Pregnancy
Both labels say the drugs may cause fetal harm, based on animal studies, and that weight loss offers no benefit during pregnancy.[1][2] The Wegovy label says to discontinue it at least 2 months before a planned pregnancy, because semaglutide stays in the body for weeks.[1] The Zepbound label says to discontinue it when pregnancy is recognized; it does not include a 2-month statement.[2] Human data are too limited to measure the risk of birth defects or miscarriage.[2] Lilly runs a pregnancy exposure registry for people exposed to Zepbound during pregnancy.[2]
Birth control pills
The Zepbound label says tirzepatide may make oral hormonal contraceptives less effective, because it slows stomach emptying, an effect that is largest after the first dose. It advises switching to a non-oral method, or adding a barrier method, for 4 weeks after starting and for 4 weeks after each dose increase.[2] The Wegovy label does not include this advice.[1] Many forum reports describe unplanned pregnancies; we could not find reliable data on how often that happens, so this page does not give a number.
Breastfeeding
For Zepbound, a small study in 11 women found tirzepatide undetectable or very low in breast milk after one dose; there are no data on effects on the infant or milk supply.[2] For Wegovy injection, there are no data on semaglutide in human milk. For the Wegovy tablets, breastfeeding is not recommended, because an ingredient that helps absorption (SNAC) passes into milk.[1]
Side by side
| Wegovy (semaglutide) | Zepbound (tirzepatide) | |
|---|---|---|
| Planned pregnancy | Stop at least 2 months before[1] | Stop when pregnancy is recognized[2] |
| Oral contraceptives | No specific advice[1] | Non-oral or backup method for 4 weeks after start and each increase[2] |
| Breastfeeding | Injection: no data. Tablets: not recommended[1] | Low or undetectable in milk; no infant data[2] |
The short version
Short on the way. A 35-second captioned version of this page is in production for the Fewer Bites channel. It will be embedded here when it is live.
Questions to bring to your prescriber
Print these or screenshot them. They are conversation starters, not a checklist of things to do.
- I am planning a pregnancy, or might become pregnant: when and how should we plan stopping?
- Which form of contraception makes sense for me while I am on this medicine and during dose increases?
- I am breastfeeding: what are the options?
Education, not advice. This page explains what trials, labels and guidelines report. It does not tell anyone to start, change or stop a medicine. Your prescriber knows your history; this page does not.
Sources
- Novo Nordisk / FDA. Wegovy (semaglutide) injection and tablets, prescribing information, revised 06/2026. label
- Eli Lilly / FDA. Zepbound (tirzepatide) prescribing information, revised 08/2026. label