HealthRX.com · Printable side-effect diary
Zepbound nausea side effect diary and prescriber visit prep
Use this sheet to record your Zepbound dose history and daily nausea, vomiting and diarrhea during dose increases. Bring it to your prescriber or pharmacist to discuss tolerability and maintenance dose choices.
Zepbound treatment details
Write these down before your visit. Copy them from your prescription label and medicine box.
Current Zepbound strengthWrite the strength shown on your current prescription label
Date you started ZepboundWrite the month and year of your first weekly injection
Date of your last dose increaseWrite the date the current strength began
Prescriber and pharmacyWrite names and phone numbers
Other medicines and supplementsInclude any ginger or other anti-nausea products
Daily nausea and symptom tracker
Record each week or each day. Note any dose change in the strength column.
| Date | Dose step | Nausea level | Vomiting or diarrhea | Food and fluid notes |
|---|---|---|---|---|
Before your visit
- Bring your filled in tracker and your current prescription label
- Write down the date and time each nausea episode started
- Note any abdominal pain, including pain that spreads to the back
- Check with your pharmacist about all other medicines you take
- Confirm whether you have had trouble drinking enough fluids
- List any dizziness, reduced urination or dark urine you noticed
Questions to ask your prescriber or pharmacist
- Should my dose stay the same while my nausea settles?
- Is a lower maintenance strength an option for me?
- What signs of dehydration should I report to you right away?
- Do you want to check my kidney function given my symptoms?
- How could Zepbound affect the absorption of my other medicines?
- What abdominal pain symptoms mean I should stop and seek care?
- Which over-the-counter products are safe to discuss with you first?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.