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 for faster absorption, combination products, topical formulations with fewer systemic side effects
- 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 | 15.2% | 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 (maintenance, if needed)
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.
| 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.
Why compounded?
- Sublingual troches: Onset in ~15 minutes vs 30–60 minutes for oral tablets (bypasses first-pass liver metabolism)
- Custom doses: 30 mg, 70 mg, or any amount your physician determines is optimal
- Combination products not commercially available
Daily tadalafil (2.5–5 mg) is FDA-approved for both ED and 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 the topical minoxidil-finasteride combination showed clinically meaningful improvements vs either alone, with 92.4% achieving stable or improved outcomes at 12 months.
Dermatology: Tretinoin and Custom Compounds
Tretinoin is the gold standard topical for both acne and skin aging. 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.
Peptides and Wellness Injectables
Sermorelin
A GHRH analog that stimulates the pituitary to produce growth hormone naturally. Used for GH optimization in adults with symptoms of deficiency.
PT-141 (Bremelanotide)
A melanocortin receptor agonist (brand: Vyleesi). 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 (~$2–5/month 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 | Priapism, vision/hearing changes | BP, cardiac history |
| Finasteride | Decreased libido (2–4%) | Depression (rare), breast tenderness | Symptom monitoring, PSA |
| Tretinoin | Dryness, peeling, sun sensitivity | Severe irritation with harsh products | 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 our pharmacy partner.
- Medications delivered: Compounded specifically for you, quality-tested, shipped in discreet temperature-controlled packaging.
- Ongoing care: Monthly or quarterly physician check-ins to assess progress and adjust treatment.
Ready to get started?
Book a consultation with a board-certified physician. No insurance needed. Medications shipped to your door.
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. YourMD prescribes only FDA-approved branded GLP-1 medications (Wegovy®, Ozempic®, Zepbound®, Mounjaro®), 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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