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Those with a personal or family history of medullary thyroid cancer, multiple endocrine neoplasia syndrome type 2, or previous episodes of pancreatitis need thorough medical evaluation before starting treatment

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How a Mounjaro restart is assessed after a longer break NICEs guidance on prescribing, reviewing and stopping tirzepatide sets out the factors a prescriber should weigh when someone wants to restart, rather than a single fixed schedule: Why treatment was stopped Whether pancreatitis was suspected or confirmed Whether other adverse effects occurred, and how significant they were Previous weight-loss response to treatment How long treatment was taken for, and the highest dose reached Engagement with diet and lifestyle measures during previous treatment Whether a slower dose titration is appropriate this time This reflects the official UK missed-dose instruction (take within four days, otherwise skip, leave at least three days between doses) plus the individual factors NICE sets out for a longer break

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Curiously, it was recently reported that this pro-inflammatory cytokine, IL-6, similarly, but independently from GLP-1, slows gastric emptying (228)