Semaglutide (sold under the trade names Ozempic, Wegovy, and Rybelsus) is a glucagon-like peptide-1 (GLP-1) receptor agonist used for treating type 2 diabetes and weight loss. The weight loss medications within this class have gained popularity with individuals who wish to treat obesity or improve blood glucose control.
However, semaglutide and other GLP-1 medications are not recommended during pregnancy since their usage might cause birth defects, pregnancy complications, and hormonal imbalance. If you’re pregnant, planning pregnancy, or breastfeeding, it is crucial to understand when to stop taking semaglutide, how it could affect early pregnancy, and how it could affect the production of breast milk.
This article provides evidence-based guidance concerning the FDA guidelines, animal data, and clinical trials when using semaglutide during pregnancy.
Semaglutide is not recommended during pregnancy due to potential risks, including birth defects and pregnancy complications.
Discontinue semaglutide at least two months before conception to allow the medication to clear from the body.
Breastfeeding mothers should avoid GLP-1 medications like semaglutide due to potential effects on breast milk and infant health.
Alternative weight management strategies such as lifestyle changes, non-GLP-1 medications, and safe diabetes treatments should be considered during pregnancy.
Can Pregnant Women Take Semaglutide?
Semaglutide and other GLP-1 receptor agonists are class C drugs under the Food and Drug Administration (FDA). This is because animal studies have shown major birth defects and fetal abnormalities, but there is not sufficient data available from humans to determine the extent of the risk.
Key Concerns
Animal Studies Indicate Fetal Risks
Animal studies, as listed in the FDA’s prescribing information, have led to birth defects of major types, fetal loss, and reduced birth weight upon exposure to semaglutide.
Although human data is limited, these results cause concern regarding fetal developmental abnormalities.
Effects on Blood Sugar and Metabolic Changes
Semaglutide impacts blood sugar levels and may, therefore, affect fetal glucose supply.
Unstable blood glucose levels during pregnancy have been associated with pregnancy complications and poor fetal growth.
Effects on Blood Sugar and Metabolic Changes
Semaglutide affects blood sugar levels and insulin resistance, which may impact fetal glucose supply.
Unstable glucose levels in pregnancy are associated with pregnancy complications and poor fetal growth.
For these reasons, healthcare providers strongly advise stopping semaglutide before pregnancy to ensure a safer environment for the developing fetus.
When to Stop Semaglutide Before Pregnancy?
Novo Nordisk, the manufacturer of Ozempic, recommends stopping semaglutide at least two monthsbefore conception to allow the medication to clear completely from the body.
Since GLP-1 receptor agonists have a long half-life, traces of the drug may remain in your body for weeks after discontinuation.
For Women Using Semaglutide for PCOS or Weight Loss
Women with PCOS (polycystic ovary syndrome) who take semaglutide for weight loss or insulin resistance should consult a healthcare provider about alternative treatment options before planning pregnancy.
For Women on Semaglutide for Type 2 Diabetes
Women using semaglutide for blood sugar control should transition to a pregnancy-safe diabetes medication like insulin or metformin under the guidance of an endocrinologist or healthcare professional.
By stopping semaglutide or other GLP-1 drugs before pregnancy, women can reduce the risks of birth defects, pregnancy loss, and metabolic complications.
What If You Accidentally Took Semaglutide While Pregnant?
Many women may not realize they are pregnant in the first few weeks and may have unknowingly continued taking Ozempic, Wegovy, or Mounjaro. If this happens:
Stop taking semaglutide immediately and inform your healthcare provider.
Your doctor may recommend prenatal screenings to check for any fetal abnormalities.
Monitor blood sugar levels closely, as stopping GLP-1 drugs may lead to fluctuations in glucose levels.
There is limited human research on the effects of "Ozempic babies"—a term used to describe infants exposed to GLP-1 receptor agonists during pregnancy. However, since animal studies have shown major birth defects, it is always best to err on the side of caution.
Semaglutide and Breastfeeding: Is It Safe?
The FDA and healthcare providers recommend avoiding semaglutide, tirzepatide (Mounjaro, Zepbound), and other GLP-1 receptor agonists while breastfeeding due to unknown effects on breast milk.
Concerns About Semaglutide and Breast Milk
There are limited published clinical studies examining the transfer of GLP-1 drugs into breast milk.
Infants rely on breast milk for metabolic and hormonal balance, and exposure to GLP-1 receptor agonists could affect their growth, blood sugar levels, and digestion.
If a mother requires weight loss medication postpartum, it is best to explore alternative options under medical supervision.
Safe Alternatives for Weight Management During and After Pregnancy
For women who need weight loss support before, during, or after pregnancy, several alternatives can be considered:
Lifestyle Changes
A healthy diet and exercise plan can help safely manage body weight and BMI.
Medical nutrition therapy for women with PCOS or insulin resistance can be beneficial.
Non-GLP-1 Weight Loss Medications
Some weight loss drugs may be safer alternatives to GLP-1 RA medications for women trying to conceive.
Consult a healthcare professional before starting any weight loss medications while pregnant or breastfeeding.
Medical Supervision for Type 2 Diabetes
Women with type 2 diabetes should switch to pregnancy-safe treatments like insulin or metformin.
Regular blood sugar monitoring is essential to maintaining healthy glucose levels during pregnancy.
By working with an endocrinologist or healthcare provider, women can find safe and effective ways to achieve their weight management and blood sugar control goals during pregnancy.
Bottom Line
Semaglutide, a popular GLP-1 receptor agonist used for weight loss and type 2 diabetes management, is not recommended during pregnancy due to potential risks to fetal development, including birth defects and pregnancy complications.
If you’re pregnant, trying to conceive, or breastfeeding, it’s essential to stop semaglutide before pregnancy and consult with your healthcare provider to explore safer alternatives for weight management and blood sugar control. Always prioritize safety and follow medical advice to ensure the health of both you and your baby.
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