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If ibuprofen or another NSAID is necessary, several strategies can minimize risk: Use the lowest effective dose for the shortest duration possible for example, 200400 mg of ibuprofen every 46 hours as needed, not exceeding 1,200 mg per day for over-the-counter use unless directed by a healthcare provider Take NSAIDs with food to reduce direct gastric irritation, though this does not eliminate ulcer risk Consider gastroprotection with a proton pump inhibitor (omeprazole, pantoprazole) if NSAID use will be prolonged or if risk factors for GI bleeding are present Maintain adequate hydration to protect kidney function, particularly if experiencing semaglutide-related nausea or vomiting For patients taking Rybelsus (oral semaglutide), remember to take it on an empty stomach with no more than 4 ounces of water, then wait at least 30 minutes before taking ibuprofen or other medications

These pharmacies operate legally under federal law, which permits them to compound semaglutide for a specific patient with a valid prescription, especially during a recognized drug shortage