Tirzepatide delays gastric emptying, and its label advises that this can reduce exposure to oral hormonal contraceptives, most around the start of treatment and after each dose increase. Women relying on an oral contraceptive are advised to switch to a non-oral method or add a barrier method for four weeks after starting and after each dose escalation.
The advice is easy to miss because the dose rises every few weeks during titration, and the conversation that happened at the first prescription may not happen again. The same consultation is the moment to ask about pregnancy plans, since these drugs should be stopped before a planned conception.
- Ask every woman of reproductive age starting tirzepatide which contraceptive she uses.
- Advise a non-oral method, or a barrier method added for four weeks after starting and after each dose increase, if she relies on the pill.
- Repeat the advice at each titration step, not only at the first prescription.
- Ask about pregnancy plans in the same conversation.
Why it matters
Contraception advice shouldn't disappear after the first prescription when the dose keeps rising.
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