Frequently Asked Questions for patients about Tirzepatide (Mounjaro)

• The National Institute of Health and Care Excellence (NICE) has recommended a treatment called tirzepatide (Mounjaro®) to help manage obesity in adults. This treatment is to be used alongside healthy eating and physical activity advice. 
• This medication can be offered to people who are eligible in both specialist weight management services and primary care settings. Previously, similar medications like semaglutide (Wegovy®) and liraglutide (Saxenda®) were only recommended by NICE for prescription in specialist weight management services (which are usually hospital based services). The inclusion of tirzepatide (Mounjaro®) as a treatment option in primary care marks an opportunity to expand access and offer new treatments for people living with obesity.  
• Introducing this new treatment to an estimated 3.4 million eligible patients requires the NHS in England to develop a completely new service for weight management and train the varied healthcare professional workforce needed to deliver tirzepatide (Mounjaro®) in primary care. A staged approach will help manage the impact on existing healthcare services, ensuring tirzepatide (Mounjaro®) is prescribed safely and that patients receive appropriate support.  
• In the staged roll out, tirzepatide (Mounjaro®) will initially be offered to individuals facing the most significant health risks related to their weight. NHS South Yorkshire ICB is working to design appropriate pathways and services to support this rollout. 
• Tirzepatide is currently prescribed for the treatment of type 2 diabetes but will now also be available for weight loss purposes.  

• The weight loss medicine tirzepatide also known as Mounjaro ® is a GLP-1/GIP agonist. Other medications such as semaglutide (Wegovy ®), liraglutide (Saxenda ®), are known as GLP-1 agonists. They mimic gut hormones released by the body after eating, telling the brain you are full, they also slow down the time it takes the stomach to empty and help control blood sugar levels.  
• Until now most of these medicines have been used in the NHS to treat diabetes, to help control blood sugar levels helping improve diabetes and other health conditions. 
• Tirzepatide (Mounjaro®) can only be prescribed by a healthcare professional alongside programmes that support people to lose weight and live healthier lives, by making changes to their diet and physical activity (this is called ‘wrap around care). Tirzepatide (Mounjaro®) is an injection, that you inject yourself once a week. 
• More information can be found here: GLP-1 medicines for weight loss and diabetes: what you need to know – GOV.UK

• This medication is for people living with obesity who have a body mass index (BMI) of 35 or over and a weight related health problem; or a BMI of 32.5 and one weight related health problem for people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds, as they are at a higher risk of medical problems at a lower BMI.   
• NHS South Yorkshire ICB is working to make tirzepatide available within our specialist weight management services. However, the availability of Specialist Weight Management Services across South Yorkshire varies as does their readiness to be able to prescribe tirzepatide, so this may take some time.  

• The following groups of patients will be eligible for access to tirzepatide (Mounjaro®) in primary care in the first three years. There will be a phased approach to rollout in primary care, and initially tirzepatide (Mounjaro®) will only be available on the NHS to those with the highest clinical need.  
• This approach will ensure the service is delivered safely and that the NHS in England is able to plan for an increase in numbers of people eligible for assessment for tirzepatide (Mounjaro®), whilst building skills and knowledge within the workforce. National Institute for Health and Care Excellence (NICE) will complete a review at 3 years about who else will be able to access the medication and then more information will be provided about the next groups of people.  
• Access to the medication will be prioritised to ensure patients with the greatest clinical need can access the medication. The approach was developed based on discussions with clinical experts and engagement with key organisations. The following weight related health conditions are considered, as a way of prioritising groups of people with the greatest clinical need: 
• type 2 diabetes mellitus  
• high blood pressure  
• heart disease  
• obstructive sleep apnoea (when your breathing stops and starts while you sleep)  
• abnormal blood fats (dyslipidaemia)  

*In addition to the patients in the previous cohorts 

**Due to an increased risk of heath conditions at lower BMI thresholds in these populations, the BMI applied to assess eligibility for tirzepatide (Mounjaro®) must be adjusted by 2.5 kg/m2 in people from South Asian, Chinese, other Asian, Middle Eastern, Black African or African-Caribbean ethnic backgrounds to ensure equitable clinical prioritisation and access to appropriate treatment. 

NHS South Yorkshire Integrated Care Board is currently reviewing the options as to how tirzepatide could be provided through primary care. We will update the website when we have further information on the timelines. 

• New patient services are being developed to support access to tirzepatide through primary care and once this service has been set up, this will include the following steps:  
• Initial assessment and discussion about the best treatment option  
• There will be an assessment which will include discussions around the different options for weight management. The clinician will carry out checks to make sure you are eligible, this includes BMI, medical assessment, medication history and psychological assessment. The risks and benefits of starting the medication will be discussed, so you have the information to make the right choice for you. If you are eligible, you do not need to decide immediately if you want to start tirzepatide (Mounjaro®). More information can be found in this tirzepatide (Mounjaro®) decision aid produced by NICE.  
• If you choose to start tirzepatide (Mounjaro®), you will need up to date blood tests, to check kidney, liver and thyroid function. If these are within an acceptable range an appointment will be made with a healthcare professional to train you how to self-inject.  
• Dose adjustment and initial monitoring  
• The prescribing healthcare professional is responsible for ensuring that patients are supported with taking the medicine, adjusting the dose and managing side effects. This is a new medicine, so it is important to monitor safety, help patients take the medication and follow dietary and physical activity advice.  
• Maintenance  
• Ongoing prescribing of the medicine, review of progress and wraparound care provided for the first 9 months. 

Like all medications, tirzepatide (Mounjaro®) can cause side effects and healthcare professionals should discuss the side-effects with you. The medication will come with a Patient Information Leaflet which lists common side effects including:  

• feeling sick  
• indigestion (heartburn)  
• constipation  
• diarrhoea.  

There can be some more serious side effects, such as low blood sugar, gallstones and inflammation of the pancreas (pancreatitis).  

Tirzepatide (Mounjaro®) is a new medication, so any side effects should be reported through the Yellow Card Scheme, which is the government system used for recording side effects with medicines in the UK. 

Patients taking tirzepatide (Mounjaro®) on the NHS for obesity management will be supported by the healthcare professional who is prescribing the medication, this may be in primary care or specialist weight management services. Healthcare professionals will focus on prescribing the medication, manage side-effects, monitoring the other long-term health problems, and management of potential medicine interactions.  

Patients will also be given access to a lifestyle support programme which is called ‘wrap around care’ that focuses on diet and nutrition advice when taking the medication and physical activity advice. Through the programme, people will be encouraged to make sustainable habits that encourage long-term improvements in metabolic health, physical wellbeing and lifestyle. This lifestyle support programme will be available for the first 9 months of being prescribed the medication. 

Patients cannot be prescribed tirzepatide (Mounjaro®) if they do not wish to undertake the wraparound care support. This is because the NICE recommendations state tirzepatide (Mounjaro®) must be prescribed alongside diet and physical activity advice.  

NICE guidance recommends if you do not lose enough weight (5%) after 6 months of being on the highest dose you can manage, tirzepatide (Mounjaro®) should be stopped. This is because the medication is not working as well as it should be for you.  

Currently there is no specified time limit for being prescribed tirzepatide (Mounjaro®). The decision to continue or stop tirzepatide (Mounjaro®) should be discussed with an appropriate healthcare professional.  

Tirzepatide (Mounjaro®) should not be taken during pregnancy or just before trying to get pregnant. This is because there is not enough safety data to know whether taking the medicine can cause harm to the baby.

There is specific information about how these medications affect contraceptive methods, like the pill. The Faculty for Sexual and Reproductive Health has produced this information leaflet for patients to read: Patient-information-GLP-1-agonists-and-contraception.pdf 

Tirzepatide (Mounjaro®) can affect the absorption of other medications being taken. In some cases, this may affect how well and/or how fast those medications work; or it may make no difference. For this reason it is particularly important that patients receive follow up care and advice from a healthcare professional. This medication is still relatively new, and the healthcare community are learning about how tirzepatide (Mounjaro®) interacts with other medications, for example Hormone Replacement Therapy and oral contractives.  

Before starting the medicine, a healthcare professional will check which other medications you are taking to see if there may be any medicine interactions and to see if they are compatible when taken together. While taking the medicine, some people may find that their long-term health conditions (like high blood pressure) improve, and they might need less medication. Your healthcare professional will talk to you about this, any monitoring that might need to happen and make any necessary changes to your treatment.  

It is important to be honest with the healthcare professional if you are eligible for the medication. Let them know about any medical conditions, other medicines you are taking, the dose and if you buy any medication over the counter. This information will need to be considered before you are prescribed tirzepatide (Mounjaro®). 

Patients can continue taking tirzepatide (Mounjaro®) if they are prescribed it by the NHS to manage their diabetes. If you have any questions, contact a suitable healthcare professional.  

It is important your GP is aware you are taking tirzepatide (Mounjaro®), if it hasn’t been prescribed by the NHS, as it may impact on your health and any other treatments you are having or may need.  

When the new service is available, a  healthcare professional will determine if it is appropriate for you to receive tirzepatide (Mounjaro®) as part of your care in a different care setting (for example, through primary care).

Normal prescription charges will apply unless you are entitled to free NHS prescriptions (for example, because you have a medical exemption certificate). Follow the link to find out more about whether you are entitled to help with health costs. 

Tirzepatide (Mounjaro®) will not be suitable for everyone and not everyone who meets the eligibility criteria will want to use it to support their weight loss. There are other options available including weight loss programmes that use tried and tested methods such as lifestyle changes, nutrition and physical activity advice. Please speak to a healthcare professional about what the best option is that is offered locally to you.  

General advice on losing weight can be found on the NHS Better Health Website. This includes an NHS weight loss plan and free to download app Lose weight – Better Health – NHS. 

Each local authority has a support offer that you can self-refer to for healthy lifestyle support. 

• Sheffield Sheffield – Morelife UK 
• Rotherham Rotherham Healthwave – Helping Boost Health and Wellness 
• Barnsley Weight Management Programme – Barnsley Premier Leisure 
• Doncaster 1:1 Coaching | Well Doncaster 

There are other options available, depending on the health-related conditions you have and your BMI. Ask your General Practice about:  

• The NHS Digital Weight Management Programme supports adults living with obesity who also have a diagnosis of diabetes, hypertension or both, to manage their weight and improve their health. 

It is a 12-week online behavioural and lifestyle programme that people can access via a smartphone or computer with internet access. NHS England » The NHS Digital Weight Management Programme 

• Healthier You: NHS Diabetes Prevention Programme is free to people at risk of Type 2 diabetes. 

It is a face-to-face service with 13 friendly and supportive group-based sessions over nine months with a trained Health Coach South Yorkshire | Reed Wellbeing. 

• NHS Type 2 Diabetes Path to Remission Programme is a low calorie treatment for people in South Yorkshire living with Type 2 diabetes who are above a healthy weight. 

This expert-developed 12-month programme has three phases. To start with you’ll follow a low calorie diet for 12 weeks (replacing all normal meals with your choice of soups, shakes and porridges totalling 8-900 calories per day). Then you’ll gradually restart ‘real food’ meals over six weeks. Finally you’ll receive ongoing support for the last 8 months to help you maintain or build on your weight loss South Yorkshire: NHS Type 2 Diabetes Path to Remission – Momenta Newcastle.