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Baseline assessment before initiating Mounjaro should include: Renal function tests (estimated glomerular filtration rate) Serum electrolytes including potassium Review of concurrent medications Assessment of cardiovascular status Ongoing monitoring recommendations include: Routine follow-up : For uncomplicated patients without risk factors, electrolyte monitoring can follow standard diabetes care protocols, typically annually or as clinically indicated Enhanced monitoring : Patients with risk factors (renal impairment, concurrent diuretics, elderly) should have electrolytes checked 1-3 months after initiation and following dose escalations, following local protocols Symptomatic monitoring : Any patient experiencing persistent gastrointestinal symptoms, particularly vomiting or diarrhoea lasting more than 48 hours, should have electrolytes assessed Management strategies for patients on Mounjaro include: Dose titration : Following the recommended gradual dose escalation schedule (starting at 2.5 mg weekly for 4 weeks, then increasing to 5 mg, with further increases in 2.5 mg increments to 10-15 mg as needed) helps minimise gastrointestinal adverse effects Non-pharmacological measures : Eating smaller, more frequent meals and maintaining adequate hydration may help reduce gastrointestinal symptoms Symptomatic treatment : If non-pharmacological measures are insufficient, antiemetics may be considered for persistent nausea, though should be used judiciously with consideration of potential QT interval effects and drug interactions Hydration advice : Patients should be counselled to maintain adequate fluid intake, particularly during the initial treatment period If electrolyte disturbances are identified, management should address the underlying cause

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