In this guide
- What are compounded medications?
- Weight loss: semaglutide and tirzepatide
- Men’s health: sildenafil and tadalafil
- Hair restoration: finasteride and minoxidil
- Dermatology: tretinoin and custom compounds
- Peptides and wellness injectables
- Longevity: metformin, rapamycin, and the new frontier
- Safety, risks, and what to watch for
- How telehealth prescribing works
- Frequently asked questions
What Are Compounded Medications?
Compounded medications are custom-prepared prescriptions made by licensed pharmacists to meet a specific patient’s needs. Unlike mass-manufactured drugs that come in fixed doses and forms, compounded medications can be tailored in strength, formulation, and delivery method.
Why compounded instead of brand-name (for non-GLP-1 treatments)?
- Customization: Doses precisely tailored rather than limited to fixed manufacturer options
- Formulation: Sublingual troches as an alternative dosage form (onset data for compounded troches are limited), combination products, and topical formulations
- Not FDA-approved: compounded preparations are not FDA-approved. Ours are prepared by a licensed 503A compounding pharmacy (for example Hallandale Pharmacy or Valiant Compounding Pharmacy); the dispensing pharmacy is named on your prescription label.
- Availability: For non-GLP-1 categories, when a brand-name product faces a shortage a 503A pharmacy can prepare a patient-specific alternative
Weight Loss: Semaglutide and Tirzepatide
GLP-1 receptor agonists have fundamentally changed the medical approach to obesity. Originally developed for type 2 diabetes, these medications produce significant weight loss by mimicking a natural hormone that regulates appetite and blood sugar.
Semaglutide
Clinical data
| Trial | Dose | Duration | Mean weight loss | Key finding |
|---|---|---|---|---|
| STEP 1 (NEJM) | 2.4 mg/week | 68 weeks | 14.9% | 86% achieved at least 5% loss |
| STEP UP | 7.2 mg/week | 72 weeks | 20.7% | 33% lost 25%+ body weight |
| OASIS 4 (oral) | 25 mg/day oral | 64 weeks | 16.6% | First oral GLP-1 for weight |
| SELECT (CV) | 2.4 mg/week | 104 weeks | ~9.4% | 20% reduction in major CV events |
Our titration protocol
- Weeks 1–4: 0.25 mg/week (starter)
- Weeks 5–8: 0.5 mg/week
- Weeks 9–12: 1.0 mg/week
- Weeks 13–16: 1.7 mg/week
- Week 17+: 2.4 mg/week (usual maintenance dose of the standard Wegovy® pen, if needed; a Wegovy® HD 7.2 mg weekly dose also exists)
Tirzepatide
Tirzepatide is a dual GIP/GLP-1 receptor agonist — activating two appetite-regulating pathways. In SURMOUNT-1, participants on the highest dose achieved 22.5% weight loss over 72 weeks. Zepbound® starts at 2.5 mg weekly for 4 weeks, then increases by 2.5 mg no sooner than every 4 weeks (5, 7.5, 10, 12.5, 15 mg); the maximum is 15 mg. Tirzepatide can reduce oral contraceptive effect — use a non-oral or backup method for 4 weeks after starting and after each dose increase.
| Dose | Mean weight loss (72 wk) | Achieved 20%+ loss |
|---|---|---|
| 5 mg/week | 15.0% | 33% |
| 10 mg/week | 19.5% | 46% |
| 15 mg/week | 22.5% | 57% |
Men’s Health: Sildenafil and Tadalafil
PDE5 inhibitors remain the first-line treatment for erectile dysfunction, affecting approximately 30 million men in the US.
Generic sildenafil and tadalafil tablets are FDA-approved and are the first choice for most men.
Compounded sublingual troches
- Alternative dosage form: a troche dissolves under the tongue. It is a compounded preparation, not FDA-approved, and onset data for compounded troches are limited — there is no head-to-head evidence that troches work faster than tablets.
- Strength: set by your physician on the prescription
- Pharmacy: prepared by a licensed 503A compounding pharmacy (for example Hallandale Pharmacy or Valiant Compounding Pharmacy); the dispensing pharmacy is named on your prescription label
Daily tadalafil (2.5–5 mg) is FDA-approved for ED; only the 5 mg daily dose is approved for BPH. Continuous coverage without planning around a medication.
Hair Restoration: Finasteride and Minoxidil
Androgenetic alopecia affects more than 50% of men by age 50. Compounded topical finasteride (0.1–0.25%) delivers the active ingredient directly to the scalp with lower systemic absorption than oral. A 2025 meta-analysis of seven RCTs found that topical minoxidil-finasteride combinations showed improvements vs either alone; these studies concern topical finasteride generally, not any specific compounded product. Compounded topicals are not FDA-approved and are prepared by a licensed 503A compounding pharmacy (for example Hallandale Pharmacy or Valiant Compounding Pharmacy); the dispensing pharmacy is named on your prescription label.
Dermatology: Tretinoin and Custom Compounds
Tretinoin is one of the best-studied topicals for both acne and skin aging. Compounded formulations are not FDA-approved and are prepared by a licensed 503A compounding pharmacy (for example Hallandale Pharmacy or Valiant Compounding Pharmacy); the dispensing pharmacy is named on your prescription label. Compounding allows precise concentrations (0.025%–0.1%), custom vehicles (cream, gel, microsphere), and combination formulations: tretinoin + niacinamide for anti-aging; tretinoin + azelaic acid for melasma; tretinoin + hydroquinone for dark spots. Avoid tretinoin and hydroquinone in pregnancy or when planning pregnancy.
Peptides and Wellness Injectables
Sermorelin
A GHRH analog that stimulates the pituitary to produce growth hormone. Sermorelin is on hold and not currently prescribed while we confirm pharmacy eligibility.
PT-141 (Bremelanotide)
A melanocortin receptor agonist (FDA-approved brand: Vyleesi®; YourMD also offers a compounded PT-141 troche for women's sexual health, not FDA-approved). Works through the CNS rather than blood vessels — a completely different mechanism than PDE5 inhibitors.
B12 and Lipotropic Injections
Methylcobalamin (B12) injections bypass the GI tract. Lipotropic (MIC) injections support fat metabolism and energy as a weight-management adjunct.
Longevity: Metformin, Rapamycin, and the New Frontier
Metformin (an inexpensive retail generic) — observational studies suggest lower rates of cancer, cardiovascular disease, and all-cause mortality. The TAME trial is studying it specifically as an anti-aging intervention.
Rapamycin (sirolimus) — an mTOR inhibitor originally approved for organ transplant. In animal studies it consistently extends lifespan, and low-dose weekly regimens (1–5 mg) are prescribed off-label by some longevity physicians. Important context: human evidence remains unproven — the first randomized human trial of low-dose rapamycin for aging (PEARL, published 2025) did not meet its primary endpoint. Whether rapamycin benefits healthy adults is an open scientific question, not an established fact. We prescribe it only within a physician-monitored protocol with baseline and follow-up labs, and we will tell you plainly what the evidence does and does not show.
Safety, Risks, and What to Watch For
| Treatment | Common side effects | Serious risks (rare) | Monitoring |
|---|---|---|---|
| Semaglutide / Tirzepatide | Nausea, vomiting, diarrhea, constipation | Pancreatitis, gallbladder disease, thyroid tumors (animal studies) | Weight, symptoms, labs |
| Sildenafil / Tadalafil | Headache, flushing, nasal congestion | Severe low blood pressure with nitrates/poppers or riociguat (never combine); priapism; vision/hearing changes | BP, cardiac history, medication list |
| Finasteride | Decreased libido (2–4%) | Depression (rare), breast tenderness, rare persistent sexual effects; not for pregnancy | Symptom monitoring, PSA (lowered ~50%) |
| Tretinoin | Dryness, peeling, sun sensitivity | Severe irritation with harsh products; avoid in pregnancy | Skin tolerance |
| Metformin | GI upset (usually transient) | Lactic acidosis (extremely rare), B12 deficiency | Kidney function, B12 |
| Rapamycin | Mouth sores (at higher doses) | Immunosuppression, lipid changes | CBC, lipid panel, CMP |
How Telehealth Prescribing Works
- Health screening (5 min): Secure, HIPAA-compliant questionnaire about your history, medications, and goals.
- Physician consultation: Live evaluation via video, audio, or chat with a board-certified physician.
- Treatment plan: Your physician discusses options, risks, and prescribes electronically to a pharmacy.
- Medication paid separately: YourMD’s price is the physician care fee only — medication is never included in the care fee. Retail prescriptions are sent to a pharmacy that works for you (a local retail pharmacy such as Walmart, or a low-cost online pharmacy) and you pay the pharmacy directly; YourMDRx Savings shows cash prices and coupons. Compounded medications are an add-on: once your physician selects the compounding pharmacy, you receive a final price proposal (medication, shipping and our care fee) to accept before anything is made. You make one payment to YourMD for that proposal; the licensed compounding pharmacy prepares and ships it. (Compounded medications are not FDA-approved.) Brand GLP-1s are billed and dispensed by NovoCare®, LillyDirect™, or your insurance-covered pharmacy.
- Ongoing care: Monthly or quarterly physician check-ins to assess progress and adjust treatment.
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Start Your Free Health ScreeningFrequently Asked Questions
Are compounded medications FDA-approved?
Compounded medications are not individually FDA-approved products. However, they are prepared using FDA-approved active pharmaceutical ingredients by licensed pharmacies under federal and state regulations (USP <795> and <797>).
Does YourMD prescribe compounded GLP-1 medications?
No. For weight management YourMD prescribes only brand GLP-1 medications FDA-approved for that use (Wegovy®, the Wegovy® pill, Zepbound®, Foundayo™), routed through manufacturer-direct pharmacies. The FDA shortage designation that once permitted compounded semaglutide and tirzepatide ended in 2025, and we do not prescribe compounded GLP-1s under any circumstances.
Do I need lab work before starting?
For most treatments, a thorough health history and physician evaluation is sufficient. Your physician may recommend labs based on your situation.
What states do you serve?
Our physicians are currently licensed in Nevada, Washington, Oregon, and Wisconsin. You must be physically located in one of these states during your consultation.
Do you prescribe controlled substances?
No. YourMD does not prescribe controlled substances (Schedule I–V), including opioids, benzodiazepines, stimulants, testosterone, phentermine, or ketamine. See our full prescribing policy.
References
- Wilding JPH, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989-1002.
- Jastreboff AM, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387(3):205-216.
- Lincoff AM, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-2232.
- Gupta AK, et al. Relative efficacy of minoxidil and 5-alpha reductase inhibitors. JAMA Dermatol. 2022;158:266-274.
- Frontiers in Medicine. Minoxidil-finasteride mixed solution: systematic review and meta-analysis of RCTs. 2025.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a licensed healthcare provider before starting any medication. If you are experiencing a medical emergency, call 911.
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