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Important Safety Information

Last updated: October 9, 2026

This page is provided by White Lotus Health LLC, which operates the White Lotus Rx website.

Weight Management — Essential + Advanced

Medicine: Essential: compounded semaglutide with vitamin B12. Advanced: compounded tirzepatide with vitamin B12.

What this is: A weekly injection from a class of medicines called GLP-1 receptor agonists (Advanced: a dual GLP-1/GIP pathway), prepared by a compounding pharmacy and prescribed with a nutrition and activity plan.
How it works: It helps regulate appetite and how quickly the stomach empties.
Who it may be appropriate for: Adults with a BMI of 30 or more, or 27 or more with a weight-related condition.
Who should not use it: Anyone with a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2, a history of pancreatitis, or who is pregnant, planning pregnancy or breastfeeding.
Common side effects: Nausea, vomiting, diarrhea, constipation, stomach pain, reduced appetite.
Serious risks: Possible thyroid tumours, pancreatitis, gallbladder problems, low blood sugar (especially with insulin or sulfonylureas), kidney problems, dehydration.
When to seek care: Severe stomach pain that won't go away, a lump or swelling in the neck, trouble swallowing, signs of an allergic reaction. Call 911 in an emergency.
Interactions: Tell your provider about insulin, diabetes medicines and any oral medicines, since slower stomach emptying can change how they absorb.

Medicine: Compounded methionine, inositol, choline and vitamin B12 (MIC-B12).

What this is: A weekly compounded nutrient injection, added to a weight management program.
Who should not use it: Anyone allergic to any ingredient or to cobalt.
Common side effects: Pain, redness or swelling at the injection site; mild diarrhea.
When to seek care: Signs of an allergic reaction such as rash, swelling or trouble breathing. Call 911 in an emergency.
Interactions: Tell your provider about all medicines and supplements you take.

Medicine: Tablet: estradiol tablets. Patch: estradiol transdermal patch.

What this is: FDA-approved estrogen therapy (Tablet: daily oral. Patch: twice-weekly skin patch) for hot flashes, night sweats and other menopause symptoms.
Who it may be appropriate for: Adults in perimenopause or menopause with moderate to severe symptoms.
Boxed warning: Estrogen-alone therapy may increase the risk of endometrial cancer in people with a uterus; a progestogen is usually added. Estrogen therapy (with or without a progestogen) may increase the risk of stroke, blood clots, heart attack, breast cancer and probable dementia. Use the lowest effective dose for the shortest time needed.
Who should not use it: Anyone with breast cancer or another estrogen-dependent cancer, unexplained vaginal bleeding, a history of blood clots, stroke or heart attack, liver disease, or who is pregnant.
Common side effects: Headache, breast tenderness, irregular bleeding or spotting, nausea, bloating. Patch: skin irritation at the application site.
When to seek care: Chest pain, shortness of breath, leg pain or swelling, sudden vision or speech changes, a breast lump, unusual vaginal bleeding. Call 911 in an emergency.
Interactions: Tell your provider about all medicines and supplements, including St. John's wort and seizure medicines.

Medicine: As Needed: sildenafil. Daily: tadalafil.

What this is: FDA-approved oral medicine from a class called PDE5 inhibitors (As Needed: taken before activity. Daily: one low-dose tablet a day).
Who should not use it: Anyone taking nitrates (such as nitroglycerin) or riociguat, or who has been told sexual activity is unsafe for their heart.
Common side effects: Headache, flushing, indigestion, nasal congestion, back or muscle pain, dizziness.
When to seek care: Chest pain, an erection lasting more than 4 hours, sudden loss of vision or hearing. Call 911 in an emergency.
Interactions: Nitrates and some blood-pressure medicines (including alpha-blockers) can cause a dangerous drop in blood pressure. Avoid heavy alcohol.

Medicine: Finasteride.

What this is: An FDA-approved daily tablet from a class called 5-alpha-reductase inhibitors, for male-pattern hair loss in men. Results can take 3–6 months.
Who should not use it: Women and anyone who is or may become pregnant. Crushed or broken tablets should not be handled by someone who is or may be pregnant.
Common side effects: Lower sex drive, erection or ejaculation changes.
Serious risks: Mood changes, including depression; tell your provider about any change in mood. It can lower PSA test results; tell any healthcare provider checking your PSA.
When to seek care: Thoughts of self-harm, breast lumps, pain or nipple discharge, signs of an allergic reaction. Call 911 in an emergency.

Report side effects to your provider and to the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.

Questions about this policy may be sent to:

White Lotus Health LLC

30 N. Gould St., Sheridan, WY 82801

Monday–Friday, 9am–4pm