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It doesnt provide much information about the compounding pharmacies it uses (probably due to competition reasons) but it does say they are USA certified. Customer Support and Reviews It is pretty rare for an affordable GLP-1 provider to offer round-the-clock patient support, but MEDVi does exactly that

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However, complications can arise from frequent vomiting, such as dehydration and electrolyte imbalance, and these can provoke a critical condition if left untreated for a substantial period

doi: 10.1097/ALN.0000000000000320

The full treatment effect is usually seen at the maintenance dose of 25mg