Is retatrutide (investigational GLP‑1/GIP/glucagon‑receptor agonist) contraindicated for use during pregnancy?

Retatrutide Use in Pregnancy

Retatrutide is contraindicated during pregnancy and should be discontinued immediately if pregnancy is recognized or planned. While no specific human pregnancy data exists for retatrutide, it belongs to the GLP-1 receptor agonist class, and extrapolation from related medications provides clear guidance on pregnancy management.

Evidence-Based Contraindication

• Retatrutide is an investigational triple-hormone receptor agonist (GLP-1/GIP/glucagon) that has not been studied in pregnant humans 1, 2
• GLP-1 receptor agonists as a class should not be used during pregnancy based on animal studies showing potential fetal harm 3
• The mechanism of action—stimulating GLP-1, GIP, and glucagon receptors—raises theoretical concerns for fetal metabolic effects and growth abnormalities 1, 2, 4

Clinical Management Algorithm

For Women Currently Pregnant with Retatrutide Exposure:

• Discontinue retatrutide immediately upon pregnancy recognition 3
• Transition to insulin therapy for glycemic control if the patient has diabetes, as insulin is the preferred treatment during pregnancy 5
• Arrange multidisciplinary care involving maternal-fetal medicine specialists for fetal monitoring 6
• Document the exposure and timing (gestational age) for appropriate prenatal surveillance 6

For Women of Childbearing Potential:

• Discontinue retatrutide before attempting conception 3
• Use effective contraception while taking retatrutide 6
• Transition to insulin therapy prior to conception if diabetes management is needed 5
• Allow adequate washout time before conception, though specific duration for retatrutide is not established 6

Critical Considerations

• The single case report of liraglutide (a GLP-1 agonist) exposure in first trimester resulted in a normal pregnancy outcome, but this does not establish safety for the class or for retatrutide specifically 3
• Retatrutide causes dose-dependent increases in heart rate (up to 6.7 beats/min), which may have unknown effects on maternal-fetal hemodynamics 1, 4
• The robust weight loss effects of retatrutide (up to 24.2% at 48 weeks) could theoretically impact maternal nutritional status and fetal growth if used during pregnancy 1

Common Pitfalls to Avoid

• Do not assume that topical retinoid safety data applies to retatrutide—these are completely different drug classes despite similar naming 7
• Do not continue retatrutide based on the single normal pregnancy outcome reported with liraglutide, as this represents insufficient evidence for safety 3
• Do not delay transition to insulin therapy in pregnant patients with diabetes who were previously on retatrutide 5