Weight loss injection prescribing & administration protocol

HAUS OF ÄSTHETIK

WEIGHT LOSS INJECTION PRESCRIBING & ADMINISTRATION PROTOCOL

DATE OF IMPLEMENTATION: 1st April 2025

REVIEW DATE: 1st April 2026

VERSION NUMBER: 1.1

 

INTRODUCTION

This protocol outlines the prescribing and administration process for weight loss injections Mounjaro (Tirzepatide), Wegovy (Semaglutide), and Saxenda (Liraglutide) at Haus of Ästhetik. These medications are prescribed for lifestyle and cosmetic weight management purposes, ensuring safe, effective, and compliant use in line with MHRA and UK private prescribing regulations.

This document covers:

   • Patient eligibility and screening

   • Prescribing guidelines

   • Patient education on administration, dosage escalation, and side effects

   • Monitoring and follow-up

This protocol excludes medical weight loss under CQC regulation. Clinics registered with the CQC may offer additional services, such as blood testing, specialist referrals, and advanced metabolic screening.

 

1. PATIENT ELIGIBILITY & SCREENING

Inclusion Criteria:

   ✔ Patients aged 18 years or older.

   ✔ Patients with a BMI of ≥30 or ≥27 with weight-related concerns.

   ✔ Those struggling with weight management despite diet and exercise efforts.

   ✔ Patients with realistic expectations and commitment to lifestyle changes.

Exclusion Criteria (Contraindications):

   Patients under 18 years old.

   Pregnancy or breastfeeding.

   Personal/family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2.

   History of pancreatitis or severe gastrointestinal disorders.

   Uncontrolled mental health conditions such as eating disorders (e.g., binge eating, anorexia).

   Allergy to active ingredients in the prescribed medication.

All patients must complete a full medical history screening before prescribing.

 

2. PRESCRIBING GUIDELINES & DISPENSING

   • Prescriptions must be issued only after a face-to-face consultation.

• The prescription must include:

   • Patient’s full details and medical history.

   • Medication name, strength, and dosage instructions.

   • Batch number and expiry date recorded in medical notes.

• The patient is issued:

   • Sharps disposal container.

   • Injection needles (if required).

   • Dosage and administration guide.

 

3. PATIENT EDUCATION ON ADMINISTRATION

All patients must receive full instructions on safe self-administration, including injection technique, site rotation, and potential side effects.

A. Injection Sites & Technique

• Preferred Sites:

   ✔ Stomach (abdomen) – Avoid 2 inches around the navel.

   ✔ Thigh (outer upper leg) – Rotate site weekly.

   ✔ Upper arm – Less commonly used; requires assistance.

• Step-by-Step Injection Guide:

   1️⃣ Wash hands and clean the injection site with an alcohol swab.

   2️⃣ Remove pen cap and check medication for clarity (no particles or discolouration).

   3️⃣ Attach a new needle (if not pre-loaded) and prime the pen if required.

   4️⃣ Pinch skin at the chosen injection site to create a fold.

   5️⃣ Inject at a 90-degree angle and press down the pen button until the dose is fully delivered.

   6️⃣ Wait 10 seconds before removing the needle.

   7️⃣ Dispose of the needle safely in the provided sharps container.

 

4. DOSAGE & ESCALATION SCHEDULE

Medication	Starting Dose	Dose Escalation Schedule	Maximum Maintenance Dose
Mounjaro (Tirzepatide)	2.5mg once weekly	Increase by 2.5mg every 4 weeks if tolerated	10-15mg weekly
Wegovy (Semaglutide)	0.25mg once weekly	Increase every 4 weeks: 0.25 → 0.5 → 1.0 → 1.7 → 2.4mg	2.4mg weekly
Saxenda (Liraglutide)	0.6mg once daily	Increase by 0.6mg every 7 days	3.0mg daily

 

   • Dose escalation follows manufacturer guidelines unless the patient experiences side effects that require slowing down progression.

   • If a patient misses a dose, they should:

   • Mounjaro/Wegovy: Take it within 4 days; if longer, skip the dose and continue as usual.

   • Saxenda: If missed for 3+ days, restart at the lowest dose and gradually titrate up again.

 

5. SIDE EFFECTS & MANAGEMENT

Common Side Effects (Typically Resolves in 2–4 Weeks)

Side Effect	Frequency
Nausea & vomiting	30-40%
Diarrhoea or constipation	20-30%
Fatigue & dizziness	10-20%
Headache	10-15%
Injection site reactions	5-10%

 

• Management Tips:

   ✔ Take injections in the evening to reduce nausea.

   ✔ Eat smaller, protein-rich meals to avoid gastrointestinal distress.

   ✔ Stay hydrated (1.5–2L of water daily).

Serious Reactions (Seek Medical Attention)

   Severe vomiting or dehydration.

   Signs of pancreatitis (severe abdominal pain radiating to the back).

   Gallbladder issues (pain, jaundice, bloating).

   Signs of anaphylaxis (difficulty breathing, swelling, rash).

Patients must be informed about the MHRA Yellow Card Scheme to report adverse effects.

 

6. FOLLOW-UP & MONITORING

   ✔ Week 2 Check-In – Assess initial tolerance, side effects, and injection technique.

   ✔ Monthly Follow-Ups – Evaluate progress, adjust doses, and reinforce lifestyle advice.

   ✔ 3-Month Reassessment – Determine continuation, dose escalation, or alternative options.

 

7. LIFESTYLE & WELLNESS GUIDANCE FOR OFF-LABEL PRESCRIBING

Although GLP-1 receptor agonists are licensed for weight management in those with a BMI ≥27, private aesthetic clinics may prescribe for lifestyle and wellness purposes in patients with:

   ✔ BMI under 27 but experiencing weight fluctuations that affect confidence and well-being.

   ✔ Metabolic concerns (insulin resistance, PCOS, stress-related weight gain) without a formal diagnosis.

   ✔ Bridal weight loss plans or body image concerns requiring short-term intervention.

   ✔ Athletes or fitness enthusiasts seeking controlled appetite regulation during training cycles.

Patients prescribed off-label medication must be informed that their treatment is outside NICE BMI recommendations, and they must sign informed consent forms acknowledging this.

 

8. EMERGENCY CONTACT & AFTERCARE

For any urgent concerns or reactions, patients should contact:

📞 Emergency Line: 07514 543015 (WhatsApp available for photos/videos of reactions)

📧 Email: HausOfAsthetik@icloud.com

📍 Clinic Address: 4 Portland Square, Water Street, Bakewell, Derbyshire, DE45 1HA, United Kingdom

 

9. REGULATORY COMPLIANCE & QUALITY ASSURANCE

This protocol aligns with:

✔ MHRA guidelines on GLP-1 receptor agonist use.

✔ UK private prescribing laws for lifestyle weight loss management.

✔ ABPI & Save Face standards for non-CQC weight management services.

✔ Reviewed annually or if new safety data emerges.