Laboratory Screening Recommendations for Patients Taking Mounjaro (Tirzepatide)
Patients taking Mounjaro (tirzepatide) should have laboratory screening performed every 3-4 months during the first year of treatment, then every 4-6 months thereafter if stable.
Initial Laboratory Assessment Before Starting Mounjaro
Before initiating tirzepatide therapy, patients should undergo:
- Complete blood count (CBC)
- Comprehensive metabolic panel (including liver function tests)
- Renal function tests (creatinine, eGFR)
- Fasting glucose and/or HbA1c
- Fasting lipid profile
- Assessment for history of pancreatitis and gallbladder disease
Recommended Monitoring Schedule
First Year of Treatment
- Laboratory testing at baseline
- Follow-up testing at 4 weeks after initiation
- Subsequent testing every 3-4 months
- Liver function tests
- Renal function tests
- Fasting glucose/HbA1c
- Lipid profile
After First Year (If Stable)
- Laboratory testing every 4-6 months 1
- Liver function tests
- Renal function tests
- Fasting glucose/HbA1c
- Lipid profile
Parameters to Monitor
Glycemic Control
- HbA1c and/or fasting glucose
- Target: Improvement in glycemic parameters
Liver Function
- AST, ALT, bilirubin
- Monitor for signs of hepatic dysfunction (unexplained nausea, vomiting, abdominal pain, fatigue, anorexia, jaundice)
Renal Function
- Creatinine and eGFR
- No dose adjustment required for renal impairment, but monitoring is still recommended
Lipid Profile
- Total cholesterol, LDL, HDL, triglycerides
- Expect improvements as a beneficial effect of therapy
Special Considerations
- Weight Loss Monitoring: Document weight at each visit to assess therapeutic response
- Side Effect Assessment: Evaluate for gastrointestinal side effects at each visit (nausea 31%, diarrhea 23%, vomiting 12%, constipation 5%, abdominal pain 5%) 1
- Pregnancy Testing: Consider regular pregnancy testing in women of childbearing potential as tirzepatide should not be used during pregnancy
Adjusting Monitoring Frequency
Increase frequency of monitoring if:
- Abnormal laboratory values are detected
- Patient experiences significant side effects
- Dose adjustments are made
- Patient has comorbidities requiring closer monitoring
Maintain standard frequency if:
- Laboratory values remain stable
- Patient tolerates medication well
- No dose adjustments are needed
Clinical Pearls
- The first follow-up visit at 4 weeks is critical to assess initial response and side effect burden
- Most gastrointestinal side effects occur during dose escalation and diminish over time
- Laboratory abnormalities are uncommon with tirzepatide but should be monitored as part of good clinical practice
- Consider temporarily holding tirzepatide at least one week before elective surgical procedures
By following this monitoring schedule, clinicians can effectively track therapeutic response while ensuring patient safety during tirzepatide treatment.