Tirzepatide/Naltrexone/B12

• It is used to help control blood sugar in people with type 2 diabetes, and for other conditions as determined by your doctor.

• Tell all your health care providers that you take this drug, as well as all your other medications (prescription, OTC, vitamins, natural products). This includes your doctors, nurses, pharmacists, and dentists.
• Talk with your doctor before you drink alcohol.
• This medication should not be used with opioids. You must be opioid-free for 7 to 10 days before starting this medication.
• This medication should not be used if you have Leber’s disease (hereditary optic nerve atrophy) as it can worsen vision problems.
• One of the ingredients, Naltrexone, can potentially cause liver dysfunction or hepatitis. Your prescriber may order liver function test at the beginning of therapy and perodically thereafter.
• Birth control pills may not work as well to prevent pregnancy. If you take birth control pills, you may need to switch to another type of birth control.
• This drug may prevent other drugs taken by mouth from getting into the bo If you take other drugs by mouth, you may need to take them at some other time than this drug. Talk with your doctor.
• If you have upset stomach, vomiting, or diarrhea that does not go away, you need to avoid getting Dehydration may lead to low blood pressure or to new or worsening kidney problems.
• If you will be having any surgery or procedure, talk with your doctor. This drug may raise the risk of food getting into the lungs during surgery or other procedures that use anesthesia or deep sedation. You may need to stop this drug before these types of surgery or procedures.
• A severe and sometimes deadly pancreas problem (pancreatitis) has happened with other drugs like this one.
• Check your blood sugar as you have been told by your doctor.
• Do not drive if your blood sugar is low.
• Tell your doctor if you are pregnant, plan on getting pregnant, or are breast- You will need to talk about the benefits and risks to you and the baby.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these sideeffects or any other side effects bother you or do not go away:

• Constipation, diarrhea, stomach pain, upset stomach, heartburn, throwing up, or decreased appetite.
• Vivid dreams, insomnia, headache.
• Itching, skin rash.

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Low blood sugar can happen while taking this drug due to other medications used to treat diabetes. Signs m’ay include dizziness, headache, feeling sleepy or weak, shaking, fast heartbeat, confusion, hunger, or Call you doctor right away if you have any of these signs. Follow what you have been toldto do for low blood sugar. This may include glucose tablets, liquid glucose, or some fruit juices.
• This drug has been shown to, cause thyroid cancer in some animals. It is not known if this happens in humans. If thyroid cancer happens, it may be deadly ifnot found and treated early. Call you doctor right away if you have a neck mass, trouble breathing, trouble swallowing, or have hoarseness that will not go a Do not use this drug if you have a health problem called Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), or if you or a family member havehad thyroid cancer.
• Signs of a severe allergic reaction: rash: hives: itching: red, swollen, blistered, or peeling skin with or without fever; wheezing: tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
• Signs of kidney problems like unable to pass urine, change in how much urine is passed, blood in the urine, or a big weight gain.
• Signs of gallbladder problems like pain in the upper right belly area, right shoulder area, or between the shoulder blades; yellow skin or eyes; fever with chills; bloating; or nausea and vomiting
• Signs of a pancreas problem (pancreatitis) like severe stomach pain, chills, constipation, nausea, vomiting, fever
• Dizziness or passing out.
• A fast heartbeat.
• Change in eyesight.
• Feeling anxious or irritable.
• Low blood sugar.

These are not all the side effects or interactions that may occur. If you have questions about side effects, call your doctor. You may report side effects to the FDA at 1-800-332-1088. You may also report side effects at www.fda.gov/medwatch.

Use this drug as ordered by your doctor. Read all information given to you. Follow directions closely.

• Shake well before using.
• Keep the dose in your mouth for at least 90 seconds before swallowing.
• Do not eat or drink for at least 5 minutes after taking.
• Take with or without food.
• Do not use if the solution is leaking or has particles.
• This solution is raspberry colored and transparent. Do not use if the solution changes color.

• If it is within 4 hours after the missed dose, take the missed dose and go back to your normal time the next day.
• If it has been more than 4 hours since the missed dose, skip the missed dose and go back to your normal time the next day.
• Do not take 2 doses at the same time or extra doses.

• Store at room temperature or in refrigerator. Do not freeze.
• Protect from heat.
• Protect from light.
• Keep all drugs in a safe Keep all drugs out of the reach of children and pets.
• Throw away unused or expired drugs. Do not flush down the toilet or pour down a drain unless you are told to do so. Check with your pharmacist if you have questions about the best way to throw out drugs. There may be drug take-back programs in your area.

• Do not share your drugs with others and do not take anyone else’s drugs.
• If you think there has been an overdose, call your poison control center or get medical care right away. Be ready to tell or show what was taken, how much, and when it happened.

This generalized information is a limited summary of diagnosis, treatment, and/or medication information. It is not meant to be comprehensive and should be used asa tool to help the user understand and/or assess potential diagnostic and treatment options. It does NOT include all information about conditions, treatments, medications, side effects, or risks that may apply to a specific patient. It is not intended to be medical advice or a substitute for the medical advice, diagnosis, or treatment of a health care provider based on the health care provider’s examination and assessment of a patient’s specific and unique circumstances.

Patients must speak with a health care provider for complete information about their health, medical questions, and treatment options, including any risks or benefits regarding use of medications. This information does not endorse any treatments or medications as safe, effective, or approved for treating a specific patient.