Zepbound and Pregnancy: Birth Control, Trying to Conceive and Breastfeeding (What the Label Says)

Zepbound is a prescription medicine that contains tirzepatide, made by Eli Lilly and Company. Its FDA-approved label answers most pregnancy questions in four sections: 7.2 (birth control pills), 8.1 (pregnancy), 8.2 (breastfeeding) and 8.3 (patients who could become pregnant). This guide quotes them word for word.

Label quotes come from the Zepbound label on DailyMed, revised 8/2026 and read on September 30, 2026, checked against the same text in FDA's openFDA label service (version 40). Quotes keep the label's capital letters. This page does not reprint doses, strengths or schedules.

*Key takeaways*

• The label states that "Weight loss offers no benefit to a pregnant patient and may cause fetal harm" and advises stopping Zepbound when a pregnancy is recognized (label, section 8.1).
• Zepbound may make birth control pills less effective. The label advises switching to a non-oral method, or adding a barrier method, "for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation" (label, sections 7.2 and 8.3).
• The label says hormonal contraceptives "that are not administered orally should not be affected". That wording covers methods such as a hormonal IUD, implant, patch, ring or shot (label, section 7.2).
• The Zepbound label does not set a number of weeks or months to stop before trying to conceive. The Wegovy and Ozempic labels, which are for semaglutide, do. For tirzepatide, that timing is a decision to make with your clinician.
• In a single-dose study in 11 lactating women, tirzepatide was undetectable in 164 of 171 breast milk samples, and the label says there are no data on effects in the breastfed infant (label, section 8.2).

Can you take Zepbound while pregnant?

No, according to the label. Section 8.1 of the Zepbound label is direct: "Weight loss offers no benefit to a pregnant patient and may cause fetal harm. Advise pregnant patients that weight loss is not recommended during pregnancy and to discontinue ZEPBOUND when a pregnancy is recognized".

Human data are limited. The label states: "Available data with tirzepatide in pregnant patients are insufficient to evaluate for a drug-related risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes."

The label also points to animal studies: "Based on animal reproduction studies, there may be risks to the fetus from exposure to tirzepatide during pregnancy." In rats, "fetal growth reductions and fetal abnormalities occurred at clinical exposure in maternal rats based on AUC"; in rabbits, "fetal growth reductions were observed at clinically relevant exposures based on AUC". The label adds that "These adverse embryo/fetal effects in animals coincided with pharmacological effects on maternal weight and food consumption". MotherToBaby, a service of the Organization of Teratology Information Specialists, adds: "In animal studies, an increased chance for some birth defects was seen. However, it is unclear if these birth defects were due to the medication or other factors in the study (such as weight loss, or poorly controlled diabetes)."

For context, section 8.1 of the Zepbound label (revised 8/2026) gives background rates that apply to pregnancies in general: "In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively." The same section states that the background risk "for the indicated population is increased when compared to the general population", meaning the people Zepbound is approved to treat.

The label also explains why weight loss is not a goal in pregnancy: "Appropriate weight gain based on pre-pregnancy weight is currently recommended for all pregnant patients, including those with obesity or overweight".

Does Zepbound make birth control pills less effective?

It may, during specific windows. Section 8.3 of the Zepbound label explains the reason: "Use of ZEPBOUND may reduce the efficacy of oral hormonal contraceptives due to delayed gastric emptying. This delay is largest after the first dose and diminishes over time."

The instruction appears in section 7.2 and again in section 8.3: "Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method, or add a barrier method of contraception for 4 weeks after initiation with ZEPBOUND and for 4 weeks after each dose escalation."

The Medication Guide, written for patients, puts it plainly: "Birth control pills by mouth may not work as well while using ZEPBOUND."

Section 12.3 describes the study behind the warning. A combined birth control pill was given with a single dose of tirzepatide. Peak blood levels of the pill's hormones fell by more than half, total exposure fell by about a fifth, and the time to peak was delayed by 2.5 to 4.5 hours. These are changes in hormone levels after one dose; the label does not report pregnancy rates. The study used a combined pill, while the instruction in sections 7.2 and 8.3 covers oral hormonal contraceptives in general, which include progestin-only pills.

The label does not say which non-oral method to choose. The Medication Guide says: "Talk to your healthcare provider about birth control methods that may be right for you while using ZEPBOUND."

Which birth control methods are affected, and which are not?

The label's warning covers hormonal birth control taken by mouth. It names barrier methods as a backup and does not mention non-hormonal methods such as the copper IUD. This table sorts common methods by what the label says.

The label does not list non-oral methods one by one; the table applies its sentence on hormonal contraceptives "not administered orally" to each.

How long should you stop Zepbound before trying to get pregnant?

The Zepbound label does not give a number. It says to stop when a pregnancy is recognized (section 8.1) and to adjust pill-based birth control (sections 7.2 and 8.3), but a search of the full label text on September 30, 2026 found no waiting period before a planned pregnancy. The Medication Guide does ask patients to tell their healthcare provider if they "are pregnant or plan to become pregnant", and it says: "ZEPBOUND may harm your unborn baby."

Here the tirzepatide and semaglutide labels differ, and they are often mixed up online. The Wegovy label, section 8.3, says: "Because of the potential for fetal harm, discontinue WEGOVY in patients at least 2 months before they plan to become pregnant to account for the long half-life of semaglutide". The Ozempic label, section 8.3, says: "Discontinue OZEMPIC in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide". Those are semaglutide instructions. They are not in the Zepbound label, so this page does not carry them over.

What the Zepbound label does give is the half-life. Section 12.3 states: "The elimination half-life is approximately 5-6 days in patients with overweight or obesity". MotherToBaby puts it this way: "In healthy adults, it can take up to 30 days, on average, for most of the tirzepatide to be gone from the body." For more on this, see how long tirzepatide stays in your system.

On fertility, the label's animal data are mixed. In rat fertility studies (section 13.1), "No effects of tirzepatide were observed on sperm morphology, mating, fertility, and conception", but female rats had prolonged diestrus (a longer resting phase of the rat reproductive cycle), fewer corpora lutea, and fewer implantation sites and viable embryos at every dose tested, effects the label "considered secondary to the pharmacological effects of tirzepatide on food consumption and body weight". For people, MotherToBaby states: "It is not known if tirzepatide can make it harder to get pregnant." It also notes that "Obesity and elevated blood glucose can make it harder to get pregnant".

Because the label sets no interval, when to stop before trying to conceive, and which birth control to use until then, is a decision for you and your clinician, ideally made before you stop contraception.

What should you do if you find out you are pregnant on Zepbound?

The label's instructions are short:

• Stopping is the label's instruction. Section 8.1 advises pregnant patients "to discontinue ZEPBOUND when a pregnancy is recognized".
• Tell your healthcare provider. Section 17 of the label says: "Advise patients to inform their healthcare provider if they are pregnant or intend to become pregnant during treatment with ZEPBOUND." Tell the clinician who prescribed Zepbound and the clinician who will care for your pregnancy.
• Consider the pregnancy exposure registry. Section 8.1 states: "Pregnant patients exposed to ZEPBOUND and healthcare providers are encouraged to register by calling 1-844-524-0039 or emailing at MILEregistry@thermofisher.com."
• Ask questions about the exposure. MotherToBaby lists its Exposure Information Service, 866-626-6847, on its tirzepatide fact sheet.

The label does not say what an exposure early in pregnancy means for a particular pregnancy; section 8.1 states that the human data are insufficient to evaluate the risk.

What does the research show about GLP-1 medicines in early pregnancy?

Section 12.1 of the label states: "Tirzepatide is a GIP receptor and GLP-1 receptor agonist." The studies below report GLP-1 medicines as a class, not tirzepatide alone.

The three reach cautious conclusions. Cesta and colleagues found no large increase in major malformations, Brown and colleagues found risks were "not definitively higher" with continued use, and Ozbek and colleagues found exposure was "not consistently associated" with increased risk. None rules a risk out: Cesta and Brown call some estimates imprecise, and Ozbek notes that data on continued use remain limited. None of the abstracts gives a separate result for tirzepatide, and the studies do not replace the label's instruction to stop Zepbound when a pregnancy is recognized.

Can you breastfeed while taking Zepbound?

The label does not say yes or no; it asks for a weighing of benefits and unknowns. Section 8.2 of the Zepbound label states: "In a single-dose clinical lactation study, the concentration of tirzepatide in breast milk was found to be either undetectable or low compared to the maternal administered dose". The study included 11 healthy lactating women who each received one dose, and tirzepatide was undetectable in 164 of the 171 milk samples tested.

The same section is clear about what is not known: "There are no available data on the effects of tirzepatide on the breastfed infant or on milk production." And it sets out the decision: "The developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for ZEPBOUND and any potential adverse effects on the breastfed infant from ZEPBOUND or from the underlying maternal condition."

MotherToBaby adds: "Tirzepatide might pass into breast milk in very small amounts. Any of the tirzepatide in breast milk is likely to break down in the infant's gastrointestinal (GI) tract and not be well-absorbed by the infant." The Medication Guide says "ZEPBOUND may pass into your breast milk" and advises: "Talk to your healthcare provider about the best way to feed your baby while using ZEPBOUND."

Can Zepbound lead to an unplanned pregnancy?

It might, if you rely on birth control pills. For tirzepatide, the label points to one known mechanism: delayed stomach emptying can reduce how well birth control pills work in the windows described above. MotherToBaby spells out the consequence: "This might increase the chance of pregnancy, even if the oral birth control is taken correctly." The sources on this page do not establish how often unplanned pregnancies happen on these medicines, or why any one of them happened. For semaglutide and the menstrual cycle, see does semaglutide affect your period.

How do the tirzepatide and semaglutide labels compare on pregnancy?

Zepbound and Mounjaro contain the same active ingredient, tirzepatide. Wegovy and Ozempic contain semaglutide. Their labels word pregnancy differently. This table compares label wording, not the medicines. Text in quotation marks is quoted from the label named in the first column; text without quotation marks is our summary of that label.

Mounjaro and Ozempic are approved for type 2 diabetes, and their pregnancy sections are written for that use: the Mounjaro label notes that "There are risks to the mother and fetus associated with poorly controlled diabetes in pregnancy". Their benefit-and-risk sentence is not a statement that either medicine is safe in pregnancy. For weight loss, the Zepbound label says it "offers no benefit to a pregnant patient", and the Wegovy label says to discontinue Wegovy in pregnant patients using it for weight reduction. See also Zepbound vs Mounjaro and Zepbound side effects.

What to ask your clinician before starting or stopping

These questions can help you prepare for the conversation:

1. I take a birth control pill. Which non-oral method or backup fits me during the 4-week windows the label describes?
2. I am planning a pregnancy. The Zepbound label sets no waiting period, so when should I stop, and why?
3. Should I take a pregnancy test before I start?
4. What should I do on the day I get a positive pregnancy test?
5. If I stop Zepbound, how will we manage my weight, blood sugar or other conditions before and during pregnancy?
6. I am breastfeeding. How do the label's lactation data apply to my baby?
7. Should I join the pregnancy exposure registry if I was exposed?

What the primary sources say

• Eli Lilly and Company via DailyMed, Zepbound (tirzepatide) prescribing information, revised 8/2026 (accessed September 30, 2026): section 8.1, "Weight loss offers no benefit to a pregnant patient and may cause fetal harm."; section 8.3, "Use of ZEPBOUND may reduce the efficacy of oral hormonal contraceptives due to delayed gastric emptying."; section 7.2, "Hormonal contraceptives that are not administered orally should not be affected"; section 8.2, "There are no available data on the effects of tirzepatide on the breastfed infant or on milk production."
• U.S. Food and Drug Administration, openFDA drug label API, Zepbound label version 40, effective August 28, 2026 (accessed September 30, 2026): the same label text, including section 4, which lists as contraindications a personal or family history of medullary thyroid carcinoma or MEN 2 and "Known serious hypersensitivity to tirzepatide or any of the excipients in ZEPBOUND."
• Eli Lilly and Company via DailyMed, Mounjaro (tirzepatide) prescribing information, revised 8/2026 (accessed September 30, 2026): section 7.2, "Advise patients using oral hormonal contraceptives to switch to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiation and for 4 weeks after each dose escalation with MOUNJARO."
• Novo Nordisk via DailyMed, Wegovy (semaglutide) prescribing information, revised 6/2026 (accessed September 30, 2026): section 8.3, "Because of the potential for fetal harm, discontinue WEGOVY in patients at least 2 months before they plan to become pregnant to account for the long half-life of semaglutide".
• Novo Nordisk via DailyMed, Ozempic (semaglutide) prescribing information, revised 5/2026 (accessed September 30, 2026): section 8.3, "Discontinue OZEMPIC in women at least 2 months before a planned pregnancy due to the long washout period for semaglutide".
• MotherToBaby (Organization of Teratology Information Specialists), Tirzepatide fact sheet, June 1, 2026 (accessed September 30, 2026): "In healthy adults, it can take up to 30 days, on average, for most of the tirzepatide to be gone from the body."; "It is not known if tirzepatide can make it harder to get pregnant."
• Cesta CE and colleagues, JAMA Internal Medicine 2024;184(2):144-152 (accessed September 30, 2026): "results did not indicate a large increased risk of MCMs above the risk conferred by maternal T2D requiring second-line treatment."
• Brown JP and colleagues, Annals of Internal Medicine 2026;179(7):929-937 (accessed September 30, 2026): "estimates for MCM and SGA were imprecise and were compatible with both no increased risk and clinically relevant differences in risk."
• Ozbek L and colleagues, Diabetes, Obesity and Metabolism 2026;28(6):4503-4528 (accessed September 30, 2026): "data on continued use throughout gestation remain limited."

Every source is listed with its address below.

This article is for informational purposes only and does not constitute medical advice. Label sentences are quoted word for word from the FDA-approved prescribing information named above, as published on DailyMed on September 30, 2026, and study findings are quoted from the published abstracts. Labels change, so read the current label and the Medication Guide that came with your own medicine, and talk with your clinician before starting, stopping or changing any medicine, including birth control.

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