GLP-1 medications, pregnancy and breastfeeding: what the labels say

Short answer: the semaglutide labels (Ozempic, Wegovy, Rybelsus) in the US and Canada say to stop at least 2 months before a planned pregnancy. The Canadian Mounjaro, Zepbound and Trulicity monographs say at least 1 month. All eight Canadian monographs list pregnancy as a contraindication, and the US weight-loss labels say to stop when a pregnancy is recognized. Plan any change with your prescriber.

On this page: Pregnancy, label by label · Canada, all 8 monographs · Stop-by date calculator · Breastfeeding · Birth control · Pregnancy registries

Pregnancy: what each label says

The US prescribing information (FDA labels on DailyMed) and the Canadian product monographs (authorized by Health Canada) are worded differently, so the table lists both. "Contraindicated" means the label says the drug must not be used in that situation.

US labels: Wegovy revised June 2026, Ozempic June 2026, Rybelsus/Ozempic tablets January 2026, Mounjaro and Zepbound August 2026, Saxenda February 2026, Trulicity June 2026, Victoza October 2025. Canadian monographs: Ozempic and Rybelsus authorized July 13, 2026, Mounjaro June 23, 2026, Zepbound June 11, 2026, Wegovy December 10, 2025, Trulicity revised July 5, 2024, Saxenda and Victoza revised December 9, 2022.

Why the weight-loss labels say to stop

The US Wegovy, Zepbound and Saxenda labels say weight loss offers no benefit to a pregnant patient and may cause fetal harm. They note that appropriate weight gain based on pre-pregnancy weight is recommended for all pregnant patients, including those with overweight or obesity. The Canadian Wegovy monograph says a minimum weight gain, and no weight loss, is recommended in pregnancy. Wegovy's US label adds that people using it for MASH (a liver condition) with advanced liver fibrosis should use it in pregnancy only if the potential benefit justifies the potential risk.

What the animal and human data show

All of these labels report that available human data are too limited to establish a drug-related risk of birth defects or miscarriage. Animal studies with semaglutide, tirzepatide, liraglutide and dulaglutide found fetal abnormalities, growth reductions or early pregnancy losses, mostly alongside reduced maternal weight and food intake. For context, the US labels give a background risk in the general US population of 2 to 4% for major birth defects and 15 to 20% for miscarriage. The diabetes labels add that poorly controlled diabetes itself raises risks in pregnancy, with a background major birth defect risk of 6 to 10% when HbA1c is above 7% before conception.

Why semaglutide needs 2 months

Semaglutide stays in the body a long time. The labels call this its long washout period, which is why the stop rule is "at least 2 months before a planned pregnancy" rather than at the time you start trying. The Canadian semaglutide and Mounjaro monographs also recommend contraception for anyone who could become pregnant while on treatment.

Canada: what all eight product monographs say

Every Canadian product monograph covered on Glidedose lists pregnancy in section 2 (Contraindications), but the stop-before-pregnancy advice and the breastfeeding wording differ by drug. The rules come from section 7.1 (8.1 for Victoza), Special Populations.

Three points stand out. First, the stop period follows the drug, not the brand: semaglutide (Ozempic, Wegovy, Rybelsus) is 2 months, while tirzepatide (Mounjaro, Zepbound) and dulaglutide (Trulicity) are 1 month. The liraglutide monographs (Saxenda, Victoza) give no set period and say to stop if you wish to become pregnant or pregnancy occurs. Second, Zepbound is the only Canadian monograph that does not list breastfeeding as a contraindication. Third, the Rybelsus monograph adds a tablet-specific concern: semaglutide and its absorption enhancer SNAC both caused developmental toxicity in animals, so there may be a potential additive risk.

The Canadian Zepbound monograph repeats the US birth control advice: people on oral hormonal contraceptives should switch to a non-oral method, or add a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase. The Canadian Rybelsus, Zepbound and semaglutide monographs also recommend contraception for anyone who could become pregnant while on treatment.

Label stop-by date calculator

Enter the date you plan to start trying to conceive. This counts back the washout period printed on the label you pick. It is a calendar tool, not medical advice: your prescriber decides when and how to stop, and may suggest a different plan.

Breastfeeding: what each label says

The tablet warning is specific to semaglutide tablets. The US Wegovy label notes that the Wegovy injection does not contain SNAC, and the tablet labels point out that semaglutide products without SNAC exist that can be used during breastfeeding. Whether any GLP-1 is right for you while breastfeeding is a decision for you and your prescriber.

Birth control while on a GLP-1

The US Mounjaro and Zepbound labels and the Canadian Mounjaro monograph say tirzepatide may make birth control pills less effective. The US labels explain that tirzepatide slows stomach emptying, most of all after the first dose. They advise switching to a non-oral method, or adding a barrier method such as condoms, for 4 weeks after starting and for 4 weeks after each dose increase. The semaglutide labels do not carry this advice. The drug interactions guide has a calculator for the 4-week windows.

Pregnancy exposure registries (US)

If you become pregnant while taking these medications, the US labels encourage you or your healthcare provider to report it to the registry, which tracks pregnancy outcomes:

• Wegovy: Novo Nordisk at 1-877-390-2760 or wegovypregnancyregistry.com.
• Zepbound: 1-844-524-0039, MILEregistry@thermofisher.com, or pregnancyregistry.lilly.com/zepbound.

You can also report side effects to the FDA through MedWatch in the US, or to Health Canada through the Canada Vigilance Program.

What to note for your appointment

• The date of your last dose and the strength you were on (Glidedose logs both).
• The date you plan to start trying, or the first day of your last period if you might be pregnant.
• Which birth control you use, and whether you started or increased tirzepatide in the last 4 weeks.
• If you have type 2 diabetes, your recent HbA1c, since the labels flag diabetes control as a pregnancy risk on its own.

Sources

• Wegovy prescribing information, sections 8.1 to 8.3 (DailyMed, US)
• Ozempic prescribing information, sections 8.1 to 8.3 (DailyMed, US)
• Rybelsus and Ozempic tablets prescribing information, sections 8.1 to 8.3 (DailyMed, US)
• Mounjaro prescribing information, sections 8.1 to 8.3 (DailyMed, US)
• Zepbound prescribing information, sections 8.1 to 8.3 (DailyMed, US)
• Saxenda prescribing information, sections 8.1 and 8.2 (DailyMed, US)
• Victoza prescribing information, sections 8.1 and 8.2 (DailyMed, US)
• Trulicity prescribing information, sections 8.1 and 8.2 (DailyMed, US)
• Ozempic product monograph, sections 2 and 7.1 (Novo Nordisk Canada)
• Wegovy product monograph, sections 2 and 7 (Novo Nordisk Canada)
• Mounjaro product monograph, sections 2 and 7 (Eli Lilly Canada)
• Zepbound product monograph, sections 2 and 7.1 (Eli Lilly Canada)
• Trulicity product monograph, sections 2 and 7.1 (Eli Lilly Canada)
• Rybelsus product monograph, sections 2 and 7.1 (Novo Nordisk Canada)
• Saxenda product monograph, sections 2 and 7.1 (Novo Nordisk Canada)
• Victoza product monograph, sections 2 and 8.1 (Novo Nordisk Canada)

This page summarizes official product labels as general information. It is not medical advice. Do not start, stop or change any medication without talking to your prescriber. If you think you may be pregnant, contact your healthcare provider. Labels are updated; check the current version for your product.

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