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.
Post #3 describes the usual case. This is about the unusual one.
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.
Adding the measurement that post #3 says would settle 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.
Grateful for the specificity. Vague answers to this question are what sent me looking.
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.
A partial answer, offered because a partial answer beats none.
Pregnancy: these compounds are not approved for pregnancy. The potential risks outweigh potential benefits. Planning windows and washout (several months) are the standard approach.
I had written a reply contradicting post #10 and deleted it. Here is what survived.
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.
Picking up post #12: that is the part I would want checked first.
The most common error here is treating a trial exclusion criterion as a contraindication. They are different documents with different purposes.
Adding the caveat now so it does not have to be extracted later.
Post #12 is right about the mechanism and I think understates the practical bit.
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.
Coming back to post #15, because the follow-up matters more than the original answer.
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.
Nothing here is medical advice, and a contraindication question is one where the cost of a wrong forum answer is high.
Speaking for myself and not for anyone else who has posted here.
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.
Post #19 put the caveat in the right place and I want to underline it.
A caution and a contraindication are different levels and the difference is not stylistic. Conflating them makes the labelling sound more restrictive than it is.
Caveat: everything above assumes the paperwork is what it says it is.
Where a condition appears as a warning rather than a contraindication, the decision is a clinical one rather than a prohibition.
The arithmetic in post #23 is right; the assumption feeding it is the part to check.
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.
Post #27 describes the usual case. This is about the unusual one.
Where a contraindication is relative rather than absolute, the reasoning usually appears in the assessment report rather than the labelling.
Genuinely open to being wrong about this one.
Adding the measurement that post #27 says would settle it.
Pregnancy appears in the labelling for this class and the position is stated explicitly rather than left to inference.