Tirzepatide/B6 + Glycine
Same dual GIP/GLP-1 receptor agonist mechanism as standard tirzepatide, formulated with glycine and B6 instead of B12 as the carrier.
Medically reviewed by Dr. Jonathan Snipes, MD. Last reviewed May 6, 2026.Select vial size
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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.
Protocol & Pricing
OBP Pharmacy Price
From $225/60mg
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
Dosing matches standard tirzepatide. Provider titrates per patient response. Two vial sizes: 15mg-2.5mg/0.5mL × 2mL = 60mg total ($225) and 15mg-2.5mg/0.5mL × 6mL = 180mg total ($675).
Beyond Use Date
90 Days from compounding (USP <797>)
Use within this window from the date your vial is compounded. BUD is set per USP <797> sterile compounding standards and printed on every label.
Titration Schedule & Pricing
B12-sensitive formulation. Dosing matches standard tirzepatide; provider titrates per patient response. Two vial sizes available.
| Month | Vial | Price | Access |
|---|---|---|---|
| Starter | 60mg | $225 | Active Rx Required |
| Refill | 180mg | $675 | Active Rx Required |
Month Starter: Provider must confirm B12 sensitivity, methylation, or histamine reactions
Month Refill: Bulk refill
All prices are pharmacy passthrough at Optimal Balance Pharmacy wholesale, no markup. Add the flat $39 medical visit fee on your first order. Titration schedule above reflects the standard RxPepsDirect protocol; your provider may adjust based on tolerance and clinical response.
Medical Records & Prescription Verification
Required for any Tirzepatide/B6 + Glycine order beyond Month 1.
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 (Month 1) is dispensed after your initial RxPepsDirect medical visit. Every subsequent 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 RxPepsDirect patients on Sema or Tirz: we'll auto-match your email to your prior approved visit. 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 RxPepsDirect patients are auto-verified by email match and skip this step.
Begin onboarding →Stacking Guide
Stacks Well With
Do Not Combine With
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.
Related Peptides
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From $30/10mlLipo-C (Cyanocobalamin/MIC/L-Carnitine)
Enhanced lipotropic injection adding L-carnitine to cyanocobalamin and MIC for improved energy and fat transport.
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$37.50/30 tabletsWhy 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 telehealth visit, and dispensed by Optimal Balance 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 RxPepsDirect 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.
Common questions about Tirzepatide/B6 + Glycine
- What is Tirzepatide/Glycine from RxPepsDirect?
- 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 $225 and 180 mg total at $675, with a flat $39 medical visit fee. Optimal Balance 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 Optimal Balance 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.
- How long is Tirzepatide/Glycine stable after compounding?
- Tirzepatide/Glycine carries a Beyond Use Date (BUD) of 90 days from compounding under USP <797> sterile compounding standards (slightly shorter than the 120-day BUD on the B12 variant due to the different buffer system). The BUD is printed on every vial label by Optimal Balance Pharmacy. Refrigerate unopened vials at 36 to 46 degrees Fahrenheit. Once punctured for first use, follow the in-use BUD on your label.
- Where does RxPepsDirect 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 RxPepsDirect 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 Optimal Balance 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.