How long before conception should I stop taking Ozempic (semaglutide)?

When to Stop Ozempic (Semaglutide) Before Getting Pregnant

Ozempic (semaglutide) should be discontinued at least 2 months before a planned pregnancy due to the long washout period for semaglutide. 1

Rationale for Discontinuation

• The FDA label for semaglutide explicitly states that women should stop using Ozempic at least 2 months before planning to become pregnant 1
• This recommendation is based on the long half-life of semaglutide (approximately 1 week) and the need to ensure complete clearance from the body before conception 1
• Animal studies have shown that semaglutide exposure during pregnancy may cause:
  • Reduced fetal growth 1
  • Visceral abnormalities (heart blood vessels) 1
  • Skeletal abnormalities (cranial bones, vertebra, ribs) 1

Clinical Guidelines for Pre-Conception Planning

• The AGA Clinical Practice Update (2024) specifically mentions that ozanimod must be stopped at least 6 months before conception, placing semaglutide in the category of medications that require discontinuation before pregnancy planning 2
• Similar to other medications with potential fetal risks, pre-conception planning is essential when using Ozempic 3
• Women taking medications with potential teratogenic effects should discuss family planning with their healthcare provider well in advance 3

Comparison to Other Medications Requiring Pre-Conception Discontinuation

• Methotrexate: Recommended to be discontinued 3 months before conception 2, 3
• Mycophenolate: Recommended to be discontinued 6 weeks before conception 3
• Cyclophosphamide: Recommended to be discontinued 3 months before conception 2, 3

Management During the Transition Period

• Consider alternative treatments for the underlying condition (diabetes or weight management) that are pregnancy-compatible 3
• Implement close monitoring of the underlying condition during the pre-conception period 3
• Ensure effective contraception is used until Ozempic has been discontinued for the full 2-month period 1

Important Considerations and Potential Pitfalls

• The 2-month washout period is specifically based on semaglutide's pharmacokinetic properties and long half-life 1
• Do not confuse this recommendation with those for other medications that may have different washout periods 3
• Failure to discontinue Ozempic with adequate time before conception may expose the developing fetus to potential risks observed in animal studies 1
• Women who become pregnant while taking Ozempic should contact their healthcare provider immediately 1

Breastfeeding Considerations

• It is unknown if semaglutide passes into breast milk 1
• The benefits of breastfeeding should be weighed against potential risks when considering resuming Ozempic postpartum 1