This page summarizes important safety information for treatments available through Zorlo. It is not a complete list of side effects or interactions, and it does not replace advice from your provider or the medication guide that comes with your prescription. Tell your provider about every medication, supplement and health condition you have, and read the pharmacy information that comes with your order.
Weight management
Compounded Semaglutide and Compounded Tirzepatide (injection)
Do not use if you or a family member has had medullary thyroid carcinoma, you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2), you are pregnant or breastfeeding, or you have had a serious allergic reaction to either ingredient. In animal studies, medicines in this class caused thyroid C-cell tumors; it is not known whether they do in people. Tell your provider about any lump or swelling in your neck, trouble swallowing, or hoarseness.
Common side effects: nausea, vomiting, diarrhea, constipation, stomach pain, decreased appetite and indigestion, most often when starting or increasing a dose.
Serious side effects can include: inflammation of the pancreas (severe stomach pain that may spread to the back), gallbladder problems, low blood sugar (especially with insulin or sulfonylureas), kidney problems caused by dehydration, serious allergic reactions, changes in vision for people with diabetes, increased heart rate, and changes in mood or thoughts of self-harm.
Also know: stop these medications at least 2 months before a planned pregnancy. Tirzepatide can make birth control pills less effective after starting and after each dose increase. Tell your provider before any surgery or procedure that requires anesthesia. Compounded vials may have a different concentration from other products you have used; measure every dose exactly as your pharmacy's instructions say.
Erectile dysfunction
Sildenafil, Tadalafil, and Compounded Sildenafil + Tadalafil
Do not take with any nitrate medication (such as nitroglycerin, isosorbide mononitrate or dinitrate), recreational nitrates ("poppers"), or riociguat. The combination can cause a sudden, dangerous drop in blood pressure. Do not take if your provider has advised you that sexual activity is unsafe for your heart.
Common side effects: headache, flushing, indigestion, stuffy nose, back pain, muscle aches and dizziness.
Get emergency help for an erection lasting more than 4 hours, sudden vision loss in one or both eyes, sudden hearing loss or ringing in the ears, or chest pain during sex.
Also know: tell your provider if you take alpha-blockers or other blood pressure medicines, or certain antifungal, HIV or antibiotic medicines. Limit alcohol. A combination product contains two medicines of the same class and can increase the chance of side effects such as low blood pressure; your provider will decide whether it suits you.
Premature ejaculation
Sertraline (oral tablet, off-label use)
Sertraline is prescribed off-label for premature ejaculation. Antidepressants can increase suicidal thoughts and behaviors in people under 25. Contact your provider right away, or call or text 988, if you notice new or worse depression, anxiety, agitation or thoughts of self-harm.
Do not take with an MAOI (or within 14 days of stopping one), with pimozide, or if you are allergic to sertraline.
Common side effects: nausea, diarrhea, indigestion, sweating, trouble sleeping or drowsiness, and changes in sexual function.
Also know: taking sertraline with other medicines that affect serotonin (including triptans, tramadol and St. John's wort) can cause serotonin syndrome. It can increase the risk of bleeding with NSAIDs, aspirin or blood thinners. Do not stop suddenly without talking to your provider.
Lidocaine + Prilocaine (topical cream)
Do not use if you are allergic to lidocaine, prilocaine or similar local anesthetics, or if you have methemoglobinemia.
Use only as directed: apply the prescribed amount to intact skin, and wash it off or use a condom before sex so your partner does not absorb it. Keep it away from your eyes. Side effects can include redness, irritation or temporary loss of sensation. Get help right away for bluish or gray skin or lips, shortness of breath, headache with dizziness, or a fast heartbeat.
Hair loss
Finasteride (oral tablet)
For men only. Women who are or may become pregnant should not take finasteride or handle crushed or broken tablets, because it can cause birth defects in a male baby.
Possible side effects: lower sex drive, trouble getting an erection, and a decrease in the amount of semen. In some men these effects have continued after stopping. Breast tenderness or enlargement and allergic reactions can occur. Tell your provider about any change in mood, including depression or thoughts of self-harm.
Also know: finasteride lowers PSA levels. Tell any doctor who orders a PSA test that you take it.
Oral Minoxidil (low-dose tablet, off-label use)
Low-dose oral minoxidil is prescribed off-label for hair loss. It is a blood pressure medicine and is not suitable for everyone.
Possible side effects: dizziness or lightheadedness, fast heartbeat, swelling of the ankles or face, rapid weight gain from fluid, headache, and unwanted hair growth on the face or body. Rarely, fluid can build up around the heart.
Get help right away for chest pain, shortness of breath, fainting, or rapid weight gain with swelling. Tell your provider if you have heart disease, low blood pressure, or take other blood pressure medicines.
Compounded Topical Finasteride + Minoxidil (spray)
Apply only to the scalp. Side effects can include itching, redness, dryness or flaking. Some finasteride is absorbed through the skin, so the finasteride information above also applies. Wash your hands after use and keep the product away from women who may be pregnant, children and pets; minoxidil is toxic to cats.
Skin care
Tretinoin, and Compounded Tretinoin + Azelaic Acid + Niacinamide (topical cream)
Do not use if you are pregnant, trying to become pregnant, or breastfeeding, unless your provider has told you it is appropriate.
Common side effects: redness, dryness, peeling, burning, stinging and itching, especially in the first weeks. Azelaic acid can also cause tingling or lightening of the skin.
Also know: these products make your skin more sensitive to sunlight. Use sunscreen daily and limit sun exposure. Avoid using other drying or irritating products on the same area, and keep the cream away from your eyes, mouth and the corners of your nose.
Wellness injections
For all injections: follow the injection instructions from your pharmacy, use a new sterile needle each time, rotate injection sites, and dispose of needles in a sharps container. Injection-site redness, swelling or bruising is common. Get help right away for signs of an allergic reaction such as hives, swelling or trouble breathing.
Compounded NAD+
Side effects can include flushing, nausea, headache, stomach discomfort and discomfort at the injection site. Tell your provider about any medical conditions and medications.
Compounded Sermorelin
Side effects can include injection-site reactions, flushing, headache and dizziness. Tell your provider if you have or have had cancer, a pituitary or thyroid condition, or if you are pregnant. Your provider may require lab work before prescribing.
Compounded Glutathione
Side effects can include injection-site reactions and, rarely, allergic reactions. Tell your provider about any asthma or other medical conditions.
Vitamin B12 (Cyanocobalamin)
Do not use if you are allergic to cobalt or vitamin B12, or have Leber's disease. Side effects can include mild diarrhea, itching and injection-site pain. Rarely, serious allergic reactions occur.
About compounded medications
Compounded medications are prepared by a licensed pharmacy for an individual patient under a valid prescription, for example to combine ingredients or provide a different form or strength. The FDA does not approve compounded medications or verify their safety, effectiveness or quality. Compounded medications are not the same as commercially manufactured drug products. Every compounded product on Zorlo is labeled "Compounded."
Reporting side effects
If you have a side effect, message your provider through your patient portal. You can also report side effects to the FDA's MedWatch program at fda.gov/medwatch or 1-800-FDA-1088.