Ozempic (Semaglutide) and Pregnancy: What to Know

What does the evidence say about ozempic during pregnancy?

1. Product labeling calls for stopping semaglutide about 2 months before a planned pregnancy, though in healthy adults it can take roughly 6 weeks on average for most of the medication to clear the body, and pregnancy safety data remains limited to case reports and one study of 168 pregnancies on GLP-1 medications that found no increased chance of birth defects. 1
2. Because semaglutide has an approximate 7-day half-life, a washout of at least 5 half-lives, about 35 days, is recommended before conception to minimize fetal exposure, and even the largest prospective cohort of 168 pregnancies found no increased risk of congenital anomalies, though the evidence is still described as limited and largely observational. 2
3. GLP-1 medications including semaglutide show promise for improving fertility outcomes in women with obesity or polycystic ovary syndrome, which is one reason pregnancy can happen unexpectedly for people not using contraception while taking it. 2
4. In a small study of 8 breastfeeding parents taking injectable semaglutide, none of the breast milk samples had measurable semaglutide, and the 8 breastfed infants were reported to have normal growth and development, though experts still recommend monitoring infant growth and development and favor injectable over oral semaglutide during breastfeeding. 3
5. Federal guidance on weight-management medications states plainly that if you are pregnant or planning to become pregnant, you should not take weight-loss medications, since they may harm the fetus. 4

Is ozempic safe in each trimester?

• First trimester. Unplanned exposure often happens here, since many people don't realize they're pregnant right away and semaglutide's long half-life means it can still be clearing your system into early pregnancy. Contact your prescriber as soon as you get a positive test so monitoring and next steps can be planned together, rather than stopping and waiting to see what happens.
• Second trimester. If pregnancy is confirmed while you're using Ozempic for diabetes management, your care team will typically move you to a diabetes medication with more pregnancy safety data, since Ozempic itself isn't recommended once pregnancy is confirmed. Weight-management use has no established role at any stage of pregnancy.
• Third trimester. Weight-management medications, including Ozempic, are not recommended at any point in pregnancy. If gestational diabetes develops later on, that's managed with medications separately studied for pregnancy rather than by restarting a GLP-1 medication.