Saxenda (liraglutide 3.0 mg) is not safe for pregnancy and should be discontinued if pregnancy occurs or is planned. This GLP-1 receptor agonist, licensed for weight management in adults with obesity, lacks sufficient human safety data during pregnancy. Animal studies have shown potential reproductive toxicity, including reduced foetal weight and developmental abnormalities. UK guidance from the MHRA and product licence clearly advises against Saxenda use during pregnancy. Women of childbearing potential should use effective contraception whilst taking Saxenda and discuss pre-conception planning with their GP or prescriber well in advance of attempting to conceive.

Is Saxenda Safe During Pregnancy?

Saxenda (liraglutide 3.0 mg) is not recommended for use during pregnancy. The UK product licence (SmPC) clearly states that Saxenda should not be used during pregnancy and should be discontinued if pregnancy occurs or is planned. This recommendation stems from limited human data on the safety of liraglutide during pregnancy, alongside animal studies that have shown potential adverse effects on foetal development.

Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist originally developed for type 2 diabetes management and subsequently approved for weight management. The medication works by mimicking the action of the naturally occurring hormone GLP-1, which regulates appetite and food intake. Whilst liraglutide has demonstrated efficacy in weight reduction, its effects on the developing foetus remain inadequately studied in human populations.

Animal reproduction studies have identified potential risks. In animal studies, liraglutide has been associated with reproductive toxicity, including reduced foetal weight and skeletal/visceral abnormalities at exposure levels comparable to human therapeutic doses. However, it is important to note that animal studies do not always predict human outcomes, and due to limited human data, the risk to human pregnancies cannot be excluded.

The lack of robust clinical data in pregnant women means healthcare professionals adopt a precautionary approach. Pregnancy itself requires careful nutritional management to support both maternal and foetal health, making weight loss medications generally inappropriate during this period. Women of childbearing potential taking Saxenda should use effective contraception, as advised in the product information, and discuss pregnancy planning with their healthcare provider well in advance.

Weight Management Options for Pregnant Women

Weight management during pregnancy focuses on healthy gestational weight gain rather than weight loss. The National Institute for Health and Care Excellence (NICE) provides clear guidance that intentional weight reduction is not recommended during pregnancy, even for women with obesity. Instead, the emphasis shifts to maintaining a balanced diet, appropriate physical activity, and monitoring for pregnancy-related complications.

For pregnant women with a body mass index (BMI) over 30 kg/m², NICE recommends:

• Enhanced antenatal care with additional monitoring for pregnancy complications

• Dietary advice from a registered dietitian focusing on nutritional quality rather than calorie restriction

• Appropriate physical activity tailored to individual circumstances, typically 150 minutes of moderate-intensity exercise weekly as recommended by the UK Chief Medical Officers' guidance, unless contraindicated

• Assessment of weight only when clinically indicated rather than routine repeated weighing at each appointment

Gestational weight gain should be individualised according to pre-pregnancy BMI and overall health. Women with obesity may benefit from specialist advice about appropriate weight changes during pregnancy, but specific numeric targets are not routinely set in UK practice. The focus remains on nutrient-dense foods that support foetal development, including adequate protein, folate, iron, calcium, and essential fatty acids.

Pregnant women should avoid restrictive dieting, as this may compromise foetal nutrition and development. Women with a BMI ≥30 kg/m² should be offered screening for gestational diabetes with a 75g oral glucose tolerance test at 24-28 weeks, and may be advised to take low-dose aspirin from 12 weeks if at increased risk of pre-eclampsia. Some areas offer specialist antenatal services for pregnant women with obesity, providing multidisciplinary support throughout pregnancy and the postnatal period. The NHS provides access to these services through GP or midwife referral.

Planning Pregnancy While Taking Saxenda

Women planning pregnancy should discontinue Saxenda before attempting to conceive. The UK product information does not specify a particular washout period, but advises that the medication should be stopped if planning pregnancy. Liraglutide has a half-life of approximately 13 hours, meaning it takes several days for the drug to be eliminated from the body. Women should discuss the timing of discontinuation with their prescriber and use effective contraception until reviewed.

Pre-conception planning offers an opportunity to optimise health before pregnancy. Women taking Saxenda who wish to conceive should arrange a pre-conception consultation with their GP or practice nurse. This appointment typically includes:

• Review of current medications and discontinuation of Saxenda with appropriate timing

• Folic acid supplementation at the appropriate dose (5 mg daily for women with BMI ≥30 kg/m² as recommended by the Royal College of Obstetricians and Gynaecologists)

• Assessment of other health conditions such as diabetes, hypertension, or polycystic ovary syndrome

• Discussion of healthy weight management strategies to maintain weight or continue gradual weight loss before conception

• General preconception health optimisation including lifestyle advice and nutritional guidance

Weight loss itself may improve fertility outcomes, particularly in women with polycystic ovary syndrome. Many women with obesity experience improved ovulation and menstrual regularity following weight reduction, potentially enhancing conception chances. However, it is crucial to use reliable contraception until Saxenda has been discontinued as advised by the prescriber.

Some women may benefit from continued weight management support during the pre-conception period through NHS weight management services, dietetic input, or behavioural programmes. Establishing sustainable lifestyle changes before pregnancy helps maintain weight loss and promotes healthier gestational weight gain. Women with significant obesity may be referred to specialist pre-conception services that provide multidisciplinary support tailored to individual needs.

What to Do If You Become Pregnant on Saxenda

If you discover you are pregnant whilst taking Saxenda, stop the medication immediately and contact your GP or midwife. Prompt action ensures appropriate antenatal care can be arranged and any potential risks assessed. Human data on liraglutide exposure during pregnancy are limited, and your healthcare team will need to discuss this with you.

Your healthcare provider will arrange several important steps:

• Confirmation of pregnancy through examination and dating ultrasound scan

• Detailed medical history including duration of Saxenda use and timing relative to conception

• Booking appointment with the midwifery team, ideally before 10 weeks of pregnancy

• Risk assessment for pregnancy complications, with enhanced monitoring if indicated

• Referral to specialist services if additional support is needed

Early antenatal care follows standard pathways for women who have taken Saxenda during early pregnancy. The standard 20-week anomaly scan provides detailed assessment of foetal anatomy and can identify most structural abnormalities. Any additional scans would only be arranged if clinically indicated, not routinely due to liraglutide exposure alone.

Do not restart Saxenda during pregnancy or whilst breastfeeding. According to the product information, liraglutide should not be used during breastfeeding as it is unknown whether the medication passes into breast milk. Women wishing to resume weight management after pregnancy should discuss timing with their healthcare provider, particularly if breastfeeding.

If you experience any concerning symptoms during pregnancy—such as severe abdominal pain, vaginal bleeding, reduced foetal movements, or signs of pre-eclampsia (severe headache, visual disturbances, or sudden swelling)—contact your midwife or maternity unit immediately. These symptoms require urgent assessment regardless of previous Saxenda use. Your antenatal team will provide individualised guidance on weight management, nutrition, and monitoring throughout your pregnancy.

If you experience any suspected side effects from medications, including Saxenda, you can report these through the MHRA Yellow Card scheme.

Frequently Asked Questions