Is Ozempic Safe to Take While Pregnant?

Ozempic is a glucagon-like peptide-1 (GLP-1) receptor agonist containing semaglutide as the active ingredient. It is a once-weekly injectable drug that was developed to treat type 2 diabetes. It is also used to lower the risk of heart attack, stroke, or cardiovascular disease. While Ozempic is not approved for weight management, clinicians can prescribe it off-label for weight loss. On the other hand, Wegovy, which also contains semaglutide, has been approved by the U.S. Food and Drug Administration (FDA) for weight management when used in conjunction with diet and exercise. 

While Ozempic is proven to provide several health benefits, it’s probably not safe to use Ozempic during pregnancy. Continue reading to learn more about what we know about Ozempic and pregnancy.

Is Ozempic Safe to Take While Pregnant?

Since it is unknown if Ozempic is safe for expecting mothers, this medication is not recommended during pregnancy. It is pregnancy category C, meaning animal studies indicate that reduced food intake caused by GLP-1 agonist drugs can have harmful consequences, including miscarriages and birth defects in the developing baby. However, since there aren’t enough studies in humans to confirm the safety of taking Ozempic during pregnancy, researchers and healthcare providers cannot yet fully assess the exact safety concerns.

Healthcare providers recommend discontinuing semaglutide (Ozempic or Wegovy) treatment at least 2 months before a planned pregnancy. This is because semaglutide has a long half-life of 7 days, and a complete washout of the drug from the body occurs about 8-10 weeks after the last dose.

Learn about Ozempic for weight loss.

What Happens If You Get Pregnant On Ozempic?  

The current guidelines in reproductive-aged women are to discontinue Ozempic use at least 2 months before a planned pregnancy and to stop taking Ozempic immediately if an unplanned pregnancy is confirmed due to an increased risk of harm to the developing baby.

Possible Health Implications

Clinical trials and pharmacovigilance data on semaglutide use in pregnant patients are insufficient to establish its association with miscarriage, major birth defects, or adverse outcomes for the mothers or fetuses. However, animal studies on pregnant rats, rabbits, and monkeys have shown that Ozempic may lead to pregnancy loss and birth defects, with their offspring being smaller as well. 

Weight gain during pregnancy is necessary due to the growth of maternal tissues and the developing baby. Appropriate weight gain is recommended for all pregnant women, including overweight and obese women. Therefore, the weight loss associated with GLP-1 agonist medications like Ozempic and Wegovy could harm the developing baby. 

Results of Animal Studies

Currently, the available information on the effects of Ozempic during pregnancy is derived from animal studies. These studies have shown that pregnant monkeys, rats, and rabbits face an increased risk of birth defects and pregnancy loss when exposed to Ozempic. Furthermore, the offspring of these animals were found to have smaller birth weights, which is linked to various other health issues.

Although animal studies provide insights, we cannot assume the effects of Ozempic during pregnancy solely based on these findings. Therefore, it is crucial to be highly vigilant about family planning while using Ozempic (and other similar medications).

Insights From Post-Marketing Studies

An observational cohort study involving 50,000 pregnant women with type 2 diabetes found no significant increase in birth defects among those who took GLP-1 medications early in their pregnancies, specifically around the time they discovered they were pregnant.

The study included women with type 2 diabetes who filled at least one prescription for diabetes medications, including Ozempic, metformin, insulin, and others, from 90 days before pregnancy until the end of the first trimester. The mothers and their infants were monitored for up to one year after birth. Read more about metformin and pregnancy.

While these findings are encouraging, the authors note that filling prescriptions around the time of conception does not necessarily mean the medications were actually consumed, particularly if they were filled a month prior. Much more research is needed to better understand the risks associated with GLP-1 agonist medications during pregnancy.

Future Research on Ozempic in Pregnancy

More research on women’s health and pregnancy while taking semaglutide is underway. We will know more about the possible health implications on the fetus in the near future as the results of more peer-reviewed studies become available. 

The FDA asked Novo Nordisk to establish a pregnancy registry for Wegovy (which contains semaglutide at higher doses for weight loss). The goal is to better understand the effects of semaglutide on pregnant women and their unborn babies. Data from this registry are expected to come out after 2027. 

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Are There Potential Benefits of Ozempic Use During Pregnancy?

If you are on Ozempic for diabetes management, your healthcare provider may recommend continuing on the medicine for blood glucose control after carefully weighing the risks vs benefits, or they may switch you to a different anti-diabetes drug.

GLP-1 drugs like Ozempic help to control blood sugar levels in people with type 2 diabetes. Treatment with these drugs can therefore lower the maternal and fetal risks associated with poorly controlled diabetes, including the risk of:

• Pre-eclampsia

• Diabetic ketoacidosis

• Spontaneous abortions

• Preterm delivery

• Delivery complications

• Major birth defects

• Stillbirth

• Macrosomia (larger than average baby) and related complications

What Should You Do If You Become Pregnant While Taking Ozempic?

If pregnancy occurs while taking a GLP-1 agonist medication, you should inform your doctor right away. Your doctor can discuss the best course of action to manage your blood sugar levels and ensure a healthy pregnancy.

Does Ozempic Prevent Pregnancy?

Ozempic does not prevent pregnancy. In fact, Ozempic may increase fertility, making pregnancy more likely. Doctors recommend using birth control pills or a barrier method such as condoms to prevent pregnancy while on GLP-1s. 

However, if you are planning a pregnancy, it’s important to discuss coming off of  GLP-1s at least two months before a planned pregnancy. Talk to your doctor about medication discontinuation, as well as healthy lifestyle changes, such as diet and exercise, for weight management. 

Ozempic and Fertility  

GLP-1 drugs are approved by the U.S. Food and Drug Administration (FDA) to treat diabetes and obesity. In overweight or obese women, significant weight loss can result in increased fertility. There are reports of women who struggled for years with infertility and subsequently experienced surprise pregnancies resulting in “Ozempic babies” after taking GLP-1s for diabetes or obesity.

For women who are struggling with infertility, Ozempic babies conceived while on GLP-1 drugs can be a happy coincidence. However, animal studies indicate an increased risk of miscarriage and birth defects. 

Based on currently available data, the use of weight loss medications is not recommended during pregnancy. Therefore, it’s important to carefully discuss the risks and benefits of pregnancy on Ozempic with your doctor. 

Safe Medication Practices During Pregnancy  

• Some medicines are safe to take during pregnancy, while others can cause harm to your baby, affecting your baby’s growth and development or causing serious birth defects.

• You should check with your doctor or pharmacist before taking any medicine during pregnancy, including prescription drugs, over-the-counter medications, herbal remedies, and dietary supplements.

• Keep in mind that stopping treatment with some medications can also cause problems for you and/or your baby. If you are on prescription medications for chronic medical conditions such as high blood pressure, diabetes, asthma, epilepsy, or depression, don’t stop taking them without talking to your doctor. 

Safe Alternatives To Ozempic During Pregnancy 

Since we don’t know if GLP-1s like Ozempic are safe during pregnancy, the recommendation is to focus on eating a healthy, well-balanced diet and staying active while you’re pregnant. Experts also say that you should not go on a diet to try and lose weight while you’re pregnant. This can be harmful to your developing baby.

Keep in mind that for most women, a healthy weight gain during pregnancy is between 25 and 35 pounds or 12 and 16 kilograms. If you are overweight or obese at the start of your pregnancy, you may need to gain less weight (10 to 25 lbs or 4 to 11 kgs). 

Breastfeeding and Ozempic  

Risks of Breastfeeding While On Ozempic  

Animal studies in lactating rats have shown that semaglutide is detected in milk at levels that are 3 to 12 times lower than the mother’s blood concentration of the drug. 

There is no data in humans on whether semaglutide affects milk production in lactating women or whether the presence of semaglutide in human breast milk can harm a breastfed infant. 

Recommendations For Nursing Mothers 

Nursing mothers should discuss the benefits vs risks of Ozempic while breastfeeding with their doctors. Points to keep in mind are the health benefits of breastfeeding for the infant as well as the clinical needs for blood sugar control in the mother. 

Health Implications For Infants  

The potential health risks of exposure to Ozempic and other GLP-1 drugs in nursing infants are not fully understood. Doctors typically advise against using Ozempic while breastfeeding unless the benefits of the medication in the mother significantly outweigh the potential risks for the infant. Learn which medications to avoid while breastfeeding.

Frequently Asked Questions

Can You Take Weight Loss Shots While Pregnant?

You should not take weight loss treatments such as semaglutide (Wegovy or Ozempic) or tirzepatide (Mounjaro or Zepbound) while pregnant. The safety of these drugs during pregnancy has not been established. Compare Mounjaro vs Ozempic for weight loss.

Does Ozempic Improve Fertility?

Ozempic and other GLP-1 agonist medications are not fertility medications, and there is no scientific evidence to indicate that Ozempic can improve fertility. However, Ozempic can indirectly enhance fertility by improving blood sugar control and aiding weight loss. There are reports of many surprise “Ozempic babies” born to women taking semaglutide and other GLP-1 drugs, including women who had been struggling with infertility for years.