Metabolic support

In stock

PrescriptionMetformin

From$59/mo^*

Get Started

* Oral, in 3, 6 or 12 month plans. Prices may vary.

Filled by US pharmaciesFSA and HSA eligiblePay over time with Klarna

Same-day doctor visits and prescriptions
Free expedited shipping, all 50 states
24/7 personalized care
Prescribed after a physician review

A medication that lowers the glucose your liver makes and helps your body respond to insulin.

It is not a stimulant, and your prescriber sets the dose for you.

Metformin

A tablet, once or twice a day, with food
Two strengths, each with its own price

Low-dose naltrexone

One capsule a day, usually at bedtime
Not for anyone taking opioid medication

Both are prescribed only after a physician review. Your prescriber decides whether either fits your plan.

A 24/7 care team, day or night
A personal action plan to your goal
Physician visits and follow-ups
Dose adjusted as you progress
Help with side effects
Medication from a US pharmacy

Online visitA few questions, no charge
Physician reviewA licensed US physician
ApprovalCharged only if approved
PharmacyPrepared in the US
DeliveryExpedited shipping included
Ongoing careCheck-ins and dose changes

Cancel anytime, online in your account. No call, no form, no fee.

Canceling does not stop an order already sent to the pharmacy. If one is on its way, write to [email protected] and we will help.

The statements on this page have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. The FDA does not review or approve any compounded medications for safety or effectiveness.

Important Safety Information (opens in a new tab)

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Personalized medicine,
in three simple steps

Get started Check eligibility

Submit your application
and meet with a doctor

Step1

Complete a quick form and meet a licensed provider 100% online. They'll see if a treatment plan is right for you.

Get your medication
delivered at home

Step2

Once approved, your prescription ships directly to your door, fast and free.

Receive 24/7 support
and ongoing care

Step3

Regular check-ins and on-demand medical support to keep you on track.

More than a prescription

Most online programs ship a box. Sipra stays with you.

Sipra compared with a typical online program
		Typical online programs
No membership fee	No fee	Often a monthly fee
The Sipra PromisePay only if a physician approves.	$0 today	Often charged at checkout
Leave anytimeCancel online. No call, no form.	Anytime	Steps may vary
One price, shipping includedVisits and support too.	Included	Fees may vary
US-licensed pharmaciesURAC, ACHC and LegitScript accredited	Accredited	May vary
Tested before it shipsPotency, plus sterility for injections	Yes	Testing may vary
Dosing set by your physician	Included	Follow-up may be limited
Side effect support	Included	May vary
Care team messaging, day or night	Anytime	Hours may be limited

Start my visit

Nothing is charged until a physician approvesFSA and HSA eligible

How metformin and LDN work

Works in the brain, at a low dose.

Brain

Naltrexone acts on the brain's opioid receptors; at a low dose a prescriber may use it off label alongside a weight plan.

Usually taken at bedtime.

Sleep

LDN is one capsule a day, usually at night. Vivid dreams or mild sleep changes can happen early and usually fade.

Lowers the sugar your liver makes.

Liver

Metformin's main action. It is FDA approved for type 2 diabetes.

Helps insulin work better.

Insulin

Metformin helps your body respond to insulin, so blood sugar is easier to keep steady.

Taken with food.

Stomach

A metformin tablet once or twice a day, with a meal, at the strength your prescriber sets.

Settles in over weeks.

Gut

Stomach upset is common early on metformin and usually eases; your prescriber reviews the dose with you.

Metformin is FDA approved for type 2 diabetes and naltrexone for alcohol and opioid dependence. Their use for weight is off label. Individual results vary.

The pharmacy behind your treatment

Get started Check eligibility

Licensed 503A pharmacy

Your treatment ships to all 50 states

Compounded in the USA

Made for you, never mass-produced

Tested before it ships

Sterility, endotoxin, and potency, under USP 795 and 797

Independently accredited

URAC, ACHC, and LegitScript

From your visit to your door

Exactly what happens after your visit, who handles it, and when you pay. Nothing is charged until a physician approves.

Start my visit

01Online visit
A few questions, no charge
02Physician review
A licensed US physician
03Approval
Charged only if approved
04Pharmacy
Prepared in the US
05Delivery
Expedited shipping included
06Ongoing care
Check-ins and dose changes

Start my visit

Sipra Medical Reviewer

“The science on GLP-1 medications is genuinely strong, but the medicine is only part of it. What matters is whether you have a real plan and a physician who stays with you through the dose changes and the plateaus, because that is where lasting results actually come from.”

Dr. Jillian Foglesong StabileMD, FAAFP, DABOM

Board-certified family physician and Diplomate of the American Board of Obesity Medicine.

American Board of Family Medicine

American Board of Obesity Medicine

Wake Forest University School of Medicine

Metformin and LDN questions, answered

Metformin is a daily tablet that lowers the glucose your liver makes and helps your body respond to insulin. It is FDA approved for type 2 diabetes. A prescriber may add it to a weight plan off label for metabolic support, including for people who are not candidates for a GLP-1. Individual results vary.

It is naltrexone compounded at a small fraction of the FDA-approved dose, taken as one capsule a day, usually at bedtime. Naltrexone is FDA approved for alcohol and opioid dependence; at a low dose a prescriber may use it off label alongside a weight plan. It is not for anyone taking opioid medication.

Your physician decides. They review your full history, including every medication you take, and add either one only if it fits your plan.

Stomach upset is common in the first weeks on metformin and usually settles. Low-dose naltrexone can cause vivid dreams or mild sleep changes early on, which usually fade. Your care team is reachable when anything comes up, and your prescriber can adjust the dose.

A licensed physician reviews your full history, including your other medications and conditions, before prescribing. Neither is right for everyone, and naltrexone is not for anyone taking opioids. The compounded version of naltrexone is prepared by a licensed US pharmacy to your prescription and is not FDA-approved.

You see every plan length, its monthly price, and its total before you start, with no hidden fees. Nothing is charged at checkout: your plan total is charged once, only if a physician approves your treatment, and it includes physician follow-up, ongoing support, and expedited shipping. The two metformin strengths are priced separately.

A licensed physician prescribes and follows up, and your care team answers questions and adjusts your plan as your body responds, included, not an add-on. Sipra stays with you from your first dose through every refill.