Managing Your GLP-1 Treatment at Ondra Health: Refills, Dose Changes, and Provider Access
Getting approved and receiving your first shipment is the beginning, not the end. GLP-1 treatment spans months — sometimes years — and involves dose titration, occasional side effect management, and ongoing clinical support. Here is how all of that works at Ondra Health.
Key takeaways
All ongoing care — refill requests, dose changes, clinical questions — is handled through secure messaging with your provider at Wasef Health, PC.
Pricing is flat across all dose levels — your cost does not increase as you titrate from starter dose to maintenance dose.
Dose changes require provider approval — never self-adjust your dose without messaging your provider first.
Refills are sent to the same pharmacy that filled your first prescription. You do not need to resubmit a full intake for ongoing treatment.
How refills work
After your first shipment, refills are managed through your patient portal. Your prescription is set up on a recurring cycle aligned with your treatment plan — your provider determines the appropriate refill cadence based on your dose and vial size. You do not need to resubmit a full health intake for each refill; the provider reviews your ongoing treatment at each refill to confirm continued eligibility and make any necessary adjustments.
Refills are sent to the same pharmacy that dispensed your original prescription. Shipping is free and orders typically arrive within a few business days of processing. If you need to adjust your refill timing — for example, if you are traveling or if your schedule has shifted — message your provider through the portal and they can coordinate accordingly.
When to request your next refill
Do not wait until you have used your last dose to request a refill. Because compounding pharmacies prepare medications to order and shipping takes several business days, it is good practice to initiate your refill when you have 7–10 days of medication remaining. This helps avoid a gap in treatment. If you do end up missing doses, tell your provider rather than adjusting your schedule on your own.
How dose changes work
GLP-1 medications are titrated — you start at a low dose and increase gradually over weeks or months. This is not optional or a formality; it is clinically important for minimizing side effects and giving your body time to adapt. Your provider sets your initial titration schedule at the point of prescribing, and dose decisions throughout treatment are theirs to make with you.
Semaglutide titration — standard schedule
Weeks 1–4: 0.25mg weekly. Weeks 5–8: 0.5mg weekly. Weeks 9–12: 1mg weekly. Weeks 13–16: 1.7mg weekly. Week 17+: 2.4mg weekly (maintenance). Your provider may adjust this schedule based on your tolerance and response. Some patients stay at a lower dose longer; some progress faster. Individual schedules vary.
Tirzepatide titration — standard schedule
Weeks 1–4: 2.5mg weekly. Weeks 5–8: 5mg weekly. Weeks 9–12: 7.5mg weekly. Weeks 13–16: 10mg weekly. Weeks 17–20: 12.5mg weekly. Week 21+: 15mg weekly (maximum dose). As with semaglutide, your actual titration may differ based on your clinical profile and how you are tolerating each step.
To request a dose change — either upward because you are tolerating the current dose well and have been on it for 4+ weeks, or downward because side effects are persistent — send a message to your provider through the patient portal. Describe what you are experiencing, how long you have been on your current dose, and what you are hoping to change. Your provider will review and respond, typically within 24 hours. Your next shipment will reflect any updated dose.
Never self-adjust without provider input
Drawing up a higher dose than prescribed, injecting more frequently than weekly, or skipping steps in the titration schedule without provider guidance is not safe. GLP-1 side effects (nausea, vomiting, diarrhea) are directly related to dose — escalating too quickly is a common cause of intolerable side effects and treatment discontinuation. Your provider is there to guide this; use them.
How to reach your provider
All clinical communication at Ondra Health happens through secure messaging with your provider at Wasef Health, PC. You can send a message at any time through your patient portal at care.ondra.health.
Good reasons to message your provider
You have been on the same dose for 4+ weeks and feel ready to titrate up. Side effects are persistent or worsening beyond the typical adjustment period. You are experiencing something unexpected and are not sure if it is medication-related. You want to discuss switching medications. You need to pause treatment — for surgery, pregnancy planning, or another reason. You have a new medication or health condition that may be relevant to your GLP-1 treatment.
If something urgent happens
For severe, acute symptoms — significant abdominal pain that does not resolve, difficulty breathing, signs of a serious allergic reaction, or anything that feels like a medical emergency — do not wait for a portal message reply. Call 911 or go to your nearest emergency room. Your provider can follow up via secure message once you are safe.
Pricing during ongoing treatment
Ondra Health's pricing is flat across all dose levels. Your cost for compounded semaglutide is the same whether you are on 0.25mg (starter) or 2.4mg (maintenance). The same is true for tirzepatide across the 2.5mg–15mg range. This is a deliberate structural choice — at some GLP-1 platforms, the price increases as your dose increases, meaning you pay more precisely at the point in treatment when you are consuming more medication.
Current pricing
Compounded semaglutide: $113/month (quarterly plan, $339 billed quarterly) or $149/month (monthly plan).
Compounded tirzepatide: $183/month (quarterly plan, $549 billed quarterly) or $219/month (monthly plan).
Pricing is the same at all dose levels. Free shipping and supplies included. Starter Pack pricing is available for first-time GLP-1 patients on their first quarterly order. Full pricing detail at ondra.health/blog/ondra-health-pricing.
What to do if your medication is delayed or damaged
Occasionally, shipments are delayed by carrier issues or arrive with concerns about the packaging or temperature exposure. In either case, contact the Ondra support team via your patient portal. Do not use medication that arrived without cold packaging, that appears damaged, or that you believe may have been exposed to high heat or freezing during transit — contact support first and they can advise. The support team can coordinate replacement shipments through your pharmacy if there is a confirmed issue.
How to pause or stop treatment
You can pause or stop treatment at any time. Message your provider before stopping if possible — they can advise on what makes sense for your situation.
Stopping treatment is commonly followed by gradual weight regain — the SURMOUNT-4 trial (Aronne et al., JAMA, 2023) found that participants who discontinued tirzepatide regained a substantial portion of lost weight over the following 52 weeks. This does not mean you cannot stop, but it is worth discussing the transition with your provider before discontinuing.
Frequently asked questions
How do I request a refill at Ondra Health?
Refills are managed through your patient portal at care.ondra.health. Log in, navigate to your prescription, and request a refill — or message your provider directly if you have questions about timing or your next dose. Refills are fulfilled by the same pharmacy that filled your first prescription. Request your refill when you have 7–10 days of medication remaining to avoid a gap.
Can I increase my own dose if I feel ready?
No — dose changes require provider approval. This protects you from escalating too quickly, which is a primary cause of severe GI side effects on GLP-1 medications. Message your provider through the portal, describe your current experience, and they will advise on whether and when a dose increase is appropriate.
Does my cost increase when my dose increases?
No. Ondra Health's pricing is flat across all dose levels for both semaglutide and tirzepatide. You pay the same rate whether you are at 0.25mg or 2.4mg semaglutide, or at 2.5mg or 15mg tirzepatide. This is not true of all GLP-1 telehealth platforms — some charge more as doses increase.
How quickly will my provider respond to a message?
Most messages receive a response within 24 hours on business days. Urgent clinical concerns flagged in your message are prioritized. Clinical communications are handled by a licensed provider at Wasef Health, PC. If you have a medical emergency, do not rely on portal messaging — call 911 or go to your nearest emergency room.
† This article is for informational purposes only and does not constitute medical advice. All prescribing and clinical decisions are made by licensed providers at Wasef Health, PC based on individual evaluation. Compounded semaglutide and tirzepatide are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or manufacturing quality. Titration schedules referenced are based on FDA-approved prescribing information for Wegovy® (semaglutide, Novo Nordisk) and Zepbound® (tirzepatide, Eli Lilly) — individual schedules set by your provider may differ. SURMOUNT-4 trial data sourced from Aronne et al., JAMA, 2023. Pricing reflects current published rates and is subject to change. Ondra Health is not affiliated with Novo Nordisk or Eli Lilly.