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The lack of ATP collapses the vesicular proton gradient, forcing stored catecholamines to leak out of the vesicles and flood the axoplasm/cytoplasm of the nerve terminal (Silver et al., 2001)
Important safety considerations include a boxed warning for medullary thyroid carcinoma risk (contraindicated in patients with personal/family history of MTC or Multiple Endocrine Neoplasia syndrome type 2), and warnings regarding pancreatitis, gallbladder disease, and hypoglycemia risk when used with insulin or sulfonylureas
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Mounjaro users may face added hypoglycemia risk when combined with other diabetes drugs
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