Safety information

Know what you're taking.

Plain-language summaries by treatment. Discuss every line with your provider before starting any medication. If you experience a serious side effect, stop the medication and contact a clinician — or call 911.

On this page
Semaglutide · tirzepatide

GLP-1 receptor agonists

GLP-1 medications are not approved for type 1 diabetes. Clients with prior pancreatitis or MTC/MEN2 should not use these medications.

Common4
  • Nausea, vomiting, diarrhea, constipation (very common; dose-related)
  • Decreased appetite (intended effect; also a side effect)
  • Headache, fatigue (early weeks)
  • Injection-site reactions
Serious — seek care5
  • Pancreatitis (severe abdominal pain → stop the medication and seek emergency care)
  • Gallbladder disease (rapid weight loss can precipitate gallstones)
  • Thyroid C-cell tumors (boxed warning; contraindicated with personal/family history)
  • Hypoglycemia if combined with insulin or sulfonylureas
  • Acute kidney injury (from dehydration from severe GI symptoms)
Sildenafil · tadalafil · vardenafil

PDE5 inhibitors

Never combine with nitrate medications. Discuss any cardiovascular history with your provider before use.

Common5
  • Headache
  • Facial flushing
  • Nasal congestion
  • Indigestion
  • Mild vision changes (blue tint, increased light sensitivity)
Serious — seek care4
  • Severe blood-pressure drop with nitrates → absolute contraindication
  • Sudden vision loss (NAION) — rare but vision-threatening
  • Sudden hearing loss — rare
  • Priapism (erection lasting >4 hours) — emergency, seek care immediately
Oral · topical

Finasteride + minoxidil

It takes 3-6 months to see results. Discontinuation reverses any gains within 6-12 months.

Common3
  • Initial shed (4-12 weeks; hair sheds before regrowth)
  • Scalp itch or irritation (minoxidil)
  • Mild sexual side effects (finasteride): decreased libido, erectile dysfunction
Serious — seek care4
  • Persistent sexual side effects after stopping (post-finasteride syndrome) — rare
  • Mood changes, depression (finasteride) — uncommon but real
  • Pregnancy risk: finasteride is teratogenic — pregnant partners must not handle crushed tablets
  • Liver dysfunction (finasteride) — monitor in clients with liver disease
Non-controlled TRT

Clomiphene / enclomiphene / hCG

These protocols preserve fertility — preferred when conception is part of your near-term plan.

Common5
  • Mood fluctuation
  • Visual disturbances, especially with clomiphene (typically resolves on discontinuation)
  • Hot flashes
  • Acne
  • Injection-site reactions (hCG)
Serious — seek care4
  • Estrogen elevation (especially with clomiphene)
  • Hematocrit elevation — requires monitoring
  • Worsening of obstructive sleep apnea
  • Prostate concerns (PSA elevation; risk in clients with prostate cancer history)
Emergency

If something feels wrong, don't wait for us.

Severe abdominal pain, chest pain, difficulty breathing, signs of allergic reaction, sudden vision or hearing loss — call 911 immediately. Do not wait for our team to respond to a message.

Call 911