**** For women prescribed GLP1 injections ***

There is no safety data about the use of these medications in pregnancy so it is advised that reliable contraception should be used whilst using the injections and for a period afterwards depending on which one you are using: eg 1m for mounjaro (tirepatide) 2m for wegovy (semaglutide) 12w for byetta (exenatide).

If you are using oral contraception (combined or progesterone only pills) there may be an effect on their absorption if using mounjaro (tirzapetide) thus reducing their contraceptive effect.  It is advised that additional methods (eg condoms) be used for 4 weeks after starting the injections and for 4 weeks after each dose increase.  Alternatively you might wish to discuss another method (eg patches/implant, coil).  Because the gastrointestinal side effects of tirzepatide, mounjaro can be greater than with the other injections it is not felt that there is this need if using other injections (eg wegovy or byetta).  However, if you have significant side effects such as vomiting or severe diarrhoea for more than 24 hours, then you should follow the 'missed pill' rules and use additional contraceptive methods and discuss with your doctor.

If you are on HRT using oral progesterone in combination with transdermal oestrogen (patches, gel or spray) you need to increase the progesterone dose to 300mg (3 tabs) if on a sequential regimen (progesterone for 2 weeks out of 4) or from 100mg to 200mg if on a continuous combined regimen.  This applies when starting the medication for 4 weeks and for 4 weeks after each dose increase.  This advice is for ANY of the GLP1 weight loss injections.

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