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Compounded semaglutide contains the same active ingredient as Wegovy and Ozempic, semaglutide, prepared by a licensed compounding pharmacy and prescribed by a licensed provider

Management strategies: Keep doses at 100 mcg per injection If prolactin-related symptoms emerge, vitamin B6 (P-5-P form, 50-100 mg daily) can help More significant prolactin elevation may require pharmaceutical management with a healthcare provider Consider switching to ipamorelin, which does not significantly elevate prolactin at any dose Water retention and joint effects The elevated GH levels produced by GHRP-6 can cause fluid retention, manifesting as bloating, puffiness (particularly in the face and extremities), and joint stiffness

JAMA 325(14):14141425 Garvey WT, Batterham RL, Bhatta M et al (2022) Two-year effects of semaglutide in adults with overweight or obesity: the STEP 5 trial

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