Nobody has said the unglamorous part of pregnancy yet, so: most of the variation is explained by things that are boring to write about and easy to check.
Pregnancy as an absolute contraindication — setting out what I have, and where I think it stops being reliable.
Pregnancy keeps being re-asked here and I think that is because the answer is conditional and the conditions never travel with it.
Attempting to write the conditional version down properly. Corrections welcome and expected — I would like this to end up as a maintained page rather than a fifth thread.
Nobody has said the unglamorous part of pregnancy yet, so: most of the variation is explained by things that are boring to write about and easy to check.
Concurrent insulin or sulfonylureas: not an absolute contraindication but requires dose adjustment and close monitoring for hypoglycemia. The combination is used with caution, not avoided.
A guess, clearly labelled as one.
I read post #3 twice before replying, because I had assumed the opposite.
Disordered eating history: appetite suppression can trigger relapse in people with history of anorexia, bulimia, or other eating disorders. This is a relative contraindication requiring specialist input.
This is the sort of thing the wiki should carry and currently does not.
This follows post #3 rather than contradicting it.
History of pancreatitis: these compounds can rarely trigger pancreatitis. History of pancreatitis increases relative risk. That is a relative contraindication, not absolute, but requires monitoring.
This is the sort of thing that ought to be settled and apparently is not.
A methods point on pregnancy rather than a substantive one: if the comparison is not like for like, the difference you are measuring is the difference in method.
Appreciated. The plain phrasing does more work here than a longer post would.
Medullary thyroid carcinoma (personal or family history) or multiple endocrine neoplasia type 2: absolute contraindication. The rodent preclinical signal is real enough to exclude this population.
Coming back to post #11, because the follow-up matters more than the original answer.
I would put moderate confidence on the mainstream reading of pregnancy and no more. That is not scepticism for its own sake; it is where the sourcing actually stops.
This follows post #12 rather than contradicting it.
The confident answers on pregnancy and the well-sourced answers are not the same answers, which is the most useful thing I have learned reading this category.
I read post #14 twice before replying, because I had assumed the opposite.
A rodent toxicology finding underlying a contraindication is worth understanding, because it explains why the contraindication is narrow rather than broad.
That matches what I was told, which is not the same as knowing it.
No disagreement from me. Posting only so the question does not look ignored.
Pregnancy appears in the labelling for this class and the position is stated explicitly rather than left to inference.
That is the version I would defend. It is not the version I started with.
Prior hypersensitivity to the product or its excipients is a contraindication that people forget applies to the excipients too.
I have separated what I observed from what I concluded, which does not always happen.
Gastroparesis or severe delayed gastric emptying: these compounds slow gastric emptying. Pre-existing severe gastroparesis can be worsened. That is a relative contraindication depending on baseline severity.
Nothing above should be read as advice about what anyone else should do.
On post #19 — agreed on the reasoning, with one qualification.
Pregnancy: these compounds are not approved for pregnancy. The potential risks outweigh potential benefits. Planning windows and washout (several months) are the standard approach.
Caveat: everything above assumes the paperwork is what it says it is.
Reading rather than contributing, but this is the most useful thread I have found on it.
This follows post #23 rather than contradicting it.
Somebody's condition being on a list does not settle the decision, and somebody's condition being absent from one does not either.
The step people skip is the one I have spelled out.
Anyone posting a contraindication claim should include the source. Without one it circulates and hardens.
Coming back to post #27, because the follow-up matters more than the original answer.
Nothing here is medical advice, and a contraindication question is one where the cost of a wrong forum answer is high.
Genuinely open to being wrong about this one.
This is the sort of exchange that makes the archive worth searching.