Introduction
GLP-1 drugs have changed how we manage type 2 diabetes and obesity. But can you use them safely while taking birth control?
Many women in their reproductive years take GLP-1 receptor agonists like Ozempic, Wegovy, or Trulicity. In addition, millions also depend on the combined oral contraceptive pill (COCP) to prevent unwanted pregnancies.
But this is what’s concerning: GLP-1 medications tend to slow down food digestion. So, does it affect how well the body absorbs the pill, and does it affect its efficacy?
In this guide, we tackle these matters in greater detail.
How GLP-1 Medications Work
Overall, GLP-1 receptor agonists mimic a natural hormone that helps regulate blood sugar and appetite. Specifically, they work in three main ways:
- Boost insulin release after eating
- Suppress glucagon (which raises blood sugar)
- Slow gastric emptying
That last one—slower stomach emptying—is great for appetite control. But it can also delay how fast other drugs are absorbed.
For example, GLP-1 drugs semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro®) are long-acting weekly injections. Hence, they remain active in your system for days.
Moreover, this extended effect raises red flags about timing and interactions—especially with medications requiring precise absorption, like the pill.
How the Pill Works
Generally, the combined oral contraceptive pill contains ethinyl estradiol and progestin. Correspondingly, these hormones prevent ovulation and thicken cervical mucus.
To be effective, women must take the pill consistently. The small intestine absorbs it in the small intestine and enters the bloodstream quickly.
But this process depends on your digestive timing.
If a medication such as a GLP-1 drug delays stomach emptying, then it could delay the pill’s absorption—and possibly reduce its effectiveness.
GLP-1 and Birth Control
In particular, the main issue is delayed gastric emptying. When food (and medication) sits in the stomach longer, the timing of absorption changes.
GLP-1 medications can:
- Reduce the peak concentration of oral contraceptive hormones
- Delay the time to reach peak levels
In one pharmacokinetic study, oral contraceptives’ efficacy dropped by about 20% when women took them with tirzepatide. But they stayed within the effective range.
This means that efficacy wasn’t totally lost—but hormone levels were measurably lower.
What the Evidence Shows
Clinical trials and FDA labeling offer some clarity:
Semaglutide’s prescribing information confirms that taking semaglutide can affect the absorption of concomitantly administered oral medications. They also recommended discontinuing semaglutide at least two months before a planned pregnancy because of the drug’s long half-life. Half-life refers to the time it takes for a drug’s active substance in your body to reduce by half.
Likewise, tirzepatide, a dual GIP/GLP-1 agonist, shows similar effects in early studies.
The bottom line: It is best to consult your healthcare provider before considering taking contraceptive pills and GLP-1s simultaneously. Never belittle the risk of pregnancy and potential fetal harm.
“Patient safety is Lilly’s top priority, and we actively engage in monitoring, evaluating, and reporting safety information for all our medicines,” reads part of Eli Lilly’s message to Fortune about how GLP-1s can impact pills’ efficacy.
Timing and Practical Guidance
If you use both a GLP-1 agonist and the combined pill, then make sure you have your doctor’s green light. Also, seek their advice on the right timing of dosages.
More importantly, consider switching to a non-oral/barrier forms of contraceptive if timing becomes difficult. Options include:
- Vaginal ring
- Hormonal IUD
- Contraceptive patch
- Injectable contraception
Also, watch for breakthrough bleeding. This could signal that hormone levels are fluctuating—and your contraception may be less reliable.
GLP-1 With Most Effect
The degree to which GLP-1 medications affect oral contraceptive absorption depends on the drug’s half-life and duration of action.
Experts consider semaglutide, which has a half-life of about seven days, to have a moderate impact on pill absorption. This is due to its strong and sustained effect on gastric emptying.
Similarly, dulaglutide, with a half-life of roughly five days, likely exerts a comparable effect, although less data is available.
Tirzepatide, with dual GIP and GLP-1 activity and a half-life around five days, may have even stronger impact. This is based on early pharmacokinetic studies.
In contrast, liraglutide (Victoza®), a daily injectable with a half-life of approximately 13 hours, appears to have less impact. Specifically, it doesn’t affect as much the timing and efficacy of oral contraceptive absorption.
Therefore, shorter-acting GLP-1 medications may be preferable for individuals who want to avoid potential interactions with the pill.
Takeaways
It’s possible that you can safely take GLP-1 medications and the combined oral contraceptive pill—if you manage the timing. But it’s still best to consult your doctor before proceeding.
Here’s what to remember:
- GLP-1s delay gastric emptying, which can delay pill absorption.
- Clinical data show some reduction in hormone levels, but not enough to make the pill ineffective.
- It might be better to consider non-oral birth control options in the meantime.
Frequently Asked Questions
What if I take both at the same time by accident?
One-time overlap is unlikely to cause pregnancy. Resume proper timing the next day and consider backup if you’re unsure.
Are all GLP-1s equally risky with the pill?
No. Weekly injections like semaglutide and tirzepatide may have stronger effects than daily options like liraglutide.
Should I switch to an IUD or patch?
If pill timing becomes hard to manage, non-oral options offer consistent protection and bypass digestive absorption.
What supplements should not be taken with GLP-1?
It might not be advisable to take other weight loss supplements while taking GLP-1. This includes products such as garcinia cambogia, ephedra, and green tea extract. Consider the potential effect on your appetite.
What should I avoid while on GLP-1?
It might not be safe for you to take GLP-1 receptor agonists if you:
- Have personal or family history of Medullary Thyroid Carcinoma (MTC)
- Have a history of pancreatitis
- Have severe Gastrointestinal Disease
- Are pregnant and/or breastfeeding
- Are allergic or have hypersensitivity reactions
- Have Type 1 Diabetes
- Have kidney problems
- Have gallbladder disease
- Are in your senior years
- Have mental health concerns
What drugs should you not take with semaglutide?
Unless you’ve cleared their use with your doctor, you should not take aspirin and other drugs for appetite control. In addition, you should also not take with semaglutide medicines for colds, asthma, cough, or sinus problems.
Can I stop a GLP-1 drug if I get side effects?
Yes, but always talk to your doctor first because some side effects improve with time. Meanwhile, others may signal a serious issue.
What drugs should you not take with semaglutide?
Unless you’ve cleared their use with your doctor, you should not take aspirin and other drugs for appetite control. In addition, you should also not take with semaglutide medicines for colds, asthma, cough, or sinus problems.
Are GLP-1 drugs better than probiotics for increasing hormone levels?
GLP-1 receptor agonists like semaglutide (Ozempic, Wegovy) are effective for diabetes and weight loss. However, they come with side effects. In contast, probiotics and gut-friendly foods may offer a natural, long-term approach to supporting GLP-1 function.
Can I boost GLP-1 levels naturally?
Yes, certain lifestyle changes can stimulate its natural production. For instance, eating foods rich in fiber, protein, and healthy fats can help. In addition, regular exercise and managing blood sugar levels also support its activity.
Photo: Freepik
