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In addition to delaying gastric emptying, GLP-1RAs exert direct effects on the central nervous system to suppress appetite and promote weight loss [9, 11]

The following strategies may help people taking GLP1 or GIP/GLP1 medications to reduce nausea, though they may not work for everyone: Eat smaller meals: Instead of three big meals, try eating smaller, more frequent meals throughout the day

Look for drugs that have been authorized by Health Canada by checking for the eight-digit Drug Identification Number (DIN) on the label and by searching Health Canada's drug product database

Combining medication with lifestyle modificationseven modest ones like daily walkingreduces rebound weight gain significantly and supports long-term metabolic health

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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