Refill Prescription Schedule a Consultation

Compounding

Welcome to our pharmacy's compounding services, where precision meets personalization in medication management. Compounding is the art and science of creating custom medications tailored to the unique needs of each patient. At Vital Pharmacy, our skilled pharmacists blend innovation with pharmaceutical expertise to deliver solutions that cater specifically to your health requirements. Whether it's adjusting dosage forms, flavors, or ingredients to accommodate allergies or preferences, we're dedicated to ensuring your medication experience is as effective and comfortable as possible. Discover the difference of compounding at Vital Pharmacy, where your health is our priority.

Sublingual Semaglutide (SubSema)

The Semaglutide 1 mg/mL Sublingual Suspension is a liquid medication specifically designed for sublingual use. Packaged in pre-filled oral syringes, it allows for precise dosing and is ideal for patients who need smaller doses or find injections challenging. This sublingual method also potentially extends the medication's beyond-use dates (BUDs), enhancing its stability and user-friendliness.

This formulation of Semaglutide is commonly utilized for managing type 2 diabetes, aiding in weight loss, and addressing obesity issues.

Formula Information

At Vital Pharmacy, our Semaglutide 1 mg/mL Sublingual Suspension is a precisely developed liquid formulation aimed at providing an effective way to manage various health conditions. Designed for sublingual administration, it uses the innovative SubMagna™ SL HMW base. This cutting-edge vehicle is anhydrous, self-emulsifying, and enhances permeation, making it ideal for delivering drugs with high molecular weights (HMWs) directly into the systemic circulation via the mucosal tissues under the tongue.

This sublingual administration method bypasses the gastrointestinal tract, preventing the degradation of the active pharmaceutical ingredient (API) and avoiding the inconsistent absorption issues seen with oral ingestion. This is particularly advantageous for Semaglutide, a medication used in the treatment of type 2 diabetes and obesity, ensuring more reliable and consistent drug delivery, which is crucial for maintaining its therapeutic effectiveness.

When applied under the tongue, the SubMagna™ SL HMW base interacts with saliva to form an emulsion, enhancing the solubility and dispersibility of Semaglutide. The base's unique mucoadhesive properties prolong the contact time between the medication and the mucosal tissues, potentially increasing the absorption of the API. This feature, along with the permeation-enhancing effects of the base, facilitates the efficient delivery of Semaglutide into the bloodstream, which may improve glycemic control in patients with type 2 diabetes and support weight management in individuals with obesity.

The anhydrous nature of the SubMagna™ SL HMW base also contributes to the formulation's stability, offering the potential for extended beyond-use dates (BUDs), which is an important consideration for both patients and prescribers. The suspension is provided in oral syringes, allowing for precise dosing and ease of administration, making it an excellent option for patients who may have difficulty swallowing tablets or capsules or who require smaller doses.

At Vital Pharmacy, we are dedicated to providing high-quality, patient-centered care. We recognize the importance of personalized medication solutions and are here to support both patients and prescribers with any questions regarding our Semaglutide 1 mg/mL Sublingual Suspension. Please feel free to contact us for more information or guidance on this innovative formulation.

Drug Interactions and Management

When used alongside insulin or other insulin secretagogues like sulfonylureas, semaglutide can heighten the risk of hypoglycemia. To mitigate this risk, it may be necessary to lower the dosage of these agents. Patients should monitor their blood glucose levels closely and recognize hypoglycemia symptoms such as dizziness, shakiness, sweating, and confusion.

Semaglutide's effect on gastric emptying can reduce the effectiveness of oral medications that require specific concentration thresholds, such as antibiotics or oral contraceptives. Patients might need to use additional contraceptive methods and adjust the timing of oral medication doses after consulting with their healthcare provider.

For medications with a narrow therapeutic index, like levothyroxine, concurrent use with semaglutide may necessitate dose adjustments and close monitoring. Maintaining a consistent dosing schedule and being vigilant for signs of altered efficacy or adverse effects is crucial.

Patients using medications that can cause hypoglycemia, such as non-selective beta-blockers or alcohol, should be informed about the increased risk of hypoglycemia and the potential masking of symptoms. Avoiding excessive alcohol and recognizing hypoglycemia signs is advisable.

The SubMagna™ SL HMW base's permeation-enhancing properties may influence the absorption of other sublingual or buccal medications. Healthcare providers should assess the potential for altered absorption and adjust dosing or administration times accordingly.

Patients should inform their healthcare providers about all medications, supplements, and over-the-counter drugs they are taking to ensure a thorough review of potential interactions. If adverse reactions or unexpected effects occur, contacting a healthcare provider immediately is essential. For any questions or concerns about the semaglutide 1 mg/mL sublingual suspension or its interactions with other medications, patients can reach out to their pharmacy for professional advice and support.

*Note: The beyond-use-date (BUD) will be determined based on the specific formulation and should be strictly adhered to, as per the pharmacy's compounding guidelines and regulatory standards.

How it Works

The Semaglutide 1 mg/mL Sublingual Suspension is a carefully crafted medication intended for absorption under the tongue. This liquid formulation is provided in pre-dosed oral syringes, ensuring precise dosing and ease of use, especially for patients who may have trouble swallowing pills or need smaller doses. The sublingual method is beneficial as it bypasses the gastrointestinal system, avoiding potential degradation or altered absorption that can lead to inconsistent bioavailability.

Our formulation employs the SubMagna™ SL HMW base, which is designed to deliver drugs of varying molecular weights, including high molecular weight (HMW) substances such as Semaglutide. This advanced vehicle is anhydrous, meaning it lacks water, enhancing its stability and possibly extending its beyond-use date (BUD). The base's self-emulsifying property allows it to form an emulsion upon contact with saliva, which improves the solubility and dispersibility of the active pharmaceutical ingredient (API).

Additionally, the SubMagna™ SL HMW base includes permeation enhancers and mucoadhesive properties. These features are crucial for promoting the absorption of the medication through the mucosal tissues under the tongue. The mucoadhesive quality ensures the medication stays in contact with the sublingual mucosa longer, facilitating more efficient and potentially greater absorption of the API into the bloodstream.

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used to treat type 2 diabetes and sometimes for chronic weight management. It mimics the incretin hormones, which help regulate blood glucose levels by stimulating insulin secretion and reducing glucagon release when blood glucose levels are elevated. Additionally, it slows gastric emptying and decreases appetite, which can aid in weight loss for patients with obesity.

Using the sublingual route with our Semaglutide formulation may provide a more consistent and reliable response, as it avoids gastrointestinal degradation and first-pass metabolism in the liver, common with orally ingested medications. This can result in better glycemic control and improved outcomes for patients with type 2 diabetes, along with supporting weight management efforts.

For any questions or more information about the Semaglutide 1 mg/mL Sublingual Suspension, please contact Vital Pharmacy. Our team of compounding pharmacists is ready to offer the support and guidance needed for effective patient treatment.

Other Uses

Although primarily intended for managing type 2 diabetes mellitus, the Semaglutide 1 mg/mL Sublingual Suspension could have other applications due to the unique properties of the SubMagna™ SL HMW base. This base efficiently delivers high molecular weight (HMW) substances and enhances permeation, potentially making it suitable for a variety of medications that benefit from sublingual administration. These could include hormones, peptides, or other biological drugs that usually have poor oral bioavailability due to degradation in the gastrointestinal tract or first-pass metabolism in the liver.

The sublingual delivery system of the SubMagna™ SL HMW base may also be beneficial for medications requiring rapid onset of action, as this route can offer quicker absorption into the bloodstream compared to oral administration. This feature is particularly advantageous for medications needed in acute situations, such as certain analgesics, antiemetics, or treatments for anaphylaxis. Moreover, the mucoadhesive properties of the base extend the contact time with mucosal tissues, which can be useful for drugs requiring sustained release for prolonged therapeutic effects.

Additionally, the anhydrous nature of the SubMagna™ SL HMW base may help extend the beyond-use dates (BUDs) of compounded medications, which is valuable for drugs sensitive to moisture degradation. This characteristic is especially important for medications not frequently used or compounded in small batches for individual patients. The sublingual suspension form is also ideal for patients who have difficulty swallowing tablets or capsules, such as pediatric, geriatric, or neurologically impaired patients, broadening the potential patient population that could benefit from this formulation.

It is crucial to use Semaglutide 1 mg/mL Sublingual Suspension for conditions other than type 2 diabetes based on clinical evidence and under the supervision of a healthcare professional. Patients or prescribers interested in exploring this formulation for other uses, or who have questions about the formulation, are encouraged to contact Vital Pharmacy. Our team of experienced compounding pharmacists is dedicated to providing the necessary information and support to help you make informed decisions about your healthcare or the care of your patients.

Frequently Asked Questions About Semaglutide 1 mg/mL Sublingual Suspension

What is Semaglutide 1 mg/mL Sublingual Suspension?

Semaglutide 1 mg/mL Sublingual Suspension is a liquid medication formulated for absorption under the tongue. It is delivered in pre-dosed oral syringes to ensure precise dosing and is designed to mix with saliva under the tongue, enhancing the absorption of the active pharmaceutical ingredient (API).

How does the SubMagna™ SL HMW base enhance Semaglutide delivery?

The SubMagna™ SL HMW base is a sophisticated sublingual suspension vehicle that is anhydrous, self-emulsifying, and permeation-enhancing. It is designed to efficiently deliver drugs of varying molecular weights, including high molecular weight substances like Semaglutide. Its unique properties improve solubility, dispersibility, and mucoadhesion, which can enhance the absorption of the medication through the mucosal tissues.

What are the advantages of using a sublingual suspension for Semaglutide?

Administering Semaglutide sublingually offers several benefits, such as quicker onset of action, avoidance of degradation in the gastrointestinal tract, and reduced impact of hepatic first-pass metabolism. This can improve the medication's bioavailability. Additionally, the sublingual route is convenient for patients who have difficulty swallowing pills or capsules.

How should I use the Semaglutide Sublingual Suspension?

To use the Semaglutide Sublingual Suspension, dispense the contents of the oral syringe under your tongue. Hold the liquid under your tongue for the recommended time before swallowing to maximize absorption.

Can I eat or drink right after taking Semaglutide Sublingual Suspension?

It is generally advised to wait a few minutes after taking the suspension before eating or drinking. This waiting period allows the medication to be fully absorbed through the sublingual mucosa. Follow any specific instructions provided by your healthcare provider regarding food and drink.

Is Semaglutide Sublingual Suspension suitable for children?

The appropriateness of Semaglutide Sublingual Suspension for pediatric use depends on the specific medical indications and should be determined by a healthcare provider.

What should I do if I miss a dose of Semaglutide Sublingual Suspension?

If you miss a dose, take it as soon as you remember. If it is nearly time for your next dose, skip the missed dose and continue with your regular schedule. Do not double up to compensate for a missed dose. Consult your healthcare provider for personalized advice.

How should I store Semaglutide Sublingual Suspension?

Store the Semaglutide Sublingual Suspension at room temperature, away from direct light and heat. Keep the bottle tightly closed when not in use. Refer to the product label or consult your pharmacist for specific storage instructions.

What are the potential side effects of Semaglutide Sublingual Suspension?

Like all medications, Semaglutide Sublingual Suspension may cause side effects. Common ones include nausea, vomiting, diarrhea, and abdominal pain. If you experience severe or persistent side effects, contact your healthcare provider immediately.

Can Semaglutide Sublingual Suspension be used with other medications?

It is important to discuss all medications, supplements, and over-the-counter drugs you are taking with your healthcare provider to ensure compatibility with Semaglutide Sublingual Suspension. Some medications may interact with Semaglutide, affecting its efficacy or increasing the risk of side effects.

What is the beyond-use-date (BUD) for Semaglutide Sublingual Suspension?

The beyond-use-date for Semaglutide Sublingual Suspension can vary based on the specific formulation and storage conditions. The anhydrous nature of the SubMagna™ SL HMW base may allow for longer BUDs. Always check the expiration date on the bottle and follow the guidance provided by your pharmacist or healthcare provider.

Low Dose Naltrexone

Low-Dose Naltrexone (LDN) is a medication primarily used to manage various certain chronic conditions. Developed in the 1960s and approved by the FDA, LDN is derived from the drug Naltrexone, which is typically used in higher doses to treat addiction to opioids or alcohol. Unlike its higher-dose counterpart used for addiction treatment, LDN is administered at significantly lower doses, often at bedtime. LDN is thought to modulate the immune system and reduce inflammation, which can benefit individuals with autoimmune diseases, chronic pain syndromes, and certain mood disorders. It's important to note that LDN is often prescribed off-label, meaning its use for these conditions hasn't been officially approved by regulatory agencies. Despite this, many patients report improvements in symptoms and quality of life with LDN therapy. As with any medication, it's essential to discuss potential risks and benefits with your healthcare provider before starting LDN treatment.

Formula Information

A basic formulation of LDN can be created by crushing commercially available naltrexone tablets and blending them with water. These tablets contain a small amount of naltrexone, usually ranging from 1.5 to 4.5 milligrams per dose. This compounded mixture remains stable for up to 90 days when refrigerated, though it may have a bitter or gritty taste. Microcrystalline cellulose, often used as a filler or binder in pharmaceuticals, serves as an ideal diluent for creating lower doses. The process involves thoroughly mixing the naltrexone powder with microcrystalline cellulose to achieve the desired dosage strength, usually ranging from 1 to 4.5 milligrams.

Precision and uniformity in mixing are crucial to ensure consistent dosing throughout the mixture. Once blended, the resulting mixture can be encapsulated or compressed into tablets for easy administration. LDN tablets may come in different strengths depending on the manufacturer, so it's important to follow the dosage instructions provided by your healthcare provider or pharmacist. Additionally, LDN tablets may contain inactive ingredients such as fillers, binders, and coatings to help with stability, absorption, and swallowing. Moreover, it sustains its effectiveness, as evidenced by its capacity to provoke withdrawal symptoms in chronic opiate-dependent individuals.

Drug Interactions

You should never take low-dose naltrexone if you’ve been using opioid medications, including narcotic pain relievers like codeine, morphine, hydrocodone, and oxycodone. Naltrexone blocks these drugs from binding to the receptors in your brain, which can rapidly precipitate or worsen the symptoms of opioid withdrawal. If you’re beginning LDN treatment, allow at least 10 to 14 days after your last dose of opioids. It’s generally recommended that you abstain from alcohol while taking naltrexone. The combination isn’t known to be hazardous on its own, but consuming alcohol may diminish the effectiveness of low-dose naltrexone. It can also exacerbate certain side effects, such as nausea, headache, and dizziness. Most adverse reactions with low-dose naltrexone involve narcotic pain relievers, but it’s also important to be aware of other drug interactions. For instance, certain cough suppressants and antidiarrheal medications may contain codeine, hydrocodone, or other opioids. While these medications are only available by prescription, it’s essential to check labels carefully and contact a healthcare professional if you have any questions. Naltrexone does not cause physical or psychological dependence, and patients are not known to experience withdrawal upon sudden discontinuation. Nonetheless, you should never stop taking low-dose naltrexone abruptly without first consulting your doctor.

How it Works

Low-dose naltrexone (LDN) operates in a distinct manner compared to its higher-dose counterpart. While naltrexone is traditionally prescribed in higher doses to treat addiction by blocking the effects of opioids, LDN is used off-label for various conditions. In low doses (typically 1-4.5 milligrams), naltrexone exhibits different pharmacological properties. It's believed to modulate the immune system and affect the release of certain neurotransmitters, including endorphins. By temporarily blocking opioid receptors, LDN may prompt the body to increase production of endorphins, which are natural pain-relieving and mood-regulating substances. This mechanism is thought to contribute to its potential efficacy in managing conditions such as chronic pain, autoimmune diseases, and certain mood disorders. However, further research is needed to fully elucidate the mechanisms and efficacy of LDN across different conditions.

Other Uses

LDN is commonly used off-label for the following conditions:

· Chronic pain conditions such as fibromyalgia and neuropathic pain

· Autoimmune diseases like multiple sclerosis, rheumatoid arthritis, and Crohn's disease

· Inflammatory conditions such as chronic fatigue syndrome and irritable bowel syndrome (IBS)

· Certain mood disorders like depression and anxiety