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Mounjaro is not recommended in patients with: Severe gastrointestinal disease , including severe gastroparesis, as Mounjaro further slows gastric emptying Caution is advised in patients with: History of pancreatitis careful consideration and monitoring are required Diabetic retinopathy rapid glycaemic improvement may transiently worsen retinopathy, particularly in patients on insulin No dose adjustment is required in renal impairment, though renal function should be monitored if significant gastrointestinal adverse effects or dehydration occur