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Washout approach (more common): Administer final Wegovy dose Wait 7 to 10 days (approximately 1.5 half-lives) Start Zepbound 2.5 mg Rationale: minimizes overlapping GLP-1 receptor activation, reduces nausea risk Overlap approach (less common, used when continuous appetite suppression is critical): Administer final Wegovy dose Start Zepbound 2.5 mg 3 to 4 days later Rationale: prevents gap in therapeutic effect during washout Risk: higher nausea and GI side effect burden during overlap window Most providers use washout
The Denmark cohort study found that women exposed to semaglutide in early pregnancy had comparable outcomes to those on insulin alone
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