Mounjaro (tirzepatide) is a prescription medicine licensed in the UK for treating type 2 diabetes mellitus in adults. Accessing Mounjaro requires meeting specific clinical criteria, whether through the NHS or private healthcare. Understanding the requirements to get Mounjaro is essential for patients considering this treatment option. Eligibility depends on factors including diabetes control, previous treatments, BMI, and response to therapy. This article outlines the medical assessments, eligibility criteria, and pathways for obtaining Mounjaro in the UK, helping patients navigate the process safely and appropriately.

What Is Mounjaro and What Is It Used For?

Mounjaro (tirzepatide) is a prescription medicine licensed in the UK for the treatment of type 2 diabetes mellitus in adults. It belongs to a class of medications known as dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonists. By mimicking the action of these naturally occurring hormones, Mounjaro helps to regulate blood sugar levels, enhance insulin secretion when glucose is elevated, and reduce the release of glucagon.

The medication is administered as a once-weekly subcutaneous injection using a pre-filled pen device. Treatment typically starts at a dose of 2.5 mg once weekly, with gradual up-titration every 4 weeks to a maintenance dose of 5-15 mg as tolerated. Tirzepatide works by slowing gastric emptying, which helps to reduce appetite and promote a feeling of fullness. This mechanism not only aids glycaemic control but also supports weight loss, which is particularly beneficial for individuals with type 2 diabetes who are overweight or obese.

Mounjaro is typically prescribed when other glucose-lowering therapies, such as metformin, have not provided adequate blood sugar control. It may be used alone (when metformin is contraindicated or not tolerated) or in combination with other antidiabetic medications, including insulin. Importantly, Mounjaro should not be used in patients with type 1 diabetes or for the treatment of diabetic ketoacidosis.

Mounjaro must not be used during pregnancy or breastfeeding unless the potential benefit clearly outweighs any risk. Women of childbearing potential should use effective contraception while taking tirzepatide.

It is important to note that while Mounjaro has demonstrated significant weight loss effects in clinical trials, patients should follow the specific indication for which their clinician has prescribed it, in line with the current UK marketing authorisation and NICE guidance.

NHS Eligibility Criteria for Mounjaro

Access to Mounjaro on the NHS is governed by NICE guidance and local formulary decisions made by integrated care boards (ICBs). NICE technology appraisal guidance (TA924) recommends tirzepatide as an option for treating type 2 diabetes in adults, with specific eligibility criteria detailed in NICE guideline NG28 (Type 2 diabetes in adults: management).

To be eligible for NHS-funded Mounjaro, patients typically must meet the following criteria:

• Confirmed diagnosis of type 2 diabetes mellitus with inadequate glycaemic control despite existing treatment

• Tirzepatide may be considered as part of a triple therapy regimen (with metformin and another oral agent) or as a dual therapy with metformin when other options are unsuitable

• Tirzepatide may be used as monotherapy when metformin is contraindicated or not tolerated

• It may be considered when a person has a higher BMI and would benefit from weight loss, or when insulin would be the next treatment option but is not appropriate

NICE guidance (NG28) stipulates that treatment should only continue if there is a beneficial metabolic response, defined as a reduction of at least 11 mmol/mol (1.0%) in HbA1c and a weight loss of at least 3% of initial body weight at six months. If these targets are not met, Mounjaro should be discontinued.

It is important to note that tirzepatide should not be prescribed in combination with DPP-4 inhibitors (such as sitagliptin or linagliptin), as they work through related mechanisms.

Local variation exists across the UK, as individual ICBs may apply additional restrictions based on budget considerations and local prescribing policies. Patients are advised to discuss their eligibility with their GP or diabetes specialist team, who can confirm whether Mounjaro is available and appropriate within their local area.

Private Prescription Requirements for Mounjaro

Patients who do not meet NHS eligibility criteria, or who wish to access Mounjaro more quickly, may consider obtaining a private prescription. Private healthcare providers, including specialist weight management clinics and online prescribing services, can prescribe Mounjaro, but strict clinical and regulatory safeguards apply.

To obtain Mounjaro privately, patients must:

• Undergo a comprehensive medical assessment by a UK-registered prescriber (GP, specialist, or appropriately qualified prescribing clinician)

• Have a confirmed diagnosis of type 2 diabetes or meet criteria for other licensed indications as per the current UK marketing authorisation

• Provide a full medical history, including current medications, allergies, and any history of pancreatitis, thyroid disease, or diabetic retinopathy

• Have recent blood test results, including HbA1c, renal function (eGFR), and liver function tests

• For women of childbearing potential, pregnancy should be excluded before starting treatment, and effective contraception advised during treatment

Contraindications must be carefully assessed. Mounjaro is not suitable for individuals with type 1 diabetes, diabetic ketoacidosis, or severe gastrointestinal disease. The UK SmPC advises caution in patients with a history of pancreatitis. Patients should be monitored for signs of dehydration if they experience significant gastrointestinal side effects, particularly if they have renal impairment.

Private prescriptions for Mounjaro are typically issued for one to three months initially, with ongoing monitoring and review required before further supplies are authorised. Patients should be aware that private treatment can be costly, with monthly expenses often exceeding £200, and that not all private providers adhere to the same clinical standards. It is essential to choose a registered and regulated provider to ensure safe and appropriate prescribing practices.

Medical Assessments Needed Before Starting Mounjaro

Before initiating Mounjaro, a thorough clinical assessment is essential to ensure the medication is safe and appropriate for the individual patient. This assessment should be conducted by a qualified healthcare professional with expertise in diabetes management or metabolic medicine.

Key components of the pre-treatment assessment include:

• Detailed medical history: Review of diabetes duration, previous treatments, cardiovascular risk factors, and any history of pancreatitis, thyroid disorders, gallbladder disease, or gastrointestinal disease

• Physical examination: Measurement of weight, height, BMI, blood pressure, and pulse

• Laboratory investigations: Recent HbA1c (within the past three months), fasting glucose, renal function (serum creatinine and eGFR), liver function tests, lipid profile, and thyroid function tests if clinically indicated

• Assessment of diabetic complications: Screening for retinopathy, neuropathy, and nephropathy, particularly if these have not been evaluated recently

• Medication review: Evaluation of current antidiabetic agents, especially insulin or sulfonylureas, which may require dose reduction to prevent hypoglycaemia when starting Mounjaro. DPP-4 inhibitors should be discontinued before starting tirzepatide

• Pregnancy status: For women of childbearing potential, pregnancy testing and contraception counselling

Patients should also be counselled on the potential adverse effects of Mounjaro, which most commonly include gastrointestinal symptoms such as nausea, vomiting, diarrhoea, and constipation. These effects are usually mild to moderate and tend to diminish over time. However, patients should be advised to seek medical attention if they experience severe or persistent abdominal pain, which could indicate pancreatitis or gallbladder disease.

Patient education is a critical component of the assessment process. Individuals must be trained on proper injection technique, pen device handling, injection site rotation, and safe disposal of needles. They should also understand the importance of adhering to a healthy diet, regular physical activity, and ongoing blood glucose monitoring as part of comprehensive diabetes management. Instructions for managing missed doses should be provided in line with the SmPC guidance.

How to Access Mounjaro in the UK

Accessing Mounjaro in the UK involves navigating either the NHS pathway or the private healthcare route, depending on individual circumstances and eligibility.

For NHS patients, the process typically begins with a consultation with your GP or diabetes specialist nurse. If you have type 2 diabetes with suboptimal control despite existing treatment, and you meet the NICE eligibility criteria, your clinician may initiate a referral to a specialist diabetes service or prescribe Mounjaro directly if they are confident in doing so. Given the high demand and cost of GLP-1 receptor agonists, some areas operate shared care protocols, where initiation occurs in secondary care and ongoing prescribing is managed in primary care.

Patients should be prepared for the possibility of a waiting period, as local formularies, budget constraints, and current supply challenges for GLP-1 receptor agonists may limit immediate access. It is advisable to have an open discussion with your healthcare team about realistic timelines and alternative treatment options if Mounjaro is not immediately available.

For private access, patients can approach:

• Private GPs or endocrinologists who can assess suitability and issue a prescription

• Specialist weight management or diabetes clinics, many of which offer telemedicine consultations

• Regulated online prescribing services that provide remote assessments by UK-registered clinicians

When choosing a private provider, ensure they are registered with the Care Quality Commission (CQC) in England, Healthcare Improvement Scotland (HIS), Healthcare Inspectorate Wales (HIW), or the Regulation and Quality Improvement Authority (RQIA) in Northern Ireland. Verify that prescribers are registered with the General Medical Council (GMC). Be cautious of services that do not require a thorough medical assessment or offer prescriptions without appropriate clinical oversight.

Ongoing monitoring is essential regardless of how Mounjaro is accessed. Patients should have regular follow-up appointments (typically every three to six months) to assess treatment response, monitor for adverse effects, and adjust therapy as needed. Blood tests, including HbA1c and renal function, should be repeated periodically. If you experience concerning symptoms such as severe abdominal pain, persistent vomiting, visual changes, or signs of an allergic reaction, contact your GP or seek urgent medical attention immediately. Suspected side effects should be reported via the MHRA Yellow Card Scheme.

Frequently Asked Questions