heart rate — report a racing or pounding heartbeat at rest.
Depression or suicidal thoughts — pay attention to changes in mood or behavior and tell your provider promptly.
Severe stomach or bowel problems, including slowed stomach emptying and, rarely, intestinal blockage (ileus). Not recommended if you have severe gastroparesis.
Food or liquid getting into the lungs during surgery or a procedure — tell every clinician, especially your anesthesia team, that you take this medication before any procedure that uses anesthesia or deep sedation.

Common side effects

Drug interactions

Insulin and sulfonylureas (glipizide, glimepiride, glyburide) raise the risk of low blood sugar; doses may need adjusting.
These medicines slow stomach emptying, which can change how oral medicines are absorbed. Medicines with a narrow margin (for example warfarin, levothyroxine, some seizure medicines) should be monitored more closely.
Alcohol can worsen nausea and increase the chance of low blood sugar.
Do not combine with other GLP-1 medicines or other prescription weight-loss drugs unless your provider directs it.
Birth-control pills may work less well for a period after you start tirzepatide and after each dose increase. Use a non-oral method or add a barrier method (such as condoms) for 4 weeks after starting and for 4 weeks after every dose increase.

Missed dose

Based on FDA-approved tirzepatide labeling: if you miss a 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 take your next dose on the usual day. Do not take two doses within 3 days of each other.

Also important

Never share your vial, syringes, or needles with anyone, even if the needle is changed.
Tell your provider about every medical condition and every medicine, vitamin, and supplement you take.
Losing weight can change how much of other medicines you need. Keep every prescriber informed.

How to inject Compounded Tirzepatide → View treatment →

Weight loss

Compounded GLP-1

GLP-1 receptor agonist (selected by your provider)

Compounded GLP-1 medication is a compounded medication prepared by a state-licensed pharmacy for an individual prescription. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are dispensed. Your provider selects the specific GLP-1 medicine (such as semaglutide or tirzepatide) after reviewing your intake, and your prescription label will name it. Read that product's safety information above as well. FDA-approved GLP-1 medicines are available; ask your provider about them.

Do not use if

You or a family member has had medullary thyroid carcinoma (MTC), or you have MEN 2.
You have had a serious allergic reaction to a GLP-1 medicine or any ingredient in the preparation.
You are pregnant, planning to become pregnant, or breastfeeding.
You have type 1 diabetes or a history of diabetic ketoacidosis.
You have a history of pancreatitis, severe stomach or bowel disease (including gastroparesis), or diabetic retinopathy — tell your provider so the risk can be weighed.

Serious risks — get medical help

Pancreatitis — stop use and get medical help right away for severe pain in your stomach area that will not go away, with or without vomiting; the pain may spread to your back.
Gallbladder problems (gallstones, inflammation) — pain in the upper stomach, fever, yellowing of the skin or eyes, or clay-colored stools.
Low blood sugar (hypoglycemia), especially if you also take insulin or a sulfonylurea — dizziness, shakiness, sweating, confusion, fast heartbeat, or blurred vision.
Kidney injury — vomiting, diarrhea, or nausea can cause dehydration that worsens kidney function, including in people without prior kidney disease. Drink fluids.
Serious allergic reactions (anaphylaxis, angioedema) — swelling of the face, lips, tongue, or throat, trouble breathing or swallowing, severe rash, fainting, or very fast heartbeat. Stop use and call 911.
Diabetic retinopathy complications — tell your provider about any change in vision, particularly if you have type 2 diabetes.
Increased heart rate — report a racing or pounding heartbeat at rest.
Depression or suicidal thoughts — pay attention to changes in mood or behavior and tell your provider promptly.
Severe stomach or bowel problems, including slowed stomach emptying and, rarely, intestinal blockage (ileus). Not recommended if you have severe gastroparesis.
Food or liquid getting into the lungs during surgery or a procedure — tell every clinician, especially your anesthesia team, that you take this medication before any procedure that uses anesthesia or deep sedation.

Common side effects

Drug interactions

Insulin and sulfonylureas (glipizide, glimepiride, glyburide) raise the risk of low blood sugar; doses may need adjusting.
These medicines slow stomach emptying, which can change how oral medicines are absorbed. Medicines with a narrow margin (for example warfarin, levothyroxine, some seizure medicines) should be monitored more closely.
Alcohol can worsen nausea and increase the chance of low blood sugar.
Do not combine with other GLP-1 medicines or other prescription weight-loss drugs unless your provider directs it.

Missed dose

Missed-dose guidance differs between GLP-1 medicines. Follow the instructions your provider gives for the specific medicine on your label, and see the semaglutide or tirzepatide entry above.

Also important

Never share your vial, syringes, or needles with anyone.
Tell your provider about every medical condition and every medicine, vitamin, and supplement you take.

How to inject Compounded GLP-1 → View treatment →

Weight loss · Wellness

MIC + B12 Injection

Lipotropic blend (methionine, inositol, choline) with vitamin B12

MIC + B12 is a compounded medication prepared by a state-licensed pharmacy for an individual prescription. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are dispensed. There is no FDA-approved medicine containing this combination, and the FDA has not approved it for weight loss or any other use. Vitamin B12 injection on its own is FDA-approved for treating B12 deficiency. Published evidence that lipotropic injections change weight is limited.

Do not use if

You are allergic to cobalt, cobalamin (vitamin B12), or any ingredient in the preparation.
You have Leber's hereditary optic neuropathy — B12 injections can worsen optic-nerve damage in this condition.
You are pregnant or breastfeeding, unless your provider has specifically reviewed this with you.
You have kidney disease, liver disease, metabolic acidosis, or a history of heart disease or high homocysteine — methionine and choline may need extra caution. Tell your provider.

Serious risks — get medical help

Allergic reactions, including rare anaphylaxis with injected B12 — hives, swelling of the face or throat, wheezing, or trouble breathing. Stop use and call 911.
Low potassium can occur early in treatment when a severe B12 deficiency is being corrected; report muscle weakness, cramps, or an irregular heartbeat.
B12 can improve blood counts and mask an undiagnosed folate deficiency; your provider may check labs.

Common side effects

Pain, redness, warmth, or bruising at the injection site; mild nausea or upset stomach; headache; diarrhea; a brief fishy body odor from choline in some people. These are usually mild and short-lived.

Drug interactions

Chloramphenicol can reduce the blood-count response to vitamin B12.
Tell your provider about all medicines and supplements, including other B-vitamin or methionine-containing products, so doses are not doubled up.
Alcohol can worsen nausea and affects liver handling of these nutrients.

Missed dose

If you miss a dose, take it when you remember unless your next dose is due within a day or two — then skip it and continue your usual schedule. Do not take two doses to catch up.

Also important

MIC + B12 does not replace nutrition, activity, or a prescribed weight-loss medicine.
Never share needles or vials.

How to inject MIC + B12 → View treatment →

Wellness

Sermorelin Injection

Growth-hormone-releasing hormone (GHRH) analog

Sermorelin is a compounded medication prepared by a state-licensed pharmacy for an individual prescription. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are dispensed. The FDA-approved sermorelin product (Geref®) was discontinued in 2008 for commercial reasons, so no FDA-approved sermorelin is currently marketed, and sermorelin is not approved for wellness, anti-aging, recovery, or sleep. Evidence for those uses in adults is limited.

Do not use if

You have had an allergic reaction to sermorelin or any ingredient in the preparation.
You have an active cancer or are being evaluated for one — stimulating growth hormone is not advised. Tell your provider about any personal history of cancer.
You are pregnant or breastfeeding.
You have untreated thyroid disease, diabetes or pre-diabetes, sleep apnea, or you take corticosteroids — these can blunt the response or need closer monitoring. Tell your provider.

Serious risks — get medical help

Allergic reactions — hives, swelling of the face or throat, wheezing, or trouble breathing. Stop use and call 911.
Signs of too much growth-hormone activity — joint pain, swelling of the hands or feet, numbness or tingling in the fingers (carpal tunnel), or new headaches. Tell your provider; your dose may need to change.
Changes in blood sugar — growth hormone can raise glucose. Report increased thirst, urination, or fatigue, especially if you have diabetes.

Common side effects

Pain, redness, or swelling at the injection site; headache; flushing; dizziness; feeling restless or sleepy; changes in taste; nausea; trouble swallowing (uncommon). Most are mild and pass quickly.

Drug interactions

Corticosteroids (such as prednisone), thyroid medicines, and some pain relievers (aspirin, indomethacin) can reduce the response to sermorelin.
Insulin and other diabetes medicines may need adjusting because growth hormone affects blood sugar.
Tell your provider about every medicine and supplement you take.

Missed dose

If you miss a dose, skip it and take your next dose at the usual time. Do not double up. Sermorelin is normally taken at bedtime on an empty stomach; follow your prescription label.

Also important

Sermorelin is not human growth hormone, and it is not a treatment for obesity or a substitute for sleep, nutrition, or exercise.
Never share needles or vials.

How to inject Sermorelin → View treatment →

Wellness

NAD+ Injections

Nicotinamide adenine dinucleotide (a cellular coenzyme)

NAD+ is a compounded medication prepared by a state-licensed pharmacy for an individual prescription. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are dispensed. There is no FDA-approved NAD+ drug, and NAD+ is not approved for energy, longevity, cognition, or any other use. Human evidence is limited and does not establish a specific benefit; your provider will discuss what is and is not known.

Do not use if

You have had an allergic reaction to NAD+ or any ingredient in the preparation.
You are pregnant or breastfeeding — safety has not been studied.
You have an active cancer, serious heart disease, or significant liver or kidney disease — discuss the risks with your provider first.

Serious risks — get medical help

Allergic reactions — hives, swelling of the face or throat, wheezing, or trouble breathing. Stop use and call 911.
Chest tightness or pressure, a racing heart, or feeling faint — most often when NAD+ is injected too quickly. Stop the injection and rest; seek care if it does not pass within minutes or if you have chest pain.

Common side effects

Pain, redness, or bruising at the injection site; flushing or warmth; nausea or stomach cramping; headache; lightheadedness; temporary tiredness or, in some people, feeling wired. Injecting slowly reduces most of these.

Drug interactions

Data on drug interactions are limited. Tell your provider about every medicine and supplement — especially blood-pressure medicines and other NAD-related supplements (niacin, nicotinamide riboside, NMN) so you are not stacking doses.
Alcohol may worsen flushing and nausea.

Missed dose

If you miss a dose, take it when you remember unless your next dose is close — then skip it and continue your usual schedule. Do not double up.

Also important

Inject slowly, over the time your provider specifies, and sit or lie down for the first few doses.
Never share needles or vials.

How to inject NAD+ → View treatment →

Wellness

Glutathione Injection

Antioxidant tripeptide

Glutathione is a compounded medication prepared by a state-licensed pharmacy for an individual prescription. Compounded drugs are not FDA-approved, and the FDA does not review them for safety, effectiveness, or quality before they are dispensed. There is no FDA-approved glutathione drug, and glutathione is not approved for any use, including antioxidant support or skin changes. The FDA has cautioned about injectable glutathione compounded from non-sterile powder after reports of adverse events; ask your provider how and where yours is prepared.

Do not use if

You have had an allergic reaction to glutathione or any ingredient in the preparation.
You have asthma — inhaled glutathione has caused bronchospasm, so injectable use needs particular caution. Tell your provider.
You are pregnant or breastfeeding — safety has not been studied.
You are receiving chemotherapy or radiation — antioxidants may interfere with some treatments. Do not start without your oncology team's agreement.

Serious risks — get medical help

Allergic reactions — hives, swelling of the face or throat, wheezing, or trouble breathing. Stop use and call 911.
Signs of a contaminated product — fever, chills, shaking, nausea, or a sudden drop in blood pressure within hours of an injection. Seek care immediately and report it.

Common side effects

Pain, redness, or bruising at the injection site; mild abdominal cramps, bloating, or loose stools; flushing; headache. These are usually brief.

Drug interactions

Data are limited. Tell your provider about every medicine and supplement, especially cancer treatments and other antioxidant products.
Alcohol depletes glutathione and may worsen stomach upset.

Missed dose

If you miss a dose, take it when you remember unless your next dose is close — then skip it and continue your usual schedule. Do not double up.

Also important

Glutathione is not a treatment for any disease and should not delay evaluation of new symptoms.
Never share needles or vials.

How to inject Glutathione → View treatment →

All treatments

General precautions

All VIV RX treatments are prescription-only and are prescribed by an independent, US-licensed provider after an online medical evaluation. Not everyone is a candidate.
Compounded medications are not FDA-approved and are not evaluated by the FDA as equivalent to any FDA-approved product. Ask your provider whether an FDA-approved option is right for you.
Store medication as directed on your pharmacy label, keep it out of reach of children and pets, and never share vials, syringes, or needles.
Tell every clinician who treats you — including dentists and anesthesia teams — which of these medications you take.
This information does not replace the guidance of your provider or the pharmacy leaflet that comes with your medication. It is not a complete list of risks.

This page is general safety information for prescription treatments offered through the VIV RX platform. It does not replace the guidance of your provider or the pharmacy leaflet dispensed with your medication, and it is not medical advice. Product names marked ® are trademarks of their respective owners and are referenced only to identify the FDA-approved medicines whose labeling informs this page.

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