Nowadays there are many patients that are using injectable weight loss medication either for diabetes or for weight loss (normally privately) such as Tirzepatide (Mounjaro) and Semaglutide (Ozempic, Wegovy, Rybelsus). These medications work partly by slowing down how your stomach empties which can affect how well other medicines (particularly the contraceptive pills or HRT tablets) are absorbed by your body. Newly released clinical guidance has highlighted safety concerns regarding the combined use of these treatments.
If you take the contraceptive pill:
➤ Tirzepatide (Mounjaro)
This medicine may reduce how well the pill works. You should:
• Use a non-oral method (e.g. coil or implant) or
• Add a barrier method (like condoms) for 4 weeks after starting or increasing the dose.
Use extra protection (like condoms) if you have vomiting or diarrhoea and follow the missed pill rules (see the patient information leaflet which comes with your pill) if you vomit within 3 hours of taking the pill or have diarrhoea for more than 24 hours.
➤ Semaglutide (Ozempic, Wegovy, Rybelsus), exenatide, liraglutide, dulaglutide or lixisenatide
• Do not appear to reduce the effectiveness of the pill.
• However, if you are experiencing side effects like vomiting or diarrhoea can still reduce how well the pill is absorbed. So, use extra protection (like condoms) if you have vomiting or diarrhoea and follow the missed pill rules (see the patient information leaflet which comes with your pill and the guidance for missed pill) if you vomit within 3 hours of taking the pill or have diarrhoea for more than 24 hours.
Please see further information here:
Patient-information-GLP-1-agonists-and-contraception.pdf
Guidance for missed pill:
Forgot Your Pill? Use Our Missed Pill Calculator | The Lowdown
Alternative contraception options can be found here:
Long-acting Reversible Contraception (LARC)
Contraceptive injection – Sexual Health Oxfordshire
If you’re taking Hormone Replacement Therapy (HRT):
This applies if your HRT includes progesterone tablets like:
• Progesterone (also called Utrogestan)
• Norethisterone
•Medroxyprogesterone acetate (also called Provera)
There is some concern that weight loss medications – such as Tirzepatide (Mounjaro) and Semaglutide (Ozempic, Wegovy, Rybelsus) – may reduce how well these tablets are absorbed. This could lead to irregular bleeding and may affect the protection of your womb lining (potentially leading to an increased risk of endometrial cancer).
What are the options?
- Mirena coil (IUS):
- Progesterone cover for HRT for up to 5 years.
- A contraceptive for 8 years.
- Combined HRT patch:
- Can contain both hormones (oestrogen + progestogen) and bypasses the stomach.
- Increase oral progesterone dose:
- Your GP or private specialist may recommend a higher dose for 4 weeks after starting or increasing the dose of your weight loss medication.
- Using progesterone oral capsules vaginally:
- Not licensed but is commonly used in other cases. You can start using this if already prescribed.
Please contact us to talk through the best choice for you if you still need some help or contact your private provider of your weight loss medication.
With best wishes,
The Practice Team