Please read the information below carefully if you are using Mounjaro and a Contraceptive tablet or oral HRT. If you feel this applies to you or would like to discuss further, please contact the surgery via Patchs.
Many patients are now using weight loss medications like Tirzepatide (Mounjaro) or Semaglutide (Ozempic, Wegovy, Rybelsus) — either for diabetes or privately for weight loss. These medications work partly by slowing down how your stomach empties — which can affect how well other medicines (like the contraceptive pill or HRT tablets) are absorbed by your body.
Medication
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Brand name examples (commonly known as)
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Tirzepatide
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Mounjaro
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Semaglutide
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Ozempic, Wegovy, Rybelsus
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Exenatide
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Bydureon BCise
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Liraglutide
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Saxenda, Diavic, Victoza
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Dulaglutide
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Trulicity
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Lixisenatide
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Contained in Suliqua
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GLP-1 Agonists and Oral Contraception
What should I do if I am taking the contraceptive pill and using Tirzepatide or a semaglutide:
Tirzepatide (Mounjaro): Tirzepatide may reduce how well the contraceptive pill works. You should use a non-oral methods of contraception (e.g. coil or implant) or a barrier method (like condoms) for four weeks after starting Mounjaro and also for four weeks after increasing your dose of Tirzepatide (Mounjaro). You should also use extra protection (like condoms) if you have vomiting or diarrhoea and should 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) and others: These do not appear to reduce the effectiveness of the pill currently however side effects like vomiting or diarrhoea can still reduce how well the pill is absorbed. Therefore you should 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.
Other GLP-1 Medications such as Exenatide, Liraglutide, Dulaglutide and Lixisenatide are currently not known to have a direct interaction with oral contraception.
Is Emergency Contraception affected if I am taking a GLP-1 medication?
We do not know yet if oral emergency contraception is affected by GLP-1 agonists. The copper IUD (Coil) is the most effective method of emergency contraception and is not affected by diarrhoea and vomiting. If you require emergency contraception, please ensure you tell the healthcare practitioner about all medication you are taking including GLP-1 agonists.
Please see further information here : Patient-information-GLP-1-agonists-and-contraception.pdf which has been created by the Faculty of Sexual and Reproductive Healthcare (February 2025).
GLP-1 agonists and HRT medication
There is some concern that weight loss medications - such as Tirzepatide (Mounjaro) may reduce how well the progesterone tablets (Progesterone, Utrogestan, Norethisterone and Medroxyprogesterone Acetate) 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 my options if I am taking oral progesterone as part of my HRT medication and also on a GLP-1 agonist?
Options are changing the oral progesterone component of HRT to
- A Mirena Coil: which is the most ideal option as it works for 5 years as part of HRT and is also a contraception.
- Combined HRT Patch: contains both oestrogen and progesterone and bypasses the stomach
- Increasing the oral progesterone dose: It is currently recommended that the progesterone dose is doubled for four weeks after initiation of a GLP-1 agonist and also subsequently for four weeks after each increase in GLP-1 agonist dose.
Mounjaro/ GLP1s – Can Mansfield Medical centre Prescribe this for my weight loss.
Currently we are not able to prescribe Mounjaro purely for weight loss. We are aware of the national media coverage advising that GOs can now prescribe these medications which might lead to some confusion. Within Coventry and Warwickshire ICB (Integrated Care Board), GPs are not commissioned and are not allowed to prescribe Mounjaro for weight loss, even if the national criteria are met. There is a specialist community clinic being set up locally which GPs will be able to refer to in due course for patients that meet the eligibility criteria. We do not yet have a date for when this service will be rolled out however it is anticipated to be in Autumn of 2025. We are sorry that this may be disappointing to hear there is a delay. Please see the Coventry and Warwickshire ICB website which gives some more information on the current situation, and you can review the eligibility criteria. It is worth checking back to this website (Link below) periodically to see if the service is up and running, and if you believe that you meet the criteria at that time, we will be happy to discuss are feral with you Weight Management Drugs - Happy Healthy Lives.
Please see the following statement from the primary care weight management service. “To ensure fair and sustainable access, the NHS is carefully planning how to integrate Tirzepatide (Mounjaro) and other GLP-1 agonists into weight management services. In Coventry and Warwickshire, we are undertaking a full review of our obesity care pathways. This work is essential to provide the necessary capacity and support for patients who may benefit from this treatment. What this means for you – NHS referrals: If you need support with weight management, you can be referred to existing combined tier 3 or Tier 4 weight management services through your GP. Private treatment: While private, clinics may offer weight loss medications, the NHS will not take over the prescribing or monitoring of these treatments.
“Right to Choose Providers”: We are aware that at lease one “right to choose” provider, Ovivia, is promoting its online weight loss service directly to patients. Coventry and Warwickshire ICB does not commission Ovia or any other “right to choose” weight management provider at present, because we do not consider their offer to be consistent with our approach and policy to weight loss service in Coventry and Warwickshire.
The Mounjaro injections for weight loss will be delivered by a new weight management service soon. With around 65% of adults in Coventry and Warwickshire being classified as overweight or obese, demand for these medications is expected to be high. By developing robust systems and pathways, we aim to:- Prioritise patients most in need- Ensure safety and proper lifestyle support alongside medication- deliver a fair and consistent service.”