← Weight Loss & Metabolic

Tirzepatide/B6 + Glycine

The same tirzepatide as Tirzepatide/B12, compounded with glycine and vitamin B6 instead of B12, for people who have reacted to B12. Your provider sets the dose.

Dr. Jonathan Snipes, MDMedically reviewed by Dr. Jonathan Snipes, MD. Last reviewed May 6, 2026.

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Each row is one vial at one dose, not a bundle. You order one vial at a time, and your provider moves you up when you are ready.

Larger vials for current patients, fewer reorders

Tirzepatide/B6 + Glycine dispensed by a licensed U.S. 503A compounding pharmacy

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Tirzepatide With Glycine: What It Is

Tirzepatide with glycine is compounded tirzepatide made with glycine and B6 in place of B12. The active ingredient is the same as in Tirzepatide/B12. Providers choose it for patients who have reacted to B12, or when they want a formulation without it. It is a twice-weekly injection under the skin, and your provider sets the dose. A 60 mg vial is $180 and a 180 mg vial is $540 at the pharmacy, plus the $39 medical review.

Which tirzepatide is right for me?

All 3 have the same active ingredient. They differ in what it is compounded with and how much you take. Your provider reviews the choice before anything is prescribed.

Dual-Pathway ActionSuperior Weight LossB12-Free CofactorGlycine Buffer

What It Is

Tirzepatide compounded with B6 and glycine instead of B12. Identical active ingredient and weight-loss mechanism as Tirzepatide/B12. Chosen when a patient has reacted to B12 or when a provider wants a cleaner cofactor profile.

How It Works

Same as Tirzepatide/B12: dual GIP and GLP-1 receptor activation for appetite control, blood sugar regulation, and metabolic enhancement. The B6/glycine carrier is pharmacologically inert with respect to weight loss.

Who It's For

Adults indicated for compounded tirzepatide who have a known B12 sensitivity or whose provider has specifically requested the glycine formulation.

Who Should Avoid It

Same as Tirzepatide/B12: avoid with thyroid cancer history, MEN2, pancreatitis, gastroparesis, or pregnancy.

Ready to add Tirzepatide/B6 + Glycine?

A licensed provider reviews every order.


Tirzepatide/B6 + Glycine Side Effects

Compounded tirzepatide is not FDA approved and has no trials of its own. The numbers below come from the FDA label for Zepbound®, the brand-name tirzepatide taken once a week, in adults treated for weight loss. Our dosing is twice a week, so use them as a guide.

Most common side effects

Percent of people in each group, Zepbound® once weekly versus placebo.
Side effectPlacebo5 mg10 mg15 mg
Nausea8%25%29%28%
Diarrhea8%19%21%23%
Vomiting2%8%11%13%
Constipation5%17%14%11%
Stomach pain (abdominal pain)5%9%9%10%
Indigestion (dyspepsia)4%9%9%10%
Injection site reactions2%6%8%8%
Tiredness (fatigue)3%5%6%7%
Allergic reactions (hypersensitivity)3%5%5%5%
Burping (eructation)1%4%5%5%
Hair loss1%5%4%5%
Acid reflux (GERD)2%4%4%5%

Serious risks on the label

  • Thyroid C-cell tumors: tirzepatide caused them in rats, and it is unknown whether it does in people. Do not use it if you or a family member has had medullary thyroid cancer, or if you have MEN 2 (boxed warning).
  • Severe stomach and bowel side effects.
  • Kidney injury from dehydration after nausea, vomiting or diarrhea.
  • Gallbladder problems.
  • Pancreatitis (an inflamed pancreas).
  • Serious allergic reactions.
  • Low blood sugar. The risk is higher with insulin or a medicine that makes the body release more insulin, such as a sulfonylurea.
  • Worsening diabetic eye disease in people with type 2 diabetes.
  • Food or liquid getting into the lungs during anesthesia or deep sedation. Tell the care team about it before any procedure.

Tell your provider about any of these in your health screening. Your provider reviews your history before anything is prescribed.

Source: Zepbound (tirzepatide) prescribing information, Revised 8/2026, Table 1, adults with obesity or overweight in Studies 1 and 2; section 5 and the boxed warning.

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Protocol & Pricing

Pharmacy Price

From $180/60mg

You pay pharmacy price. No markup.

Glycine carrier: reserved for patients with B-12 sensitivity, methylation issues, or histamine reactions. Higher carrier cost reflects formulation complexity, not the peptide itself.

Starting Dose

Per provider. Formulation reserved for B12-sensitive patients

Form

Injectable vial (60mg or 180mg total at 15mg-2.5mg/0.5mL. Tirzepatide + B6/glycine)


Dosing Protocol

Subcutaneous injection twice weekly, matching standard tirzepatide dosing. Provider titrates the dose up per patient response as tolerated. Two vial sizes: 15mg-2.5mg/0.5mL × 2mL = 60mg total ($180) and 15mg-2.5mg/0.5mL × 6mL = 180mg total ($540).

Beyond Use Date

90 Days from compounding (USP <797>)

A licensed U.S. 503A compounding pharmacy assigns this date and prints it on your vial label. Always follow the label.

Ready to add Tirzepatide/B6 + Glycine?

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Compounded Tirzepatide Dosage Chart

Dosing for this formulation matches standard compounded tirzepatide: two subcutaneous injections per week, spaced 3 to 4 days apart, stepped up monthly only if tolerated. Your provider prescribes the same schedule drawn from this formulation's vials.

Treatment monthDose per injectionWeekly total
1 (starter)1.5mg3.0mg
23.0mg6.0mg
34.25mg8.5mg
45.5mg11.0mg
57.0mg14.0mg
6+ (maintenance)8.25mg16.5mg

Compounded tirzepatide is not the branded once-weekly product. The Rx Peps Direct protocol follows the same monthly step-up pattern but splits each week's amount across two smaller injections to flatten the post-injection peak where nausea clusters. Your provider sets your actual dose, and if your prescription label ever differs from this chart, follow the label.


Tirzepatide + Glycine Vial Sizes & Pricing

B12-sensitive formulation. Dosing matches standard tirzepatide; provider titrates per patient response. Two vial sizes available.

This is a dose schedule, not bundle pricing. Each row is one vial for that dose, and you order one vial at a time. New patients start on the starter vial; your provider moves you up when you are ready.

Treatment monthVialPriceAccess
First fill60mg$180 Starter
Refill180mg$540 Active Rx Required

First fill: Starter, no prior Rx needed. Your provider confirms the glycine formulation is right for you (B12 sensitivity, methylation, or histamine reactions)

Refill: Bulk refill

All prices are wholesale pharmacy passthrough, no markup, per vial. Each order also includes the flat $39 medical review. Titration schedule above reflects the standard Rx Peps Direct protocol; your provider may adjust based on tolerance and clinical response.


Medical Records & Prescription Verification

Required for any Tirzepatide/B6 + Glycine order after the starter vial.

Why this is required

Unlike other peptides we prescribe, GLP-1 medications (semaglutide and tirzepatide) carry real medical risk when titration is not supervised by a physician. Over-dosing or skipping titration steps can cause severe nausea, dehydration, gastroparesis (delayed stomach emptying), and in rare cases pancreatitis or hypoglycemic events.

People with a personal or family history of medullary thyroid carcinoma, MEN2 syndrome, active pancreatitis, or severe gastroparesis should not take GLP-1 agonists at all. These are decisions that have to be made between a patient and their provider, not by a website.

For these reasons, the FDA-approved versions (Ozempic®, Wegovy®, Mounjaro®, Zepbound®) require a prescription. Our compounded versions follow the same standard. The starter vial needs no prior prescription: your provider can prescribe it after your initial Rx Peps Direct medical review. Every later vial (whether you titrate up with us or refill at a maintenance dose) requires us to verify that you are under active medical care for this medication.


What you can upload

  • A copy of your current prescription (PDF or photo)
  • A medical record or chart note from your prescribing provider showing the active medication and dose
  • A pharmacy printout or label from your most recent fill
  • A recent lab result with your provider's name and the medication noted

Existing Rx Peps Direct patients on Sema or Tirz: we'll auto-match your email to your prior approved order. No additional upload required for routine ladder step-ups.


When you'll upload

You'll upload your documentation during onboarding, after you complete the intake form and the contraindication review, just before consent. Existing Rx Peps Direct patients are auto-verified by email match and skip this step.

Begin onboarding →

Ready to add Tirzepatide/B6 + Glycine?

A licensed provider reviews every order.


Stacking Guide

Stacks Well With

Lipo-B (Cyanocobalamin/MIC)Lipo-C (Cyanocobalamin/MIC/L-Carnitine)Ondansetron 4mg ODT

Do Not Combine With

Tirzepatide/B12Semaglutide/B12Semaglutide/B6 + GlycineSemaglutide MicrodoseTirzepatide Microdose

Ready to add Tirzepatide/B6 + Glycine?

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GLP-1 protocol guide

Read the Tirzepatide/B6 + Glycine protocol guide

Microdosing semaglutide or tirzepatide means running them below the FDA-approved starter dose. The vial-duration math, the published evidence, and how to start with a provider.

Read guide

Related Peptides


Independently tested

Tirzepatide/B6 + Glycine certificate of analysis

All 4 Tirzepatide/B6 + Glycine samples tested for sterility and endotoxin passed both. Latest sample received by the lab Oct 2, 2026.

Every Tirzepatide/B6 + Glycine batch dispensed by a licensed U.S. 503A compounding pharmacy is independently tested by Eagle Analytical Services (FDA-registered, A2LA ISO 17025 accredited). Sterility testing checks that nothing grows in the sample; the USP <85> endotoxin test checks for bacterial toxins that can cause fever. Below is the lab's own report for each of the 4 most recent lots.

Lot LG342011059, received Oct 2, 2026

Sterility
PassScanRDI Sterility Test. Started Oct 2, 2026, completed Oct 7, 2026. Method suitability ETX-250808-0163
Bacterial endotoxin
PassUSP <85>. Measured <2 EU/mL, limit 1400 EU/mL. Started Oct 5, 2026, completed Oct 6, 2026
Sample, as printed
TIRZEPATIDE/ GLYCINE 15 MG/ 2.5 MG/ 0.5 ML (2 ML) Injection
Lot #
LG342011059
Storage
Refrigerated
Received by lab
Oct 2, 2026
Laboratory
Eagle Analytical Services Inc., Houston, TX
Submission #
ETX-261002-0313
Signed
Alison Eng, Quality Control Manager
Scan of Eagle Analytical report ETX-261002-0313 for lot LG342011059. Opens the original PDF.
Eagle Analytical report ETX-261002-0313. Open the original PDF (opens in a new tab)

Eagle Analytical Services is an independent FDA-registered laboratory, A2LA accredited to ISO 17025, based in Houston, Texas. They have no commercial relationship with Rx Peps Direct. Rx Peps Direct prescribes; the pharmacy compounds and dispenses; Eagle tests every batch. Three separate companies. Results apply only to the tested sample as received. Browse our full quality program on the quality page.

Ready to add Tirzepatide/B6 + Glycine?

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Why this is legal in 2026

Compounded tirzepatide is dispensed under Section 503A of the Federal Food, Drug, and Cosmetic Act, which authorizes a state-licensed pharmacy to compound a drug for an identified individual patient with documented medical need. Each prescription is patient-specific, written by a licensed nurse practitioner or physician assistant after a documented medical review, and dispensed by the pharmacy in Texas.

The FDA enforcement-discretion period that allowed mass compounding during the tirzepatide shortage ended on March 19, 2025 for 503B outsourcing facilities and February 18, 2025 for 503A pharmacies. The 503A patient-specific exception is statutory and was not affected by either deadline.

Full breakdown of the pathway, the regulatory citations, and the documented medical-need criteria Rx Peps Direct providers use is on our compounded tirzepatide legality page.

GLP-1 medications are compounded semaglutide or tirzepatide. Compounded versions are not the same as branded Ozempic®, Wegovy®, Mounjaro®, or Zepbound®. Compounded medications are prepared by licensed pharmacies and are not FDA-approved drug products.


How to get Tirzepatide/B6 + Glycine prescribed online

Compounded Tirzepatide is available by prescription after an online medical review, then dispensed by a licensed 503A pharmacy under the patient-specific pathway. There is no membership, just a medical review fee per order, and automatic refills are optional.

  1. 1

    Complete a $39 medical review. Answer a short intake about your health history and your goals for Tirzepatide/B6 + Glycine. The $39 fee is the only charge Rx Peps Direct collects, paid once, not a recurring subscription.

  2. 2

    A licensed provider reviews it. A US-licensed clinician reviews your intake and, if Tirzepatide/B6 + Glycine is appropriate for you, writes a patient-specific prescription. The starting dose is typically Per provider. Formulation reserved for B12-sensitive patients.

  3. 3

    The pharmacy compounds and ships it. A licensed 503A compounding pharmacy in Texas compounds Tirzepatide/B6 + Glycine and ships it pre-reconstituted by FedEx overnight in a reusable cooled case. Your fill is Injectable vial (60mg or 180mg total at 15mg-2.5mg/0.5mL. Tirzepatide + B6/glycine), and you pay the pharmacy From $180/60mg at wholesale, with no clinic markup, plus a $15 flat FedEx overnight shipping fee charged by the pharmacy.

Rx Peps Direct prescribes Tirzepatide/B6 + Glycine in the 28 states plus Washington, DC where its medical team is licensed. Start your $39 medical review or browse all peptides for weight loss. Comparing services first? See how Rx Peps Direct stacks up against seven other providers in our best telehealth for compounded peptides comparison.

Ready to add Tirzepatide/B6 + Glycine?

A licensed provider reviews every order.


Common questions about Tirzepatide/B6 + Glycine

What is Tirzepatide/Glycine from Rx Peps Direct?
Tirzepatide/Glycine is the same dual GIP and GLP-1 receptor agonist as Tirzepatide/B12, formulated with glycine and vitamin B6 instead of cyanocobalamin (B12) as the buffer carrier. Two vial sizes are available: 60 mg total at $180 and 180 mg total at $540, with a flat $39 medical review. The pharmacy compounds the formulation under a 503A patient-specific prescription. Eagle Analytical Services tests every batch for sterility (ScanRDI or Celsis) and bacterial endotoxin (USP <85>); the Certificate of Analysis is published on this page.
What's the difference between the Glycine and B12 variants of compounded tirzepatide?
The active ingredient (tirzepatide) is identical in both formulations, so the weight-loss mechanism, dose response, and clinical effect are the same. The only difference is the carrier: cyanocobalamin (B12) in the standard formulation versus glycine with vitamin B6 in the Glycine variant. Glycine is a simple amino acid that buffers the solution and supports liver phase-II detoxification pathways. The Glycine variant is typically prescribed when a patient has documented B12 sensitivity, an MTHFR methylation gene variant, or when their provider wants a cleaner cofactor profile. Both formulations are compounded by a licensed U.S. 503A compounding pharmacy.
Why is glycine in the formulation?
Glycine is included as a stabilizing buffer and as a small functional support for hepatic glutathione synthesis. It is pharmacologically inert with respect to GIP and GLP-1 receptor activation. The amount per vial is well within physiologic range and does not exceed typical dietary glycine intake from a day of protein-containing meals. The B6 (pyridoxine) supports homocysteine metabolism and is included at a microdose.
Is the dose ladder the same as Tirzepatide/B12?
Dosing matches standard tirzepatide because the molecule is the same. Your provider titrates per your response and tolerance, typically starting at 1.5 mg twice weekly and stepping up every 4 weeks if tolerated. The two Glycine vial sizes (60 mg and 180 mg at 15 mg-2.5 mg per 0.5 mL) accommodate both starter and maintenance dosing without frequent vial changes during titration.
What is the compounded tirzepatide glycine dosage chart?
Compounded tirzepatide with glycine follows the standard compounded tirzepatide schedule: 1.5 mg twice weekly (3 mg per week) to start, stepped up monthly only if tolerated, reaching a 16.5 mg-per-week maintenance strength by month 6. The full chart with per-injection doses is published on this page. Your provider draws that same schedule from the glycine vials, and your prescription label always takes precedence over the chart.
How long is Tirzepatide/Glycine stable after compounding?
Tirzepatide/Glycine carries a Beyond Use Date (BUD) of 90 days from compounding, a date a licensed U.S. 503A compounding pharmacy assigns from the preparation, container and storage rather than one USP <797> prescribes, the same as the B12 variant. The BUD is printed on every vial label by the pharmacy. Refrigerate unopened vials at 36 to 46 degrees Fahrenheit. Once opened, keep the vial in the fridge and use it until it is empty or it reaches the date printed on its label, whichever comes first.
Where does Rx Peps Direct test Tirzepatide/Glycine for sterility?
Every batch of Tirzepatide/Glycine is tested by Eagle Analytical Services, an FDA-registered, A2LA ISO 17025-accredited independent laboratory in Houston, Texas. Sterility is tested using the ScanRDI or Celsis platform. Bacterial endotoxin is tested under USP <85>. The Certificate of Analysis for the specific lot you receive is linked from this product page and from the central /quality page; you can verify the lot number on your shipping label against the published report.
Can I switch from Tirzepatide/B12 to Tirzepatide/Glycine?
Switching between the B12 and Glycine variants is a clinical decision your Rx Peps Direct provider makes. Common reasons to switch include documented B12 sensitivity, MTHFR methylation variants, copper-zinc imbalance, or patient preference for a simpler cofactor profile. The active dose remains the same; only the carrier changes. Message your provider through your dashboard to request the switch and include the reason so they can document the rationale in your chart.
Does Tirzepatide/Glycine work for weight loss the same as Mounjaro?
Yes. Tirzepatide/Glycine uses the same active ingredient (tirzepatide) at the same dose as Mounjaro, so the weight-loss mechanism is identical. The carrier (glycine + B6) is pharmacologically inert with respect to GIP and GLP-1 receptor activation. Clinical trial data on tirzepatide showed 15 to 22 percent mean body weight loss over 72 weeks at therapeutic doses; that data applies to the Glycine variant because the molecule is the same.
What side effects should I expect on Tirzepatide/Glycine?
The side-effect profile mirrors standard tirzepatide: nausea (most common during dose escalation), reduced appetite, constipation, occasional diarrhea, fatigue in the first 4 to 6 weeks, and rare hair shedding tied to rapid weight loss. Some patients with B12 sensitivity tolerate the Glycine variant slightly better. If side effects are severe or do not improve after the first 4 weeks, message your provider through the dashboard for a protocol review.
Is glycine safe long-term in compounded GLP-1s?
Glycine is one of the most abundant amino acids in the human diet and in the body's own protein turnover. The amount included as a buffer in the Tirzepatide/Glycine formulation a licensed U.S. 503A compounding pharmacy compounds is far below the dose used in clinical glycine supplementation studies (typically 3 to 15 grams per day for sleep or hepatic support). Glycine has no known long-term safety signal at these microdoses. The active ingredient (tirzepatide) is the variable that matters clinically, and tirzepatide is being continuously studied in long-term cardiovascular outcomes trials.

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