Who Should Not Take a GLP-1 Medication

The second list: warnings, not rule-outs

Contraindications and warnings are different sections of the label and carry different weight. The placements in the table below follow each product's FDA prescribing information as of August 2026.

Wegovy's Warnings and Precautions include risk of thyroid C-cell tumors, acute pancreatitis, acute gallbladder disease, hypoglycemia, acute kidney injury due to volume depletion, severe gastrointestinal adverse reactions, hypersensitivity reactions, diabetic retinopathy complications in patients with type 2 diabetes, heart rate increase, and pulmonary aspiration during general anesthesia or deep sedation. Mounjaro's Warnings and Precautions section covers risk of thyroid C-cell tumors, acute pancreatitis, hypoglycemia with concomitant use of insulin secretagogues or insulin, hypersensitivity reactions, acute kidney injury due to volume depletion, severe gastrointestinal adverse reactions, diabetic retinopathy complications in patients with a history of diabetic retinopathy, acute gallbladder disease, and pulmonary aspiration during general anesthesia or deep sedation. The Zepbound label's Warnings and Precautions section covers risk of thyroid C-cell tumors, severe gastrointestinal adverse reactions, acute kidney injury due to volume depletion, acute gallbladder disease, acute pancreatitis, hypersensitivity reactions, hypoglycemia, diabetic retinopathy complications in patients with type 2 diabetes mellitus, pulmonary aspiration during general anesthesia or deep sedation, and never sharing a Zepbound KwikPen between patients.

Condition by condition

Medullary thyroid cancer in the family

The labels name medullary thyroid carcinoma. A first-degree relative's diagnosis matters here; the exact tumor type is what a provider will ask for.

Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)

MEN 2 appears in the same contraindication sentence as MTC on every label above. A personal history or a confirmed family history is a rule-out on the label, not a monitoring item.

A past serious reaction to semaglutide or tirzepatide

If you have previously had a serious hypersensitivity reaction to the molecule or to an excipient in the product, that product is contraindicated. This is drug-specific: the labels write it per ingredient. The phrasing differs slightly between the two molecules — the semaglutide labels contraindicate a "prior serious hypersensitivity reaction" to semaglutide or its excipients, while the tirzepatide labels contraindicate "known serious hypersensitivity" to tirzepatide or its excipients. Either way, what matters is telling your provider about any past reaction, including which product and which reaction.

Taking insulin or an insulin secretagogue

Not a rule-out. It is a dosing problem. Hypoglycemia with concomitant use of insulin secretagogues or insulin sits in the Warnings and Precautions section, which is why a provider needs your full current medication list before starting.

Already taking another GLP-1

Concomitant use of Wegovy tablets or Wegovy injection with other semaglutide-containing products or with any other GLP-1 receptor agonist is not recommended. Coadministration of Zepbound with other tirzepatide-containing products or with any GLP-1 receptor agonist is not recommended. Switching from one to another is a supervised transition, not an overlap.

Age

Both Zepbound indications are limited to adults; the safety and effectiveness of Zepbound have not been established in pediatric patients. The indications for Wegovy tablets are limited to adults; the pediatric weight-reduction indication for patients aged 12 years and older applies to Wegovy injection only. The label pairs those two limits in one sentence: the safety and effectiveness of Wegovy tablets have not been established in pediatric patients or in patients with MASH. So the adult MASH indication is injection-only as well, and form matters for more than convenience. All three OZEMPIC injection indications are restricted to adults with type 2 diabetes mellitus. Mounjaro is indicated as an adjunct to diet and exercise to improve glycemic control in adults and pediatric patients 10 years of age and older with type 2 diabetes mellitus.

Using an oral contraceptive pill

Not a rule-out, but it changes what you need to do. Females of reproductive potential using oral hormonal contraceptives should switch to a non-oral contraceptive method or add a barrier method of contraception for 4 weeks after initiating Mounjaro and for 4 weeks after each dose escalation.

Surgery or a procedure under sedation

The Zepbound label warns of pulmonary aspiration during general anesthesia or deep sedation. Tell whoever is scheduling the procedure that you are on a GLP-1.

Four things the standard bullet lists get wrong

Each correction below is drawn from the FDA prescribing information for these products — the Contraindications, boxed warnings, and Warnings and Precautions sections, as of August 2026.

"Any thyroid cancer." The labels say medullary thyroid carcinoma. That is a specific tumor type, and it is the one written into the contraindication.

"It causes thyroid cancer." The boxed warnings describe a rodent finding. It is unknown whether Wegovy causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans, as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.

"Pancreatitis means never." Acute pancreatitis has occurred in clinical trials with semaglutide; Wegovy should be discontinued promptly if pancreatitis is suspected and should not be restarted if pancreatitis is confirmed. That is a rule about stopping, and it is in Warnings and Precautions, not Contraindications. Read that placement carefully, though. Acute pancreatitis is a serious condition, and the label's instruction not to restart after a confirmed episode is absolute. "Not an automatic exclusion" means a prescriber weighs it deliberately, with your history in front of them — it does not mean it is a minor detail to mention in passing.

"GLP-1s are all shots." Wegovy is marketed in two distinct dosage forms under a single brand name and a single FDA label: WEGOVY (semaglutide) injection, solution, and WEGOVY (semaglutide) tablet. Zepbound is administered exclusively as a subcutaneous injection; the FDA label describes it only as 'injection, for subcutaneous use' and no oral dosage form of Zepbound is listed in the label.

How Measured screens

Measured's intake begins with a 2-3 minute eligibility quiz followed by a more detailed medical assessment, after which a provider reviews the information and creates a personalized treatment plan. Measured states all healthcare providers on its platform are licensed U.S. physicians or nurse practitioners with training and experience in obesity medicine and weight management.

Two things to know: Measured states lab work is not routinely required to participate in its program, though a provider may recommend or request laboratory testing based on the patient's medical history, current health conditions, medications, or individual treatment needs. And Measured states video is not required for medication consultations, and that medical evaluations and follow-up care are conducted asynchronously through secure, HIPAA-compliant messaging within the Measured patient portal.

On thresholds generally: meeting a telehealth program's enrollment criteria is not the same as being approved for a medication. Provider review determines whether treatment is offered, and the FDA-approved indication for the specific medication governs the population it is labeled for.

A decline about safety is not a decline about access

If a provider decides a GLP-1 is not clinically appropriate for you, that is a safety decision and paperwork cannot change it. Measured prescribes FDA-approved GLP-1 medications and compounded alternatives, specifically semaglutide (Ozempic, Wegovy), tirzepatide (Mounjaro, Zepbound), compounded alternatives when brand medications are unavailable, and oral medications including metformin, topiramate, and bupropion/naltrexone. Compounded medications are not reviewed or approved by the FDA for safety or effectiveness. Whether any of these is right for you is a provider decision, not a menu choice.

If the obstacle is access rather than safety, the paths are different. Measured is available in 26 states, which it says allows it to serve roughly 80% of the U.S. population (as of August 2026). For patients with commercial insurance, Measured performs a benefits check to determine which medications may be covered under the patient's plan, and Measured's insurance concierge team submits prior authorizations on the patient's behalf and keeps the patient updated on the insurance plan's determination. Coverage depends entirely on your specific plan and no approval is promised.

What this article does not cover

We only publish what we can source. This page does not address pregnancy, breastfeeding or trying to conceive; gastroparesis or other gastric motility conditions; a history of eating disorders; chronic kidney disease staging; type 1 diabetes; or thyroid cancer types other than medullary. The omission is deliberate. Ask your provider directly, and bring the specific diagnosis with you.