Weight Loss Treatment

TOC

Medical weight loss treatment at HADA NO CLINIC

At our clinic, we offer weight loss treatments using medications such as Mounjaro, Ozempic, Rybelsus, Lusefi, and Metformin, all under the supervision of a doctor and with regular check-ups.

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Medication	Dosage	Features
Mounjaro	Weekly injection	Targets GIP/GLP-1 receptors to suppress appetite and increase energy expenditure
Ozempic	Weekly injection	Targets GLP-1 receptors to suppress appetite and increase energy expenditure
Rybelsus	Oral, once daily
Lusefi	Oral, once daily	Inhibits glucose reabsorption in the kidneys, promoting glucose excretion through urine
Metformin	Oral, twice daily	Inhibits glucose production in the liver and reduces glucose absorption in the digestive tract Promotes GLP-1 secretion from the intestines to suppress appetite

Mounjaro (Tirzepatide)

Mounjaro (Tirzepatide), also known internationally as Zepbound, is a once-weekly injection that helps suppress appetite and increase energy expenditure, aiding in weight loss. It works on both GLP-1 and GIP receptors, offering potentially greater weight loss effects compared to medications that target only the GLP-1 receptor.

While Mounjaro is approved as a treatment for diabetes, it has not yet been approved as a weight loss medication in Japan, meaning it is not covered by the Pharmaceutical Side Effect Relief System.

Mounjaro Prices (incl. tax)

Drug	Price / pen (1 week)	Price / 4 pens (4 weeks)
Mounjaro 2.5mg	¥5,500	¥22,000
Mounjaro 5mg	¥9,900	¥39,600
Mounjaro 7.5mg	¥14,300	¥57,200
Mounjaro 10mg	¥18,700	¥74,800
Mounjaro 12.5mg	¥23,100	¥92,400
Mounjaro 15mg	¥26,400	¥105,600

Item	Price
Alcohol swabs (20 pieces)	¥165
Anti-nausea medication (10-day supply)	¥660

A consultation is required for a prescription (¥3,850 for the first visit / ¥1,650 for follow-up visits). Additionally, a blood test (¥3,982) is needed at the initial visit and every three months to monitor for side effects.
After use, the needle retracts automatically into the pen for safety. Dispose of the pen in a sturdy container (like a milk carton), seal it with tape, and discard it as burnable trash. If you wish to dispose of items at our clinic, a medical waste fee of ¥440 will be charged.

Ozempic / Rybelsus (Semaglutide)

Ozempic and Rybelsus (Semaglutide) are medications that can help with weight loss by suppressing appetite and increasing energy expenditure. Ozempic, also known internationally as Wegovy when prescribed for weight management, is a once-weekly injection, while Rybelsus is a once-daily oral tablet. Both work by acting on GLP-1 receptors to reduce appetite, making them effective for weight management.

However, both medications are approved for diabetes treatment and not for obesity, so they are not covered by the Pharmaceutical Side Effect Relief System.

Ozempic Prices (incl. tax)

Drug	Price / pen
Ozempic 2mg	¥26,400
Dosage	Number of Pens Needed for 4 Weeks
0.25mg	0.5 pens （¥13,200）
0.5mg	1 pen （¥26,400）
1mg	2 pens （¥52,800）
1.5mg	3 pens （¥79,200）
2mg	4 pens （¥105,600）

Item	Price
Injection needles (14 pieces)	¥660
Alcohol swabs (20 pieces)	¥165
Needle disposal container (incl. medical waste fee)	¥440
Anti-nausea medication (10-day supply)	¥660

A consultation is required for a prescription (¥3,850 for the first visit / ¥1,650 for follow-up visits). Additionally, a blood test (¥3,982) is needed at the initial visit and every three months to monitor for side effects.
Do not dispose of used needles in household trash. Place them in a needle disposal container and return it to the clinic when full. Once sealed, the lid cannot be opened. Additional medical waste fees will apply if you use a container other than the one provided by our clinic.

Rybelsus Prices (incl. tax)

Drug	Price
Rybelsus 2mg	30 tablets ¥9,900
Rybelsus 7mg	30 tablets ¥22,440
Rybelsus 14mg	30 tablets ¥33,000

A consultation is required for a prescription (¥3,850 for the first visit / ¥1,650 for follow-up visits). Additionally, a blood test (¥3,982) is needed at the initial visit and every three months to monitor for side effects.

Lusefi

Lusefi is a once-daily oral medication that helps with weight loss by preventing the reabsorption of glucose in the kidneys, leading to glucose being excreted in the urine. It supports effective weight loss by inhibiting SGLT2 (sodium-glucose cotransporter).

Recently, SGLT2 inhibitors have also gained attention as senolytic drugs, which help eliminate senescent cells by activating the immune system^{29 30}.

While Lusefi is approved as a diabetes treatment, it has not been approved for weight loss, meaning it is not covered by the Pharmaceutical Side Effect Relief System.

Lusefi Prices (incl. tax)

Drug	Price
Lusefi 2.5mg	10 tablets ¥9,900 30 tablets ¥14,850
Lusefi 5mg	10 tablets ¥7,260 30 tablets ¥21,780

A consultation is required for a prescription (¥3,850 for the first visit / ¥1,650 for follow-up visits). Additionally, a blood test (¥3,300) is needed at the initial visit and every three months to monitor for side effects.

Metformin

Metformin is a twice-daily oral medication that supports weight loss by inhibiting glucose production in the liver and reducing glucose absorption in the digestive tract. It also promotes the secretion of GLP-1 from the intestines, helping to suppress appetite.

Metformin has been reported to have various anti-aging and rejuvenating effects, such as maintaining mitochondrial function, activating muscle recovery, anti-inflammatory properties, and inhibiting cellular aging^{31 32 33}. Current clinical trials worldwide (TAME trials) ³⁴ are examining its effectiveness in slowing the progression of age-related diseases such as cancer, heart disease, and dementia.

While Metformin is approved as a diabetes treatment, it has not been approved for weight loss, meaning it is not covered by the Pharmaceutical Side Effect Relief System.

Metformin Prices (incl. tax)

Drug	Price
Metformin 250mg	60 tablets ¥1,980
Metformin 500mg	60 tablets ¥2,970

A consultation is required for a prescription (¥3,850 for the first visit / ¥1,650 for follow-up visits). Additionally, a blood test (¥3,300) is needed at the initial visit and every three months to monitor for side effects.

Dosage and Administration

How to use Mounjaro

Storage:

Store in the refrigerator (2–8°C) and avoid freezing. It can also be stored at room temperature (below 30°C) for up to 3 weeks.

Injection Method:

Inject subcutaneously (into the fat) in the abdomen or thigh once a week, on the same day each week. It can be taken regardless of meals. Do not inject into muscles or veins. Follow the “Instructions for Use” provided during your consultation to use it correctly.

Dosage Schedule:

Period	Dosage
Weeks 1–4	2.5 mg / week
Weeks 5–8	5 mg / week
Weeks 9–12	7.5mg / week
Weeks 13–16	10mg / week
Weeks 17–20	12.5mg / week
Week 21+	15mg / week

Since nausea and discomfort may occur initially, start with 2.5 mg once a week and gradually increase the dose every 4 weeks according to the table, up to a maximum of 15 mg.

If the effect is strong or side effects persist, maintain the current dosage without increasing it.

How to use Ozempic

Storage:

Store in the refrigerator (2–8°C) and avoid freezing. It can be stored at room temperature (below 30°C) for up to 8 weeks.

Injection Method:

Inject subcutaneously (into the fat) in the abdomen or thigh once a week, on the same day each week, regardless of meals. Do not inject into muscles or veins. Follow the “Instructions for Use” provided during your consultation to use it correctly.

Dosage Schedule:

Period	Dosage
Weeks 1–4	0.25mg / week
Weeks 5–8	0.5mg / week
Weeks 9–12	1mg / week
Weeks 13–16	1.5mg / week
Week 17+	2mg / week

Since nausea and discomfort may occur initially, start with 0.25 mg once a week and gradually increase the dose every 4 weeks according to the table, up to a maximum of 2 mg.

For 1.5 mg, use 1 mg and 0.5 mg pens. For 2 mg, administer two 1 mg injections.

If the effect is strong or side effects persist, maintain the current dosage without increasing it.

How to use Rybelsus

Administration:

Take 1 tablet with approximately half a glass of water (120 mL or less) on an empty stomach before your first meal or drink of the day. After taking it, wait at least 30 minutes before eating, drinking, or taking other medications. Do not split, chew, or take two tablets at once.

Dosage Schedule:

Period	Dosage
1st Month	3mg
2nd Month	7mg
3rd Month+	14mg

Since nausea and discomfort may occur initially, start with 3 mg once daily and gradually increase the dose each month according to the table, up to a maximum of 14 mg.

If the effect is strong or side effects persist, maintain the current dosage without increasing it.

Who Should Not Receive Treatment

You may not be eligible for weight loss treatment if you meet any of the following criteria:

A. All Drugs (Mounjaro / Ozempic / Rybelsus / Lusefi / Metformin)

Pregnant or breastfeeding women
People with diabetes (consult at an insurance-covered facility)
Those with severe kidney or liver issues
Those allergic to similar drugs
Those at risk of hypoglycemia due to extreme exercise, excessive alcohol intake, pituitary/adrenal insufficiency
Those who are underweight (BMI <18.5), have low body fat (<15% men, <20% women), or have eating disorders

In addition to the criteria in section A, you may not be eligible for treatment if:

Mounjaro / Ozempic / Rybelsus

You meet any of the criteria in “A”
You have severe gastrointestinal issues or a history of pancreatitis
You have depression or suicidal tendencies
You have thyroid issues or a family history of medullary thyroid cancer or MEN2

Side Effects

Mounjaro / Ozempic / Rybelsus

1. Gastrointestinal symptoms: Nausea, vomiting, diarrhea, constipation, abdominal discomfort, bloating. Usually temporary and improves with continued use.
2. Injection site reactions (excl. Rybelsus): Redness, swelling, lumps. Usually temporary. Rotate injection sites.
3. Kidney issues: Dehydration from diarrhea/vomiting may cause kidney problems. Stay hydrated.
4. Increased heart rate: If sustained, stop the medication and consult a doctor.
5. Hypoglycemia: Symptoms include cold sweats, shaking, palpitations, hunger, headaches, drowsiness, seizures. Take 20g of sugar or 200ml juice and rest. Avoid driving or using machinery until symptoms pass.
6. Pancreatitis, gallstones, cholecystitis, cholangitis, jaundice: Rare but seek immediate medical attention for severe abdominal pain, back pain, vomiting, or fever. Rapid weight loss increases the risk of gallstones; keep weight loss under 5% per month.
7. Anaphylaxis, angioedema: Rare but seek emergency help for itching, hives, facial/throat swelling, difficulty breathing, dizziness.
8. Thyroid C-cell tumors (medullary thyroid cancer): Cases in rats/mice, but human relevance is unclear. Report any neck swelling or lumps. Regular calcitonin blood tests will be conducted.

Lusefi

1. Frequent urination, dehydration: Diuretic effects may cause increased urination, thirst, dizziness, lightheadedness. Pause medication and rehydrate.
2. Abnormal urine tests: Positive glucose, ketones, protein in urine.
3. Cystitis, genital candidiasis: Sugar in urine can lead to infections. Prevent this by drinking lots of water, wearing breathable underwear, and changing sanitary pads often. Avoid washing inside the vagina, as it reduces its natural cleaning ability.
4. Pyelonephritis, necrotizing fasciitis, sepsis: Seek immediate medical help for chills, fever, back/side pain, genital pain/swelling, or general fatigue.
5. Hypoglycemia: Symptoms include cold sweats, shaking, palpitations, hunger, headaches, drowsiness, seizures. Take 20g of sugar or 200ml juice and rest. Avoid driving or using machinery until symptoms pass.
6. Ketoacidosis: Seek immediate medical help for nausea, abdominal pain, or altered consciousness.

Metformin

1.Gastrointestinal symptoms: Diarrhea, nausea, loss of appetite, abdominal pain, vomiting are common. Usually improves after 1-2 months, but consult a doctor if persistent.
2. Hypoglycemia: Symptoms include cold sweats, shaking, palpitations, hunger, headaches, drowsiness, seizures. Take 20g of sugar or 200ml juice and rest. Avoid driving or using machinery until symptoms pass.
3. Lactic acidosis: Rare but serious. Symptoms include gastrointestinal distress, fatigue, muscle pain, rapid breathing. Stop medication and seek emergency medical help immediately.
4. Liver dysfunction, jaundice: AST, ALT, and bilirubin levels may rise, leading to jaundice. Report any abnormalities to your doctor immediately.
5. Rhabdomyolysis: If you have muscle pain, weakness, or blood in your urine, stop using the medication immediately and consult your doctor.

Pregnancy, Breastfeeding, and Fertility planning

These drugs are not for use during pregnancy or breastfeeding. Discontinue Mounjaro, Ozempic, or Rybelsus 2 months before trying to conceive, and Lusefi or Metformin 1 month before trying to conceive. No reported effects on male fertility.

Drug Interactions

Mounjaro / Ozempic / Rybelsus (Caution)

Oral Contraceptives	May reduce the effectiveness of birth control pills.
Warfarin	May increase or decrease its effects.
Other Diabetes Medications	Higher risk of hypoglycemia.

Lusefi (Caution)

Other Diabetes Medications	Higher risk of hypoglycemia.
Beta-Blockers (Blood Pressure/Arrhythmia Medications)	Higher risk of hypoglycemia.
Salicylates (Aspirin, Azulfidine, Asacol, Pentasa, etc.)	Higher risk of hypoglycemia.
MAO Inhibitors (Parkinson’s/Tuberculosis Medications)	Higher risk of hypoglycemia.
Loop and Thiazide Diuretics	Increased diuretic effect.

Metformin (Contraindications/Prohibited)

Alcohol (Excessive Consumption)	Increases lactic acidosis risk from liver issues and dehydration.

Metformin (Caution)

Iodine Contrast Agents	Increases risk of lactic acidosis due to kidney impairment.
Gentamicin	Increases risk of lactic acidosis when combined with nephrotoxic antibiotics.
Diuretics, SGLT2 Inhibitors (Lusefi)	Increases risk of lactic acidosis due to dehydration.
Other Diabetes Medications	Higher risk of hypoglycemia.
Anabolic Steroids	Higher risk of hypoglycemia.
Beta-Blockers	Higher risk of hypoglycemia.
Salicylates (Aspirin, Azulfidine, Asacol, Pentasa, etc.)	Higher risk of hypoglycemia.
MAO Inhibitors	Higher risk of hypoglycemia.
OCT2, MATE1, MATE2-K Inhibitors (Cimetidine, Dolutegravir, Bictegravir, Vandetanib, Isavuconazole, Pimetesepib, etc.)	May increase the effect of Metformin.
Imeglimin Hydrochloride (Twymeeg)	May cause gastrointestinal symptoms.

Alcohol Interaction

Moderate drinking is generally safe, but avoid heavy drinking as it can cause hypoglycemia.
【Recommended Limit】Up to 500ml of beer, 1 cup of sake, or 200ml of wine per day.

Interactions Between Diet Medications (Diabetes Drugs)

GLP-1 receptor agonists (Mounjaro, Ozempic, Rybelsus), SGLT2 inhibitors (Lusefi), and Metformin have a low risk of hypoglycemia alone but increase the risk when combined. Follow your doctor’s instructions and get regular check-ups and tests. If you are prescribed diet or diabetes drugs from other clinics, inform your doctor.

References & Website List

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The TAME Trial Targeting the Biology of Aging. Ushering a New Era of Interventions. The official web resource of the TAME Trial, managed by the American Federation for Aging Research.