WWYD? - GP response to Mounjaro

[wanttoimprovemyhealth]

I have type 2 diabetes, high blood pressure and am overweight. Life has been stressful over the past few years and i have let my health slide (all my fault- focusing on other things). I know I need to get a grip.

Since January I have been watching what I eat and am trying to sort out my medication. I am also interested in trying Mounjaro, paying privately (I can't afford to take time off work to attend lots of NHS appointments). As a diabetic I thought I should check with my GP first. Have been trying to get an appointment for weeks- finally got one today and she said she doesn't know anything about Mounjaro, the side effects and as such said I should not try it. She said she would normally advise me to speak to the pharmacist to find out about counter indications etc but they are on maternity leave.

I feel quite deflated my her response. I have read lots of reviews and it seems that it could potentially be very beneficial for someone in my circumstances. Unfortunately there are no other GPs available to speak to in the practice for another opinion and she also runs the other local NHS practice. Just not sure where to go from here. Wondered if anyone else had experienced anything similar with their GP and what they did? Thank you.

Sadly this is the case for many GP’s. It is an amazing medication and anyone who is educated will tell you to go for it.

word of warning though - it is expensive and you will be paying it for a long time - possibly forever.

I get mine from medexpress and they are very good on listing what meds you can be on and what is not advisable .

@Queenofthejabs

And again, the gp is duty bound to discuss medication a patient is taking with them when it impacts on health conditions such as diabetes.

OP went in to the GP to discuss it with the intention of getting a private prescription. GPs do not do consultations for people looking to get private meds. Neither they should. Now if OP had approached the GP and asked about it through the NHS I would fully expect the GP to discuss/refer or whatever but OP had no intention of attending appointments and wanted to get it private from the get go.

There is a lot of misinformation about being T2 and taking one of these GLP1’s. They are not prescribing it to diabetics for weight loss they would prescribe it to manage your blood sugars if other medication was not working for you. It’s not a diabetic weight loss drug it’s not licensed for that. It has 2 uses, one is for management of diabetes (and weight loss might be one of the side effects) and then weight loss - and the weight loss licensing is not expected to be dealt with by GP’s. You need to speak to a prescriber (of the drug who is responsible for the decision) about your current meds and if you qualify for it as the GP isn’t prescribing it and isn’t responsible for it. They are not ‘duty bound’ to talk about this med with you as it’s not being prescribed for the diabetes management, you want to lose weight so going to obtain it privately. The prescribing guidelines are all laid out with the companies who provide the medication so I don’t see why anyone needs the Gp’s opinion about whether to start taking it - you will either be eligible or you will not, and you may or may not have side effects.

My doctor suggestede the drug beginning with O. I took it for about three months and never got it again! I had no problems with it but obviously the supply goes to people with a few 1lbs to lose!

That's crazy as my friend's been prescribed it to.help.with her diabetes!

Out of interest @wanttoimprovemyhealth how often do you check your blood sugars , how often is your Hba1c checked ? How often do you check your blood pressure ? Do you have the means to do this at home ?
I ask because if you lose a substantial amount of weight , which is your aim, then the chances are all of those are going to reduce and you are going to need to be able to provide that information to the GP so they can adjust your medications accordingly ?

My doctor wouldn’t prescribe it as I’m not type 2 so I went privately with a local pharmacy and they have been great so far, he recommended Mounjaro and I’ve had very little side effects and have lost almost 2 stone since early December. Good luck 😊

I went to MedExpress. I had to answer loads of health/medical questions and also send them a pic to see whether I was a suitable candidate for Mounjaro.

The op did not go in wanting a consultation for a private medication. She went in to ask about the impact on her diabetes and how that would work with those meds. This is what the gp is supposed to manage.

I had exactly the same from my GP. He didn't know anything about it and said it probably wasn't safe because a nurse had died taking it.
I laughed at this exchange because I just couldn't believe this conversation had taken place.
I went on to educate myself, did all the research online and bought it privately.
I've been on it for two months and have lost 2 stone.

@Queenofthejabs

The op did not go in wanting a consultation for a private medication. She went in to ask about the impact on her diabetes and how that would work with those meds. This is what the gp is supposed to manage.

GPs do not manage medication prescribed privately though, that's what the private provider does.

You could pay for a one off appt with a private diabetes specialist for advice.

I would be really interested to know if those of you taking it privately also have T2? I ask because i, like the OP, am T2 and am seriously struggling to lose weight to keep it under control (I'm also on metformin). I want to try an injectable and would be willing to pay privately. However, Boots, who a few people on this thread have recommended, refused to give it to me. They said that as I already have T2 my GP should prescribe it. I have been so upset by this as, as far as I know, I can't get it so simply from my GP either. I feel I can't get it anywhere now, even if willing to pay. So where are T2s getting it from, privately??

OP can still ask for medical advice from a GP.

No mounjaro is a known drug in the industry and the op can pay privately and still ask the gp to provide advice as the gp will have the ops full medical history, there are many occasions you are told to check with your gp before you go ahead with someting privately. If it was some real random drug no ones ever heard of I would understand but it's not.

I'm not in the UK so the system is different here but I have quite problematic T2 diabetes and my endocrinologist prescribed Ozempic and it has been helpful. I'm not sure how it works in the UK but some chronic conditions are covered by a drugs scheme here even if they are private prescriptions and diabetes is covered under that. I would be prepared to pay privately though as it has really helped, I have lost a good bit of weight although have another 5kg or so until I'm in the normal range BMI and that last bit is very slow.

I have a continuous glucose monitor, which I do have to pay for as it's only free for T1. I find it immensely useful and it might be something for you to consider for a few months if you start on Mounjaro so that you can see your glucose patterns and which foods affect it the most. I take a slow release insulin (also Metformin, Diamicron, Ramipril and Atorvastatin) so before I had a cgm I was finger-pricking at least four times a day and the cgm is both less annoying than finger-pricking and gives a clearer overall picture of what's going on through the day. I use a Freestyle Libre and it costs me €65 for a fortnight.

I would also recommend getting a home blood pressure monitor if you're worried that you might need to change the Ramipril dosage, although it shouldn't be too sudden a change and you can always go and see your gp if you're starting to feel signs of lower blood pressure like feeling dizzy if standing up quickly.

Your GP wouldn’t be able to give much information, mine is useless when it comes to my diabetes, you need to speak to a diabetic nurse.

It’s very hard to get on the NHS (ask me how I know, and it’s a long process, they like to try all the cheap options first)

If you are paying privately you need to speak to the prescribing specialist, they will be able to advise you.

I’m baffled at the amount of people who are suggesting this is none of the GP’s business and the OP should not be bothering them. If that’s the case why do the private prescribers bother informing your GP that you have been prescribed? Perhaps because the medication potentially impacts your pre existing conditions or interacts with your current prescriptions? Which surely makes informing your GP and discussing it with them before you start if you have long standing medical conditions particularly reasonable - and makes the GP response fairly unacceptable.

I'm quite baffled at the amount of people that have no understanding of private medicine tbh. It's not just weight loss injections this applies to, if you are seeing a private specialist and they prescribe you meds the GP doesn't take any involvement in that either. It's standard. Having everyone in your medical record is normal, I have had private rheumatologists, psychiatrists and respiratory consultants all notify my GP, it's not as people seem to suggest so the GP can work out of any medication interacts with your new prescription- that's done at source by the private consultation. They should know you are taking it for future appointments, particularly for those who slip into ED territory, but they are not sent the details to 'check'

My GP prescribed Victoza for me years ago for T2 diabetes. All went well until everyone wanted yo take semeglutide for obesity and Victoza went out of production. My GP offered me Ozempic, Mounjaro and any of the others so it is perfectly OK for a GP to prescribe them. I was tired of injecting so started semeglutide pills before Christmas along with metformin. So far so good. Perhaps ask for them....sold as Rybelus. Much cheaper and specifically for T2.

She didn’t ask them to manage it, I am not sure why you’re fighting this, a diabetic patient is absolutely able to ask a gp on how this will impact their diabetes and the gp is duty bound to respond. The answer of I don’t know so don’t take it is unacceptable,

it isn’t a race to the bottom on just how shit a gp can be.

Some of the misinformation on here is dire...

Op, I am in a similar position, high blood pressure that's medicated and overweight

I went to my GP who said that she wasn't sure about the weight loss medication but that thr NHS had commissioned a weight loss management programme that in my area ar least is ran by a company called Oviva. They looked into it and raised a referral for me. This will involve weight loss jabs, but also the wrap around services for the psychological side of things as well. There is a bit of a waiting list but once I'd had the referral, (blood test and current bmi) everything else is done virtually so no time off work needed. There is an app for logging moods, eating etc
I'm at the start of things, have initial consultation early March, but happy to share actual and lived experience.

https://www.chemistanddruggist.co.uk/news/regulation/new-online-pharmacy-regs-effective-immediately-amid-weight-loss-risks-TSE3SX3QUZFYBNYLZJFNTGK6LM/

Strange that the new regs are actually including checking with GP before prescribing, as one of the safety features then 🤔

Strange that the new regs are actually including checking with GP before prescribing, as one of the safety features then 🤔

It does not say they will check with the GP, it says they may verify the information given with the GP.