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Important safety considerations include: Caution in patients with personal or family history of medullary thyroid carcinoma or Multiple Endocrine Neoplasia syndrome type 2 (patients should be counselled about thyroid symptoms) Previous serious hypersensitivity to tirzepatide Pregnancy or breastfeeding (effective contraception required in women of childbearing potential) Caution in patients with gastrointestinal disease, particularly severe gastroparesis History of pancreatitis (requires careful assessment) Women using oral contraceptives should use additional barrier contraception for 4 weeks after starting tirzepatide and after each dose increase, or consider non-oral contraceptive methods In the UK, tirzepatide for weight management may be available through private prescription , while NHS availability would depend on NICE guidance and local commissioning decisions

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doi: 10.1523/JNEUROSCI.6078-08.2009 95 KangH