WEIGHT MANAGEMENT

Obesity or overweight is described as weight which is higher than what is considered as a healthy weight for a given height. According to CDC, obesity affected about 93 million adults in US. Obese individuals are at a greater risk of developing heart disease, kidney disease, stroke, and type 2 diabetes. The most common causes of obesity include:

  • Diseases – Various diseases such as hypothyroidism, polycystic ovary syndrome, cushing’s
    syndrome, and depression can cause obesity
  • Genetics – Genetics plays a role in obesity as people can be obese if both their parents were
    obese
  • Physical inactivity– A sedentary lifestyle can cause people to burn less calories leading to obesity
  • Overeating – Consumption of food high in fat content leads to increased calorie intake leading to
    obesity
  • Medications – Certain medications can cause weight gain such as antidepressants, insulin, oral
    contraceptives and steroids
  • Psychological factors – Eating in response to emotions of sadness, anger, boredom or
    depression can cause obesity

Weight management includes creating a unique plan for individual patient based on initial assessment,
creating long term goals, regular checks on progress and modifying behavioral patterns to maintain a
healthy weight.

medical weight loss

Texas Star Pharmacy can provide customized compounding formulation for patient as each patient
requirement is unique based on their weight management plans. Some of the custom compounded
formulations that we provide include:

  • Appetite Suppressants – Formulations containing phentermine which reduce appetite by
    stimulating region of the brain called hypothalamus to release norepinephrine
  • Lipotropic injections – These injections help in the fat burning process by enhancing the liver
    and gallbladders activity by increasing the metabolism of fat deposits
  • Vitamin B12 Injections – Vitamin B12 influences the metabolism by increasing energy. It also has
    beneficial effects on concentration and memory

We can help you achieve the goals of your weight management therapy. Please discuss with you doctor
or reach out to our compounding pharmacist for further information.

SEMAGLUTIDE/PYRIDOXINE 1000MCG-25MG/ML Injection MDV (1ML & 4ML)

What is Semaglutide and Pyridoxine combination injection and how it works?

Semaglutide: primarily belongs to the class of antidiabetic agents, more specifically Glucagon-Like Peptide-1.
Mechanism of action:

  1. It works by stimulating glucose-dependent insulin release from the pancreatic islets.
  2. It has also been shown to slow gastric emptying,
  3. Inhibits inappropriate post-meal glucagon release
  4. and reduce food intake.
It is an FDA approved product for patients with Type 2 Diabetes and chronic Obesity leading towards metabolic diseases.
Pyridoxine: also known as Vitamin B6 is critically needed nutrient for

  1. providing a jumpstart in the metabolism of protein, carbohydrates, and fats,
  2. vital the production of neurotransmitters and the formation of nicotinic acid
  3. it is essential for maintaining a healthy nervous system, skin, muscles, and blood.
  4. Additionally, it has stimulating effect on thyroid function and prevents water retention.
When added to Semaglutide as an adjuvant ingredient, might help jumpstart weight loss process by facilitating all healthy aspects of metabolism.

What are the clinical uses of Semaglutide/Pyridoxine combination injection?

  1. Diabetes mellitus, type 2, treatment: As an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. This can cause risk reduction of major cardiovascular events (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke) in adults with type 2 diabetes mellitus and established cardiovascular disease.
  2. Weight management, chronic: As an adjunct to a reduced-calorie diet and increased physical activity for chronic weight management in adults with an initial BMI of ≥30 kg/m2 (obesity), or ≥27 kg/m2 (overweight) in the presence of at least one weight-related comorbid condition (e.g., hypertension, type 2 diabetes mellitus, dyslipidemia).

How Semaglutide/Pyridoxine combination injection should be used?

This injection should only be used as prescribed by the healthcare practitioner after complete evaluation. Once prescribed a titration protocol must be followed to determine a safe and effective dose for individually identified patient.

Prior to prescribing, monitoring parameters should include, BMI, Hemoglobin A1C, Thyroid and other endocrine function to rule out cancer.

Weight Management Dosing protocol: For use as an adjunct to diet and exercise in patients with a BMI ≥30 kg/m2, or in patients with a BMI ≥27 kg/m2 and ≥1 weight-associated comorbidity (e.g., hypertension, dyslipidemia).
Initial dosage: Dosed as Semaglutide-Pyridoxine combination dose:

Dosage titration

Adjust dosage using the following schedule: In patients who do not tolerate a dosage increase, consider delaying the increase for an additional 4 weeks:

  1. Week 1 through week 4
    0.25mg-6.25mg (0.25mL) Subcutaneously every week. It will be dispensed in 1 mL for one month’s supply)
  2. Week 5 through week 8
    0.5mg-12.5mg (0.5mL) Subcutaneously every week. It will be dispensed in 1 mL x 2 MDVs for one month’s supply)
  3. Week 9 through week 12 and onward
    1mg-25mg (1mL) Subcutaneously every week. It will be dispensed in 1x4mL MDV 2 for one month’s supply).

Typically, this protocol is used for 3 months and if no results are seen discontinuation of the therapy is recommended. Texas Star Pharmacy do not recommend increasing dose above 1mg of Semaglutide for moderate weight loss goals. However, it is up to the healthcare provider to determine the maximum dose per administration and duration of therapy.

Based on the available literature, maximum dose can be titrated from 1mg once weekly injection from week 9 to week 12, →1.7 mg once weekly injection from week 13 to week 16, →2.4mg once weekly injection week 17 onward. Always be extra vigilant when higher doses are prescribed because as the dose increases, so does the adverse effects and side effect profile.

What are the contraindications of Semaglutide/Pyridoxine Injection therapy?

  1. Hypersensitivity to any Glucagon-Like Peptide
  2. Thyroid cancer/tumor
  3. Any type of endocrine (single or multiple) melanoma

What are the Warnings/Precautions to Semaglutide and Pyridoxine injection?

Here is a list of conditions where this product should be used with caution.

  1. Pancreatitis (dose related)
  2. Diabetic retinopathy (in diabetic patients)
  3. Acute or chronic kidney injury/failure (in diabetic patients and dose related)
  4. Gall bladder disease (for example Cholelithiasis when rapid/substantial weight loss is achieved)
  5. Delayed gastric emptying (affects the absorption and kinetics of other narrow therapeutic drugs used as concomitant therapy for other medical conditions)

What are the possible side effects of Semaglutide/Pyridoxine injection?

Gastrointestinal side effects comprise majority of the side effect profile.
Diarrhea up to 10%, vomiting up to 9%, constipation up to 6%, abdominal distention and flatulence up to 3%, Gastroesophageal reflux disease up to 2% and Cholelithiasis less than 2%.

What if I miss my weekly dose that is supposed to be administered on a specific day of the week?

Take the missed dose as soon as you recall. But skip it completely if its less than 48 hours before the next weekly dose.

How does Semaglutide/Pyridoxine injection come and how it should be stored?

Semaglutide/Pyridoxine comes in only one concentration as 1000MCG(1mg)/25mg per mL, Multidose vial in 1mL and 4mL vials. The potency of the compounded preparation is assessed and validated for longer duration, but each vial shall be used up to 28-day period from the time of first puncture.

Opened and unopened vials must be stored in the refrigerator to maintain efficacy. Do not freeze the unopened vials.

References:
Facts and comparison Semaglutide and Pyridoxine injections Pyridoxine – ResearchGate and PubChem & PubMed – NCBI
Disclaimer: This content is for informational purposes only and is not intended to provide medical advice or take the place of the information or treatment from a physician. All readers/viewers of this content are advised to consult their doctors or qualified health professionals regarding health and therapy questions. Texas Star Pharmacy, the publisher, nor writers of this content take responsibility for possible health consequences of any person(s) reading or following the information in this informational content. All viewers of this content should consult their physicians before beginning or modifying any medication, nutritional supplement, diet, technique, or health regimen.
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