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2012;30 Suppl 2(02):S217229

Its safe on propranolol with the usual caveats: Start with bodyweight exercises like squats, wall push-ups, and seated rows Avoid holding your breath during heavy lifts, as this can cause sharp spikes in blood pressure Build up gradually over weeks rather than days If you feel lightheaded between sets, sit down and let your blood pressure recover before continuing When to speak to your GP Contact your GP, prescriber, or specialist team if you experience: Dizziness or lightheadedness when standing up, particularly during the first month of Mounjaro or after a dose increase A resting heart rate consistently below 55 bpm, or unusual shortness of breath at rest Symptoms of low blood sugar that you cant easily identify (confusion, sweating without an obvious cause, unusual hunger), particularly if you also take insulin or a sulphonylurea A worsening of migraine frequency or anxiety symptoms during Mounjaro dose escalation Significant or rapid weight loss without expected reductions in blood pressure, which may mean your propranolol dose now needs adjusting Cold hands or feet, sleep disturbance, or low mood that started or worsened after combining the medications If you experience chest pain, severe shortness of breath, fainting, or signs of a slow or irregular heart rhythm, call 111 for urgent advice or 999 if symptoms are severe

The MAPK pathway influences cell proliferation and differentiation