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This means there is a real risk of reduced pill effectiveness, especially during: The first four weeks after starting Mounjaro The first four weeks after any dose increase Guideline advice: Use backup contraception, such as condoms, or switch to non-oral methods like: Intrauterine devices (IUDs) Contraceptive implants Vaginal rings Contraceptive injections Patches Failing to use additional protection during these periods may increase the risk of unplanned pregnancy