Is Ozempic safe to take during pregnancy or while trying to conceive? Experts weigh in
Written by ABC Audio All Rights Reserved on February 2, 2023
(NEW YORK) — The growing popularity of drugs like Ozempic, Mounjaro and Wegovy, designed to help people with Type 2 diabetes and obesity, has raised new questions about what those drugs could mean for pregnancy and fertility.
The medications, all brand names for a compound called semaglutide, have grown in popularity thanks to reported use by celebrities and posts from everyday people on social media about successful weight loss, many from women of childbearing age.
Given as a daily oral medication or weekly injection, drugs like Ozempic, Mounjaro and Wegovy, called GLP-1 RAs, help people produce insulin and lower the amount of sugar in the blood.
They also work by slowing down movement of food through the stomach and curbing appetite, thereby causing weight loss.
Side effects of the drugs can include severe nausea and constipation.
Because semaglutides are relatively new on the market — approved by the Food and Drug Administration within the last five years to treat Type 2 diabetes and obesity — there is still research to be done on exactly how they impact women of childbearing age, experts say. In addition, people who don’t have diabetes or obesity can still be prescribed the drugs “off-label,” which may have different impacts.
ABC News’ Good Morning America spoke with two experts who shared the latest on semaglutides and pregnancy.
Are Ozempic and other semaglutide medications safe to take during pregnancy?
No, according to Dr. Amanda Velazquez, director of obesity medicine in the Department of Surgery at Cedars-Sinai Medical Center in Los Angeles.
“This class of medications are not recommended for women who are pregnant,” Velazquez told GMA. “There have not been any studies that have been conducted to test these drugs in women who are currently pregnant, so they’re not at this time recommended.”
The FDA also says in its safety profiles of Ozempic, Wegovy and Mounjaro that they should not be taken during pregnancy, noting there is “insufficient data” available.
The FDA also explains that the drugs could cause weight loss, and that “weight loss offers no benefit to a pregnant patient and may cause fetal harm.”
Velazquez noted that in addition to there not being enough human research to show GLP-1 RAs are safe during pregnancy, animal studies have shown complications.
“For a human, what’s the effect on baby or mom? We don’t know,” she said. “However, from animal studies we know that animals that were on these medications and pregnant, it reduced the embryo size and it can cause abnormalities, developmental abnormalities, for the developing fetus.”
How long do you have to be off a semaglutide medication before getting pregnant?
The FDA recommends that people discontinue semaglutide treatment at least two months before they plan to become pregnant.
Dr. Sarah Lassey, a board-certified OB-GYN and co-director of the diabetes in pregnancy program at Boston’s Brigham and Women’s Hospital, said that window of time allows the medication to leave the body.
“We know that these medications can kind of be in your body for a longer period of time,” Lassey told GMA. “So we recommend transitioning off of this class of medication essentially two to three months prior to when you plan to start getting pregnant.”
Going off of the medications should be done under the supervision of a medical provider, just as when you start the medications, according to both Lassey and Velazquez.
Is the risk of semaglutides and pregnancy atypical?
No, according to Velazquez.
“This is a very standard risk,” she said. “These drugs are like drugs in other medical classes that we use in the sense that you shouldn’t be looking at these as unique.”
Velazquez said the medications for Type 2 diabetes and obesity should not be looked at differently than other drugs that a person would take for heart disease or high blood pressure, for example.
“It’s not the drugs, it’s that we see them as an option versus something that’s medically necessary,” she said, “when really this is medically necessary for many patients who find it difficult to lose weight, and that’s 70% of the population who are overweight or obese right now.”
Why would a person who wants to become pregnant take a semaglutide medication?
Drugs like Ozempic, Mounjaro and Wegovy can be very effective in helping people lower their blood sugar levels and get to a healthy weight, which can be critical for a healthy pregnancy, according to Lassey.
“We know that poorly controlled diabetes during pregnancy is associated with both maternal and fetal outcomes in a pregnancy,” she said, noting those risks can include miscarriage, birth defect, stillbirth and preeclampsia. “Our way to prevent any of these adverse outcomes is to control blood glucose levels and hemoglobin A1c in the time prior to conceiving as well as throughout the pregnancy.”
Lassey said that while the medications aren’t recommended generally for people who want to become pregnant in a short amount of time, for others, they can be lifesaving.
“If you’re a 20 to 30-year-old with diabetes and obesity, potentially, I think these classes of medications have really significant benefit for improving your blood sugar values and improving your overall cardiovascular profile,” she said. “So we’d recommend those medications knowing that down the line, if and when you were to conceive, we would have to change those medications.”
Do semaglutide medications impact fertility?
Lassey said there is not enough long-term research at this point to know how the medications may impact fertility.
“We just don’t know,” she said, adding, “However, we know that when people have better blood sugar control and things like that, they have lower rates of miscarriage and improvement in their fertility, typically.”
What to do if you get pregnant while taking a semaglutide medication
A person who becomes pregnant unexpectedly while taking a semaglutide should contact their healthcare provider, who can help them transition off the medication and make sure they are receiving proper maternal care.
The FDA also says on its website that there will be a “pregnancy exposure registry” that monitors outcomes in women “exposed to semaglutide during pregnancy,” and says pregnant women who are impacted and healthcare providers should contact the drug’s manufacturer.
Can you take a semaglutide medication while breastfeeding?
No, the medications have not been proven to be safe while breastfeeding, according to both Lassey and Velazquez.
“The data about breastfeeding, even about the availability of whether or not you can find these drugs in the breast milk, is very limited,” Lassey said. “It just hasn’t been studied yet, so we wait to initiate these medications until patients report that they have stopped breastfeeding.”
Both doctors also said that knowing that the medications will need to be stopped during pregnancy and breastfeeding should not prevent a person from considering them.
“This shouldn’t be a barrier to one trying out these drugs if they qualify and if they think this would be a good adjunct to their treatment plan from their healthcare provider,” said Velazquez. “What we do is we start the drug, in conjunction with a healthy lifestyle plan, we help them lose weight, improve their weight-related medical conditions and optimize their health for a healthier pregnancy and a healthier overall being … and then you [can] resume the medication once you’re done breastfeeding.”
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