Is Ozempic safe while pregnant?

The popularity of medications such as Ozempic, Mounjaro, and Wegovy, which are intended to help with type 2 diabetes and obesity, has sparked questions regarding the potential implications of these drugs on pregnancy and fertility.  

Ozempic (semaglutide) is a type of medication called a glucagon-like peptide-1 receptor agonist—GLP-1 for short. It was originally developed to help treat type 2 diabetes and decrease people’s risk of cardiovascular events by helping to control blood sugar, slow digestion, and curb appetite.

Ozempic has been approved for this use and is considered a safe, effective medication. It and other GLP-1’s can still result in some minor side effects, primarily digestive upsets including bloating, constipation, nausea, and vomiting—but most people find that they’re tolerable and even subside with time. According to clinical data, less than 4% of people dropped out of Ozempic studies due to side effects.

Novo Nordisk, the manufacturer of Ozempic, recommends that if a person is taking Ozempic, they should stop the drug at least two months prior to pregnancy to permit a “washout” period so that it can leave their systems (yes, it can take Ozempic up to 2 months to completely leave the body).

Keep in mind that Ozempic and other GLP-1 medications are newer drugs and we don’t have as much data on how these medications affect human pregnancy. What we do know is that animal studies show birth defects and pregnancy losses in pregnant rats who were taking semaglutide. While animal studies don’t always translate perfectly to the way the drug affects humans, it’s considered too risky for pregnant people to take Ozempic without a compelling medical reason. 

That being said, diabetes and obesity—health conditions that Ozempic treats—can also be risky during pregnancy. Both are associated with higher rates of pregnancy and birth complications for both the baby and parent. Controlling blood sugar while pregnant is important in order to avoid complications such as gestational diabetes and hypertension. Fortunately, there are other medications known to be safe during pregnancy to keep diabetes under control. 

If you become pregnant while taking Ozempic and didn’t plan that pregnancy, there’s no reason to panic. Tell your healthcare provider right away. If you’re taking Ozemic or another GLP-1 medication to control your blood sugar and treat diabetes, they can help transition you to another medication to manage your diabetes.

Novo Nordisk says that Ozempic for type 2 diabetes should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. What this means is that if you’re trying to become pregnant and want to take Ozempic because of certain health conditions—or if you’re taking Ozempic and you become pregnant—it’s critical to have an open conversation with a healthcare provider about your health status. They are the ones who can help make the safest, most informed decision about when and how to take Ozempic.

Many factors impact a person’s fertility, including any pre-existing health conditions, family history, diet, weight, hormone balance, and overall wellness. This is the case for people trying to become pregnant through intercourse and those using fertility treatment like in vitro fertilization (IVF).

While Ozempic isn’t known to boost or hinder fertility, it does directly improve obesity, and obesity has a clear link to female infertility, causing issues like anovulation (when a person’s ovaries don’t release an egg). In this case, if a person was having fertility issues due to their weight, Ozempic might be able to help by putting their body into a more optimal state to conceive.

However, the recommendation that women stop taking Ozempic two months before trying to conceive is still the standard — not because of fertility issues, but because of missing data on safety for the unborn child. So, if you’re experiencing infertility and your healthcare provider thinks that obesity may be a contributing factor, discuss fertility planning early. This may allow you time to start taking Ozempic, lose the appropriate amount of weight for your health and fertility goals, and allow for a washout period before trying to get pregnant.

While maternal obesity can have a negative impact on the health of a pregnancy, weight loss during pregnancy—including through weight loss drugs—is not recommended. Weight management should happen before pregnancy and continue through the postpartum period. Weight loss through diet restriction can also deprive the fetus of vital nutrients, and no weight loss drugs are considered absolutely safe during pregnancy.

Weight and a healthy pregnancy

There’s no doubt that maternal weight can have a big impact on the health of a pregnancy and delivery outcomes; obesity is linked to higher rates of complications that include gestational diabetes, hypertension, pre-eclampsia, cesarean sections, delivery complications, and preterm birth. Multiple professional bodies, including the Institute of Medicine, the National Research Council, and the American College of Obstetrics and Gynecology (ACOG), recommend that people who are overweight or obese attain a healthier weight prior to becoming pregnant. At the same time, weight gain is essential for a healthy pregnancy. This ensures that the mother’s body can provide adequate nutrition and calories for the baby to grow, develop key organs, and remain healthy throughout the pregnancy.

There’s controversy about how much weight one should gain during pregnancy. While some risks may increase when there is limited maternal weight gain, other risks go down when the obesity level decreases, and it’s unclear where that balance point is. 

The Centers for Disease Control and Prevention (CDC) offers a chart showing how much weight a woman should gain during pregnancy, based on their body mass index (BMI) before pregnancy. For example, if a woman is underweight (BMI lower than 18.5), the CDC recommends they should gain around 28 to 40 pounds. There’s also a helpful weight gain calculator from the Institute of Medicine that can help you calculate the healthy amount of weight you should gain during pregnancy.

For pregnant women with obesity, the evidence isn’t clear-cut enough to provide generalized recommendations about weight gain or loss. Careful weight management during pregnancy in close contact with a healthcare provider is key. Personalized care should take into account the trade-offs between risks and benefits for the individual mother and child. Depending on the person’s diet and lifestyle, weight management may be possible without restricting essential calories to the baby (for example, by simply cutting out soda and fast food). 

The pre-pregnancy period is the ideal time to lose weight when trying to conceive, and even a small weight loss can make a big difference; for women with obesity, losing as little as 10 pounds has been demonstrated to reduce the risk of developing gestational diabetes by as much as 40% compared to women without weight change. It’s recommended that people try to lose weight at a slow, steady rate (e.g., a 10% weight loss over six months) as a means to safely and sustainably lower body weight.

Diet modification and increasing exercise is the recommended way to do this. This can include:

• Cutting back on daily calories, especially from sugary drinks or snacks

• Eating foods with ample healthy nutrients, such as whole grains, fish, lean meats, nuts, beans, fruits, and vegetables

• Doing 150 minutes of moderate physical activity each week, including strengthening exercises

For some people who struggle with obesity or controlling their blood sugar, weight loss drugs like Ozempic are combined with diet and exercise to achieve healthy weight loss before becoming pregnant. Since it’s recommended that women stop Ozempic two months before a planned pregnancy, they should be used before actually trying to conceive.

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Current version

June 16, 2023

Written by

Nancy LaChance, BSN, RN

Fact checked by

Felix Gussone, MD

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About the medical reviewer

Felix Gussone, MD, Ro

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.