Mounjaro

1. Remove your medication from the refrigerator and make sure all the items you need are nearby on a clean surface. This includes your medication pen, alcohol swab, sharps bin and disposable needle.

2. Wash your hands thoroughly with soap.

3. Pull off the pen cap.

4. Check your pen for any signs of damage and check that the medication is clear and colourless to slightly yellow in the window of the pen.

5. Do not use medication if the pen has signs of damage or if the medication is cloudy or discoloured.

6. Wipe the red inner seal of the pen with one of the alcohol wipes.

7. Select a needle to use for your injection and check the paper tab and the outer needle cap for damages. If you see any damage, dispose of the needle in a sharps bin as this could affect sterility.

8. Tear off the paper tab from the needle, then push the needle onto the pen and twist until it's secure.

9. Remove both caps from the needle, keeping the outer cap for later to safely dispose of your medication.

1. Slowly turn the dose knob until you hear 2 clicks and the extended line is shown in the dose window. This is the prime position.

2. With the needle pointing upwards, tap the cartridge holder gently to collect air bubbles at the top.

3. Release some medicine into the air by pushing the dose knob in until it stops, then slowly count to 5 while holding the dose knob. A small amount of medicine should come out the tip of the needle and the "0" icon must be shown in the dose window.

4. If a small amount of medicine is not released, repeat these steps an additional 2 times. After 2 failed priming attempts, replace the needle and try once more.

5. A visible droplet at the needle tip confirms success. If absent after 3 total attempts (2 with the original needle and 1 with new needle), contact MedExpress.

When choosing an injection site remember to choose one where you can see the pen window and is easily accessible. Our clinical team also recommends rotating your injection sites each time you inject to reduce the possibility of injection site reactions.

1. Choose an injection site: upper arms, stomach or the front of your thighs.

2. Clean the site with the alcohol swab provided.

1. Turn the dose knob until it stops and the ‘1’ icon is shown in the dose window.

2. Position the pen at the injection site at a 90 degree angle.

3. Insert the needle into your skin and inject the medication by pressing and holding the dose button until "0" appears, then continue holding for 5 seconds to ensure full delivery.

4. Remove the needle from your skin.

5. If blood appears at the injection site, press on it lightly with a clean tissue, but do not rub the area.

1. Lead the needle tip into the outer needle cap on a flat surface. Once the needle is covered, carefully push the outer needle cap completely on.

2. Unscrew the needle and dispose of it in your sharps bin.

3. Put the pen cap on your pen after each use and store it safely in the refrigerator until your next dose.

When starting Mounjaro, you’ll begin with 2.5 mg once a week for the first four weeks. Your dose then increases every four weeks until you reach the recommended maintenance dose of 15 mg per week.

These symptoms could indicate pancreatitis, a serious condition that requires urgent medical attention.

• Severe, persistent stomach pain. Severe means:

  • It’s so intense (around 8 or more out of 10) that you can’t focus on anything else

  • It makes it nearly impossible to handle normal daily tasks (like walking, getting dressed, or eating)

  • It doesn’t improve with over-the-counter pain relief or rest

  • It radiates to your back or underneath your right ribcage or your right shoulder

  • You also have severe vomiting (3 or more times a day, or having blood or something that looks like coffee grounds in vomit)

If you experience any of the following, stop taking your medication immediately. These symptoms could indicate anaphylaxis or a severe allergic reaction that requires urgent medical attention.

• Difficulty breathing, or swelling of the lips, tongue, or throat - these could be signs of a severe allergic reaction, which can be life-threatening.
• Severe pain underneath your right ribcage that may spread to your shoulder or back. This may be accompanied by vomiting, a high temperature or a rapid heartbeat. These symptoms could suggest acute gallbladder problems.

Nausea is an uncomfortable feeling in your stomach that can make you feel like you might vomit. It's often described as a queasy sensation, like your stomach is churning or feeling sour. It can make you feel very unsettled or 'off'.

Your treatment works by slowing down how quickly your stomach empties, which helps you feel fuller for longer. Nausea can occur because the food stays in your stomach longer and causes your stomach to stretch. This triggers signals that send a message to the brain, making you feel nauseous.

• Drink plenty of fluids (cold water, herbal teas)

• Get lots of fresh air

• Eat small and frequent meals

• Reduce intake of foods high in sugar and fat

• Avoid cooking or eating strong smelling foods

These strategies help with nausea by calming the digestive system and reducing triggers that can make it worse.

Vomiting is when your body forcefully pushes the contents of your stomach out through your mouth, usually after feeling nauseous. It can feel like a pressure in your stomach, as your muscles contract strongly to force the contents of your stomach up. Many people feel a sudden sense of relief once it's over.

Your treatment works by slowing down how quickly your stomach empties, which helps you feel fuller for longer. However, this can cause vomiting, just like it can cause nausea, because the food stays in your stomach longer and causes it to stretch. This triggers signals that are sent to the brain, which may lead to vomiting.

• Stay hydrated by taking small sips of water. You could also try herbal teas such ginger and peppermint.

• Eat small and frequent meals to keep your energy levels up. Stick to a bland diet that is easy on your stomach, such as toast, rice and bananas.

Diarrhoea is when you have frequent, loose or watery stools. You might feel sharp or dull discomfort in your stomach, which often gets worse just before you need to go to the bathroom. You may have an urgent need to go to the toilet more than three times a day.

Diarrhoea can happen while using GLP-1s because the medication slows down how quickly food moves through your stomach, which can disrupt normal digestion.

• Drink plenty of fluids (water, herbal teas)

• Eat small and frequent meals

• Rest – take it easy and allow your body to recover

• Consider taking oral rehydration salts from a pharmacist to replace lost fluids and electrolytes

• Paracetamol for pain relief

Constipation occurs when it’s difficult to pass stool and you have fewer than three bowel movements in a week. The stools are often dry, hard or lumpy - sometimes resembling pellets or marbles - because your colon has absorbed too much water. This can lead to pain or discomfort when trying to pass stool.

Your treatment can cause constipation due to slowing down the movement of food and waste through your digestive system.

• Drink plenty of fluids (water, herbal teas)

• Eat high-fibre foods such as prunes, figs, and oats

• Take regular walks – exercise can stimulate bowel movements.

• Consider glucomannan supplements – glucomannan is a water soluble fibre that softens stools to make them easier to pass. It can also help with regular bowel movements.

Stomach pain refers to discomfort or aching felt anywhere in the abdomen. There are different types of stomach pain but how you manage the pain depends on the type you’re experiencing.

Trapped wind usually feels like bloating or pressure in your stomach, sometimes with burping or gas.

Stomach cramps usually feel like sharp, intermittent pains that often come in waves.

• Avoiding spicy or greasy foods
• Holding a heat pack to your stomach
• Chewing food slowly

Injection site reactions refer to localised skin responses that occur after an injection. Symptoms often present within 24 to 48 hours of injection and may include pain, redness, swelling, warmth, itching, bruising or tenderness at the injection site.

They happen because the body is responding to the injection itself, the medication, or how it was administered.

• Rotate your injection site each week. You can alternate between different areas such as your lower stomach, thigh, arm, and buttocks. This helps prevent irritation.
• Make sure you’re correctly injecting your medication

Fatigue is a persistent, overwhelming tiredness or lack of energy that lingers even after rest, making it difficult to perform daily tasks and activities.

You may experience fatigue while taking GLP-1s because of your reduced calorie intake, dehydration, and blood sugar fluctuations.

• Make sure you are eating enough nutrient-dense food to get the calories you need for energy
• Ensure you are getting enough vitamins. For example, vitamin B12 (found in meat, fish, cheese, and eggs) is important for energy production. Low vitamin D levels are also linked to fatigue, and while sunlight is the best source of this vitamin (we recommend that you always wear SPF 50 sunscreen), it is also found in oily fish, red meat, liver, and egg yolks
• Check your iron levels, as low levels can cause fatigue. Iron is found in liver, red meat, and beans such as red kidney beans, edamame beans, and chickpeas
• Exercise regularly to boost energy
• Try to stick to the same sleep schedule and aim for 7 to 9 hours of sleep a night.
• Have a relaxing sleeping area (not too bright, noisy, or warm)
• Vitamin supplementation

Burping, also known as eructation, is when gas is released from your stomach and comes out through your mouth, often with a noticeable sound. It is a normal way for your body to get rid of air that you have swallowed while eating or drinking.

Your treatment slows down how quickly food leaves your stomach, meaning that food stays in your stomach for longer. As a result, gas can build up during digestion and may be released through burping.

• Eat and drink slowly to help reduce the amount of air you swallow
• Avoid fizzy drinks
• Avoid chewing gum and sweets
• Take regular walks - exercise can aid digestion and improve bloating

Heartburn is a burning sensation in the chest or throat caused by stomach acid backing up into the oesophagus. It typically feels like a burning sensation behind your breastbone or a sour taste in your mouth.

Your treatment slows down how quickly food leaves your stomach. As a result, food stays in the stomach for longer, which can increase the chance of acid reflux. Acid reflux is when stomach acid moves backward into the food pipe and causes heartburn.

• Reducing your caffeine intake
• Don’t eat too close before you go to bed
• Avoid rich, spicy, or fatty foods
• Heartburn medication

Dizziness can feel like a range of sensations, including lightheadedness, feeling unsteady, faint, or as if your surroundings are spinning (vertigo).

You may experience dizziness on GLP-1s due to changes in blood sugar levels and dehydration.

• Drink plenty of fluids (water, herbal teas)
• Lie down until the dizziness passes
• Move carefully and slowly
• Get plenty of rest
• Avoid coffee, cigarettes and alcohol

Hair loss occurs when the normal cycle of hair growth is disrupted and is typically due to telogen effluvium - a type of hair loss that leads to increased shedding all over the scalp. Telogen effluvium feels like sudden, excessive hair shedding, often noticeable when brushing, washing, or running your fingers through your hair.

Hair loss while using Mounjaro or Wegovy is typically triggered by rapid weight loss (like that caused by GLP-1s). Rapid weight loss can cause hair loss because your body sees it as a form of stress. Your body will temporarily pause things that it doesn’t see as critical, like hair growth. This type of hair loss is usually temporary and hair will often grow back once your body adjusts.

• Aim for a gradual and steady weight loss of 0.5-1kg per week to reduce stress on your body.
• Ensure your diet includes sufficient amounts of protein, iron, zinc, and B vitamins (like biotin), which are essential for hair growth.
• Manage stress, as high stress levels can disrupt hair follicle function. Focus on relaxation techniques like meditation, gentle exercise, or breathing exercises.
• Once your weight stabilises, this side effect usually subsides and your hair should regrow to its original thickness.

The gall bladder is a pear-shaped organ that sits near your right ribcage. Gallstones are hardened deposits of bile or cholesterol that form in the gallbladder.
Gallstones don’t usually cause any symptoms, and many people don’t realise they have them.

Your treatment can result in rapid fat loss. When this happens, the liver releases extra cholesterol into bile - a fluid stored by the gallbladder that helps to digest fat. When there is too much cholesterol, it can form crystals that turn into stones. On top of that, weight loss can slow down how quickly the gallbladder empties, which gives gallstones more time to form.

If you have gallstones, seek medical attention immediately.

The medical term for changes in taste is ‘dysguesia’. Dysgeusia isn’t a serious medical condition, but it can impact your appetite.
Common symptoms include:

• A persistent metallic or bitter taste in all foods
• Sweet or salty foods lose their usual flavor
• Foods that once tasted good now seem unpleasant
• A lingering bad taste in the mouth, even without eating anything

GLP-1s may impact the brain region responsible for taste and reward, which could explain this side effect.

• Change up your food choices by eating citrus fruits, vinegar, and pickles. Avoid very sweet or spicy foods.
• Drink plenty of water to prevent a dry mouth
• Switch from metal utensils to plastic or ceramic
• Brush and floss your teeth regularly
• Avoid smoking

Heart palpitations are the feeling that your heart is racing or beating very fast. You might notice a “fast pulse” at rest.

Heart palpitations can be caused by changes in blood sugar levels and dehydration, both of which can affect heart rhythm. In some cases, the medication may also indirectly stimulate the nervous system, leading to an increased heartbeat. They can be brief or last for a few minutes.

• Monitor your resting heart rate, either manually or by using a smartwatch/fitness tracker, and note any episodes of palpitations (an unusual awareness of your heartbeat).
• Reduce triggers by cutting back on or avoiding caffeine, alcohol, and smoking—all of which can raise heart rate.

It’s more likely to affect people who have type 2 diabetes, particularly those taking other medications such as insulin that lower blood sugar levels.

• What is it?

  Hypoglycaemia is a condition where your blood sugar (glucose) levels drop below a healthy range (typically below 70 mg/dL).
  Common symptoms of low blood sugar include:

  • Feelings of hunger, dizziness, confusion, tiredness, or weakness
  • Mood changes such as anxiety or irritability
  • Sweating
  • Shaking
  • Tingling lips
  • Heart palpitations
  • Changes in vision including blurred vision
• Why does this happen?

  GLP-1s increase insulin release after eating, so combining them with other glucose-lowering drugs can sometimes push blood sugar too low.

• Here’s what we recommend:
  • Have something sugary straight away – like fruit juice, a fizzy drink, glucose tablets, or sweets to raise your blood sugar. Once you start feeling better, follow up with something longer-lasting, like a slice of bread or some biscuits, to help keep your blood sugar steady.

Recent research has shown that there is no link between GLP-1 medication use and increased thyroid cancer risk in humans. However, some early research has suggested that GLP-1 medications may carry a potential risk of thyroid C-cell tumours, including medullary thyroid carcinoma (MTC).

Current guidance is that patients with a personal or family history of any thyroid cancer (including MTC or Multiple Endocrine Neoplasia syndrome type 2 (MEN2)) should not be prescribed GLP-1 medications.

If your personal or family history of any of these conditions changes, stop taking your treatment immediately and inform your MedExpress prescriber.

If your treatment is still working well for you and you’re not experiencing serious side effects, our prescribers can continue your treatment for as long as you need to support weight loss maintenance.

Some people stay on treatment long-term, while others may decide to taper off gradually. We’ll help you find the approach that works best for you.

It’s normal to feel concerned about stopping your treatment. In clinical studies, many people who stopped taking weight loss medication regained a significant portion of the weight they had lost within a year. This is because these medications help to manage your underlying biology - not willpower.

That’s why it is important to understand that obesity is a chronic, relapsing medical condition. Just like other long-term health issues, it may require ongoing management and for some people, that includes continued use of medication.

Whether you choose to stay on treatment or taper off gradually, we will continue to provide ongoing support as you navigate the next phase of your weight loss journey.

Our team is here to support you.