Important Info about Microdosing GLP-1

This page covers safety information for microdosing regimens of both Compounded Tirzepatide and Compounded Semaglutide. Where the two medications differ, the difference is stated. Where they do not, the information applies to both.Read this alongside the full safety information for your specific medication: Compounded Tirzepatide · Compounded Semaglutide.

What is microdosing?
Microdosing means taking a dose of a GLP-1 medication that is lower than the doses studied in clinical trials and lower than the doses described in approved prescribing information. It is sometimes used to support a slower, gentler start to treatment, to help manage side effects, or as part of a longer-term maintenance approach after an initial course of treatment.You should understand three things before starting:There is no official definition of a "microdose." No regulator has established a standard microdosing schedule for tirzepatide or semaglutide. What counts as a microdose varies between prescribers.Microdosing is an off-label use. It is not part of any approved dosing regimen for tirzepatide or semaglutide. Approved dosing information for these molecules describes a structured titration schedule, not a reduced-dose schedule.The evidence base is limited. The safety and effectiveness of tirzepatide and semaglutide were established in trials using standard titration. Microdosing regimens have not been studied to the same standard, so outcomes are less predictable and are largely extrapolated from higher-dose data.Microdosing should only be done on the instruction of a licensed doctor who knows your medical history, and never by adjusting your own prescribed dose on your own initiative.

What are Compounded Tirzepatide and Compounded Semaglutide?Both are prescription injectable medications used to improve blood sugar control in adults with type 2 diabetes. They may also support weight loss in adults with a body mass index (BMI) of 30 or higher, or 27 and above with weight-related health conditions, when used alongside a reduced-calorie diet and increased physical activity.Neither medication is a substitute for insulin. Neither is approved for the treatment of type 1 diabetes or diabetic ketoacidosis.

What should I know about compounded medicines?Compounded medications are prepared by licensed pharmacists when an approved product cannot meet a patient's medical needs. Unlike approved commercial products, compounded preparations are not individually evaluated by regulators for safety, effectiveness, or manufacturing consistency before they are supplied.This matters more, not less, at microdose volumes:Small volumes magnify measuring errors. A small absolute error when drawing up a dose becomes a large percentage error when the intended dose is very small. Follow your dosing instructions precisely and use only the syringes supplied or specified for you.Never attempt to divide, split, or partially discharge a prefilled pen. Pens are calibrated to deliver fixed doses. Manipulating a pen, counting clicks, or attempting to draw medication out of a pen can cause dosing errors, device failure, and contamination.Storage matters. These medications require refrigeration. Improper storage or temperature excursions can affect the medication. Follow the storage instructions supplied with your medication and ask your pharmacist if you are unsure.Never use a product from an unverified source. Only use medication supplied through your prescription. Never use, share, or buy GLP-1 medication from an unverified seller or a social media source.

Who should not microdose Compounded Tirzepatide or Compounded Semaglutide?These restrictions apply regardless of dose. A lower dose does not make them safe.Do not use either medication if you:Have a personal or family history of medullary thyroid carcinoma (MTC).Have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).Are allergic to tirzepatide, semaglutide, or any of the ingredients in your preparation.Are pregnant or breastfeeding. Tell your doctor immediately if you become pregnant while using either medication.Microdosing is also not appropriate as a way to make a prescription last longer, to share medication with another person, or to self-treat without a consultation.If you are unsure about your medical history, speak with your healthcare provider before starting treatment.

How is a microdosing regimen used?Both medications are given as a once-weekly subcutaneous injection into the abdomen, thigh, or upper arm. Rotate the injection site each week. You may self-inject at home or follow your doctor's instructions for administration.Your prescribed dose and schedule are specific to you. Do not increase, decrease, or change the frequency of your dose without speaking to your doctor first.If you miss a dose:Compounded Tirzepatide — take it as soon as possible within 4 days. If more than 4 days have passed, skip the missed dose and resume your regular dosing schedule.Compounded Semaglutide — take it as soon as possible within 5 days. If more than 5 days have passed, skip the missed dose and resume your regular dosing schedule.Never double up on doses to make up for a missed one, and do not mix either medication with other injectables unless your doctor instructs you to.Store your medication in the refrigerator. If it is kept at room temperature, follow your pharmacist's instructions for safe storage. Dispose of used needles and syringes in a designated sharps container.

What should I tell my healthcare provider before microdosing?Give your provider your complete medical history and a full list of everything you take, including prescription medicines, over-the-counter medicines, vitamins, and supplements. In particular, tell them if you:Have or have had thyroid cancer, pancreatitis, gallbladder disease, or kidney or liver problems.Have diabetic retinopathy or any other diabetic eye disease.Have a history of an eating disorder.Have a history of depression, mood changes, or suicidal thoughts or behaviour.Are pregnant, planning to become pregnant, or breastfeeding.Take insulin or sulfonylureas, as combining these with a GLP-1 medication increases the risk of low blood sugar. Your provider may need to adjust those doses.Take oral hormonal contraceptives. Tirzepatide can reduce their absorption. Your provider may advise a non-oral contraceptive or an additional barrier method after starting treatment and after any dose increase.Before any surgery or procedure involving anaesthesia or deep sedation, tell your surgeon and anaesthesiologist that you are using a GLP-1 medication, and tell them your dose and when you last took it. These medications slow stomach emptying, which can leave food in the stomach even after fasting and increase the risk of food or fluid entering the lungs during a procedure. This applies to microdosing as well as standard dosing.

What are the most serious side effects?Serious side effects are uncommon, but they can occur at any dose. Stop using the medication and seek immediate medical care if you experience:Possible thyroid tumours — a lump or swelling in the neck, trouble swallowing, shortness of breath, or persistent hoarseness.Pancreatitis — severe or persistent abdominal pain, which may radiate to your back, with or without vomiting.Gallbladder problems — upper abdominal pain, fever, yellowing of the eyes or skin, or pale stools.Severe low blood sugar (hypoglycaemia) — shakiness, confusion, dizziness, blurred vision, rapid heartbeat, or excessive sweating. The risk is highest if you also take insulin or a sulfonylurea.Kidney problems — dehydration from persistent nausea, vomiting, or diarrhoea can lead to kidney injury or worsen existing kidney disease.Severe allergic reactions — rash, itching, swelling of the face, lips, tongue, or throat, or difficulty breathing.Changes in vision — for Compounded Semaglutide in particular, tell your doctor about any change in your vision during treatment.Changes in mood or behaviour — new or worsening depression, or any thoughts of self-harm or suicide. Contact your healthcare provider immediately.

What are the most common side effects?The most common side effects are nausea, diarrhoea, vomiting, constipation, and abdominal discomfort. Injection site reactions, fatigue, headache, and reduced appetite can also occur.Side effects are generally most noticeable when starting treatment or after a dose change, and often improve as your body adjusts. Lower doses may reduce how often side effects occur and how intense they feel, but they do not remove the risk. If symptoms persist, worsen, or interfere with eating and drinking normally, contact your doctor.

What microdosing does not doBeing clear about the limits is part of using this treatment safely.A lower dose generally means a smaller effect. Microdosing is not expected to produce the degree of blood sugar improvement or weight loss seen at the doses used in clinical trials.Microdosing has not been shown to be safer overall. It may reduce dose-related side effects, but it does not eliminate the risks described on this page, and it has not been studied for long-term safety at the same standard as approved dosing.It is not a standalone solution. Any GLP-1 regimen works best alongside a healthy diet, adequate protein intake, regular physical activity including resistance training, and ongoing clinical review.It does not reduce cardiovascular risk in people without type 2 diabetes. Neither medication has been shown to reduce the risk of heart attack, stroke, or other cardiovascular events in this group.Weight regain is possible after stopping. Discuss any plan to stop, pause, or step down treatment with your doctor rather than stopping on your own.

Additional safety informationNever share injection pens, syringes, or needles, even if the needle has been changed. Sharing can transmit serious infections.Keep all your medication out of the reach of children.Attend your scheduled check-ins. Because microdosing sits outside approved dosing schedules, ongoing monitoring by your doctor is more important, not less.If you have any questions about your dose, your schedule, or a symptom you are experiencing, contact your care team before making any change yourself.

Reporting side effects

To report side effects in the Philippines, contact the Philippine Food and Drug Administration (FDA) through their Adverse Drug Reaction (ADR) Reporting System or call +63 2-8809-5596.

For full prescribing information and additional details, visit the Philippine FDA website.