Important safety information
Last updated: October 14, 2026
This page summarizes key safety information for medications prescribed through RYNA Health’s affiliated clinicians. It does not include everything you need to know. Your clinician and pharmacist are your best source of information about your treatment — tell them about every medicine, supplement and health condition you have.
About compounded medications. Many medications offered through RYNA are compounded by licensed U.S. pharmacies. Compounded medications are not FDA-approved: the FDA does not review them for safety, effectiveness or quality before they are dispensed.
GLP-1 medications: semaglutide & tirzepatide (including microdosing)
Possible risk of thyroid tumors, including cancer. In animal studies, these medicines caused thyroid C-cell tumors. It is not known whether they cause these tumors in people. Do not use them if you or a family member has had medullary thyroid carcinoma (MTC), or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your clinician right away about a lump or swelling in your neck, trouble swallowing, hoarseness or shortness of breath.
Do not use if you are pregnant, planning to become pregnant, or breastfeeding, or if you have had a serious allergic reaction to semaglutide or tirzepatide.
Serious side effects can include:
- Inflammation of the pancreas (pancreatitis): severe stomach pain that won’t go away, with or without vomiting
- Gallbladder problems, including gallstones
- Low blood sugar, especially if you also take insulin or a sulfonylurea
- Kidney problems, often from dehydration caused by vomiting or diarrhea
- Serious allergic reactions
- Changes in vision in people with type 2 diabetes
- Depression or thoughts of self-harm — tell your clinician about any mood changes
The most common side effects are nausea, vomiting, diarrhea, constipation, stomach pain and decreased appetite. Tell your clinician if you are having surgery or a procedure that needs anesthesia.
ED medications: sildenafil, tadalafil, vardenafil & apomorphine
Never take these medicines with nitrates (such as nitroglycerin for chest pain) or with “poppers” (amyl or butyl nitrite), or with riociguat. The combination can cause a sudden, dangerous drop in blood pressure.
Talk with your clinician before sex if you have heart problems — sexual activity puts extra strain on the heart. Stop and get medical help right away if you have chest pain, dizziness or nausea during sex.
Get emergency care if you have:
- An erection lasting more than 4 hours (priapism), which can permanently damage the penis
- Sudden loss of vision in one or both eyes
- Sudden decrease or loss of hearing, sometimes with ringing in the ears or dizziness
Use caution with alpha-blockers (for blood pressure or prostate), other blood pressure medicines and large amounts of alcohol, which can lower blood pressure. Common side effects include headache, flushing, upset stomach, nasal congestion, back pain and changes in color vision.
Apomorphine can cause nausea, dizziness, yawning, sleepiness and low blood pressure. Do not take it with ondansetron or similar anti-nausea medicines (5-HT3 blockers).
NAD+, B12 MIC & Sermorelin
NAD+ (injection, nasal spray or oral) may cause nausea, flushing, headache, fatigue or stomach upset, and injection-site pain or redness. Injections that are given too quickly can cause chest tightness or cramping. B12 MIC (methionine, inositol, choline and vitamin B12) may cause injection-site pain, mild diarrhea or itching. Do not use if you are allergic to cobalt or vitamin B12, or have Leber’s disease. Sermorelin may cause injection-site pain, swelling or redness, flushing, headache, dizziness or trouble sleeping. Do not use if you are pregnant or breastfeeding, have an active cancer, or have a known allergy to sermorelin. Tell your clinician if you have thyroid problems.Menopause hormone therapy (HRT)
Estrogen therapy carries risks, including blood clots, stroke, heart attack, breast cancer, and endometrial cancer in women with a uterus who do not also take progesterone. Use the lowest effective dose for the shortest time that meets your treatment goals, and review your treatment with your clinician regularly.
Do not use estrogen if you are pregnant, have unexplained vaginal bleeding, or have had breast cancer, a blood clot, a stroke, a heart attack or liver disease. Call your clinician about breast lumps, unusual vaginal bleeding, chest pain, leg pain or swelling, sudden severe headache or changes in vision.
Non-hormonal options (paroxetine, desvenlafaxine) can interact with other medicines, including tamoxifen and blood thinners, and may cause nausea, dizziness or sleep changes. Antidepressants carry a warning about suicidal thoughts in some people; tell your clinician about any mood changes.
Report a side effect
If you have a side effect, message your care team in your patient account or email care@rynahealth.com. You may also report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088. In an emergency, call 911.