Medications Side Effects
- Most side effects can be managed with over-the-counter (OTC) options and/or adjustments in the medication dose. Severe side effects are rare.
- Do NOT make medication adjustments without consulting the Red Rocks Wellness staff. Making adjustments can increase the risk of side effects.
- If you are experiencing side effects with increasing frequency or severity, please reach out to Red Rocks Wellness staff for further evaluation.
- The following lists of side effects are not all-inclusive. If you have concerns about the medications you are taking, please contact your provider immediately.
Any cases that seem urgent should be addressed at an urgent care or emergency department.
Hormone and Thyroid Side Effects
Acne
- For mild acne, use a gentle face wash twice daily, followed by a non-comedogenic moisturizer.
- For moderate acne, topical OTC options include benzoyl peroxide (which can be drying so must be paired with appropriate moisturizer) and/or topical retinoids.
- Prescriptions for medications may be indicated in more severe cases.
Bloating/Water Retention
- Increase water.
- Decrease sodium intake.
- A dose adjustment may be indicated. Please schedule an appointment with the provider to discuss further.
- Over-the-counter diuretics (also known as water pills) are available at local pharmacies.
- Prescription diuretics may be used if indicated.
Headache
- Can often be a sign of water retention, or because of too much or too little hormone. Please schedule an appointment with the provider to discuss possible dose adjustments.
Fatigue
- Can be due to too little or too much hormone. Please schedule an appointment with the provider to discuss possible dose adjustments.
Constipation or Diarrhea
- Can be due to too little or too much hormone. Please schedule an appointment with the provider to discuss possible dose adjustments.
Hair Growth
- Medication adjustments may be indicated.
- Laser hair removal.
- Spironolactone may be helpful for women.
Menstrual Cycle Changes
- This can be normal when initially making hormone changes, but please let your provider know.
- Contraceptive methods must be used while taking medications like Semaglutide, Tirzepatide, phentermine, and testosterone.
- If pregnancy is a possibility while taking medications prescribed by Red Rocks Wellness, please reach out to your provider for guidance ASAP.
Post-Menopausal Bleeding
- This can be normal when initially starting HRT, but please let your provider know.
- Prolonged or continued bleeding can indicate uterine polyps or fibroids.
- Medication adjustments may be indicated. Please reach out to your provider for guidance.
Semaglutide & Tirzepatide Side Effects
Constipation
- Increase water intake.
- Men need 3.7 liters (125 ounces) daily.
- Women need 2.7 liters (91 ounces) daily.
- Increase fiber.
- Men need 30-40 grams daily.
- Women need 25-35 grams daily.
- Sources of fiber:
- Vegetables, whole grains, prunes, Metamucil/psyllium husk
- Magnesium citrate (195-300mL in a single daily dose or in divided doses with a full glass of water)
- Alternative: 300-600mg (tablets) at bedtime
- Miralax (max: 34-68*g/day if used on occasion. 17g/day for 7 days if used for multiple days)
Dizziness
- Increase water intake.
- Men need 3.7 liters (125 ounces) daily.
- Women need 2.7 liters (91 ounces) daily.
- Eat at regular intervals. Try not to go more than 4 hours without eating something (can be a small snack).
- Increase fiber intake to help stabilize blood sugar levels.
- If episodes are frequent or severe, discontinue medication and schedule an appointment ASAP.
- Can often be a sign of dehydration or hypoglycemia. Try drinking some water and/or eating a small snack to see if this helps.
Fatigue
- Can be a normal part of eating fewer calories (energy). If you have not already, track your calories for a few days and set up an appointment with your provider to review your caloric intake.
- B12 supplements can help with energy.
- If you are taking thyroid medication, we will want to check thyroid labs to ensure that your medication is still achieving therapeutic levels
- If accompanied by dizziness, you may be experiencing hypoglycemia (low blood sugar), which can be treated by eating 15-30 grams of carbohydrates.
Nausea and vomiting
- Nausea may be induced by certain foods (i.e. greasy, fatty, sugary, acidic foods), large meals, dehydration, eating close to bedtime, and intense exercise. Such factors may need to be modified as necessary.
- Tums (max: 15 tablets or 7,500 mg/day)
- Pepto Bismol (max: 8 doses/day)
- Ginger (max: 3-4 g/day) chews, capsules
- Ginger, Chamomile, or Peppermint Tea
- Dramamine/Dimenhydrinate (max: 400 mg/day)
- Bonine/Meclizine (max: 100mg/day)
- Prescription for Nausea/Vomiting is available on request.
- Zofran/Ondansetron 4-8mg every 8 hours as needed
Oral Appetite Suppressants
Phentermine, Phendimetrazine, and Diethylpropion
Constipation & Dry Mouth
- Increase water intake.
- Men need 3.7 liters (125 ounces) daily.
- Women need 2.7 liters (91 ounces) daily.
- Increase fiber.
- Men need 30-38 grams daily.
- Women need 21-25 grams daily.
- Sources of fiber:
- Vegetables, whole grains, prunes, Metamucil/psyllium husk
- Chewing gum can be helpful for dry mouth.
Headache
- Can be a sign of dehydration or high blood pressure. Try drinking some water to see if this helps.
- If headache does not resolve or worsen, please discuss with provider or seek medical care at an urgent care/emergency department.
Heart Racing & High Blood Pressure
- Do not combine these medications with stimulants!
- Please discuss these symptoms with your provider as a lower dose may be needed.
Insomnia
- Taking these medications later in the day or combining them with other stimulants (e.g. coffee) can increase risk of sleep disturbance. Make sure to take the medication first thing in the morning and do not combine with other stimulants.