When to Stop Wegovy Before Pregnancy
Stop Wegovy (semaglutide) at least 2 months before attempting to conceive. 1
FDA-Mandated Discontinuation Timeline
The FDA drug label for semaglutide explicitly states that women should discontinue the medication at least 2 months before a planned pregnancy due to semaglutide's long washout period. 1 This recommendation is based on the drug's pharmacokinetic profile rather than clinical judgment.
Pharmacokinetic Rationale
- Semaglutide has a 7-day half-life, requiring 4-5 weeks to reach steady state and an equivalent time for elimination. 2
- The 2-month (8-week) discontinuation window allows approximately 5 half-lives to pass, ensuring near-complete drug clearance before conception. 2
- This extended washout period is necessary because semaglutide is a long-acting GLP-1 receptor agonist with sustained systemic exposure. 2
Comparison to Other Teratogenic Medications
The 2-month timeline for Wegovy is notably shorter than other medications requiring pre-conception discontinuation:
- Methotrexate requires 3 months before attempting conception due to teratogenicity risk. 3
- JAK inhibitors and sphingosine-1-P modulators require 3 months before conception. 3
- Mycophenolate requires 6 weeks before conception. 4
This places semaglutide in an intermediate category—requiring more planning than some medications but less than highly teratogenic agents like methotrexate.
Essential Pre-Conception Measures
Use reliable contraception while taking Wegovy until the 2-month washout period is complete. 4 This prevents unintended pregnancy exposure during the elimination phase.
Transition to pregnancy-safe weight management strategies during the 2-month washout period, including:
- Nutritional optimization and lifestyle modifications 3
- Alternative pregnancy-compatible treatments for underlying conditions (diabetes, obesity) 5
- Daily folic acid supplementation (400 μg/day for general population) 3
- Daily vitamin D supplementation 3
Critical Timing Considerations
If pregnancy occurs while taking Wegovy, stop the medication immediately upon pregnancy discovery and seek obstetric counseling. 3 While the FDA label emphasizes planned discontinuation, unplanned pregnancy requires immediate cessation.
Plan for at least 3 months of disease control (if using Wegovy for diabetes) before conception when possible, though the mandatory 2-month drug washout is the minimum requirement. 3
Common Pitfalls to Avoid
- Do not assume shorter discontinuation periods are adequate—the 2-month timeline is based on semaglutide's unique pharmacokinetics and cannot be shortened. 1, 2
- Do not continue Wegovy during early pregnancy thinking first-trimester exposure is safe—the FDA specifically requires pre-conception discontinuation. 1
- Do not delay contraception counseling—women of reproductive age on Wegovy need reliable birth control until the full washout period is complete. 4