GLP-1 Medication Informed Consent
Last updated: September 29, 2026
This consent describes the risks, benefits and alternatives of treatment with GLP-1 receptor agonist medications (such as semaglutide) and GLP-1/GIP dual agonists (such as tirzepatide) for weight management, including lower-dose (“microdose”) protocols. Read it fully before consenting. When you tick the GLP-1 Medication Informed Consent box in the intake and submit it, we record that you agreed, the version of this document and the date and time.
1. About these medications
GLP-1 medications mimic natural gut hormones that help regulate appetite and blood sugar. For weight management they are used together with a reduced-calorie diet and more physical activity. They are usually given as a once-weekly injection under the skin, starting at a low dose that is gradually increased (“titrated”) over several months. Only a licensed clinician can decide whether one is right for you and at what dose.
2. Boxed warning — risk of thyroid C-cell tumors
The FDA-approved versions of semaglutide and tirzepatide carry an FDA boxed warning: in rodent studies these medications caused thyroid C-cell tumors. It is unknown whether they cause thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans. Do not use these medications if you or a family member has ever had MTC, or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your clinician right away if you get a lump or swelling in your neck, hoarseness, trouble swallowing or shortness of breath. The same warning applies to compounded versions.
3. Common side effects
- Nausea, vomiting, diarrhea or constipation (the most common, usually improving over time)
- Abdominal pain, indigestion, bloating or burping
- Decreased appetite, fatigue, headache, dizziness
- Injection-site reactions (redness, itching)
4. Serious risks
- Pancreatitis: severe, persistent abdominal pain (with or without vomiting) needs immediate medical attention; stop the medication.
- Gallbladder disease: gallstones and gallbladder inflammation, especially with rapid weight loss.
- Low blood sugar (hypoglycemia): the risk is higher if combined with insulin or a sulfonylurea.
- Kidney injury: usually from dehydration caused by vomiting or diarrhea; keep drinking fluids.
- Gastroparesis: delayed stomach emptying, which may also affect how oral medications are absorbed.
- Severe allergic reactions: anaphylaxis and angioedema have been reported.
- Vision changes in people with diabetic retinopathy.
- Mood changes: tell your clinician right away about depression or thoughts of self-harm.
- Aspiration risk with anesthesia or sedation: tell any surgeon or anesthesiologist that you take a GLP-1 medication before any procedure.
5. Pregnancy and fertility
GLP-1 medications may cause harm to an unborn baby and must not be used during pregnancy or while breastfeeding. Stop at least 2 months before a planned pregnancy. These medications may also reduce the effectiveness of oral contraceptives (particularly tirzepatide); discuss contraception with your clinician.
6. Compounded medication disclosure
Medications prescribed through MyRxProvider may be compounded semaglutide or tirzepatide. By consenting, you understand that:
- Compounded drugs are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness or quality before they are dispensed.
- Compounded medications are prepared by independent, state-licensed U.S. pharmacies for an individual patient on a prescription. They are not the same as, and may differ from, FDA-approved products such as Wegovy®, Ozempic®, Zepbound® or Mounjaro®, and may contain different inactive ingredients or additives.
- Your dosing instructions and syringe measurements may differ from FDA-approved pens. Follow the instructions on your pharmacy label exactly, and ask your care team if anything is unclear. Dosing errors can cause serious side effects.
- FDA-approved alternatives exist and may be available to you through other channels, including through insurance. Your clinician can discuss them with you.
- Once dispensed, a compounded prescription cannot be returned (see the Terms of Service).
7. Expected benefits and results
In clinical studies of FDA-approved semaglutide and tirzepatide, many people combining the medication with diet and exercise lost a meaningful amount of weight. Results vary and are not guaranteed. Compounded medications have not been studied in those trials. Some people lose little or no weight, and weight is often regained after stopping.
8. Alternatives
Alternatives to GLP-1 therapy include lifestyle changes alone (diet, exercise, behavioral therapy), other prescription weight-management medications, FDA-approved GLP-1 products, bariatric surgery, and no treatment. Your clinician can discuss these options with you.
9. Your commitments
- Use the medication only as directed; never raise your dose without your clinician’s approval.
- Store the medication as instructed (many GLP-1s must be refrigerated) and never share it.
- Report side effects promptly and complete scheduled check-ins.
- Tell all of your healthcare providers that you take a GLP-1 medication.
10. Acknowledgment
By ticking the GLP-1 Medication Informed Consent box in the intake, you confirm that you have read and understood this document, including the boxed warning and the compounded-medication disclosure; that no specific weight-loss result has been promised to you; that you have had the chance to ask questions (you can email support@myrxprovider.com at any time); and that you consent to GLP-1 treatment if, and only if, a licensed clinician decides it is appropriate for you.