Who Cannot Take Tirzepatide: Contraindications and Key Cautions

Step 1: Absolute contraindications that rule tirzepatide out entirely

Some conditions place tirzepatide completely off the table, regardless of BMI or how strong the case for weight management might otherwise be. The most significant is a personal or family history of medullary thyroid carcinoma (MTC). Rodent studies raised a signal for thyroid C-cell tumours, and although it has not been confirmed in humans, the precautionary position in the UK licence is clear: tirzepatide is contraindicated if you or a close blood relative have had this cancer. The same applies to Multiple Endocrine Neoplasia type 2 (MEN2), a hereditary condition that carries a high risk of MTC.

Being pregnant, trying to conceive, or breastfeeding also places tirzepatide firmly off the treatment list. Animal reproduction studies have shown adverse effects, and there is no adequate human safety data. The MHRA advises using effective contraception while on GLP-1 medicines and for a wash-out period before attempting to conceive. If you fall pregnant during treatment, you should stop the medicine and contact your prescriber straightaway. You can read further detail on this in our guide to whether tirzepatide is right for you.

Tirzepatide is not licensed for anyone under 18. The clinical trials that underpin the UK licence were conducted in adults, so there is simply no evidence base to draw on for younger patients, and a prescriber cannot lawfully prescribe it for this age group on a weight-management basis.

Step 2: Serious conditions that make tirzepatide unsuitable or require very careful weighing up

Beyond the hard contraindications, a number of medical histories call for close scrutiny before a prescriber can reach a decision. Pancreatitis sits at the top of this list. On 29 January 2026, the MHRA issued a Drug Safety Update for GLP-1 medicines, confirming that acute pancreatitis is a known, if infrequent, risk and can be serious: the MHRA Drug Safety Update advises healthcare professionals and patients to be alert to severe, persistent stomach pain that may travel through to the back, with or without vomiting, as a warning sign requiring urgent medical attention. If you have a history of pancreatitis, your prescriber will want to understand the cause and severity before considering whether tirzepatide is appropriate.

Severe gastrointestinal disease, including conditions that significantly affect gastric motility, may also make tirzepatide unsuitable. The medicine slows gastric emptying as part of its mechanism, which can worsen symptoms in people who already have gastroparesis or related disorders. Serious liver or kidney disease may require additional caution, and your prescriber will review any relevant results before proceeding.

Severe allergic reaction to tirzepatide or to any of its inactive ingredients is a contraindication. If you have had a documented allergic response to another GLP-1 medicine, tell your prescriber at the outset; it does not automatically mean tirzepatide cannot be used, but it shapes the clinical conversation considerably. For a thorough look at the contraindications specific to the Mounjaro brand, our Mounjaro-specific contraindications page goes into further detail.

Step 3: Situations that require discussion, not automatic exclusion

A number of circumstances call for an honest conversation with a prescriber rather than an outright no. Diabetic retinopathy is one: rapid glucose-lowering in people with type 2 diabetes and existing retinopathy has, in trials of other GLP-1 medicines, been associated with worsening of eye complications. Your prescriber will want to know your retinopathy status if diabetes is part of your picture.

Kidney function matters too. Tirzepatide itself does not directly damage the kidneys, but severe dehydration from vomiting or diarrhoea in the early weeks of treatment can put strain on them. People with moderate or severe renal impairment are monitored more carefully, and significant renal impairment may affect whether the medicine is appropriate at all.

Mental health history is another area the consultation will touch on. People who have experienced suicidal ideation or self-harm are monitored carefully during GLP-1 treatment. This is not a blanket exclusion, but it does mean your prescriber needs the full picture. If you have a history of disordered eating, or are currently struggling, that matters too and is worth raising openly, alongside reaching out to a service such as Beat, which supports people with eating disorders.

One practical situation worth knowing about: oral contraceptive users need an extra contraceptive method, such as condoms, for the first four weeks of tirzepatide treatment and for four weeks after every dose increase. This is because tirzepatide's effect on gastric emptying may reduce how much of the pill is absorbed. There is no equivalent evidence for this with injectable semaglutide, so the advice is specific to tirzepatide. NHS England's guidance on weight-management injections covers this point, as does our team's work during the consultation review. Similarly, if you take HRT, a conversation about switching to a transdermal form, such as a patch or gel, is worth having with your GP before starting.

Step 4: What the consultation at nume actually checks

Every consultation submitted to our pharmacy is read by a GPhC-registered Independent Prescriber, not software. They review your health history, current medications, and eligibility in full before any decision is made. Photo ID is checked, and weight is verified on video: the process exists precisely because suitability cannot be assessed from a BMI number alone.

If you are transferring from another provider or requesting a dose increase, evidence of your current treatment is required before our prescribers will proceed. That is a safety measure, not a bureaucratic one. People sometimes ask whether the 12pm weekday order cut-off affects them if they need a quick turnaround; the same-day clinical review happens Monday to Friday for consultations received in time, with dispatch that afternoon once approved and delivery the next working day by DPD. If your injection day falls awkwardly around that schedule, our guidance on whether you can take tirzepatide a day early and our separate page on whether taking tirzepatide two days early is safe explain what the evidence says about adjusting your timing.

If you are unsure whether something in your history might be relevant, it is always better to raise it. The consultation is confidential and the prescriber's job is to find a safe path forward, not to gatekeep unnecessarily. You can explore what tirzepatide treatment involves through our Mounjaro overview page, and our guide to BMI eligibility for Mounjaro sets out the full threshold picture. For a broader look at the weight-loss options we offer, our treatment overview is a good starting point.