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Absolute contraindications Do not use compounded semaglutide with B12 if you have: A personal or family history of medullary thyroid carcinoma (MTC) Multiple Endocrine Neoplasia syndrome type 2 (MEN 2) Known hypersensitivity to semaglutide or cyanocobalamin Leber hereditary optic neuropathy (a contraindication specific to the cyanocobalamin component) Active pregnancy (semaglutide showed embryofetal toxicity in animal studies) Understanding drug interactions is especially important for people using peptide therapy broadly, as multiple compounds can produce unpredictable interactions

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