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New Guidelines on GLP-1 Drugs for Obesity Released | MedPage Today

Absolute contraindications (provider cannot prescribe): Personal history of medullary thyroid carcinoma (MTC) Family history of MTC or multiple endocrine neoplasia syndrome type 2 (MEN2) Current pregnancy or breastfeeding Known hypersensitivity to tirzepatide Relative contraindications (provider may prescribe with caution and monitoring): History of pancreatitis (increased risk of recurrence, though causality is debated) Severe gastroparesis (tirzepatide slows gastric emptying further) Diabetic retinopathy (rapid glucose lowering can worsen retinopathy in the short term) Chronic kidney disease stage 4-5 (limited safety data, dose adjustment may be needed) History of gallbladder disease (rapid weight loss increases gallstone risk) Active eating disorder (medication-induced appetite suppression can worsen disordered eating) Required baseline labs: A1C (to assess diabetes status) Comprehensive metabolic panel (kidney function, liver function, electrolytes) Lipid panel (baseline cardiovascular risk) TSH (thyroid function) Some providers also order: Lipase (baseline pancreatic enzyme level) Pregnancy test (for women of childbearing age) Calcitonin (controversial

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