GLP-1 FAQ Hub:
Semaglutide, Tirzepatide, NAD+ &
Men's Health Questions Answered

Pricing varies by program, formulation, and plan selected:

- Weight Loss (GLP-1): Semaglutide programs are $169/mo. Tirzepatide programs are $219/mo. - Longevity (NAD+ & Peptides): NAD+ nasal spray 900 mg: $112 for 1 month; oral sermorelin low dose: $149 for 1 month or $429 for 3 months; injectable sermorelin low dose: $169 for 1 month. Longer 3- and 6-month plans available for select products. - Men's Health: Sildenafil or tadalafil from $39 for a 1-month supply; Quattro Sublingual from $69 per 5-pack.

All pricing is all-inclusive: licensed provider review, medication if prescribed, and shipping if prescribed. No membership fee, no separate provider fee. Final pricing depends on the specific program, formulation, and plan selected. No insurance required. Everything is disclosed before you pay.

No. Open Water Rx is built around clear, upfront pricing. You can review program costs before starting. There are no separate consultation fees, pharmacy dispensing fees, or shipping surcharges.

Some optional add-ons, such as additional lab work beyond what is clinically indicated, may carry separate costs. Your provider will inform you of any additional costs before they are incurred.

Pricing and availability are subject to clinical appropriateness and regulatory requirements.

No. Open Water Rx programs are cash-pay and do not require insurance. We do not accept insurance and do not submit claims to insurance companies.

Open Water Rx does not submit insurance claims. Your privacy and billing questions should be reviewed in the applicable privacy policy and with your insurer where relevant. All pricing is transparent and disclosed before you pay.

Yes. You can cancel through your patient portal at any time, and no advance notice is required. Orders are nonrefundable once the pharmacy has processed the item, as compounded medications are prepared specifically for individual patients by a licensed pharmacy and cannot be returned or resold.

If you are considering cancelling due to side effects or concerns, we encourage you to contact your provider first. Many issues can be addressed by adjusting your dosing schedule. See the full cancellation policy for details.

Semaglutide plans through Open Water Rx are $169/mo. This is an all-inclusive price that covers: licensed medical provider review and evaluation, compounded semaglutide prescription if clinically appropriate, medication dispensed from a licensed compounding pharmacy, shipping directly to your door if a prescription is issued (included in plan price), and ongoing provider support and secure messaging.

Pricing is subject to clinical appropriateness and regulatory requirements. No insurance is required or accepted.

Injectable tirzepatide is $219 per month.

Tirzepatide is priced higher than semaglutide due to the more complex active pharmaceutical ingredient and manufacturing process. Pricing is subject to clinical appropriateness and regulatory requirements.

No. Compounded semaglutide and tirzepatide are not covered by insurance. Because they are compounded medications prepared for an individual patient, they are not eligible for insurance reimbursement or pharmacy benefit coverage.

Open Water Rx does not accept insurance and does not submit claims to insurance companies. Open Water Rx does not submit insurance claims; your privacy and billing questions should be reviewed in the applicable privacy policy and with your insurer where relevant.

The all-inclusive pricing through Open Water Rx is designed to be transparent and predictable: semaglutide $169/mo and tirzepatide $219/month, covering clinician review, medication if prescribed, and shipping if prescribed.

Open Water Rx pricing is all-inclusive. The monthly plan price covers your licensed medical provider review, compounded medication if prescribed, shipping if prescribed, and ongoing provider support.

There are no separate consultation fees, no pharmacy dispensing fees, and no shipping surcharges. Some optional add-ons, such as additional lab work beyond what is clinically indicated, may carry separate costs. Your provider will inform you of any additional costs before they are incurred.

Pricing and availability are subject to clinical appropriateness and regulatory requirements.

No. Open Water Rx uses flat month-to-month pricing with no long-term prepayment required and no membership or separate provider fees. You pay one flat monthly rate regardless of your prescribed dose — medication, shipping if prescribed, and ongoing support are all included.

No. Open Water Rx pricing is a flat monthly rate regardless of your prescribed dose, for each program. Your semaglutide plan at $169/mo or tirzepatide plan at $219/mo covers the full titration schedule — from your starting dose through your maintenance dose — at the same monthly price. There are no additional charges when your provider increases your dose, and no separate fees for the medication itself. The all-inclusive price covers licensed provider review, medication if prescribed through a licensed pharmacy, shipping if prescribed, and ongoing provider support at every dose level.

Your provider will recommend the dosing schedule that is clinically appropriate for you, and the monthly price remains the same throughout.

Semaglutide is a GLP-1 receptor agonist that activates a single hormonal pathway involved in appetite regulation and blood sugar control. Individual results vary and are not guaranteed.

Tirzepatide is a dual GIP/GLP-1 receptor agonist that activates two pathways simultaneously. This dual mechanism may produce greater appetite suppression. Both are prescription-only medications prescribed by a licensed medical provider when clinically appropriate. Your provider will recommend the right fit based on your individual health profile, goals, and medical history. Individual results vary and are not guaranteed.

For most eligible patients, the clinical evidence strongly supports GLP-1 therapy as an effective, medically supervised weight loss option. GLP-1 receptor agonists have been studied in large-scale clinical trials involving tens of thousands of patients over multiple years.

Like all prescription medications, GLP-1 therapy carries potential side effects, most commonly gastrointestinal symptoms such as nausea, mild stomach discomfort, and occasional constipation, particularly during dose escalation. These typically subside as your body adjusts.

The decision is made by a licensed medical provider based on your individual health profile. If GLP-1 therapy is not clinically appropriate for you, your provider will tell you. Open Water Rx does not prescribe to patients for whom the therapy is not indicated.

GLP-1 therapy is not appropriate for everyone. A licensed medical provider will review your full health history before any prescription is issued. GLP-1 medications are generally not prescribed for patients with:

- A personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) - A history of pancreatitis - Certain gastrointestinal conditions - Pregnancy or plans to become pregnant - Certain other medical conditions or medication interactions

This is not a complete list. Your provider will assess your full health profile and make an independent clinical determination. If GLP-1 therapy is not right for you, your provider will explain why and may suggest alternatives.

Semaglutide is a GLP-1 receptor agonist that mimics a natural gut hormone called glucagon-like peptide-1. After you eat, GLP-1 is released and signals your brain that you are full, slows the rate at which your stomach empties, and helps regulate blood sugar.

Semaglutide amplifies these signals significantly and sustains them throughout the week with a single weekly injection. The result is a meaningful and sustained reduction in appetite, leading to lower caloric intake without the constant hunger that makes traditional dieting so difficult.

In clinical trials with FDA-approved semaglutide formulations (Wegovy®), patients achieved significant weight loss over 68 weeks. Compounded semaglutide has not been evaluated in the same trials. Individual results vary and are not guaranteed.

Most patients notice the first effects of semaglutide within 1 to 2 weeks of starting therapy, typically as a subtle reduction in appetite or earlier feelings of fullness at meals.

Meaningful weight loss usually begins within 4 to 8 weeks. The full effect builds gradually as the dose is titrated upward over several months according to your provider's schedule.

Timeline overview: - Week 1 to 2: Subtle appetite reduction, possible mild nausea - Week 4 to 8: Noticeable weight loss begins for most patients - Month 3 to 6: Continued weight loss as dose reaches therapeutic levels - Month 6 to 12: Sustained weight loss, often stabilizing as dose is optimized

Individual response varies. Your provider will monitor your progress and adjust your plan accordingly.

Research consistently shows that weight tends to return when semaglutide is discontinued. In the STEP 1 extension study, patients who stopped semaglutide regained approximately two-thirds of their lost weight within one year of stopping.

This is not a failure of willpower. Semaglutide works by actively suppressing appetite signals. When the medication is stopped, those signals return to their previous levels.

For many patients, semaglutide is most effective as a long-term program rather than a short-term intervention. Your licensed medical provider will discuss the appropriate duration of treatment based on your individual health profile and goals. If you are considering stopping, always consult your provider first rather than stopping abruptly.

Rapid weight loss on semaglutide, as with any significant caloric deficit, can include some loss of lean muscle mass alongside fat loss. This is a known consideration with GLP-1 therapy.

To minimize muscle loss while on semaglutide, most providers recommend: - Prioritizing adequate protein intake at every meal, even when appetite is significantly reduced - Incorporating resistance exercise or strength training into your routine - Avoiding excessively low caloric intake

The clinical significance of muscle loss on semaglutide is still being studied. Current evidence suggests that the cardiovascular and metabolic benefits of the fat loss achieved with semaglutide outweigh the muscle loss concern for most eligible patients. Your provider will give you personalized guidance.

No. Wegovy® and Ozempic® are FDA-approved brand-name medicines containing semaglutide manufactured by Novo Nordisk. Compounded semaglutide is prepared by a licensed pharmacy pursuant to an individual prescription; it is not a generic version of those brand medicines and is not represented as bioequivalent, clinically equivalent, or interchangeable. Open Water Rx works exclusively with pharmacies that use the base API, not salt derivatives such as semaglutide sodium or semaglutide acetate.

Semaglutide for weight loss is administered as a once-weekly subcutaneous injection. The dose is gradually increased over several months to minimize side effects and allow your body to adjust.

A typical titration schedule starts at a low dose (commonly 0.25mg per week) and increases incrementally every 4 weeks until reaching the target therapeutic dose. The specific schedule is determined by your licensed medical provider based on your individual health profile, tolerance, and clinical response.

Do not adjust your dose without consulting your provider. Rushing the titration schedule is one of the most common causes of significant gastrointestinal side effects.

Semaglutide is administered as a once-weekly subcutaneous injection, meaning it is injected just under the skin rather than into a muscle or vein. Common injection sites include the abdomen, upper thigh, or upper arm.

Your prescribing provider and dispensing pharmacy will provide detailed injection instructions specific to your medication formulation. General best practices include: - Rotating injection sites each week to avoid skin irritation - Injecting at the same time each week for consistency - Allowing the medication to reach room temperature before injecting if refrigerated - Using a new needle for each injection

Most patients find the injection straightforward after the first few times. If you have concerns about self-injection, discuss them with your provider.

The fastest way to access tirzepatide is through a licensed telehealth provider like Open Water Rx. Because the entire process is online, you do not need to find a clinic near you. Your evaluation, clinician review, prescription, and medication delivery all happen entirely from home.

Open Water Rx supports clinician-guided care across the United States where permitted. Available nationwide in all 50 states. The process: complete a short online intake (about five minutes), have your case reviewed by a licensed medical provider, and receive your medication shipped directly to your address if the clinician determines treatment is appropriate.

Tirzepatide plans are $219/month, covering clinician review, compounded tirzepatide from a licensed pharmacy, and shipping if prescribed. No insurance required.

Tirzepatide is a GLP-1 receptor agonist, so it is technically a type of GLP-1 medication. The key distinction is that tirzepatide is a dual agonist: it activates both the GLP-1 receptor and the GIP receptor simultaneously.

Standard GLP-1 medications like semaglutide activate only the GLP-1 receptor. Tirzepatide's dual mechanism may produce stronger appetite suppression. Clinical trials with FDA-approved tirzepatide formulations (Zepbound®) demonstrated significant weight loss. Compounded tirzepatide has not undergone the same trials.

When people refer to 'GLP-1 medications' as a category, they typically mean the entire class including both semaglutide and tirzepatide. Tirzepatide is the more advanced dual-receptor option within that class. Individual results vary and are not guaranteed.

Tirzepatide is highly effective, but it does have drawbacks worth understanding before starting:

- Cost: Tirzepatide plans are $219/mo through Open Water Rx, higher than semaglutide plans at $169/mo, due to the more complex active pharmaceutical ingredient and manufacturing process. - Gastrointestinal side effects: Nausea, constipation, stomach discomfort, and occasional diarrhea are common, particularly during dose escalation. - Injection requirement: Like semaglutide, tirzepatide is a weekly subcutaneous injection. - Muscle mass: Rapid weight loss on tirzepatide can include some lean muscle loss. Adequate protein intake and resistance exercise are recommended. - Ongoing commitment: Weight tends to return when tirzepatide is discontinued without lifestyle changes in place. - Prescription required: Tirzepatide is a prescription-only medication. A licensed medical provider must determine it is clinically appropriate for you.

Your provider will review all relevant risks and benefits with you during your evaluation.

Both tirzepatide and semaglutide have been studied in large-scale clinical trials and have well-characterized safety profiles. Neither is definitively 'safer' than the other in a general sense. The safety comparison depends on the individual patient.

Both medications share a similar side effect profile, primarily gastrointestinal symptoms such as nausea, constipation, and stomach discomfort. Both carry the same class-level contraindications, including a personal or family history of medullary thyroid carcinoma or MEN 2.

Tirzepatide's dual GIP/GLP-1 mechanism is newer, and long-term data beyond 2 to 3 years is still accumulating compared to the longer track record of GLP-1 monotherapy. However, the clinical trial data available to date does not indicate that one is meaningfully safer than the other for the general eligible population.

Your licensed medical provider will assess your individual health profile and recommend the medication that is most appropriate for you specifically. This is general information, not medical advice.

Based on published clinical trial data, most tirzepatide patients begin to see meaningful weight loss within 4 to 8 weeks of starting therapy. Losing 20 pounds typically takes 2 to 4 months for many patients, though this varies significantly based on starting weight, dosage, adherence, diet, and activity level.

Tirzepatide may produce faster weight loss than semaglutide for some patients. Clinical trials with FDA-approved tirzepatide formulations demonstrated significant weight loss over 72 weeks.

Individual results vary and are not guaranteed. GLP-1 therapy is not a quick fix. It works best as part of a sustained, medically supervised program with appropriate nutrition and activity.

While on tirzepatide, most providers recommend avoiding or limiting the following:

- High-fat, greasy, or fried foods: These worsen nausea and gastrointestinal side effects - Large meals: Tirzepatide significantly slows gastric emptying; large portions can cause substantial discomfort - Alcohol: Can worsen nausea, affect blood sugar regulation, and add empty calories - Skipping meals entirely: Adequate nutrition is important for preserving lean muscle mass, even when appetite is significantly reduced - Stopping tirzepatide abruptly without provider guidance: Discuss any changes with your provider - Rushing dose escalation: The titration schedule exists to minimize side effects

Your licensed medical provider will give you personalized guidance. This is general information, not medical advice.

Tirzepatide works through multiple mechanisms, not just appetite suppression.

Appetite suppression is the primary driver: tirzepatide activates GLP-1 and GIP receptors in the brain and gut, significantly reducing hunger signals and increasing feelings of fullness. This leads to a meaningful reduction in caloric intake.

Beyond appetite suppression, tirzepatide also: - Slows gastric emptying, which prolongs feelings of fullness after meals - Improves insulin sensitivity and glucose metabolism - May have direct effects on fat cell metabolism through GIP receptor activation, though the full mechanism is still being studied

The net result is that the body enters a sustained caloric deficit, which drives fat loss. Individual results vary and are not guaranteed.

Tirzepatide produces faster and greater weight loss than most other interventions because of its dual mechanism. By activating both GLP-1 and GIP receptors simultaneously, it creates a stronger and more sustained reduction in appetite than GLP-1 monotherapy alone.

Many patients on tirzepatide report a dramatic reduction in food noise, the constant background thoughts about food and hunger that most people experience. When appetite is significantly suppressed, caloric intake drops substantially, often without feeling deprived.

Additionally, tirzepatide improves insulin sensitivity and glucose metabolism, which affects how efficiently the body stores and uses energy.

If you feel you are losing weight very rapidly, ensure you are still eating adequate protein to preserve lean muscle mass, stay well-hydrated, and communicate with your provider. Individual results vary.

Most patients notice the first effects of tirzepatide within the first 1 to 2 weeks of starting therapy, typically as a reduction in appetite or earlier feelings of fullness at meals.

Meaningful weight loss usually begins within 4 to 8 weeks. The full effect of tirzepatide builds gradually as the dose is titrated upward over several months.

Timeline overview: - Week 1 to 2: Subtle appetite reduction, possible mild nausea - Week 4 to 8: Noticeable weight loss begins for most patients - Month 3 to 6: Significant weight loss as dose reaches therapeutic levels - Month 6 to 12: Continued weight loss, often accelerating as dose is optimized

Individual response varies. Your provider will monitor your progress and adjust your plan accordingly.

Yes. GLP-1 medications prescribed by an independent licensed medical provider through Open Water Rx may ship directly to your home in plain, unmarked packaging through licensed pharmacy partners. There is no clinic visit, no pharmacy counter interaction, and nothing on the outside of the package that identifies the contents or the sender as a medical or weight loss company.

The entire process from evaluation to delivery is 100% online and private. Your health information is handled in accordance with HIPAA privacy standards and is never shared without your explicit consent.

For patients who prefer to keep their treatment private, the telehealth model offers a significant advantage over in-person clinics: no visible prescription at a local pharmacy, no waiting rooms, and no office visits. Open Water Rx does not accept insurance and does not submit claims. Open Water Rx does not prescribe, dispense, compound, manufacture, or ship medications. Fulfillment is handled through licensed pharmacy partners.

The most commonly reported downsides of GLP-1 therapy include:

- Gastrointestinal side effects: nausea, stomach discomfort, constipation, or diarrhea, especially during dose escalation - Injection requirement: GLP-1 medications are administered as a weekly subcutaneous injection - Cost: Without insurance coverage, GLP-1 therapy requires an ongoing monthly investment. Open Water Rx plans are $169/mo and $219/mo, covering clinician review, medication if prescribed, and shipping if prescribed. - Muscle loss risk: Rapid weight loss can include some lean muscle mass loss. Your provider may recommend protein intake and resistance exercise to mitigate this. - Ongoing commitment: GLP-1 therapy works best as part of a sustained program. Weight may return if medication is discontinued without lifestyle changes in place.

Your provider will discuss all relevant risks and benefits with you during your evaluation.

The most commonly reported side effect of GLP-1 medications is nausea, particularly during the initial weeks of treatment and when the dose is increased. In clinical trials, nausea was reported by a significant portion of patients but was generally mild to moderate and temporary.

Nausea typically peaks during dose escalation and subsides as your body adjusts to the medication. Eating smaller, lower-fat meals helps manage it.

Other common gastrointestinal side effects include constipation, mild stomach discomfort, and occasional diarrhea. Serious side effects are rare but possible. Your licensed medical provider will review all relevant risks with you before prescribing.

The timeline varies significantly by individual. Based on published clinical trial data, most patients begin to see meaningful weight loss within 4 to 8 weeks of starting GLP-1 therapy. Losing 20 pounds typically takes 3 to 6 months for many patients, though this depends on your starting weight, dosage, adherence, diet, and activity level.

Clinical trials with FDA-approved semaglutide and tirzepatide formulations demonstrated significant weight loss over 68–72 weeks.

Individual results vary and are not guaranteed. GLP-1 therapy is not a quick fix. It works best as part of a sustained, medically supervised program.

On your first day of GLP-1 therapy, most patients do not feel dramatic effects immediately. The medication takes time to build up in your system.

What you may notice in the first few days: - Mild nausea or stomach awareness, usually appearing within a few hours and lasting a day or two - A subtle reduction in appetite, often noticed at the next meal - Occasional mild fatigue as your body adjusts

What you likely will not notice yet: - Significant weight loss (this takes weeks) - Strong appetite suppression (this builds gradually)

Your provider will give you a titration schedule, typically starting at a low dose and increasing gradually over several weeks to minimize side effects. Follow your dosing instructions carefully.

Patient experiences vary, but the most commonly reported feelings after the first injection include:

- Mild nausea or stomach awareness, usually appearing within a few hours and lasting a day or two - A subtle reduction in appetite, often noticed at the next meal - Occasional mild fatigue or lightheadedness - Some patients report feeling little to nothing after the first dose, which is normal at the starting dose

The first injection is typically at the lowest dose in your titration schedule, so effects are often subtle. Side effects tend to be most noticeable during dose increases. Most patients find that symptoms improve significantly after the first 2 to 4 weeks as their body adjusts.

Fat loss patterns on GLP-1 therapy follow the same general principles as other forms of weight loss: the body tends to lose fat from the abdomen and visceral fat stores first, which is actually the most clinically significant type of fat loss from a health standpoint.

Visceral fat, the fat stored around internal organs, is metabolically active and associated with increased cardiovascular and metabolic risk. Reducing it has meaningful health benefits beyond aesthetics.

Subcutaneous fat and fat in specific areas like the face, arms, and legs tends to reduce more gradually. Individual fat distribution patterns vary significantly based on genetics, sex, age, and other factors. Results are not guaranteed and vary by individual.

GLP-1 therapy is designed for long-term use in eligible patients. Clinical trials have studied patients on GLP-1 medications for up to 2 years, and ongoing research continues to evaluate longer-term use.

For many patients, GLP-1 therapy is most effective as a sustained program rather than a short-term intervention. Research has shown that weight tends to return when GLP-1 medications are discontinued without lifestyle changes in place.

Your licensed medical provider will assess your ongoing eligibility and clinical appropriateness at each follow-up. The duration of your program is determined by your provider based on your individual health profile, goals, and response to treatment. There is no fixed maximum duration for clinically appropriate patients.

Patients who have been through GLP-1 therapy commonly share these insights:

- Start slow and be patient. The medication works gradually. The titration schedule exists for a reason. - Nausea is real but temporary. It typically peaks during dose increases and fades as your body adjusts. Eating smaller, lower-fat meals helps. - Protein matters. GLP-1 therapy reduces overall appetite, which can make it easy to under-eat protein. Prioritizing protein helps preserve lean muscle mass. - Hydration is important. Reduced appetite can also mean reduced fluid intake. Drink water consistently throughout the day. - The appetite suppression is different from willpower. Many patients describe it as simply not thinking about food the way they used to. - Results take time. Meaningful weight loss typically begins within 4 to 8 weeks. Focus on the trend over months. - Your provider is your partner. Use the secure messaging system. Ask questions. Report side effects.

While on GLP-1 therapy, most providers recommend avoiding or limiting:

- High-fat, greasy, or fried foods: These can worsen nausea and gastrointestinal side effects - Large meals: GLP-1 slows gastric emptying; eating large portions can cause significant discomfort - Alcohol: Can worsen nausea and may interact with blood sugar regulation - Skipping meals entirely: While appetite is reduced, adequate nutrition is important for preserving muscle mass and energy - Stopping the medication abruptly without provider guidance: Discuss any changes with your provider

Your licensed medical provider will give you personalized guidance based on your health profile. This is general information, not medical advice.

There is no strict requirement to eat before your GLP-1 injection, as it is a weekly subcutaneous injection rather than an oral medication. However, many patients find that:

- Eating a light, low-fat meal or snack before injecting can help reduce nausea in the hours following the injection - Avoiding heavy, greasy, or high-fat meals around injection time is helpful - Staying well-hydrated before and after your injection supports overall comfort

Your provider will give you specific guidance on injection timing and technique. If you experience significant nausea after injections, discuss it with your provider.

Most patients who feel their best on GLP-1 therapy follow a few consistent practices:

- Prioritize protein at every meal. Aim for adequate protein intake even when appetite is reduced. - Eat smaller, more frequent meals. GLP-1 slows digestion; smaller portions are more comfortable and reduce nausea. - Stay hydrated. Reduced appetite can mean reduced fluid intake. Drink water consistently throughout the day. - Move your body. Light to moderate exercise, even walking, supports weight loss, mood, and muscle preservation. - Follow your titration schedule. Do not rush dose increases. - Communicate with your provider. Use secure messaging to report side effects or ask questions. - Be patient with the process. GLP-1 therapy is a sustained program. The best results come from consistency over months, not weeks.

Yes. In addition to injectable GLP-1 programs, Open Water Rx offers oral GLP-1 options for patients who prefer a non-injection approach or who have been evaluated by a licensed provider and determined to be appropriate candidates.

Oral GLP-1 options may include compounded oral formulations of GLP-1 receptor agonists, as well as other oral weight management medications reviewed by your licensed provider. The specific options available depend on clinical appropriateness, provider review, and regulatory requirements.

Oral semaglutide is $259/month. All treatment decisions are made by independent licensed providers. Not all patients qualify.

Oral GLP-1 medications and injectable GLP-1 medications both work through the same GLP-1 receptor pathway, but there are meaningful differences in delivery, dosing, and clinical profile:

- Delivery: Oral medications are taken daily (typically in tablet or capsule form), while injectable GLP-1s are administered once weekly via subcutaneous injection. - Dosing: Oral GLP-1 formulations generally require higher total daily doses because a portion of the active ingredient is broken down during digestion, a process known as first-pass metabolism. - Effectiveness: Published clinical data for injectable semaglutide and tirzepatide shows higher average weight loss percentages than currently available oral GLP-1 options. However, oral options can still produce meaningful results for eligible patients. - Side effects: Gastrointestinal side effects are common with both oral and injectable GLP-1 medications, though the profile may differ slightly by formulation. - Preference: Some patients strongly prefer oral medication over self-injection. Your licensed provider will discuss whether an oral option is appropriate for your goals and health profile.

Individual results vary and are not guaranteed. Your provider will recommend the formulation that is most appropriate for you.

Oral GLP-1 options may be appropriate for patients who:

- Prefer a daily pill over a weekly injection - Have a needle phobia or discomfort with self-injection - Have been evaluated by a licensed provider and determined to be appropriate candidates - Are looking for a more gradual approach to GLP-1 therapy - Want flexibility in dosing or a simpler daily routine

Eligibility is determined solely by your licensed medical provider based on your individual health profile, goals, and clinical appropriateness. Oral GLP-1 options are not suitable for all patients. Some patients may respond better to injectable formulations.

If you are interested in oral GLP-1 options, mention this during your intake. Your provider will evaluate whether an oral option is appropriate for you.

Oral semaglutide through Open Water Rx is $259/month. This is an all-inclusive price that covers:

- Licensed medical provider review and evaluation - Oral medication prescription if clinically appropriate - Medication dispensed from an licensed compounding pharmacy - Shipping directly to your door if a prescription is issued - Ongoing provider support and secure messaging

Pricing is subject to clinical appropriateness, provider review, and regulatory requirements. Oral GLP-1 options are generally priced higher than injectable semaglutide programs at $169/mo, reflecting the formulation complexity and daily dosing requirements. No insurance is required or accepted.

Yes. Oral GLP-1 medications available through Open Water Rx are compounded formulations prepared by licensed compounding pharmacies for individual patients when a licensed provider determines they are clinically appropriate.

Open Water Rx works exclusively with pharmacies that use base active pharmaceutical ingredients (APIs), not salt derivatives. Your licensed provider makes the clinical determination of whether compounded oral GLP-1 therapy is appropriate for you individually.

Oral GLP-1 medication is typically taken once daily, usually in the morning on an empty stomach or as directed by your prescribing provider. Specific instructions depend on the formulation prescribed.

General guidance for oral GLP-1 medications: - Take at the same time each day for consistency - Follow your provider's instructions regarding food timing - Swallow with a full glass of water - Do not crush, chew, or split tablets unless specifically instructed by your provider - If you miss a dose, take it as soon as you remember unless it is close to your next scheduled dose

Your dispensing pharmacy will include detailed administration instructions with your medication. Always follow the specific directions provided by your provider and pharmacist.

NAD+ (nicotinamide adenine dinucleotide) is a coenzyme involved in cellular energy production and metabolic function. NAD+ levels naturally decline with age.

NAD+ programs through Open Water Rx may support cellular energy, recovery, and healthy aging when clinically appropriate. Options may include injectable, nasal, or oral formulations depending on the patient and provider review.

A licensed provider must determine that treatment is clinically appropriate before any prescription is issued. Results vary and are not guaranteed.

Depending on the treatment and what is clinically appropriate, NAD+ delivery options may include:

- Injectable (subcutaneous injection) - Nasal spray - Oral dropper

The specific formulation and delivery method are determined by your licensed medical provider based on your health profile, goals, and clinical appropriateness. Not all delivery options are available to all patients.

Longevity programs at Open Water Rx are designed for adults interested in supporting energy, recovery, and healthy aging through clinician-reviewed care.

Common reasons patients explore longevity programs include: - Reduced energy or recovery capacity - Interest in supporting healthy aging - Performance and wellness optimization - Complementing an existing health or fitness routine

Eligibility is determined by an independent licensed provider based on your individual health profile. Not all patients qualify, and results vary.

Longevity pricing varies by product, dose, route, and plan length. Entry points include NAD+ nasal spray 900 mg at $112 for 1 month, oral sermorelin low dose at $149 for 1 month or $429 for 3 months, and injectable sermorelin low dose at $169 for 1 month, with longer 3- and 6-month plans available for select products.

All pricing is all-inclusive: licensed provider review, medication if prescribed, and shipping if prescribed. Final pricing depends on the specific program, formulation, and plan. No insurance required. Everything is disclosed before you pay.

Peptide programs may be considered for energy, recovery, strength, or wellness goals, depending on the patient and provider review.

Peptides are short chains of amino acids that act as signaling molecules in the body. Different peptides have different mechanisms and potential applications.

A licensed provider must determine that treatment is clinically appropriate. Results vary and are not guaranteed.

Available peptide options may include:

- Clinician-reviewed peptide injections as determined appropriate by a licensed provider - Clinician-reviewed sermorelin orals (low or high dose) as determined appropriate by a licensed provider - Other options as clinically appropriate and available

Availability depends on clinical appropriateness, provider review, and regulatory requirements. Not all options are available to all patients. Your licensed provider will recommend what is appropriate for your individual health profile.

Yes. Eligible patients may complete a private online intake for provider-reviewed sexual health treatment. If a licensed provider determines that treatment is clinically appropriate, a prescription may be issued and medication shipped discreetly to your door.

Open Water Rx offers multiple formulation options for men's sexual health, including Quattro Sublingual, sildenafil, and tadalafil. Patients must be 21 or older. Patients 75 or older may be limited to single-ingredient options.

All treatment decisions are made by independent licensed providers. A prescription is not guaranteed.

Yes. The entire process is private and online. Intake is completed from home, and medication ships in plain, unmarked packaging if prescribed. Nothing on the outside of the package identifies the contents or the sender as a medical or sexual health company.

Open Water Rx does not submit insurance claims. Your privacy and billing questions should be reviewed in the applicable privacy policy. Your health information is handled in accordance with HIPAA privacy standards.

ED medications (such as sildenafil and tadalafil) are not appropriate for everyone. A licensed medical provider will review your full health history before any prescription is issued.

ED medications are generally not prescribed for patients who:

- Take nitrate medications (such as nitroglycerin) for heart conditions - Have certain cardiovascular conditions or recent cardiac events - Take certain blood pressure medications or alpha-blockers - Have certain other health conditions or medication interactions

This is not a complete list. Your provider will assess your full health profile and make an independent clinical determination. If ED medication is not appropriate for you, your provider will explain why.

Open Water Rx offers multiple clinician-reviewed formulation options for men's sexual health, including:

- Quattro Sublingual (a sublingual — not an injection) in 5-, 10-, 15-, and 20-packs - Sildenafil tablets (50 mg and 100 mg) in 6, 12, or 18 tablets - Tadalafil 20 mg tablets in 6, 12, or 18 tablets

The specific formulation is determined by your licensed medical provider based on your health profile, goals, and clinical appropriateness. Not all options are available to all patients. Patients must be 21 or older.

Sildenafil or tadalafil from $39 for a 1-month supply; Quattro Sublingual from $69 per 5-pack. Final pricing depends on the specific formulation and plan selected.

All pricing is all-inclusive: licensed provider review, medication if prescribed, and shipping if prescribed. No insurance required. Everything is disclosed before you pay.

Shipping timelines vary depending on your location and the dispensing pharmacy. Most patients receive their medication within 3 to 7 business days after their prescription is issued and processed by the pharmacy.

Typical timeline from intake to delivery: - Day 1: Complete online intake form (approximately 5 minutes) - Day 1 to 3: Licensed medical provider reviews your case - Day 2 to 4: Prescription issued if clinically appropriate; pharmacy processes order - Day 5 to 10: Medication delivered to your door

Timelines may vary based on provider review volume, pharmacy processing time, and shipping carrier. You will receive tracking information once your order ships. Available nationwide in all 50 states.

Yes. Shipping is included in your plan price if a prescription is issued. There are no separate shipping fees or surcharges.

Semaglutide plans are $169/mo and tirzepatide plans are $219/mo. Shipping to your door is included in the plan price if medication is prescribed. If treatment is not approved during initial review, you are not charged.

Yes. Medications ship in plain, unmarked packaging. Nothing on the outside of the package identifies the contents or the sender as a medical or weight loss company.

The entire process from evaluation to delivery is 100% online and private. Your health information is handled in accordance with HIPAA privacy standards. Open Water Rx does not submit insurance claims. Your privacy and billing questions should be reviewed in the applicable privacy policy.

Compounded semaglutide and tirzepatide are typically shipped with appropriate cold-chain packaging to maintain temperature during transit. Upon arrival:

- Refrigerate your medication promptly (typically 36F to 46F / 2C to 8C) - Do not freeze - Keep away from direct light - Check the expiration date on your vial - Follow any specific storage instructions included with your shipment

Your dispensing pharmacy will include detailed storage and handling instructions with your medication. If you have questions about storage, contact your provider through secure messaging.

If your medication arrives damaged, appears incorrect, or you have any concerns about the shipment, contact Open Water Rx immediately by emailing members@openwaterrx.com. Do not use medication that appears damaged or compromised.

We will work with the dispensing pharmacy to resolve the issue as quickly as possible. Replacement shipments for verified pharmacy or shipping errors are handled on a case-by-case basis. Do not discard any packaging or documentation until the issue is resolved, as this may be needed for the pharmacy's quality review process.

GLP-1 medications can be shipped to any address in the states where Open Water Rx operates. If you are traveling within a covered state, you can update your shipping address by contacting Patient Support before your next refill ships.

For travel outside covered states or internationally, plan ahead: - Request your refill early enough to receive it before you travel - Carry your medication in its original packaging with pharmacy labeling - Keep medication refrigerated during travel; use a small insulated travel case with ice packs for transit - TSA allows injectable medications in carry-on luggage; carry your prescription documentation

Contact your provider through secure messaging if you have specific travel concerns.

Eligibility for GLP-1 therapy is determined by a licensed medical provider based on your individual health profile. General eligibility criteria typically include:

- BMI of 30 or higher (obesity), or BMI of 27 or higher with at least one weight-related health condition such as type 2 diabetes, hypertension, or high cholesterol - Age 18 or older - No contraindications to GLP-1 therapy - Residing in a state where Open Water Rx services are available (available nationwide in all 50 states, subject to individual clinical review)

This is not a complete list. Your provider will review your full health history and make an independent clinical determination. Eligibility is not guaranteed.

A licensed medical provider will review your full health history before any prescription is issued. GLP-1 medications are generally not prescribed for patients with:

- A personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) - A history of pancreatitis - Certain gastrointestinal conditions - Pregnancy or plans to become pregnant - Certain other medical conditions or medication interactions

This is not a complete list. Your provider will assess your full health profile and make an independent clinical determination. If GLP-1 therapy is not right for you, your provider will explain why.

The FDA-approved indications for GLP-1 medications for weight management generally require a BMI of 30 or higher, or a BMI of 27 or higher with at least one weight-related comorbidity such as type 2 diabetes, hypertension, or dyslipidemia.

Your licensed medical provider will assess your BMI along with your full health profile. BMI is one factor in the clinical determination, not the only one. Eligibility is not guaranteed and is determined solely by your provider.

Yes, in many cases. Both semaglutide and tirzepatide have been studied extensively in patients with type 2 diabetes and have shown strong results for both blood sugar control and weight loss. Tirzepatide in particular has demonstrated exceptional results for type 2 diabetes management due to its dual GIP/GLP-1 mechanism.

If you have type 2 diabetes, your licensed medical provider will factor this into their recommendation and may consider it a supporting factor for GLP-1 therapy. Your provider will also review any current diabetes medications for potential interactions.

This is general information, not medical advice. Eligibility is determined by your provider.

Possibly, but your licensed medical provider will need to review your current medications before prescribing. GLP-1 medications can interact with certain drugs, particularly:

- Insulin and other diabetes medications (risk of hypoglycemia) - Oral medications that require precise timing relative to meals (GLP-1 slows gastric emptying, which can affect absorption) - Certain blood pressure medications

Disclose all current medications, supplements, and over-the-counter drugs on your intake form. Your provider will assess potential interactions and make an independent clinical determination. Do not stop or adjust any current medications without consulting your provider.

Lab work requirements depend on your individual health profile and your provider's clinical judgment. Not all patients require labs before starting GLP-1 therapy.

Your licensed medical provider will review your intake information and determine whether baseline lab work is clinically indicated. Common labs that may be ordered include:

- Comprehensive metabolic panel (CMP) - HbA1c (for patients with diabetes or prediabetes) - Thyroid function tests (TSH) - Lipid panel

If labs are required, your provider will advise you on how to obtain them. Base labs when clinically indicated are included in your plan. Additional lab work beyond what is clinically indicated may carry separate costs.

Base labs when clinically indicated are included in your Open Water Rx plan. This means if your licensed medical provider determines that baseline or follow-up lab work is necessary for your care, the cost of those labs is covered.

Additional lab work beyond what is clinically indicated, or labs ordered at your own request, may carry separate costs. Your provider will inform you of any additional costs before they are incurred.

Not all patients require lab work. Your provider will assess your individual situation.

Open Water Rx supports clinician-guided care across the United States. Available nationwide in all 50 states.

In most states, the clinician review is fully asynchronous — no webcam or live call required. A small number of states require a brief phone or video call with your clinician before a prescription can be issued. If that applies to you, we will let you know clearly after your intake.

Some states impose additional restrictions or disclosure requirements. Some states, including Mississippi, impose additional restrictions on weight-loss treatment options. When you complete your intake, availability in your state will be confirmed as part of the process.

Most programs require patients to be adults (18 or older). Specific age requirements vary by program:

- GLP-1 weight loss programs: Generally for patients ages 18 to 74 for new patients, subject to provider review. Patients 75 or older may have additional clinical considerations. - Men's health programs: Patients must be 21 or older. Patients 75 or older may be limited to single-ingredient options. - Longevity and peptide programs: Generally for adults 18 or older, subject to provider review.

Age eligibility is one factor in the clinical determination. Your licensed provider will assess your full health profile.

Yes. Your health information is handled in accordance with HIPAA privacy standards and is never sold or shared without your explicit consent.

Open Water Rx does not submit insurance claims. The entire process is online and private. Medication ships in plain, unmarked packaging. Your privacy and billing questions should be reviewed in the applicable privacy policy.

Refills through Open Water Rx are designed to be seamless. As part of your ongoing plan, your licensed medical provider will review your progress and issue refill prescriptions when clinically appropriate.

Typical refill process: 1. Your provider reviews your progress (via secure messaging check-in or follow-up questionnaire) 2. If treatment remains clinically appropriate, a refill prescription is issued 3. The pharmacy processes and ships your next supply 4. Medication arrives before your current supply runs out

You do not need to restart the intake process for each refill. Your ongoing plan includes continued provider oversight and refill management. Contact your provider through secure messaging if you have questions about your refill timing.

We recommend initiating your refill request at least 7 to 10 days before your current supply runs out. This allows time for provider review, pharmacy processing, and shipping.

For most patients on an ongoing plan, refills are managed proactively as part of your care. If you are approaching the end of your current supply and have not received refill communication, reach out to your provider through secure messaging.

Do not run out of medication without contacting your provider. Interruptions in GLP-1 therapy may require restarting at a lower dose to minimize side effects.

Yes. Dose adjustments are a normal part of GLP-1 therapy. Your licensed medical provider will assess your progress, tolerance, and clinical response at each follow-up and may adjust your dose accordingly.

Common reasons for dose adjustment at refill: - Titrating up to the next dose level on schedule - Reducing dose due to side effects - Maintaining current dose if you are at your target therapeutic level - Adjusting based on weight loss progress and clinical goals

Do not adjust your dose on your own. All dose changes must be directed by your licensed medical provider.

If you miss a weekly GLP-1 injection, the general guidance is:

- If it has been less than 5 days since your missed dose: administer the missed dose as soon as you remember, then resume your regular weekly schedule - If it has been 5 or more days since your missed dose: skip the missed dose and resume your regular weekly schedule on the next scheduled day - Do not take two doses in the same week to make up for a missed dose

If you miss multiple doses in a row, contact your provider through secure messaging before resuming. Extended interruptions in GLP-1 therapy may require restarting at a lower dose to minimize side effects.

This is general guidance. Always follow the specific instructions provided by your licensed medical provider.

Yes. Secure provider messaging is available throughout your program and is included in your monthly plan price. You do not need to schedule a separate appointment or pay an additional fee to contact your provider between refills.

Common reasons patients use secure messaging between refills include: - Questions about dosing or injection technique - Reporting side effects or unexpected symptoms - Asking about dietary or lifestyle guidance - Requesting a dose adjustment before the next scheduled refill - General questions about their treatment plan

Your licensed medical provider will respond through the secure messaging system. Response times vary. For urgent medical concerns, contact emergency services or your primary care provider rather than waiting for a telehealth response.

Every Open Water Rx plan includes ongoing provider support as part of the monthly price. This includes:

- Secure provider messaging throughout your program - A 30-day async review after your initial prescription - Monthly async follow-up until steady-state dosing is reached - Quarterly async follow-up once you are at your maintenance dose - Dose adjustment guidance at each follow-up - Refill prescription management

In most states, the initial clinician review is fully asynchronous — no webcam or live call required. A small number of states require a brief phone or video call before a first prescription can be issued. If that applies to you, we will let you know after your intake.

Open Water Rx does not charge separately for provider messaging or follow-up reviews. All of this is included in your plan.

If you experience a side effect, contact your provider through secure messaging as soon as possible. Your licensed medical provider can advise on whether the side effect is expected, suggest ways to manage it, or adjust your dosing schedule if appropriate.

Common manageable side effects (nausea, mild stomach discomfort, constipation) can often be addressed by: - Eating smaller, lower-fat meals - Slowing the dose titration schedule - Adjusting injection timing

If you experience severe symptoms such as severe abdominal pain, persistent vomiting, signs of an allergic reaction, or any symptom that feels like a medical emergency, seek emergency care immediately. Do not wait for a telehealth response in an emergency.

Yes. If you contact your provider through secure messaging with a clinical reason for a dose adjustment, your licensed medical provider can review your situation and issue a revised prescription if they determine it is clinically appropriate.

Common reasons for mid-cycle dose adjustments include: - Significant side effects that warrant slowing the titration schedule - Insufficient response at the current dose - A change in your health status or medications

Do not adjust your dose on your own. All dose changes must be directed by your licensed medical provider. Contact your provider through secure messaging to discuss any concerns about your current dose.

Open Water Rx is built for adults who want clinician-guided GLP-1 and longevity care without the barriers of the traditional system. It is an especially strong fit if you want a licensed medical provider to personally review your case (not an algorithm or a queue), prefer one transparent all-inclusive monthly price with no separate membership or hidden fees, want flat-dose pricing that stays the same as your provider adjusts your dose over time, value direct ongoing access to your care team from home on your own schedule, live anywhere in the U.S. and want discreet tracked delivery if medication is prescribed, or want a small, hands-on team that answers questions before signup and stays with you through refills. Every intake is reviewed by an independent licensed provider, and eligibility is determined by that provider based on your individual health profile.

No. Compounded medications are not FDA-approved finished drug products. They have not been evaluated by the FDA for safety, efficacy, or quality in the same manner as commercially manufactured drugs.

Compounded medications are prepared by licensed compounding pharmacies for individual patients based on a prescription from a licensed medical provider. They are legal and regulated under federal and state pharmacy law.

Open Water Rx works exclusively with licensed compounding pharmacies that use base active pharmaceutical ingredients, not salt derivatives. Your provider will review all relevant information before prescribing.

No. Open Water Rx does not manufacture, compound, or dispense medications. Open Water Rx is a telehealth platform that connects patients with independent licensed medical providers.

If a licensed provider determines that treatment is clinically appropriate, a prescription is sent to a licensed compounding pharmacy, which prepares and ships the medication directly to the patient.

Compounded semaglutide and tirzepatide are medications prepared by a licensed compounding pharmacy for an individual patient based on a prescription from a licensed medical provider.

Compounding allows a pharmacy to prepare a medication in a specific dose, formulation, or delivery method that may not be available in a commercially manufactured product. Compounded medications are legal and regulated under federal and state pharmacy law.

Open Water Rx works exclusively with pharmacies that use the base active pharmaceutical ingredient (API), not salt derivatives.

Compounded semaglutide from a licensed pharmacy using the base active pharmaceutical ingredient (API) has been used by a large number of patients under medical supervision. Quality and safety depend significantly on the compounding pharmacy's practices, standards, and oversight.

Open Water Rx works exclusively with licensed compounding pharmacies that use the base semaglutide API, not salt derivatives (such as semaglutide sodium or semaglutide acetate), which have raised additional safety concerns.

Your licensed medical provider will assess whether compounded GLP-1 therapy is appropriate for you individually. This is general information, not medical advice.

Brand-name GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) are FDA-approved finished drug products manufactured by pharmaceutical companies under strict FDA oversight. They have been evaluated for safety, efficacy, and quality through the full FDA approval process.

Compounded GLP-1 medications are prepared by a licensed compounding pharmacy for an individual patient.

Key differences: - Availability: Compounded options may be available when brand-name products are on shortage or when a specific formulation is needed. - Customization: Compounding allows for specific doses or formulations not available commercially. - Pricing: Open Water Rx offers transparent, all-inclusive monthly plans. Pricing is not the medical reason for prescribing compounded medications.

Open Water Rx does not claim that compounded medications are equivalent to or interchangeable with FDA-approved products. Compounded semaglutide and tirzepatide are prescribed only when an independent licensed provider determines there is a valid individual clinical reason, not simply as a lower-cost alternative.

No. Open Water Rx works exclusively with compounding pharmacies that use the base semaglutide active pharmaceutical ingredient (API), not salt derivatives such as semaglutide sodium or semaglutide acetate.

Salt derivatives of semaglutide have raised concerns from the FDA and medical community because they are chemically distinct from the active ingredient in FDA-approved products and have not been evaluated for safety or efficacy. The FDA has specifically warned against the use of semaglutide salt forms in compounded products.

This is an important quality distinction. If you are evaluating other telehealth providers, ask specifically whether they use the base API or a salt derivative.

Open Water Rx works with licensed compounding pharmacies that meet our quality and compliance standards. Our published pharmacy network includes Emerald Compounding Pharmacy, Striker Pharmacy, Foothills Professional Pharmacy, and EPIQ Scripts. Pharmacy partners may vary by medication and patient location. See Surfbound Health’s pharmacy partners at https://surfbound.co/pharmacies.

All pharmacies we work with: - Are licensed under applicable federal and state pharmacy law - Use the base active pharmaceutical ingredient (API), not salt derivatives - Operate under applicable federal and state pharmacy regulations

Your prescription will be dispensed by a licensed compounding pharmacy. Pharmacy information will be included with your shipment documentation.

An independent licensed medical provider reviews your health history and determines whether treatment is appropriate. These are licensed healthcare professionals who make independent clinical determinations based on your individual health profile.

Open Water Rx is a telehealth platform, not a medical practice. All prescribing decisions are made solely by independent licensed providers. Open Water Rx does not direct or influence clinical decisions.

No. All treatment decisions are made by independent licensed providers after reviewing your health history, medications, and individual health profile.

Open Water Rx does not guarantee prescriptions. A prescription is issued only when a licensed provider determines that treatment is clinically appropriate for you. If treatment is not appropriate, your provider will explain why and may suggest alternatives.

This is a fundamental aspect of responsible telehealth: prescriptions are only issued when clinically warranted.

Possibly, depending on your health profile and provider review. Some patients may be appropriate for more than one program, for example, a weight loss program alongside a longevity program.

Your licensed medical provider will assess your full health profile and determine what is clinically appropriate. Do not start multiple programs without provider guidance, as some medications may interact or require coordinated dosing.