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additional contraceptive methods are advised for 4 weeks after starting treatment and after each dose increase Patients with severe gastrointestinal disease (e.g., gastroparesis) should generally avoid Mounjaro If the patient is on insulin, doses should not be rapidly reduced when starting Mounjaro, as this increases the risk of diabetic ketoacidosis Patients should be counselled to report symptoms suggestive of thyroid C-cell tumours (neck mass, difficulty swallowing, persistent hoarseness) A collaborative approach involving endocrinologists, GPs, and diabetes specialists is often beneficial to ensure comprehensive care and monitoring

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