Safety Alerts: Weight Loss Injections including semaglutide (Wegovy or Ozempic) or tirzepatide (Mounjaro); pregnancy, contraceptive pill and HRT
You have been signposted to this webpage as you have been flagged up as a patient who is using injectable weight loss medication, in combination with either the contraceptive pill and / or oral progestogens for endometrial protection for HRT, OR you are a female aged under 55.
If you are no longer taking weight loss medications, this advice is not needed.
For those using injectable weight loss medication, please consider the following advice and submit an online consultation request to discuss with a clinician and to make changes.
Weight loss injections and Pregnancy
There is not enough safety data to know whether taking a GLP-1 medicine can cause harm to the baby. For this reason do not take weight loss injections, GLP-1 medicines if you are pregnant, trying to get pregnant or breastfeeding. If you get pregnant while using them, speak to a healthcare professional and stop them as soon as possible.
Weight Loss Injections and the Pill
Weight loss injection can stop the oral contraceptive pill from working correctly, which could put you at risk of unwanted pregnancy.
All women under age 55 should use contraception when using injectable weight loss medication.
Those taking Tirzepatide (Mounjaro) should switch to a non-oral method e.g. an implant or a coil, or add-in condoms for four weeks after initiation and four weeks after each dose increase, to prevent unwanted pregnancy.
Those using oral contraception who experience vomiting or severe diarrhoea as a side-effect should follow the missed pills guidance in the pill packet.
If you are using weight loss injections and the oral contraceptive pill and have concerns, please submit an online consultation request for advice from a clinician.
Weight loss injections and HRT.
Women with a BMI >30 should be using oestrogen via the skin e.g. patch, gel or spray. If you are not using oestrogen via this method, you are at increased risk of blood clots. Please contact the surgery to arrange an HRT review.
Weight loss injections delay gastric emptying and may therefore reduce absorption of oral progestogens. Transdermal (patch, gel or spray) or vaginal routes are unlikely to be affected.
Women should be advised to switch to a non-oral progestogen (combined patch or levonorgestrel intrauterine device (Mirena coil)) which would be preferable while the injectable weight loss medications are being used.
Mirena coil fitting can be carried out for women at the practice and this would be the recommended guidance to women in this situation. Please contact the surgery to be added to the waiting list.
If you do not wish to switch to a Mirena coil or a patch, please remain on your oral progestogen but arrange a consultation to increase the dose. Please be aware that there is uncertainty as to what the correct dose increase might be and whether increasing the dose is enough to ensure safety.
All of these points should have been discussed with you by your private provider prior to commencing an injectable weight loss medication and at every dose change. Should you need further assistance, please contact the surgery.