Who Shouldn't Take GLP-1 Medications? What Providers Review

GLP-1 medications are prescription drugs, and they are not right for everyone. A licensed provider reviews your history before deciding whether one is appropriate. This guide summarizes what the manufacturers' safety information says so you know what to expect. It is general information, not a screening tool, and it can't tell you whether a medication is safe for you.

When the labels say not to use them

Wegovy and Zepbound each say not to use the medication if:

• You or any of your family have ever had medullary thyroid carcinoma (MTC), a type of thyroid cancer.
• You have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).
• You have had a serious allergic reaction to the medication (semaglutide or tirzepatide) or any of its ingredients.

Both labels carry a warning about possible thyroid tumors. In studies with rodents, these medicines caused thyroid tumors, including thyroid cancer, and it is not known whether they cause such tumors in people.

Other products, other medicines

Wegovy and Zepbound each say they should not be used with other products containing the same active ingredient or with other GLP-1 receptor agonist medicines.

Conditions to discuss with your provider first

The manufacturers ask patients to tell their provider about these situations before starting:

Wegovy (NovoCare):

• Problems with your pancreas or kidneys
• Type 2 diabetes with a history of diabetic retinopathy
• Scheduled surgery or procedures that use anesthesia or deep sedation
• Pregnancy or plans to become pregnant. NovoCare says Wegovy may harm an unborn baby and that you should stop using it 2 months before you plan to become pregnant
• Breastfeeding. NovoCare says breastfeeding is not recommended during treatment with Wegovy tablets, and that it is not known whether the injection passes into breast milk
• Other medicines, especially diabetes medicines such as sulfonylureas or insulin, because Wegovy slows stomach emptying and can affect medicines that need to pass through the stomach quickly

Zepbound (Lilly):

• Problems with your pancreas, or severe stomach problems such as slowed stomach emptying (gastroparesis) or problems digesting food
• Diabetes medicines such as insulin or sulfonylureas
• A history of diabetic retinopathy
• Scheduled surgery or procedures that use anesthesia or deep sedation
• Other prescription or over-the-counter medicines, vitamins, and supplements
• Pregnancy, plans to become pregnant, breastfeeding, or plans to breastfeed. Lilly says Zepbound may harm an unborn baby and may pass into breast milk, and it describes a pregnancy exposure registry
• Birth control pills. Lilly says they may not work as well while using Zepbound and that a provider may recommend another type of birth control for 4 weeks after starting and after each dose increase
• Mood changes. Lilly lists depression or thoughts of suicide among its warnings

Children

Safety information differs by product and age group. Lilly states it is not known whether Zepbound is safe and effective in children. NovoCare lists age-specific statements for Wegovy injection and tablets. Check the current label for the product and age in question and talk with a pediatric provider.

What a provider typically reviews

A thorough evaluation usually covers:

1. Your medical history and family history
2. Current medications, supplements, and allergies
3. Measurements and tests your provider considers necessary
4. Your goals and previous efforts
5. How follow-up and monitoring will work

A provider may decide a medication is not appropriate, recommend a different approach, or ask for more information first. That is why a prescription cannot be guaranteed.

Tips for your evaluation

• Be complete and honest about your history and medications. Leaving something out can affect your safety.
• Bring a list of medications, supplements, and allergies.
• Ask what would make a medication a poor choice for you, and what alternatives exist.
• Ask what to watch for and how to reach the clinic. See GLP-1 side effects and when to call your provider.

Red flag: no real screening

The FDA lists, among telehealth red flags, a company that does not require a screening and prescription by a licensed doctor before providing medicine. See how to spot a legitimate GLP-1 telehealth provider.

Bottom line

Eligibility is an individual medical decision. If you're considering a GLP-1 medication, share your complete history with a licensed provider and ask questions until you're comfortable with the answers.