This guide explains important safety considerations before and during treatment with Wegovy, Mounjaro, Ozempic, Zepbound, or generic semaglutide.
These weight loss medications (GLP-1 medications) are not suitable for everyone, especially during pregnancy, when using hormone treatments, or if you have certain medical conditions, or if you are scheduled for surgery.
Use this guide when you need to:
Understand if you can use GLP-1 medications during pregnancy or breastfeeding
Learn how GLP-1 medications may affect contraception or hormone replacement therapy (HRT)
Check which medical conditions may affect your eligibility
Prepare for your MedExpress consultation
Know what to tell your healthcare team before surgery or any procedure with general anaesthesia or deep sedation
Understand the mental health considerations during treatment
Can I use Wegovy, Mounjaro, Ozempic, Zepbound, or generic semaglutide during pregnancy or breastfeeding?
No. Wegovy, Mounjaro, Ozempic, Zepbound, and generic semaglutide should not be used during pregnancybecause these medications may affect fetal development.
If you are:
Pregnant
Breastfeeding
Planning to become pregnant
You should not start treatment and should discuss alternatives with a healthcare professional.
Planning a pregnancy while on a GLP-1 medication
If you are planning to become pregnant, you should stop your medication at least two months before trying to conceive, because these medications stay in the body for a long time after the last dose. Your MedExpress clinician can guide you through stopping treatment safely.
Contraception considerations while using GLP-1 medications
GLP-1 medications such as Wegovy, Mounjaro, Ozempic, and Zepbound can affect how oral contraceptive pills are absorbed. Use barrier contraception (such as condoms) for 4 weeks after starting treatment and for 4 weeks after each dose increase, because oral birth control may be less effective during these periods. You may also consider a non-oral contraceptive method, such as an intrauterine device (IUD) or other contraceptive implant.
What should I do if I vomit or miss a contraceptive pill?
If you:
Miss a dose of your oral contraceptive pill, or
Experience vomiting or diarrhoea while taking the pill
You should follow standard contraceptive guidance, which may include taking a repeat dose depending on timing.
For medical advice, contact:
Your family physician or nurse practitioner, or
A provincial health advice line (for example, 811 in many provinces)
How do GLP-1 medications interact with hormone replacement therapy (HRT)?
Some people using GLP-1 medications (Wegovy, Mounjaro, Ozempic, Zepbound, or generic semaglutide) may notice changes in vaginal bleeding, especially when also using hormone replacement therapy (HRT).
This can happen because GLP-1 medications:
Slow down digestion
May affect how hormone treatments are absorbed
This effect is more likely with:
Oral HRT tablets
This effect is less likely with:
Hormone patches
Intrauterine devices (IUDs), such as the Mirena coil
Weight loss and changes in body composition may also affect hormone levels.
When should I seek medical advice about bleeding changes?
You should speak to a healthcare professional if you experience:
New or unexpected vaginal bleeding
Heavy bleeding
Ongoing or persistent bleeding
A healthcare professional may:
Check for other causes
Adjust your HRT treatment
Recommend further tests if needed
What should I do if I am having surgery or a procedure with general anaesthesia or deep sedation?
Always tell your healthcare team that you are taking Wegovy, Mounjaro, Ozempic, Zepbound, or generic semaglutide before any procedure that requires general anaesthesia or deep sedation, including planned surgery and dental procedures under sedation.
GLP-1 medications slow down how fast food leaves the stomach. There have been reports of food or liquid entering the lungs (pulmonary aspiration) in patients taking these medications during general anaesthesia or deep sedation. Your anaesthetist may ask you to:
Pause your medication before the procedure, or
Follow a longer or modified fasting period before the procedure
Follow the specific advice given by the team performing your procedure. If you are unsure, contact MedExpress clinical support before your procedure.
Are there mental health considerations during treatment?
Patients using GLP-1 medications should be aware of changes in mood and mental health during treatment.
Tell a MedExpress clinician, your family doctor, or a nurse practitioner if you experience:
New or worsening low mood, sadness, or hopelessness
Unusual changes in mood, energy, or behaviour
Thoughts of hurting yourself or thoughts of suicide
Wegovy is not used for weight management in patients with a current or recent history of suicidal thoughts or behaviour. If suicidal thoughts or behaviour develop during treatment, the medication should be stopped.
If you are having thoughts of hurting yourself or thoughts of suicide, contact emergency services on 911 or the Canada Suicide Crisis Helpline on 9-8-8.
Are there any medical conditions that would prevent me from taking Wegovy, Mounjaro, Ozempic, Zepbound, or generic semaglutide?
A MedExpress clinician will review your full medical history during your consultation to determine if GLP-1 treatment is appropriate.
You must tell the MedExpress clinical team if you have:
A history of thyroid cancer or multiple endocrine neoplasia (MEN)
A history of pancreatitis or gallbladder disease
Severe kidney disease or severe liver disease
Any allergies to GLP-1 medications or their ingredients
A current or past history of suicidal thoughts, suicidal behaviour, or severe depression (especially relevant if treatment is for weight management)
Severe stomach or digestive problems (such as severe gastroparesis or slow stomach emptying)
Diabetic eye disease (retinopathy) if you have type 2 diabetes
Any current medications or supplements you are taking, especially insulin or sulfonylureas (other diabetes medications that can lower blood sugar)
Pregnancy, breastfeeding, or plans to become pregnant
Any planned surgeries or procedures requiring general anaesthesia or deep sedation
Providing complete and accurate information helps ensure that Wegovy, Mounjaro, Ozempic, Zepbound, or generic semaglutide are prescribed safely.
Important: MedExpress clinical assessment
MedExpress provides an online consultation where a licensed clinician assesses your suitability for treatment.
MedExpress will only prescribe Wegovy, Mounjaro, Ozempic, Zepbound, or generic semaglutide if:
The medication is clinically appropriate
The treatment is safe based on your medical history
If you still need help after reviewing the information above, additional assistance is available.