Prescription weight loss that puts you first
Personalized, doctor-trusted treatment plans
Prescription treatments tailored to your unique needs
Ongoing care and check-ins included, 100% online
Prescription products require an online consultation with a healthcare provider who will determine if a prescription is appropriate. FSA/HSA eligibility and coverage varies by plan provider.
Adjust medication anytime with a provider
Personalized dosage options to help your body adjust to treatment
Adjust your dosage as needed to balance side effect and results
Change medication in partnership with a licensed provider anytime
Meal replacement bars
& shakes
Save 30% on average
with FSA and HSA
Medication to
reduce appetite
Doctor-recommended treatments
Realistic
nutrition principles
Tips tailored to your
eating profile
Support for
better sleep
Custom in-app tools
and tracking
Made to fit
your lifestyle
Plans starting
at $69/month
Meal replacement bars
& shakes
Save 30% on average
with FSA and HSA
Medication to
reduce appetite
Doctor-recommended treatments
Realistic
nutrition principles
Tips tailored to your
eating profile
Support for
better sleep
Custom in-app tools
and tracking
Made to fit
your lifestyle
Plans starting
at $69/month
Hers can help
Break the cycle
Instead of treating the surface level ups and downs of weight loss, our plans go deeper to address the underlying factors affecting you.
Feel like yourself
Get your confidence back with treatment that’s made for you and made to help you feel like you.
Live your life
Say yes with no stress and keep up with your kids, friends, and family.
Improve your health
If you’re at risk for certain medical conditions or concerns, healthy weight loss can help.
Trusted weight loss treatment plan
Each treatment includes access to a Certificate of Analysis (COA) confirming consistency, quality, and potency.
Personalized dosage plans
Dosage plans are tailored to your specific weight loss goals and preferences.
Unlimited access to licensed providers
Ongoing care comes from an experienced Care Team and vetted providers specializing in weight loss—at no extra cost.
Fast and free shipping
Two-day*, temperature-regulated shipping helps control the medication's temperature.
Featured reviews
Hear it from her
Medical intake
Answer some questions about your health history, lifestyle, and goals, 100% online.
Provider evaluation
A medical professional will review your intake and determine what’s right for you.
Personalized plan
If prescribed, you’ll get a customized holistic plan designed to work for you.
Ongoing support
Get unlimited online access to follow-ups, adjustments, and answers to questions.
What are my weight loss treatment options through Hers?
There are plenty of brand name and generic prescription drugs that the U.S. Food and Drug Administration has approved for people struggling with high BMI (body mass index), obesity, or other weight-related health conditions. Medications such as Ozempic® (semaglutide), Wegovy® (semaglutide), Rybelsus® (semaglutide), Mounjaro® (tirzepatide), Zepbound® (tirzepatide), Saxenda® (liraglutide), IMCIVREE® (setmelanotide), Qsymia® (phentermine-topiramate), Adipex-P® (phentermine), Lomaira® (phentermine), Alli® (orlistat), Xenical® (orlistat), Contrave® (naltrexone-bupropion), as well as other medications like antidepressants prescribed off-label. Many have also had clinical trials.
Through Hers you can get access to
(the same active ingredient as Ozempic® and Wegovy®).Hers also offers access to that can include metformin, bupropion, topiramate, vitamin B12, and naltrexone. Taken as a once-daily pill, these medications work in different ways to support your weight loss goals. Your provider will help you find the right medication based on your custom weight loss profile.
How much does weight loss treatment cost?
Through Hers you can get GLP-1 weight loss drugs for as little as $165 a month (when you sign up for a 12-month plan which you’ll pay for upfront in full). The oral medication kits start at just $69 a month with a 10-month plan. Total pricing varies at checkout.
Medications like GLP-1s actually don’t have to cost thousands of dollars every month without the brand name markup. At Hers, we are leveraging our size and scale to ensure access to high-quality supplies of compounded GLP-1s. This keeps prices low for our customers and ensures that providers through Hers can prescribe what is truly best for you.
Are video visits with a doctor required?
No video visit is required; a provider will review your information 100% online. If prescribed, you’ll get unlimited online access to message your provider as needed for follow-ups, adjustments, and answers to your questions.
Is insurance required?
No, Hers does not require insurance. We have a straight-forward approach to pricing and billing, as well as affordable generic options to make taking care of yourself as simple as possible.
How is Hers dealing with GLP-1 shortages?
Through Hers, you can find GLP-1s like Ozempic® and Wegovy®—but knowing that the availability of those medications can change, Hers is working closely with trusted partners to support our customers in accessing the weight loss treatment that is right for them using pharmacy compounding.
While name-brand FDA-approved drugs like Ozempic® and Wegovy® are currently in short supply, Hers also provides compounded versions of GLP-1s formulated with the same active ingredient. The formulations of these compounded semaglutide products are held to high quality standards and developed in FDA-regulated facilities. This means you can start your weight loss journey with confidence even while other drugs may be on the FDA drug shortage list.
Compounded semaglutide, including Hims & Hers’ product, is not approved or evaluated for safety, efficacy, or quality by FDA. Wegovy® (semaglutide) and Ozempic® (semaglutide) are not compounded. Wegovy® (semaglutide) is FDA-approved for weight loss. Ozempic® (semaglutide) is FDA-approved for type 2 diabetes treatment but may be prescribed off-label for weight loss at a healthcare provider’s discretion.
Who qualifies for compounded GLP-1s at Hers?
A state-licensed provider reviews the health history, weight loss goals, and unique patient needs of every individual patient to see if they qualify before prescribing any kind of treatment.
Are GLP-1s available in all states?
Unfortunately, GLP-1s are not yet available in all 50 states; however, Hers is working to expand our offering as soon as possible.
How long do I need to stay on medication?
Medication is a long-term use weight loss treatment not meant for short-term use. When you stop taking it, the triggers that previously drove unhealthy eating behaviors may return. Always speak with a licensed medical provider before stopping treatment.
When will I see weight loss results?
Remember, results aren’t instant. Because everyone’s weight loss journey is different, the timeline for results may vary from person to person.
What is a certificate of analysis?
It’s a document that verifies a compounded GLP-1 prescription’s consistency and potency.
How are compounded GLP-1s sourced?
The ingredients are sourced from FDA-regulated suppliers and the treatments are compounded in FDA-regulated facilities.
What are meal replacement bars and shakes?
Healthy meal replacement bars and shakes make nutrition simple with convenient, great-tasting, and balanced daily support. Maintaining protein intake is key to supporting muscle mass while taking weight loss medication. Meal replacement bars and shakes can serve as a valuable source of protein, vitamins, and minerals, which is important when appetite is suppressed.
What are the potential side effects of GLP-1 medications?
It’s common to experience some side effects like nausea and upset stomach as your body adjusts to the medication. They're usually temporary and are easier to manage when you know what to do. We’re here for you every step of the way as you adjust to your medication
Your dosage and how fast you increase your dosage is personalized to you, and your provider can help make adjustments as needed, anytime
Free step-by-step guides made by weight loss experts in the Hers app
24/7 messaging with a licensed provider at no extra cost
Personalized dosage and medication adjustments as needed by licensed provider
To help your body adjust, a fast-acting anti-nausea medication is included with treatment at no extra cost, if eligible
Can a provider change my dosage at any point during my treatment?
Yes. Providers personalize and adjust weight loss medication dosages based on your unique medical history and weight loss needs. Higher doses of compounded semaglutide are available at additional cost if recommended by a provider.
Can I switch medication kits if the medications don’t work for me?
Yes. Providers can change your oral medication kit prescription free of charge, anytime.
What are the potential side effects of oral weight loss medication kits?
It’s common to experience some side effects like nausea as you adjust to the medication. A fast-acting anti-nausea medication is included with treatment at no extra cost, if eligible.
Metformin's potential side effects include nausea, diarrhea, and upset stomach. Taking medication with meals can help reduce these side effects.
Bupropion’s potential side effects include trouble sleeping and feeling anxious.
Topiramate's potential side effects include tingling of the arms and legs (paresthesia), changing how foods taste, especially with carbonated beverages, sleepiness/drowsiness, difficulty with memory, effects on thinking and alertness, and kidney stones.
Naltrexone's potential side effects include nausea and vomiting.
Does Hers offer weight loss treatment for women with PCOS?
Yes. If eligible, Hers offers access to personalized weight loss treatments, including compounded GLP-1s, for women who have been diagnosed with PCOS and have a BMI of 27+.
Important Safety Information
NALTREXONE + VITAMIN B12 is a compounded product and is not FDA-approved. The FDA does not verify the safety or effectiveness of compounded drugs
NALTREXONE is a prescription medication that is FDA approved to:
treat alcohol dependence
prevent relapse to opioid dependence, after opioid detoxification.
VITAMIN B12 is a dietary supplement utilized in many areas of the body principally for the proper function of your red blood cells, nerve cells, energy levels and mood. Additionally it is used to supplement B12 when other drugs may possibly decrease its level.
NALTREXONE + VITAMIN B12 is a prescription medicine that is prescribed off-label and may help some adults with overweight and obesity lose weight and keep the weight off.
IMPORTANT SAFETY INFORMATION
NALTREXONE + VITAMIN B12 can cause serious side effects, including:
- Risk of opioid overdose. You can accidentally overdose in two ways.
- NALTREXONE + VITAMIN B12 blocks the effects of opioids, such as heroin or opioid pain medicines, examples include, but are not limited to; morphine (MS Contin), hydrocodone (Vicodin), oxycodone (Oxycontin), hydromorphone (Percocet), codeine, or tramadol. Do not try to overcome this blocking effect by taking large amounts of opioids—this can lead to serious injury, coma, or death.
- After you receive a dose of NALTREXONE + VITAMIN B12, its blocking effect slowly decreases and completely goes away over time. If you have used opioid street drugs or opioid-containing medicines in the past, using opioids in amounts that you used before treatment with NALTREXONE + VITAMIN B12 can lead to overdose and death. You may also be more sensitive to the effects of lower amounts of opioids:
- after you have gone through detoxification
- when your next NALTREXONE + VITAMIN B12 dose is due
- if you miss a dose of NALTREXONE + VITAMIN B12
- after you stop NALTREXONE + VITAMIN B12 treatment
- Tell your family and the people closest to you of this increased sensitivity to opioids and the risk of overdose.
Talk to your healthcare provider about naloxone, a medicine that is available to patients for the emergency treatment of an opioid overdose.
Call 911 or get emergency medical help right away in all cases of known or suspected opioid overdose, even if naloxone is administered.
- Sudden opioid withdrawal. To avoid sudden opioid withdrawal, you must stop taking any type of opioid, including street drugs; prescription pain medicines; cough, cold, or diarrhea medicines that contain opioids; or opioid-dependence treatments, including buprenorphine or methadone, for at least 7 to 14 days before starting NALTREXONE + VITAMIN B12. Sudden opioid withdrawal can be severe and may require hospitalization.
- Liver damage or hepatitis. NALTREXONE + VITAMIN B12 can cause liver damage or hepatitis. Tell your healthcare provider if you have any of these symptoms during treatment with NALTREXONE + VITAMIN B12:
- stomach area pain lasting more than a few days
- dark urine
- yellowing of the whites of your eyes
- tiredness
- Your healthcare provider may need to stop treating you with NALTREXONE + VITAMIN B12 if you get signs or symptoms of a serious liver problem.
You must stop taking opioids before you start taking NALTREXONE + VITAMIN B12. It is not known if NALTREXONE + VITAMIN B12 is safe and effective in children.
Who should not take NALTREXONE + VITAMIN B12?
Do not take NALTREXONE + VITAMIN B12 if you:
- are using or have a physical dependence on opioid-containing medicines, such as but not limited to, morphine (MS Contin), hydrocodone (Vicodin), oxycodone (Oxycontin), hydromorphone (Percocet), codeine, or tramadol. or opioid street drugs, such as heroin.
- are having opioid withdrawal symptoms. Opioid withdrawal symptoms may happen when you have been taking opioid containing medicines or opioid street drugs regularly and then stop. Symptoms of opioid withdrawal may include: anxiety, sleeplessness, yawning, fever, sweating, teary eyes, runny nose, goosebumps, shakiness, hot or cold flushes, muscle aches, muscle twitches, restlessness, nausea and vomiting, diarrhea, or stomach cramps.
- are allergic to NALTREXONE + VITAMIN B12 or any of the inactive ingredients in NALTREXONE + VITAMIN B12. See the medication guide for the full list of ingredients.
What should I tell my healthcare provider before taking NALTREXONE + VITAMIN B12?
Before you take NALTREXONE + VITAMIN B12, tell your healthcare provider if you:
- have liver problems, use or abuse street (illegal) drugs, have hemophilia or other bleeding problems, have kidney problems, or have any other medical conditions.
- are pregnant or plan to become pregnant. It is not known if NALTREXONE + VITAMIN B12 will harm your unborn baby. are breastfeeding. NALTREXONE + VITAMIN B12 passes into breast milk. Talk - to your healthcare provider about whether you will breastfeed or take NALTREXONE + VITAMIN B12. You should not do both.
Tell your healthcare provider about all the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements. Especially tell your healthcare provider if you take any opioid-containing medicines for pain, cough or colds, or diarrhea.
What are other possible serious side effects of NALTREXONE + VITAMIN B12?
NALTREXONE + VITAMIN B12 can cause serious side effects, including:
Depressed mood. Sometimes this leads to suicide, or suicidal thoughts, and suicidal behavior. Tell your family members and people closest to you that you are taking NALTREXONE + VITAMIN B12.
Pneumonia. Some people receiving NALTREXONE + VITAMIN B12 treatment have had a type of pneumonia that is caused by an allergic reaction. If this happens to you, you may need to be treated in the hospital.
Serious allergic reactions. Serious allergic reactions can happen during or soon after an injection of NALTREXONE + VITAMIN B12. Tell your healthcare provider or get medical help right away if you have any of these symptoms:
Pneumonia. Some people receiving NALTREXONE + VITAMIN B12 treatment have had a type of pneumonia that is caused by an allergic reaction. If this happens to you, you may need to be treated in the hospital.
Serious allergic reactions. Serious allergic reactions can happen during or soon after an injection of NALTREXONE + VITAMIN B12. Tell your healthcare provider or get medical help right away if you have any of these symptoms:
- skin rash
- swelling of your face, eyes, mouth, or tongue
- trouble breathing or wheezing
- chest pain
- feeling dizzy or faint
Common side effects of NALTREXONE + VITAMIN B12 may include:
- nausea
- sleepiness
- headache
- dizziness
- vomiting
- decreased appetite
- painful joints
- muscle cramps
- cold symptoms
- trouble sleeping
- toothache
These are not all the side effects of NALTREXONE + VITAMIN B12. Tell your healthcare provider if you have any side effect that bothers you or that does not go away. You are encouraged to report all side effects to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088. This is only a summary of the most important information about NALTREXONE + VITAMIN B12.
Need more information?
Ask your healthcare provider or pharmacist.
Important Safety Information
TOPIRAMATE + VITAMIN B12 is a compounded product and is not FDA-approved. The FDA does not verify the safety or effectiveness of compounded drugs.
TOPIRAMATE (Topamax®) is FDA approved to:
- to treat certain types of seizures (partial-onset seizures and primary generalized tonic-clonic seizures) in adults and children 2 years and older,
- with other medicines to treat certain types of seizures (partial-onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome) in adults and children 2 years and older,
- to prevent migraine headaches in adults and adolescents 12 years and older.
VITAMIN B12 is a dietary supplement utilized in many areas of the body principally for the proper function of your red blood cells, nerve cells, energy levels and mood. Additionally it is used to supplement B12 when other drugs may possibly decrease its level.
TOPIRAMATE + VITAMIN B12 is prescribed off-label and may help some adults with overweight and obesity lose weight and keep the weight off.
IMPORTANT SAFETY INFORMATION
What is the most important information I should know about TOPIRAMATE + VITAMIN B12?
TOPIRAMATE + VITAMIN B12 may cause eye problems. Serious eye problems include:
- Any sudden decrease in vision with or without eye pain and redness.
- A blockage of fluid in the eye causing increased pressure in the eye (secondary angle closure glaucoma).
These eye problems can lead to permanent loss of vision if not treated.
You should call your healthcare provider right away if you have any new eye symptoms, including any new problems with your vision.
TOPIRAMATE + VITAMIN B12 may cause decreased sweating and increased body temperature (fever). People, especially children, should be watched for signs of decreased sweating and fever, especially in hot temperatures. Some people may need to be hospitalized for this condition. If a high fever, a fever that does not go away, or decreased sweating develops, call your healthcare provider right away.
TOPIRAMATE + VITAMIN B12 can increase the level of acid in your blood (metabolic acidosis). If left untreated, metabolic acidosis can cause brittle or soft bones (osteoporosis, osteomalacia, osteopenia), kidney stones, can slow the rate of growth in children, and may possibly harm your baby if you are pregnant. Metabolic acidosis can happen with or without symptoms. Sometimes people with metabolic acidosis will:
- Feel tired
- Not feel hungry (loss of appetite)
- Feel changes in heartbeat
- Have trouble thinking clearly
Your healthcare provider should do a blood test to measure the level of acid in your blood before and during your treatment with TOPIRAMATE + VITAMIN B12. If you are pregnant, you should talk to your healthcare provider about whether you have metabolic acidosis.
Like other antiepileptic drugs, TOPIRAMATE + VITAMIN B12 may cause suicidal thoughts or actions in a very small number of people, about 1 in 500. Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you:
| • Thoughts about suicide or dying | • Feeling agitated or restless |
| • Attempts to commit suicide | • Trouble sleeping (insomnia) |
| • New or worse depression | • New or worse irritability |
| • New or worse anxiety | • Acting aggressive, being angry or violent |
| • Panic attacks | • Acting on dangerous impulses |
| • An extreme increase in activity and talking (mania) | • Other unusual changes in behavior or mood |
TOPIRAMATE + VITAMIN B12 may lower bone mineral density. TOPIRAMATE + VITAMIN B12 may decrease the density of bones when used over a long period.
TOPIRAMATE + VITAMIN B12 may have negative effects on growth in children
TOPIRAMATE + VITAMIN B12 may slow height increases and weight gain in children and adolescents when used over a long period
Do not stop TOPIRAMATE + VITAMIN B12 without first talking to a healthcare provider.
- Stopping TOPIRAMATE + VITAMIN B12 suddenly can cause serious problems.
- Suicidal thoughts or actions can be caused by things other than medicines. If you have suicidal thoughts or actions, your healthcare provider may check for other causes.
- If you have epilepsy and you stop taking TOPIRAMATE + VITAMIN B12 suddenly, you may have seizures that do not stop. Your healthcare provider will tell you how to stop taking TOPIRAMATE + VITAMIN B12 slowly.
- If you miss a single dose of TOPIRAMATE + VITAMIN B12, take it as soon as you can. However, if you are within 6 hours of taking your next scheduled dose, wait until then to take your usual dose of TOPIRAMATE + VITAMIN B12 and skip the missed dose. Do not double your dose. If you have missed more than one dose, you should call your healthcare provider for advice.
How can I watch for early symptoms of suicidal thoughts and actions?
- Pay attention to any changes, especially sudden changes, in mood, behaviors, thoughts, or feelings.
- Keep all follow-up visits with your healthcare provider as scheduled.
- Call your healthcare provider between visits as needed, especially if you are worried about symptoms.
TOPIRAMATE + VITAMIN B12 can harm your unborn baby.
- If you take TOPIRAMATE + VITAMIN B12 during pregnancy, your baby has a higher risk for birth defects called cleft lip and cleft palate. These defects can begin early in pregnancy, even before you know you are pregnant.
- Cleft lip and cleft palate may happen even in children born to women who are not taking any medicines and do not have other risk factors.
- There may be other medicines to treat your condition that have a lower chance of birth defects.
- All women of childbearing age should talk to their healthcare providers about using other possible treatments instead of TOPIRAMATE + VITAMIN B12. If the decision is made to use TOPIRAMATE + VITAMIN B12, you should use effective birth control (contraception) unless you are planning to become pregnant. You should talk to your doctor about the best kind of birth control to use while you are taking TOPIRAMATE + VITAMIN B12.
- Tell your healthcare provider right away if you become pregnant while taking TOPIRAMATE + VITAMIN B12. You and your healthcare provider should decide if you will continue to take TOPIRAMATE + VITAMIN B12 while you are pregnant.
- If you take TOPIRAMATE + VITAMIN B12 during pregnancy, your baby may be smaller than expected at birth. The long-term effects of this are not known. Talk to your healthcare provider if you have questions about this risk during pregnancy.
- Metabolic acidosis may have harmful effects on your baby. Talk to your healthcare provider if TOPIRAMATE + VITAMIN B12 has caused metabolic acidosis during your pregnancy.
- Pregnancy Registry: If you become pregnant while taking TOPIRAMATE + VITAMIN B12, talk to your healthcare provider about registering with the North American Antiepileptic Drug Pregnancy Registry. You can enroll in this registry by calling 1-888-233-2334. The purpose of this registry is to collect information about the safety of TOPIRAMATE + VITAMIN B12 and other antiepileptic drugs during pregnancy.
Before taking TOPIRAMATE + VITAMIN B12, tell your healthcare provider about all of your medical conditions, including if you:
- Have or have had depression, mood problems, or suicidal thoughts or behavior
- Have kidney problems, have kidney stones, or are getting kidney dialysis
- Have a history of metabolic acidosis (too much acid in the blood)
- Have liver problems
- Have weak, brittle, or soft bones (osteomalacia, osteoporosis, osteopenia, or decreased bone density)
- Have lung or breathing problems
- Have eye problems, especially glaucoma
- Have diarrhea
- Have a growth problem
- Are on a diet high in fat and low in carbohydrates, which is called a ketogenic diet
- Are having surgery
- Are pregnant or plan to become pregnant
- Are breastfeeding or plan to breastfeed? TOPIRAMATE + VITAMIN B12 passes into breast milk. Breastfed babies may be sleepy or have diarrhea. It is not known if the TOPIRAMATE + VITAMIN B12 that passes into breast milk can cause serious harm to your baby. Talk to your healthcare provider about the best way to feed your baby if you take TOPIRAMATE + VITAMIN B12.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. TOPIRAMATE + VITAMIN B12 and other medicines may affect each other causing side effects. Especially tell your healthcare provider if you take:
- Valproic acid (such as Depakene® or Depakote®).
- Any medicines that impair or decrease your thinking, concentration, or muscle coordination.
- Birth control that contains hormones (such as pills, implants, patches or injections). TOPIRAMATE + VITAMIN B12 may make your birth control less effective. Tell your healthcare provider if your menstrual bleeding changes while you are using birth control and TOPIRAMATE + VITAMIN B12.
Ask your healthcare provider if you are not sure if your medicine is listed above. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist each time you get a new medicine. Do not start a new medicine without talking with your healthcare provider.
How should I take TOPIRAMATE + VITAMIN B12?
- Take TOPIRAMATE + VITAMIN B12 exactly as prescribed.
- Your healthcare provider may change your dose. Do not change your dose without talking to your healthcare provider.
- Take TOPIRAMATE + VITAMIN B12 tablets whole. Do not chew the tablets. They may leave a bitter taste.
- TOPIRAMATE + VITAMIN B12 can be taken before, during, or after a meal. Drink plenty of fluids during the day. This may help prevent kidney stones while taking TOPIRAMATE + VITAMIN B12.
- If you take too much TOPIRAMATE + VITAMIN B12, call your healthcare provider right away or go to the nearest emergency room.
- If you miss a single dose of TOPIRAMATE + VITAMIN B12, take it as soon as you can. However, if you are within 6 hours of taking your next scheduled dose, wait until then to take your usual dose of TOPIRAMATE + VITAMIN B12 and skip the missed dose. Do not double your dose. If you have missed more than one dose, you should call your healthcare provider for advice.
- Do not stop taking TOPIRAMATE + VITAMIN B12 without talking to your healthcare provider. Stopping TOPIRAMATE + VITAMIN B12 suddenly may cause serious problems. If you have epilepsy and you stop taking TOPIRAMATE + VITAMIN B12 suddenly, you may have seizures that do not stop. Your healthcare provider will tell you how to stop taking TOPIRAMATE + VITAMIN B12 slowly.
- Your healthcare provider may do blood tests while you take TOPIRAMATE + VITAMIN B12.
What should I avoid while taking TOPIRAMATE + VITAMIN B12?
- You should not drink alcohol while taking TOPIRAMATE + VITAMIN B12. TOPIRAMATE + VITAMIN B12 and alcohol can affect each other, causing side effects such as sleepiness and dizziness.
- Do not drive a car or operate machinery until you know how TOPIRAMATE + VITAMIN B12 affects you. TOPIRAMATE + VITAMIN B12 can slow your thinking and motor skills, and may affect vision.
Even when taking TOPIRAMATE + VITAMIN B12 or other antiepileptic medicines, some people with epilepsy will continue to have unpredictable seizures. Therefore, use caution and talk to your doctor before beginning any activities where loss of consciousness could result in serious danger to you or those around you (including swimming, driving a car, climbing in high places, etc.).
What are the possible side effects of TOPIRAMATE + VITAMIN B12?
TOPIRAMATE + VITAMIN B12 may cause serious side effects including:
See “What is the most important information I should know about TOPIRAMATE + VITAMIN B12?”
High blood ammonia levels. High ammonia in the blood can affect your mental activities, slow your alertness, make you feel tired, or cause vomiting. This has happened when TOPIRAMATE + VITAMIN B12 is taken with a medicine called valproic acid (Depakene® or Depakote®).
Effects on thinking and alertness. TOPIRAMATE + VITAMIN B12 may affect how you think and cause confusion, problems with concentration, attention, memory, or speech. TOPIRAMATE + VITAMIN B12 may cause depression or mood problems, tiredness, and sleepiness.
Dizziness or loss of muscle coordination.
Serious skin reactions. TOPIRAMATE + VITAMIN B12 may cause a severe rash with blisters and peeling skin, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome). TOPIRAMATE + VITAMIN B12 may also cause a rash with blisters and peeling skin over much of the body that may cause death (toxic epidermal necrolysis). Call your healthcare provider right away if you develop a skin rash or blisters.
Kidney stones. Drink plenty of fluids when taking TOPIRAMATE + VITAMIN B12 to decrease your chances of getting kidney stones.
Low body temperature. Taking TOPIRAMATE + VITAMIN B12 when you are also taking valproic acid can cause a drop in body temperature to less than 95°F, feeling tired, confusion, or coma.
Effects on thinking and alertness. TOPIRAMATE + VITAMIN B12 may affect how you think and cause confusion, problems with concentration, attention, memory, or speech. TOPIRAMATE + VITAMIN B12 may cause depression or mood problems, tiredness, and sleepiness.
Dizziness or loss of muscle coordination.
Serious skin reactions. TOPIRAMATE + VITAMIN B12 may cause a severe rash with blisters and peeling skin, especially around the mouth, nose, eyes, and genitals (Stevens-Johnson syndrome). TOPIRAMATE + VITAMIN B12 may also cause a rash with blisters and peeling skin over much of the body that may cause death (toxic epidermal necrolysis). Call your healthcare provider right away if you develop a skin rash or blisters.
Kidney stones. Drink plenty of fluids when taking TOPIRAMATE + VITAMIN B12 to decrease your chances of getting kidney stones.
Low body temperature. Taking TOPIRAMATE + VITAMIN B12 when you are also taking valproic acid can cause a drop in body temperature to less than 95°F, feeling tired, confusion, or coma.
Call your healthcare provider right away if you have any of the symptoms above.
The most common side effects of TOPIRAMATE + VITAMIN B12 include:
| • Tingling of the arms and legs (paresthesia) | • Dizziness |
| • Not feeling hungry | • Sleepiness/drowsiness |
| • Nausea | • Slow reactions |
| • A change in the way foods taste | • Difficulty with memory |
| • Diarrhea | • Pain in the abdomen |
| • Weight loss | • Fever |
| • Nervousness | • Abnormal vision |
| • Upper respiratory tract infection | • Decreased feeling or sensitivity, especially in the skin |
| • Speech problems | |
| • Tiredness |
Tell your healthcare provider about any side effect that bothers you or that does not go away. You are encouraged to report all side effects to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.
These are not all the possible side effects of TOPAMAX
Important Safety Information
METFORMIN XR is a prescription medicine that is FDA approved to treat Type 2 diabetes mellitus when hyperglycemia cannot be managed with diet and exercise alone.
When prescribed off-label METFORMIN XR may help some adults with overweight or obesity lose weight and keep the weight off.
IMPORTANT SAFETY INFORMATION
What is the most important information I should know about METFORMIN XR tablets?
Lactic Acidosis. Metformin, the medicine in METFORMIN XR tablets, can cause a rare, but serious, side effect called lactic acidosis (a build-up of lactic acid in the blood) that can cause death. Lactic acidosis is a medical emergency and must be treated in a hospital.
Stop taking METFORMIN XR tablets and call your healthcare provider right away if you get any of the following symptoms of lactic acidosis:
- feel very weak and tired
- have unusual (not normal) muscle pain
- have trouble breathing
- have unusual sleepiness or sleep longer than usual
- have unexplained stomach or intestinal problems with nausea and vomiting, or diarrhea
- feel cold, especially in your arms and legs
- feel dizzy or lightheaded
- have a slow or irregular heartbeat
You have a higher chance of getting lactic acidosis if you:
- have kidney problems. People whose kidneys are not working properly should not take METFORMIN XR tablets.
- have liver problems.
- have congestive heart failure that requires treatment with medicines.
- drink a lot of alcohol (very often or short-term "binge" drinking).
- get dehydrated (lose a large amount of body fluids). This can happen - if you are sick with a fever, vomiting, or diarrhea. Dehydration can also happen when you sweat a lot with activity or exercise and do not drink enough fluids.
- have certain x-ray tests with injectable dyes or contrast agents.
- have surgery.
- have a heart attack, severe infection, or stroke.
- are 80 years of age or older and have not had your kidney function tested.
Do not take METFORMIN XR tablets if you:
- have kidney problems
- are allergic to the metformin in METFORMIN XR tablets or any of the ingredients in METFORMIN XR tablets. See the medication guide for the full list of ingredients.
- are going to get an injection of dye or contrast agents for an x-ray procedure or if you are going to have surgery and not able to eat or drink much. In these situations, METFORMIN XR tablets will need to be stopped for a short time. Talk to your healthcare provider about when you should stop METFORMIN XR tablets and when you should start METFORMIN XR tablets again.
What should I tell my healthcare provider before taking METFORMIN XR tablets?
Before taking METFORMIN XR tablets, tell your healthcare provider if you:
- have type 1 diabetes. METFORMIN XR tablets should not be used to treat people with type 1 diabetes.
- have a history or risk for diabetic ketoacidosis (high levels of certain acids, known as ketones, in the blood or urine). METFORMIN XR tablets should not be used for the treatment of diabetic ketoacidosis.
- have kidney problems.
- have liver problems.
- have heart problems, including congestive heart failure.
- are older than 80 years. If you are over 80 years old you should not take METFORMIN XR tablets unless your kidneys have been checked and they are normal.
- drink alcohol very often, or drink a lot of alcohol in short-term "binge" drinking.
- are taking insulin.
- have any other medical conditions.
- are pregnant or plan to become pregnant. It is not known if metformin will harm your unborn baby. If you are pregnant, talk with your healthcare provider about the best way to control your blood sugar while you are pregnant.
- are breast-feeding or plan to breast-feed. It is not known if metformin passes into your breast milk. Talk with your healthcare provider about the best way to feed your baby while you take METFORMIN XR tablets. Tell your healthcare provider about all the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Know the medicines you take. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.
- METFORMIN XR tablets may affect the way other medicines work, and other medicines may affect how METFORMIN XR tablets work.
Common side effects of METFORMIN XR tablets include diarrhea, nausea, and upset stomach. These side effects generally go away after you take the medicine for a while. Taking your medicine with meals can help reduce these side effects. Tell your healthcare provider if the side effects bother you a lot, last for more than a few weeks, come back after they've gone away, or start later in therapy. You may need a lower dose or need to stop taking the medicine for a short period or for good.
About 3 out of every 100 people who take METFORMIN XR tablets have an unpleasant metallic taste when they start taking the medicine. It lasts for a short time.
METFORMIN XR tablets rarely cause hypoglycemia (low blood sugar) by themselves. However, hypoglycemia can happen if you do not eat enough, if you drink alcohol, or if you take other medicines to lower blood sugar.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. The product information provided is intended only for residents of the United States. The products discussed herein may have different product labeling in different countries.
Important Safety Information
BUPROPION XL (Wellbutrin XL©) is a prescription medicine that is FDA approved to treat adults with a certain type of depression called major depressive disorder, and for the prevention of autumn-winter seasonal depression (seasonal affective disorder).
When prescribed off-label Bupropion may help some adults with overweight and obesity lose weight and keep the weight off.
IMPORTANT SAFETY INFORMATION
WARNING: CHANGES IN THINKING AND BEHAVIOR, DEPRESSION, AND SUICIDAL THOUGHTS OR ACTIONS
Suicidal Thoughts or Actions and Antidepressant Drugs
Antidepressants may increase the risk of suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment. Depression or other serious mental illnesses are the most important causes of suicidal thoughts and actions. People who have (or have a family history of) bipolar illness or suicidal thoughts or actions may have a particularly high risk. Pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if symptoms such as anxiety, irritability, impulsivity, trouble sleeping, aggressive behavior or suicidal thoughts are new, worse or worry you. BUPROPION XL has not been evaluated for use in patients under the age of 18.
Call your healthcare provider right away if you or your family member has any of the following symptoms, especially if they are new, worse, or worry you:
- thoughts about suicide or dying
- attempts to commit suicide
- new or worse depression
- new or worse anxiety
- feeling very agitated or restless
- panic attacks
- trouble sleeping (insomnia)
- new or worse irritability
- acting aggressive, being angry, or violent
- acting on dangerous impulses
- an extreme increase in activity and talking (mania)
- other unusual changes in behavior or mood
Although BUPROPION XL is not a treatment for quitting smoking, it contains the same active ingredient (bupropion) as ZYBAN, which is used to help patients quit smoking.
Some people have had serious side effects while taking bupropion to help them quit smoking, including:
New or worse mental health problems, such as changes in behavior or thinking, aggression, hostility, agitation, depression, or suicidal thoughts or actions. Some people had these symptoms when they began taking bupropion, and others developed them after several weeks of treatment, or after stopping bupropion. These symptoms happened more often in people who had a history of mental health problems before taking bupropion than in people without a history of mental health problems.
Stop taking BUPROPION XL and call your healthcare provider right away if you, your family, or caregiver notice any of these symptoms. Work with your healthcare provider to decide whether you should continue to take BUPROPION XL. In many people, these symptoms went away after stopping BUPROPION XL, but in some people, symptoms continued after stopping BUPROPION XL. It is important for you to follow-up with your healthcare provider until your symptoms go away.
What Other Important Information Should I Know About BUPROPION XL?
Before taking BUPROPION XL, tell your healthcare provider if you have ever had depression or other mental health problems. You should also tell your healthcare provider about any symptoms you had during other times you tried to quit smoking, with or without bupropion.
What Other Important Information Should I Know About BUPROPION XL?
- Seizures: There is a chance of having a seizure (convulsion, fit) with BUPROPION XL, especially in people with certain medical problems or who take certain medicines. Do not take any other medicines while you are taking BUPROPION XL unless your healthcare provider has said it is okay to take them. If you have a seizure while taking BUPROPION XL, stop taking the tablets and call your healthcare provider right away.
- High blood pressure (hypertension): Some people get high blood pressure that can be severe while taking BUPROPION XL.
- Manic episodes: Some people may have periods of mania while taking BUPROPION XL. If you have any of the following symptoms of mania, call your healthcare provider:
- greatly increased energy
- severe trouble sleeping
- racing thoughts
- reckless behavior
- unusually grand ideas
- excessive happiness or irritability
- talking more or faster than usual
- Unusual thoughts or behaviors: Some patients may have unusual thoughts or behaviors while taking BUPROPION XL, including delusions (e.g., believe you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you), or feeling confused. If this happens to you, call your healthcare provider.
- Visual problems: Some people are at risk of glaucoma which can present as: eye pain, changes in vision, or swelling and redness around the eye if they take BUPROPION XL. You should see an eye doctor to determine whether you are at risk prior to starting therapy.
- Severe allergic reactions: Some patients have severe allergic reactions to WELLBUTRIN XL. Stop taking BUPROPION XL and call your healthcare provider right away if you get a rash, itching, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, swelling of the lips or tongue, chest pain, or have trouble breathing. These could be signs of a serious allergic reaction.
Do not take BUPROPION XL if you:
- have or had a seizure disorder or epilepsy
- have or had an eating disorder such as anorexia nervosa or bulimia - are taking any other medicines that contain bupropion, including WELLBUTRIN or WELLBUTRIN SR, APLENZIN®, ZYBAN, or FORFIVO XL. Bupropion is the same active ingredient that is in WELLBUTRIN XL
- drink a lot of alcohol and abruptly stop drinking, or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines, and you stop using them all of a sudden
- take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid
- do not take an MAOI within 2 weeks of stopping BUPROPION XL unless directed to do so by your healthcare provider
- do not start BUPROPION XL if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider
- are allergic to the active ingredient in BUPROPION XL, bupropion, or to any of the inactive ingredients
Although BUPROPION XL is not a treatment for quitting smoking, it contains the same active ingredient (bupropion) as ZYBAN, which is used to help patients quit smoking. Before taking BUPROPION XL, tell your healthcare provider if you have ever had depression, suicidal thoughts or actions, or other mental health problems or any symptoms you had during other times you tried to quit smoking with or without bupropion. Also, tell your healthcare provider about your other medical conditions, including if you:
- have liver problems, especially cirrhosis of the liver
- have kidney problems
- have, or have had, an eating disorder such as anorexia nervosa or bulimia
- have had a head injury
- have had a seizure (convulsion, fit)
- have a tumor in your nervous system (brain or spine)
- have had a heart attack, heart problems, or high blood pressure
- are a diabetic taking insulin or other medicines to control your blood sugar
- drink alcohol
- abuse prescription medicines or street drugs
- are pregnant or plan to become pregnant. Talk to your healthcare provider about the risk to your unborn baby if you take BUPROPION XL during pregnancy, and about registering with the National Pregnancy Registry by calling 1-844-405-6185
- are breastfeeding. BUPROPION XL passes into your milk in small amounts
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Many medicines increase your chances of having seizures or cause other serious side effects if you take them while you are using BUPROPION XL.
The most common side effects of BUPROPION XL include: trouble sleeping, stuffy nose, dry mouth, dizziness, feeling anxious, nausea, constipation, and joint aches.
These are not all the side effects of BUPROPION XL.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient. The product information provided is intended only for residents of the United States. The products discussed herein may have different product labeling in different countries.