HealthRX.com · Printable symptom log
Wegovy activity and symptom log for adults in later life
Use this sheet to record movement sessions, dizziness, tiredness, fluid intake and heart rate readings while taking Wegovy. Bring it to your prescriber or pharmacist to discuss your activity plans.
Medicine and activity details
Write these from your pen label and your own routine. Ask your prescriber to confirm anything unclear.
Wegovy pen strength in useCopy exactly as printed on the pen
Injection day each weekThe day you usually inject
Date treatment started
Kind of activity you planFor example walking, chair exercise or a group class
Diabetes medicines taken, if anyInsulin or sulfonylurea names
Heart or kidney conditions notedWrite what your prescriber has told you
Bring and confirm before your visit
Gather these so your prescriber can review activity, dizziness and fluid symptoms together.
- Bring this log filled in for the weeks since your last visit
- List every prescription, over the counter medicine and supplement you take
- Check with your pharmacist how Wegovy may interact with your current medicines
- Confirm with your prescriber whether your heart rate should be checked at home
- Write down any fainting, near fainting or falls, with the date they happened
- Note any nausea, diarrhea or vomiting that has made fluids hard to keep up
- Bring your blood sugar records if you check them
Questions for your prescriber or pharmacist
- Does the label's advice on physical activity apply to the exercise I plan to do?
- Which activity types would you suggest I start with while taking Wegovy?
- What heart rate changes should I report to you between visits?
- How should I adjust my activity if dizziness happens after an injection?
- Should my diabetes medicine be reviewed as my activity level changes?
- What fluid plan should I follow if I have stomach symptoms?
- Would a supervised class or community program be appropriate for my situation?
- Does my kidney function need checking before I increase my activity?
Daily movement and symptom record
Write one row per day. Note the time of any dizziness and whether you were sitting or standing.
| Date | Movement done | Dizziness or tiredness | Fluids taken | Heart rate noted | Notes |
|---|---|---|---|---|---|
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.