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Specific monitoring considerations include: Visual symptoms : Report any new or worsening visual changes, particularly if you have pre-existing diabetic retinopathy Hydration status : Be vigilant about maintaining fluid intake if experiencing gastrointestinal side effects INR monitoring : If you take warfarin, more frequent INR checks may be advisable when starting or stopping milk thistle Contraception effectiveness : Remember that additional contraception is needed for 4 weeks after starting Mounjaro and after each dose increase if using oral contraceptives Patients should be aware of when to seek medical advice