Guide
Why GLP-1s are contraindicated, washout periods, and what providers recommend.
GLP-1 receptor agonists are not recommended during pregnancy. This guide covers the regulatory framing, the data we have, and how to handle pregnancy planning, accidental conception, and the post-pregnancy return to therapy.
Wegovy, Zepbound, Ozempic, and Mounjaro all carry FDA Pregnancy Category labeling that recommends discontinuation. The labels recommend stopping at least 2 months before a planned pregnancy. There are no controlled trials in pregnant humans, and animal studies have shown developmental adverse effects at exposures relevant to human dosing.
Stop your GLP-1 at least 2 months before active conception attempts. This window allows the medication to clear (semaglutide half-life is ~7 days, so 5 half-lives equals ~5 weeks; tirzepatide is similar) and gives time to re-establish a stable nutritional baseline. Discuss with your prescribing clinician and your OB-GYN.
Stop the medication immediately and contact both your prescribing clinician and your OB-GYN. Do not panic. Early-pregnancy GLP-1 exposure data does not show a clear teratogenic signal in available registries, but the recommendation is to stop. Your OB will guide pregnancy monitoring.
GLP-1s are also not recommended during breastfeeding. Whether semaglutide and tirzepatide pass into breast milk in clinically meaningful amounts is not well characterized. Most clinicians wait until breastfeeding has concluded before restarting.
Some weight regain during the off-medication window is common. This is normal. The priority during pregnancy is healthy fetal development, adequate maternal nutrition, and appropriate gestational weight gain. Postpartum, the window before restarting therapy depends on breastfeeding plans and your clinician's guidance.
Once breastfeeding has concluded, GLP-1 therapy can be restarted. Most patients restart at the same dose they were on previously, though some clinicians prefer a brief re-titration to minimize GI side effects.
GLP-1s do not interfere with hormonal contraception efficacy. However, the slowed gastric emptying can affect the absorption timing of oral contraceptives in theory. Patients on oral birth control should discuss with their clinician whether to add a barrier method or switch to a non-oral method during titration.
At least 2 months per the FDA labeling. Some clinicians prefer 3 months for additional safety margin.
Stop the medication and call both your prescribing clinician and your OB-GYN today.
Off-label use exists. Some clinicians use GLP-1s in the pre-conception period to improve insulin sensitivity, then discontinue before active conception. This is a clinician decision.
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Editorial note. This guide is for educational purposes only and does not constitute medical advice. Always consult a licensed clinician about your specific situation.