Most people have missed a dose of prescription medication at some point. But if you are taking a glucagon-like peptide-1 (GLP-1) drug for weight loss, the protocol for getting back on track may be different than missing a dose of antibiotics.
“GLP-1 receptor agonists work to decrease your appetite and help you feel fuller sooner,” says UCLA Health clinical nutrition expert Mopelola Adeyemo, MD, MPH. “Those effects can wear off when you don’t take it as prescribed. After a two-week gap, you’ll want to circle back with your provider before restarting the medication.”
Whether you go on vacation without packing your medication, experience a manufacturer shortage or simply forget to take it, you should know how to handle a gap in your treatment. Dr. Adeyemo shares what you need to know when you miss your GLP-1 medication:
What happens when you stop taking GLP-1 receptor agonists?
Weight loss medications such as Zepbound or Wegovy may not completely leave your system for 30 days. But after just five to seven days, the amount of medication in your body decreases to half. After two missed doses (14 days without medication), some people may experience adverse side effects, such as gastrointestinal discomfort, if they resume their prescription at the same dosage.
Stopping the medication should not cause any type of adverse withdrawal symptoms. But without the drugs in your system, you will likely have an increased appetite that may cause you to eat more and regain some of the weight you lost.
“Everyone responds differently when they stop taking their medication,” Dr. Adeyemo says. “Be conscious of your portion sizes and increase your non-starchy vegetables. The fiber in them can make you feel fuller to account for the increase in hunger you may experience.”
How to handle a gap in GLP-1 weight loss treatment
Each manufacturer has specific recommendations about handling missed doses and longer gaps in treatment. Your provider can also work with you to adjust to medication changes safely. But Dr. Adeyemo says that most GLP-1 drugs involve the same general protocol:
If you miss a dose…
If you can’t administer your medication on your usual day and can do so within a few days, it shouldn’t be a problem. Your weight loss and how you feel should remain unaffected. But plan to adjust your next dose so your doses are a week apart.
“If you miss a dose of Zepbound, for example, just take it as soon as possible, within four days,” Dr. Adeyemo says. “Otherwise, resume your medication at the next scheduled dose. You never want to take two doses in one week.”
If you miss two or more weeks of medication…
Once you’ve missed two doses of GLP-1 medication, it’s challenging to know just how much of the drug remains in your system. If most of the drug is gone, you may experience side effects if you resume the medicine at your regular dose.
“The best thing to do after two weeks is to reach out to your prescribing physician,” Dr. Adeyemo says. “When someone first starts treatment with a GLP-1 receptor agonist, we slowly introduce the medication for a reason — there’s a risk of gastrointestinal side effects as your body gets used to the drug. If the drug is now out of your system, you’re back in the same boat.”
Dr. Adeyemo notes that involving your provider as soon as possible is critical when you’ve missed (or will miss) two doses.
“Let’s say you’ve been on a higher dose, and it took you five months to build up to that dose,” she explains. “You might be able to resume your medication but at a lower dosage — like what you were taking at four months. If you wait too long to engage your provider, you may have to go all the way back to your initial starting dose.”
If your dose is not currently available…
Sometimes, manufacturer shortages force a treatment gap beyond your control. When that happens, avoid buying medication online or from unreputable sources. Instead, work with your provider to create a safe and reasonable plan. If your dosage is unavailable, you can take a lower dose or may be ready for a higher one. Either way, it doesn’t have to derail your progress or leave you in an unsafe position.
“The biggest concern for many people is losing the progress they’ve made,” Dr. Adeyemo says. “So, even though they’ve been off their medicine for a month, they restart at the highest dose they’ve taken without checking in with their prescribing provider first. In those types of situations, there’s risk of people getting really sick.”
If shortages continually affect your treatment, you can talk to your provider about potentially converting from one brand to another. There are currently no clear guidelines for changing brands of glp-1 agonists. Your doctor can help you navigate the dose.
Tips for avoiding a gap in GLP-1 treatment
Gaps in treatment can be frustrating, but you can take a few steps to reduce the risk of it happening and lessen the impact on your weight loss. Dr. Adeyemo recommends:
- Check the manufacturer’s website often to stay aware of potential drug shortages.
- Refill your prescriptions as soon as the pharmacy and your insurance will allow so that you have time to adjust to a shortage if needed.
- Talk to your health care provider as soon as you have concerns about a treatment gap.
“We know that typically people will regain weight when they come off GLP-1 drugs for an extended period,” Dr. Adeyemo says. “But you can get back to where you were quickly, even if you must start back on a lower dose. The point is to get you to your personal goal while keeping you safe and healthy.”
