Compounded semaglutide belongs to a class of medications called glucagon-like peptide-1 (GLP-1) agonists.

GLP-1 is a naturally occurring hormone released in response to eating. It helps improve blood sugar, metabolism, and cardiovascular health, and it has anti-inflammatory properties that can affect biomarkers.

Compounded semaglutide mimics this hormone by:

• Enhancing insulin secretion and reducing glucagon release.
• Slowing the movement of food through the gut and promoting feelings of fullness.
• Supporting a healthier metabolic balance over time.

These effects can promote favorable biomarker patterns linked to healthy aging and longevity.

Ideally, you’ll never miss a dose. But sometimes life gets in the way. If you skip or miss a dose of your medication, here’s what to do:

• If your next dose is more than 2 days away: Take your missed dose as soon as possible.
• If your next dose is less than 2 days away: Skip the missed dose and take your next dose on the regularly scheduled day.
• If you’ve skipped 2 or more consecutive weeks: Contact your Noom Med clinician for guidance.
• Do not administer double doses of compounded semaglutide.

• If you experience severe side effects, message your clinician via the Noom app right away.
• If you’re having a medical emergency, call 911 or emergency services immediately.
• For tips and support, navigate to the ‘Manage Your Side Effects’ section in the Noom app.

This packaging was rigorously tested and developed to ensure your medication remains stable at elevated temperatures and during potential shipping delays. For more information, reach out to your Care Coordination team in the Noom app.

Store your compounded semaglutide in the refrigerator—away from heat, moisture, and direct sunlight. Do not freeze.

Do not use compounded semaglutide if it has been frozen or exposed to direct sunlight. Rigorous testing shows that these medications are stable when exposed to extreme temperatures exceeding 100°F for short periods and at room temperature for several weeks.

Once you puncture your compounded semaglutide vial, you’ll need to discard it after 28 days, even if there’s some medication left. You can follow these Food and Drug Administration (FDA)-approved steps to dispose of your medication in the trash:

• Mix your medication with an unappealing substance, like dirt or used coffee grounds.
• Place the mixture in a sealed container, like a plastic bag.
• Remove all personal information on the prescription label.

Once your compounded semaglutide vial is punctured, it will need to be discarded after 28 days—even if there’s some medication left. You can throw it directly into the trash.

Discard your used syringe in a heavy-duty, hard-sided container with a lid, such as an empty laundry detergent bottle. Keep this container away from children and pets. When your container is full, you can take it to a disposal site near you.

Plan Ahead
Make sure you have enough medication and supplies to last your entire trip—plus a little extra.

Pack Properly

• If you’re traveling by car or train, explore using a portable cooler or insulated bag.
• If you’re traveling by plane, pack your medication and supplies in your carry-on rather than a checked bag.
• Leave your medication and supplies in their original packaging.

Airport Security Protocols
You can take your medication and all your supplies through security. Just be sure to give yourself extra time to allow for screening of these items.

International Rules and Regulations
Each country has its own laws and regulations for medications. Make sure to do your research before you travel. You can check with the embassy of your destination to make sure your GLP-1 is permitted.

Avoid Extreme Temperatures
Extreme temperatures—whether in the trunk of your car or a plane’s cargo hold—can make your medication less effective. So you’ll want to avoid exposing your medication to excessive heat or cold.

Store Correctly When You Reach Your Destination
Put your medication in the refrigerator as soon as you reach your destination.

The Proactive Health Program uses the smallest doses of GLP-1 of any Noom plan, with a max dose of 0.2mg per week. It includes at-home biomarker testing. The Microdose Program utilizes up to 0.6mg per week of GLP-1 and is designed for weight loss specifically. Both options are backed by Noom’s behavior change tools and clinical care teams—so you get the guidance you need, no matter your path.

Risks
Medications in the GLP-1 family have caused thyroid tumors in lab mice. It is not yet known if medications in the GLP-1 family will cause thyroid tumors or medullary thyroid cancer (MTC) in people.

No studies have confirmed a link between GLP-1 medications and thyroid tumors in humans, but if you have a history of family thyroid cancer, you may want to discuss taking a GLP-1 with your primary care provider.

Microdoses of GLP-1s can cause weight loss, especially when combined with diet and exercise programs. Please monitor your weight to make sure you’re staying in a healthy range. If your BMI falls below 20, you may be at risk of an unhealthy weight. Please speak with your Noom physician before continuing treatment.

If you develop any of the following while taking compounded semaglutide, please notify your Noom Med clinician and stop taking the medication immediately:

• Sudden vision changes. (Medications that alter blood sugar can have various effects on vision and should be evaluated promptly by an eye doctor.)
• Mass or swelling in the neck.
• Persistent pain or difficulty with swallowing.
• Persistent hoarseness.
• Persistent vomiting.
• Becoming pregnant.

Do not use compounded semaglutide if:

• You have or had an eating disorder, such as binge eating disorder, anorexia nervosa, or bulimia.
• You have a personal or family history of the following conditions:
  • Medullary thyroid cancer (MTC).
  • Multiple endocrine neoplasia type 2 syndrome (MEN-2).
• You have a personal history of the following conditions:
  • Diabetic retinopathy.
  • Pancreatitis.
  • Gallbladder disease. (This does not include cholecystectomy, or gallbladder removal.)
  • Severe gastrointestinal disease, such as ulcerative colitis or gastroparesis.
• You are currently pregnant, breastfeeding, or are planning to become pregnant.
• You have a history of drug or alcohol misuse.
• You have undergone bariatric surgery within the past 6 months.

Interactions
Compounded semaglutide can interact with other medications, including insulin and insulin-releasing medications, which can result in low blood sugar. Consult with your Noom Med clinician before starting or stopping any medication.

GLP-1s and fertility
GLP-1s can increase fertility and may make oral contraceptives less effective. You should not take a GLP-1 if you are currently pregnant or breastfeeding. If you become pregnant, please stop taking the medication and notify your Noom Med clinician right away.

Surgery
If you have an upcoming surgery or other medical procedure, talk to your surgeon or primary care provider about your current medications. You may need to temporarily stop using compounded semaglutide to avoid complications.

Side effects
Potential side effects include nausea, vomiting, diarrhea, headache, fatigue, dizziness, mild heart rate elevations, and constipation.

If you experience these or other side effects, the Noom app has tips for how to manage them in the ‘Manage Your Side Effects’ section of our Success Kit. Report any severe or troublesome side effects to your Noom Med clinician immediately.

Rare adverse events
While rare, compounded semaglutide can cause serious side effects. If you notice any of the symptoms listed below, get medical help right away, as they could signal a serious or life-threatening problem:

• Signs of an allergic reaction (e.g., rash, chest tightness, trouble breathing, swelling of the mouth or throat).
• Severe dehydration (e.g., dizziness, passing out, fast heartbeat).
• Kidney problems (e.g., change in urine output, blood in the urine, or leg swelling).
• Gallbladder problems (e.g., pain in your belly, right shoulder area, or between the shoulder blades, pale-colored stools, dark urine, yellow skin or eyes, fever or chills).
• Low blood sugar (e.g., dizziness, feeling sleepy or weak, shaking, confusion, hunger, or sweating).
• Sudden vision changes (Medications that alter blood sugar can have various effects on vision and should be evaluated promptly by an eye doctor.).
• Signs of gastroesophageal reflux disease (GERD).

Call your doctor right away if you have severe stomach or back pain or are throwing up, which may indicate severe pancreas problems.

You have or had an active eating disorder, such as anorexia nervosa or bulimia.

You have a personal or family history of the following conditions:

• Medullary thyroid cancer (MTC).
• Multiple endocrine neoplasia type 2 syndrome (MEN-2).

You have a personal history of the following:

• Retinopathy.
• Pancreatitis.
• You are currently pregnant, breastfeeding, or planning to become pregnant.
• You have a history of drug or alcohol abuse.
• You have undergone recent bariatric surgery.

Your medication may include an additive that offers additional clinical benefits. Your treatment plan from your clinician will describe any additional active ingredients they have chosen to prescribe, as well as the reason for prescribing them.