HealthRX.com · Printable titration log
Wegovy dose steps and sulfur burp tracking sheet
Use this sheet to track your Wegovy dose steps, weekly injections and sulfur-smelling burps, then take it to your prescriber or pharmacist. It records what you observe and helps you ask about the labeled schedule.
Your current Wegovy details
Copy these from your pen label and prescription. Write only what you see.
Current dose step on pen labelWrite the strength shown on the pen
Date current step startedWrite the date you began this strength
Planned date for next stepWrite the date your prescriber gave
Usual injection day of the weekWrite the weekday you inject
Any missed or late dose and dateWrite the date and what you did
Weekly injection and burp record
Fill in one row each time you inject. Note burps as mild, moderate or strong, and whether they smell of sulfur.
| Injection date | Dose strength | Sulfur burps | Other stomach symptoms | Notes |
|---|---|---|---|---|
Before your visit
Gather these items so your visit covers the details.
- Bring this completed log and your Wegovy pen box
- Bring a list of all other medicines and supplements you take
- Note how often sulfur burps happened since your last visit
- Note any dose you skipped, delayed or took late
- Confirm the date of your next scheduled step with your prescriber
- Check with your pharmacist which pharmacy refills your pen
Questions to ask your prescriber
- Does the label allow delaying the next step if I cannot tolerate this strength?
- Would a longer stay at my current strength be an option for me to discuss?
- Can we tell whether my burps are the same as ordinary belching?
- Which maintenance strength do you suggest for my weight goal?
- What should I do if I miss a dose, based on my schedule?
- Which stomach symptoms should I report to you right away?
- Should I change anything about meals or other medicines while I track this?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.