NAD⁺ Safety Information

About NAD⁺
NAD⁺ (Nicotinamide Adenine Dinucleotide) is a naturally occurring coenzyme found in all living cells. It plays a critical role in energy production, DNA repair, and overall cellular health. NAD⁺ injections are not FDA-approved for any medical condition but are commonly used in wellness medicine to support energy, focus, recovery, and healthy aging.

Warnings & Precautions

Pregnancy & Breastfeeding: Safety has not been established — not recommended unless prescribed under direct medical supervision.

Medical Conditions: Patients with liver disease, kidney disease, heart disease, uncontrolled diabetes, or cancer should use caution and consult their provider before treatment.

Injection Reactions: Redness, swelling, or tenderness may occur at the injection site.

Monitoring: Regular check-ins are recommended to assess response and ensure safe use.

Possible Side Effects

Flushing or warmth

Nausea or upset stomach

Headache

Lightheadedness or dizziness

Fatigue after injection

Soreness at injection site

These effects are usually mild and short-lived.

Drug Interactions

Because NAD⁺ impacts metabolism and energy production, it may interact with certain medications:

Diabetes Medications (insulin, metformin, GLP-1s): May alter blood sugar control.

Chemotherapy Agents: Could interfere with treatments designed to damage cancer cells.

Blood Pressure Medications: May enhance antihypertensive effects.

Other NAD⁺ Boosters (e.g., NMN, nicotinamide riboside): May amplify effects.

Always share your full medication list with your provider.

Note from Boggs Wellness

This information is provided for educational purposes only and should not replace conversations with your healthcare provider. All medical decisions should be made in consultation with your licensed provider, considering your individual health needs.

5-Amino-1MQ Safety Information

About 5-Amino-1MQ
5-Amino-1MQ is a small molecule compound (not a peptide) that works by inhibiting the enzyme NNMT (nicotinamide N-methyltransferase). By blocking NNMT, 5-Amino-1MQ increases NAD⁺ availability inside cells, supporting fat metabolism, energy production, and cellular repair. It is not FDA-approved for any condition, but is commonly used in wellness and performance medicine to support metabolism and body composition.

Warnings & Precautions

Pregnancy & Breastfeeding: Not recommended; safety data is lacking.

Medical Conditions: Use caution with liver disease, kidney disease, or uncontrolled metabolic disorders.

Long-Term Use: Often prescribed in cycles (e.g., 8–12 weeks) to avoid overstimulation of metabolic pathways.

Allergies: Avoid use if sensitive to any ingredients in the capsule.

Possible Side Effects

Digestive upset (nausea, bloating, stomach discomfort)

Headache

Temporary appetite changes

Mild fatigue (less common)

Drug Interactions

Because 5-Amino-1MQ impacts metabolism and NAD⁺ levels, it may interact with certain therapies:

Diabetes Medications: May affect blood sugar control.

Blood Pressure Medications: Could influence vascular tone; monitor closely.

Other NAD⁺ Boosters (NMN, nicotinamide riboside, niacin): Combining may increase effects.

Chemotherapy Agents: May interfere with treatments designed to slow cell growth.

Always disclose all medications and supplements to your provider.

Note from Boggs Wellness

This information is provided for educational purposes only and should not replace conversations with your healthcare provider. All medical decisions should be made in consultation with your licensed provider, considering your individual health needs.

Bupropion Saftey Information

Bupropion is FDA-approved for the treatment of major depressive disorder (MDD) and for the prevention of seasonal affective disorder (SAD) during autumn-winter months.

Healthcare providers may also prescribe Bupropion off-label to support weight loss in adults with overweight or obesity.

Black Box Warning

WARNING: CHANGES IN THINKING AND BEHAVIOR, DEPRESSION, AND SUICIDAL THOUGHTS OR ACTIONS

Antidepressants may increase the risk of suicidal thoughts or actions in children, teenagers, or young adults during the first few months of treatment.

This risk is higher in individuals with a personal or family history of bipolar disorder or suicidal behavior.

Monitor for any sudden changes in mood, behavior, or thoughts.

Call your healthcare provider immediately if you notice:

-Thoughts of suicide or dying

Suicide attempts

-New or worsening depression or anxiety

-Agitation or restlessness

-Panic attacks

-Irritability or aggression

-Acting on dangerous impulses

-Mania (e.g., rapid talking, excessive energy)

-Other unusual changes in mood or behavior

-Additional Mental Health Considerations

Bupropion contains the same active ingredient as Zyban, a medication used to help patients quit smoking.

Some individuals have experienced mental health changes when using bupropion for smoking cessation, including:

-Agitation or hostility

-Depression

-Suicidal thoughts or behavior: these symptoms may begin when starting bupropion, after several weeks, or even after stopping treatment. This is more likely in people with a history of mental health disorders.

Stop Bupropion XL immediately and contact your provider if you or a loved one notice any of these symptoms:

-Seizures

There is a risk of seizures, especially in people with specific medical conditions or when taking interacting medications.

Stop the medication and call your provider immediately if a seizure occurs.

High Blood Pressure

Bupropion may raise blood pressure, which can be severe in some cases.

Manic Episodes

May trigger mania or hypomania in individuals with bipolar disorder.

Watch for signs such as:

Increased energy or speech

Racing thoughts

Impulsive behavior

Excessive happiness or irritability

Unusual Thoughts or Behaviors

Rarely, patients may experience delusions, hallucinations, paranoia, or confusion.

Visual Problems

May increase the risk of glaucoma. Watch for eye pain, vision changes, redness, or swelling around the eyes.

Severe Allergic Reactions

Stop Bupropion XL and call your provider if you experience:

Rash, hives, or itching

Fever or swollen lymph nodes

Painful mouth sores

Swelling of lips, tongue, or face

Chest pain

Difficulty breathing

Do NOT Take Bupropion XL If You:

Have a history of seizures or epilepsy

Have or had an eating disorder, such as anorexia nervosa or bulimia

Take other bupropion-containing medications, including Wellbutrin, Wellbutrin SR, Zyban, Aplenzin, or Forfivo XL

Use alcohol or sedatives heavily and are stopping them suddenly

Are taking or have recently stopped taking an MAOI (including linezolid or methylene blue); a 14-day washout period is required

Are allergic to bupropion or any of the inactive ingredients in Bupropion XL

Tell Your Healthcare Provider If You:

Have liver or kidney problems

Have had a head injury or brain tumor

Have had a seizure or stroke

Have high blood pressure, heart disease, or have had a heart attack

Are diabetic and taking insulin or blood sugar-lowering medications

Drink alcohol or use recreational drugs

Are pregnant or planning pregnancy (call the National Pregnancy Registry at 1-844-405-6185)

Are breastfeeding — bupropion passes into breast milk in small amounts

Drug Interactions

Inform your provider of all medications and supplements you are taking. Many medications can interact with bupropion and increase the risk of seizures or other side effects.

Most Common Side Effects

Trouble sleeping

Stuffy nose

Dry mouth

Dizziness

Anxiety

Nausea

Constipation

Joint pain

This is not a full list of side effects. Report any new or worsening symptoms to your provider or the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Note from Boggs Wellness

This information is provided for educational purposes only and should not replace conversations with your healthcare provider. All medical decisions should be made in consultation with your licensed provider, considering your individual health needs.About Metformin

Metformin is FDA-approved as an adjunct to diet and exercise to improve blood sugar control in adults with Type 2 Diabetes Mellitus.

Healthcare providers may also prescribe Metformin off-label to support weight loss in adults with overweight or obesity.

Common Side Effects

Abdominal distress

Diarrhea

Nausea

Vomiting

Prescribing Information

Black Box Warning

Metformin Safety Information

Black Box Warning

Black Box Warning

Important Safety Information

Lactic Acidosis

Metformin can cause a rare but serious condition called lactic acidosis, a buildup of lactic acid in the blood that can lead to death. This is a medical emergency and must be treated in a hospital.

Stop taking Metformin XR and contact your provider immediately if you experience:

Extreme weakness or fatigue

Unusual muscle pain

Trouble breathing

Unusual sleepiness or sleeping longer than usual

Nausea, vomiting, or diarrhea

Feeling cold, especially in arms and legs

Dizziness or lightheadedness

Slow or irregular heartbeat

You May Be at Higher Risk of Lactic Acidosis If You:

Have kidney problems (Metformin should not be used if kidneys are not functioning properly)

Have liver problems

Have congestive heart failure requiring medication

Drink alcohol excessively (frequent or binge drinking)

Are dehydrated from fever, vomiting, diarrhea, sweating, or not drinking enough fluids

Are undergoing imaging with contrast dye

Are having surgery

Have had a heart attack, severe infection, or stroke

Are 80 years or older and have not had your kidney function checked

Do NOT Take Metformin XR If You:

Have kidney problems

Are allergic to metformin or any ingredients in Metformin XR

Are receiving contrast dye for an x-ray or undergoing surgery and will not be able to eat or drink—your provider may instruct you to temporarily stop the medication

💬 Tell Your Provider Before Taking Metformin XR If You:

Have Type 1 diabetes (Metformin is not for this condition)

Have a history of or risk for diabetic ketoacidosis

Have liver, kidney, or heart problems

Are over age 80 (you must have normal kidney function confirmed)

Drink alcohol regularly or engage in binge drinking

Are taking insulin or other blood sugar-lowering medications

Have other medical conditions

Are pregnant or planning pregnancy (risk to unborn baby unknown; discuss with your provider)

Are breastfeeding or plan to breastfeed (unknown if metformin passes into breast milk)

Medication Interactions

Tell your provider about all medications you take, including:

Prescription and non-prescription drugs

Vitamins

Herbal supplements

Metformin XR may interact with other medicines and change how they work—or how Metformin works.

Managing Side Effects

The most common side effects of Metformin XR include:

Diarrhea

Nausea

Upset stomach

These symptoms usually resolve over time. Taking Metformin with meals may reduce side effects.

Let your provider know if symptoms:

Persist longer than a few weeks

Come back after going away

Start later in your treatment

Become bothersome

In some cases, a dosage change or temporary discontinuation may be necessary.

Other Reported Effects

Metallic taste in the mouth (seen in ~3% of patients, usually short-lived)

Hypoglycemia is rare when taken alone but may occur with missed meals, alcohol use, or other diabetes medications

Report Side Effects

You are encouraged to report negative side effects to the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088.

This information is provided for educational purposes only and is not intended to replace discussions with your healthcare provider.

All treatment decisions must be made between you and your provider, based on your individual medical history and needs.

This product information is intended for U.S. residents only and may differ from labeling in other countries.

Naltrexone Safety Information

You may receive a compounded version of Naltrexone if your provider determines it is medically appropriate for you.

Please note: Compounded medications are not reviewed or approved by the FDA for safety, effectiveness, or manufacturing standards.

FDA-Approved Use:

Naltrexone is a prescription medication FDA-approved to:

Treat alcohol dependence

Prevent relapse to opioid dependence after opioid detoxification

Naltrexone may also be prescribed off-label to support weight loss in adults with overweight or obesity.

Common Side Effects

Abdominal pain

Nausea

Vomiting

Important Safety Information

Risk of Opioid Overdose

Naltrexone blocks the effects of opioids, including:

Prescription opioids (e.g., morphine, oxycodone, hydrocodone, codeine, tramadol)

Street drugs such as heroin

Do NOT attempt to override this effect by taking large doses of opioids, as this can lead to serious injury, coma, or death.

Once Naltrexone’s blocking effect wears off, your sensitivity to opioids increases. This means that even small amounts of opioids—taken:

After detox

When your next dose is due

After missing a dose

After stopping treatment

…can result in overdose or death.

Inform your close contacts about this increased sensitivity and the risk of overdose.

Talk to your provider about naloxone, an emergency medication for opioid overdose. Always call 911 if overdose is suspected—even if naloxone is used.

Sudden Opioid Withdrawal

To avoid withdrawal, you must stop using all opioids (including prescription, street drugs, and treatments like buprenorphine or methadone) for 7 to 14 days before starting Naltrexone.

Opioid withdrawal can be severe and may require hospitalization.

Symptoms of withdrawal may include:

Anxiety or restlessness

Muscle aches, twitches, or cramps

Runny nose or teary eyes

Yawning, chills, or goosebumps

Hot or cold flashes

Sweating or fever

Nausea, vomiting, or diarrhea

Abdominal cramping

Insomnia

Liver Damage or Hepatitis

Naltrexone can cause liver toxicity. Contact your provider if you experience:

Stomach pain (lasting more than a few days)

Dark urine

Yellowing of the eyes or skin (jaundice)

Unusual fatigue

Your provider may stop treatment if signs of serious liver damage develop.

Do NOT Take Naltrexone If You:

Are using or physically dependent on opioids

Are experiencing withdrawal symptoms

Are allergic to Naltrexone or any inactive ingredients in the formulation

💬 Before Taking Naltrexone, Tell Your Provider If You:

Have liver disease or hepatitis

Use or have used illicit drugs

Have bleeding disorders such as hemophilia

Have kidney disease

Are pregnant or planning pregnancy

Are breastfeeding (Naltrexone passes into breast milk; your provider can help weigh the risks and benefits)

Also tell your provider if you take any:

Prescription or non-prescription medications

Vitamins or herbal supplements

Especially opioid-containing products for pain, cough, or diarrhea

Other Serious Side Effects

Depressed mood: May increase the risk of suicidal thoughts or behavior. Let your provider and loved ones know you're taking Naltrexone.

Pneumonia: Rare allergic reactions may cause pneumonia requiring hospitalization.

Severe Allergic Reactions: Seek immediate medical help for:

Rash

Swelling of face, eyes, lips, or tongue

Chest pain

Wheezing or trouble breathing

Dizziness or fainting

Common Side Effects

Nausea

Sleepiness

Headache

Dizziness

Vomiting

Decreased appetite

Joint or muscle pain

Cold-like symptoms

Trouble sleeping

Toothache

These are not all possible side effects. Tell your provider if any side effect worsens or doesn’t go away.

Reporting Side Effects

You are encouraged to report negative side effects to the FDA:

www.fda.gov/medwatch or 1-800-FDA-1088

This information is provided for educational purposes only and should not replace conversations with your healthcare provider.

All treatment decisions must be made in partnership with your provider based on your unique medical history and goals.

This product information is intended for U.S. residents only and may differ from product labeling in other countriesTopiramate is an FDA-approved prescription medication used to treat specific neurological conditions and may also be prescribed off-label to support weight loss in adults with overweight or obesity.

Topiramate Safety Information

Treat partial-onset seizures and primary generalized tonic-clonic seizures in adults and children 2 years and older

Treat seizures associated with Lennox-Gastaut syndrome (with other medications)

Prevent migraine headaches in adults and adolescents 12 years and older

Common Side Effects

Drowsiness

Metallic taste (dysgeusia)

Memory or concentration difficulties

Tingling or numbness in hands and feet (paresthesias)

Important Safety Information

Eye Problems

Topiramate may cause sudden vision changes or glaucoma (increased eye pressure). These can lead to permanent vision loss if not treated promptly.

Call your provider right away if you notice:

Decreased or blurred vision

Eye pain or redness

Decreased Sweating & Overheating

Topiramate can reduce sweating and raise body temperature, especially in children.

Watch for:

High fever

Flushed skin

Confusion or lack of sweating during physical activity or hot weather

Metabolic Acidosis

Topiramate may cause a build-up of acid in your blood (metabolic acidosis), which can:

Lead to bone loss, kidney stones, or slowed growth in children

Cause fatigue, poor appetite, irregular heartbeat, or mental fog

Your provider may check your blood for acid levels during treatment.

Suicidal Thoughts and Mood Changes

Topiramate may increase the risk of suicidal thoughts or behaviors in a small number of people.

Seek immediate medical help if you experience:

Depression or anxiety

Irritability or mood swings

Thoughts of self-harm or suicide

Aggression or unusual behavior

Pregnancy and Birth Defects

Topiramate can harm your unborn baby. It may cause birth defects such as cleft lip or cleft palate, especially in the first trimester.

Tell your provider if you are pregnant, trying to conceive, or not using contraception

If pregnancy occurs, discuss your options and consider enrolling in the North American Antiepileptic Drug Pregnancy Registry: 1-888-233-2334

Topiramate may also cause low birth weight or growth issues

Do NOT Stop Topiramate Suddenly

Stopping Topiramate abruptly can lead to serious seizures, even in those without a seizure disorder. Always taper under your provider’s guidance.

Do NOT Take Topiramate If You:

Are allergic to topiramate or any of its ingredients

Tell Your Provider If You:

Have depression, suicidal thoughts, or mood disorders

Have kidney problems, kidney stones, or are on dialysis

Have a history of metabolic acidosis

Have liver disease

Have bone conditions (osteoporosis, osteomalacia, or osteopenia)

Have glaucoma or other vision problems

Are on a ketogenic diet

Are pregnant or breastfeeding

Are scheduled for surgery

Drug Interactions

Topiramate may interact with:

Valproic acid (Depakene®, Depakote®)

Medications affecting alertness or coordination

Hormonal birth control — Topiramate may reduce effectiveness

Keep a current medication list and share it with your provider and pharmacist.

How to Take Topiramate

Take exactly as prescribed

Swallow tablets whole — do not chew (they taste bitter)

Can be taken with or without food

Drink plenty of water to help prevent kidney stones

Missed Dose?

If you miss a dose and it's within 6 hours of your next one, skip it — do not double up.

If you miss more than one dose, call your provider.

Avoid While Taking Topiramate

Alcohol, which may increase side effects like dizziness or drowsiness

Driving or operating heavy machinery until you know how the medication affects you

Activities with risk of loss of consciousness (e.g., swimming, heights) if you have a seizure disorder

Other Serious Side Effects

High ammonia levels (especially with valproic acid): may cause fatigue, confusion, or vomiting

Cognitive impairment (trouble with memory, attention, or speech)

Skin reactions (e.g., Stevens-Johnson syndrome or toxic epidermal necrolysis)

Kidney stones

Drop in body temperature (especially when used with valproic acid)

Most Common Side Effects

Tingling in hands and feet (paresthesia)

Dizziness or drowsiness

Nausea or diarrhea

Loss of appetite or weight loss

Slow reaction time

Memory or speech difficulties

Nervousness or fatigue

Fever

Vision changes

Respiratory infections

Report Side Effects

To report adverse effects, contact the FDA at www.fda.gov/medwatch or call 1-800-FDA-1088

This material is for educational purposes only and does not replace personalized medical advice.

All decisions about treatment should be made in consultation with your licensed provider.

This information is intended for U.S. residents only and may differ from labeling in other countries.

Would you like this formatted into a PDF handout or added to your digital intake documents? I can package all four medication safety sheets for easy patient use.