If you could become pregnant, taking a GLP-1 medicine for weight raises practical questions. When should you stop if you’re planning a pregnancy? What if you get pregnant while taking one? Does your birth control still work? Can you breastfeed?
This article sums up what the current FDA labels say, what studies in people show so far, and what is still unknown [1, 2, 3, 4]. For background on the medicines themselves, see GLP-1 medicines for weight: how they work.
Key points
- The labels say weight loss offers no benefit during pregnancy and may harm the fetus, and that the medicine should be stopped when a pregnancy is recognized [1, 2, 3, 4].
- The label for semaglutide (Wegovy) says to stop at least 2 months before a planned pregnancy [1].
- Tirzepatide (Zepbound, Mounjaro) and orforglipron (Foundayo) may make birth control pills less effective, so their labels advise a non-oral method or a backup method for a time after starting and after each dose increase [2, 4, 5].
- Advice on breastfeeding differs by medicine [1, 2, 3, 4].
What the labels say about pregnancy
The labels for all four weight medicines say weight loss offers no benefit to a pregnant person and may harm the fetus, and that the medicine should be stopped once a pregnancy is recognized [1, 2, 3, 4]. They also note that some weight gain is recommended during pregnancy, even for people who start pregnancy with overweight or obesity [1, 2, 3, 4]. For a pregnancy with one baby, CDC recommends gaining 15 to 25 pounds if your BMI (a measure calculated from weight and height) was 25 to 29.9 before pregnancy, and 11 to 20 pounds if it was 30 to 39.9 [6].
| Medicine | If you’re planning a pregnancy | If you become pregnant |
|---|---|---|
| Semaglutide (Wegovy shots or tablets) | Stop at least 2 months before you plan to get pregnant. At the usual maintenance doses, semaglutide stays in the blood for about 5 to 7 weeks after the last dose [1]. | Stop and tell your clinician* [1]. |
| Tirzepatide (Zepbound) | The label doesn’t give a set time. Ask your clinician [2]. | Stop and tell your clinician [2]. |
| Liraglutide (Saxenda) | The label doesn’t give a set time. Ask your clinician [3]. | Stop and tell your clinician [3]. |
| Orforglipron (Foundayo) | The label doesn’t give a set time. It advises using effective birth control during treatment [4]. | Stop and tell your clinician [4]. |
*For people using Wegovy shots to treat the liver disease MASH, the label says to use it in pregnancy only if the possible benefit justifies the possible risk to the fetus [1].
Why the labels are cautious
In animal studies, semaglutide, tirzepatide and liraglutide were linked to birth defects, pregnancy loss or slower growth of the fetus at exposures similar to those in people. For semaglutide and tirzepatide, these effects happened along with weight loss or eating less in the mother animals [1, 2, 3]. Orforglipron doesn’t act on GLP-1 receptors in rats or rabbits, species in which other GLP-1 medicines have been linked to birth defects. Based on animal studies, its label still says there may be risks to the fetus [4].
In people, there isn’t enough information to know whether these medicines raise the risk of birth defects, miscarriage or other problems [1, 2, 4]. For context, among recognized pregnancies in the U.S. general population, the background risk of a major birth defect is 2% to 4%, and the risk of miscarriage is 15% to 20% [1, 2, 3, 4].
What studies in people show so far
Two recent studies give some information. Both were observational, meaning researchers analyzed existing health records instead of assigning treatments at random, so other differences between groups could affect the results [7, 8].
- A 2024 study used records from four Nordic countries, the U.S. and Israel on babies of people with type 2 diabetes. It compared babies whose mothers filled a GLP-1 prescription between 90 days before pregnancy and the end of the first trimester with babies whose mothers filled an insulin prescription in that window. Major birth defects were found in 8.3% and 7.8% of these babies, respectively. The authors called the results reassuring, with no sign of a large increase in risk, but said some estimates were imprecise and confirmation is needed [7].
- A 2026 U.S. study looked at 3,572 pregnancies in people who filled a GLP-1 prescription in the 90 days before their last menstrual period. It compared those who kept filling it into the first trimester with those who didn’t. Pregnancies not ending in a live birth, birth defects, and babies who were small or large for their stage of pregnancy were not clearly more common with continuing. But the estimates for birth defects and small babies were imprecise and fit with either no added risk or a meaningful one [8].
Neither study can rule out a risk, and the labels still say to stop the medicine once you know you’re pregnant [1, 2, 3, 4, 7, 8].
If you become pregnant while taking one
Stop the medicine and contact your clinician to plan next steps [1, 2, 3, 4]. Some labels list pregnancy registries, which collect information about the health of people who took the medicine during pregnancy and their babies [1, 2, 4]. You or your clinician can contact:
- Wegovy: 1-877-390-2760 [1]
- Zepbound: 1-844-524-0039 [2]
- Foundayo: 1-800-545-5979 (the label says a registry is planned) [4]
The Saxenda label doesn’t list a registry [3].
Birth control while taking a GLP-1
Tirzepatide and orforglipron can affect birth control pills
Tirzepatide (Zepbound, Mounjaro) and orforglipron (Foundayo) slow stomach emptying, and their labels say they may make hormonal birth control pills less effective [2, 4, 5]. In one study, a single 5 mg dose of tirzepatide lowered peak blood levels of the hormones in a combination pill by 55% to 66%, and overall levels by 20% to 23% [2]. Orforglipron hasn’t been tested with birth control pills in a clinical trial, but its label gives similar advice [4].
If you take birth control pills, these labels advise switching to a method that isn’t taken by mouth, or adding a barrier method such as condoms [2, 4, 9]:
- Tirzepatide: for 4 weeks after starting and for 4 weeks after each dose increase [2, 5]
- Orforglipron: for 30 days after starting and for 30 days after each dose increase [4]
According to the labels, hormonal birth control that isn’t taken by mouth should not be affected [2, 4]. Examples include the patch, ring, shot, implant and hormonal IUD [9]. The Foundayo label also advises using effective birth control throughout treatment [4].
Semaglutide and liraglutide
The Wegovy and Saxenda labels don’t include this switch-or-backup advice. In studies of semaglutide tablets, semaglutide didn’t change levels of two common pill hormones, ethinyl estradiol and levonorgestrel, in a clinically meaningful way [1]. In a study using liraglutide 1.8 mg a day, which slows stomach emptying about as much as Saxenda’s 3 mg dose, peak levels of these hormones were 12% to 13% lower, while overall exposure was unchanged for ethinyl estradiol and 18% higher for levonorgestrel [3].
Vomiting and diarrhea
Nausea, vomiting and diarrhea are among the most common side effects of GLP-1 medicines [1, 2, 3, 4]. CDC guidance says vomiting or severe diarrhea could, in theory, make birth control pills less effective, and it gives specific steps to follow [9]. If this happens, ask your clinician or pharmacist whether you need backup protection. See GLP-1 side effects.
Planning a pregnancy
If you might want to get pregnant, tell your clinician early, ideally before you start or as soon as your plans change [1, 2, 4]. Then you can plan together when to stop and how to protect your health afterward. People who stop weight-management medicines are likely to regain some weight, and healthy eating and physical activity may help limit regain [10]. See stopping a GLP-1 and eating well on a GLP-1.
Breastfeeding
Advice differs by medicine [1, 2, 3, 4]:
| Medicine | What the label says |
|---|---|
| Wegovy tablets | Breastfeeding is not recommended. In a study, semaglutide in breast milk was too low to measure, but an ingredient that helps the tablet get absorbed (called SNAC) does pass into milk and could build up in babies [1]. |
| Wegovy shots | There are no data on whether semaglutide shots get into breast milk or affect the baby or milk supply. The label says to weigh the benefits of breastfeeding against your need for the medicine and any possible risks [1]. |
| Zepbound | In a small study of 11 women after one 5 mg dose, tirzepatide was usually undetectable in breast milk, and the total amount found was less than 0.02% of the dose. There are no data on effects on the baby or on milk supply [2]. |
| Saxenda | There are no data in people. Liraglutide was found in the milk of rats [3]. |
| Foundayo | Not recommended while breastfeeding [4]. |
Talk with your clinician about the best way to feed your baby [1, 2, 4].
When to get medical care
- Call 911 for trouble breathing, chest pain, or swelling of your face, lips, tongue or throat [1, 11, 12].
- If you’re pregnant, CDC says to get medical care right away for urgent warning signs. These include severe nausea and vomiting (such as not being able to keep fluids down), belly pain that is severe or won’t go away, vaginal bleeding or fluid leaking, a fever of 100.4°F or higher, a headache that won’t go away or gets worse, and thoughts of harming yourself or your baby [13]. For thoughts of suicide, you can also call or text 988 [14].
- Call your clinician soon if you think you could be pregnant while taking a GLP-1 medicine, or if you’ve had vomiting or diarrhea while relying on birth control pills [1, 2, 9].
The bottom line
GLP-1 medicines for weight aren’t meant for use during pregnancy: the labels say to stop when a pregnancy is recognized, and the Wegovy label says to stop at least 2 months before a planned pregnancy [1, 2, 3, 4]. Studies in people so far haven’t shown a large increase in birth defects, but they’re limited and can’t rule out risks [7, 8]. If you take tirzepatide (Zepbound or Mounjaro) or orforglipron (Foundayo) with birth control pills, the labels advise a non-oral method or a barrier backup after starting and after each dose increase [2, 4, 5]. If you’re planning a pregnancy or breastfeeding, talk with your clinician about timing and options.
References
- Novo Nordisk. WEGOVY (semaglutide) injection, for subcutaneous use; WEGOVY (semaglutide) tablets, for oral use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective June 18, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ee06186f-2aa3-4990-a760-757579d8f77b
- Eli Lilly and Company. ZEPBOUND (tirzepatide) injection, for subcutaneous use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective August 28, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=487cd7e7-434c-4925-99fa-aa80b1cc776b
- Novo Nordisk. SAXENDA (liraglutide) injection, for subcutaneous use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective February 25, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3946d389-0926-4f77-a708-0acb8153b143
- Eli Lilly and Company. FOUNDAYO (orforglipron) tablets, for oral use: prescribing information and Medication Guide. DailyMed, U.S. National Library of Medicine. Label effective July 29, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8ac446c5-feba-474f-a103-23facb9b5c62
- Eli Lilly and Company. MOUNJARO (tirzepatide) injection, for subcutaneous use: prescribing information. DailyMed, U.S. National Library of Medicine. Label effective August 27, 2026. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d2d7da5d-ad07-4228-955f-cf7e355c8cc0
- Centers for Disease Control and Prevention. Weight Gain During Pregnancy. CDC. 2024. https://www.cdc.gov/maternal-infant-health/pregnancy-weight/index.html
- Cesta CE, et al. Safety of GLP-1 Receptor Agonists and Other Second-Line Antidiabetics in Early Pregnancy. JAMA Internal Medicine. 2024. https://pubmed.ncbi.nlm.nih.gov/38079178/
- Brown JP, et al. Continuing Glucagon-Like Peptide-1 Receptor Agonists Into the First Trimester of Pregnancy and Pregnancy Outcomes: A Target Trial Emulation Study Using Claims Information. Annals of Internal Medicine. 2026. https://pubmed.ncbi.nlm.nih.gov/42258827/
- Curtis KM, et al. U.S. Selected Practice Recommendations for Contraceptive Use, 2024. MMWR Recommendations and Reports. 2024. https://www.cdc.gov/mmwr/volumes/73/rr/rr7303a1.htm
- National Institute of Diabetes and Digestive and Kidney Diseases. Prescription Medications to Treat Overweight & Obesity. NIDDK, National Institutes of Health. 2024. https://www.niddk.nih.gov/health-information/weight-management/prescription-medications-treat-overweight-obesity
- MedlinePlus. Anaphylaxis. MedlinePlus, U.S. National Library of Medicine. 2025. https://medlineplus.gov/anaphylaxis.html
- Centers for Disease Control and Prevention. About Heart Attack Symptoms, Risk, and Recovery. CDC. 2024. https://www.cdc.gov/heart-disease/about/heart-attack.html
- Centers for Disease Control and Prevention. Urgent Maternal Warning Signs and Symptoms. CDC. 2024. https://www.cdc.gov/hearher/maternal-warning-signs/index.html
- U.S. Food and Drug Administration. FDA Requests Removal of Suicidal Behavior and Ideation Warning from Glucagon-Like Peptide-1 Receptor Agonist (GLP-1 RA) Medications. FDA Drug Safety Communication. 2026. https://www.fda.gov/drugs/drug-safety-communications/fda-requests-removal-suicidal-behavior-and-ideation-warning-glucagon-peptide-1-receptor-agonist-glp
This article is for education only and isn’t a substitute for advice from your own clinician.