HealthRX.com · Printable side-effect diary
Saxenda side effect diary for liraglutide users
Use this sheet to track side effects you notice on Saxenda, including nausea, low blood sugar, gallbladder symptoms and heart rate changes. Bring it to your prescriber or pharmacist.
About my treatment
Write what is on your medicine box and your current care plan.
Medicine name as printedFor example the brand or liraglutide
Month treatment startedMonth and year
Current weekly stepWrite the step your prescriber gave you
Diabetes diagnosisWrite yes or no
Other diabetes or sulfonylurea medicinesList names exactly as on the label
Side effects I noticed
Add a row each time something new happens or changes.
| Date | What I noticed | How long it lasted | Did I contact my provider |
|---|---|---|---|
Before my visit
- Bring the Saxenda pen or box to the appointment
- Write down every medicine and supplement you take
- List any low blood sugar readings and the time you took them
- Note any belly pain, nausea that will not settle or gallbladder symptoms
- Check whether your heart rate was recorded at recent visits
- Confirm who to call for severe symptoms and after hours
Questions to ask my prescriber or pharmacist
- Which of my side effects are common with this medicine?
- Should my sulfonylurea or other diabetes medicine be reviewed with this treatment?
- What signs would mean I need to stop and seek care right away?
- How often should my heart rate and kidney function be checked?
- What should I do if I cannot keep my step-up pace because of stomach symptoms?
- Does my history of gallbladder problems change my treatment plan?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.