Many patients are now sourcing prescriptions for weight loss medication from private providers.
When we are informed of this, we inform these providers that we are unable to review your medical history on their behalf safety and for contraindications. The practice is under substantial pressure to provide NHS care and is not resourced to review notes on behalf of private providers. We advise them to ask the patient to access their notes online/via the NHS app, and you can go through these with you themselves. Alternatively, you can request copies of your medical records to share with them. We also inform them, for the avoidance of doubt, the medicolegal liability for ensuring that there are no contraindications to your prescribing lies entirely with them, and they should not assume that the lack of a positive reply from us means that no contraindications exist.
Important notice for patients using weight loss medications and taking the pill or HRT
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) areabsorbed by your body.
If you take the contraceptive pill:
Tirzepatide (Mounjaro)
This medicine may reduce how well the pill works.
You should:
- Use a non-oral method (e.g. coil or implant) or
- Add a barrier method (like condoms) for 4 weeks after starting or increasing the dose.
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.
Semaglutide (Ozempic, Wegovy, Rybelsus) and others
- These do not appear to reduce the effectiveness of the pill.
- But side effects like vomiting or diarrhoea can still reduce how well the pill is absorbed. So, 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
Please see further information here: Patient-information-GLP-1-agonists-andcontraception.pdf
If you’re taking Hormone Replacement Therapy (HRT):
This applies if your HRT includes progesterone tablets like:
- Progesterone or Utrogestan
- Norethisterone
- Medroxyprogesterone acetate
There is some concern that weight loss medications – such as Tirzepatide (Mounjaro)
and Semaglutide (Ozempic, Wegovy, Rybelsus) – may reduce how well these tablets 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 the options?
Please contact us to talk through the best choice for you.
Options include:
Mirena coil (IUS):
- The ideal option in most cases.
- Works for 5 years as part of HRT and is also contraceptive.
Combined HRT Patch:
- Contains both hormones (oestrogen + progestogen) and bypasses the stomach.
Increase oral progesterone dose: - Your GP may recommend a higher dose for 4 weeks after starting or increasing
the dose of your weight loss medication.