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Printable GLP-1 side-effect diary

The most useful thing you can bring to an appointment about side effects is not a feeling but a list: what, when, how bad, and what was going on. This diary has a row for each episode and a column that makes patterns visible — the number of days since your dose.

By the Cafeity teamUpdated

The short answer

This free diary has room for twelve side-effect episodes, each with the date, time, days since your last dose, the symptom, a severity score from 0 to 5, what you ate or did beforehand and what helped. A box on the page lists the warning signs the medication guides say need prompt medical help, such as severe stomach pain that will not go away.1 It prints on US Letter or A4, with no sign-up.

Preview of the printable GLP-1 side-effect diary: a landscape table with columns for date, time, days since dose, symptom, severity 0 to 5, what was eaten or done before, and what helped, plus a box listing the warning signs that need prompt medical help.

Download

US Letter PDF176 KB A4 PDF176 KB

Free, no sign-up, no email address. Print it, or open it on a tablet and write on it.

Why "days since dose" is the key column

Most side effects of GLP-1 medicines are gastrointestinal, and the labels describe them as most common during dose increases.21 Within each week, many people also notice them clustering a day or two after an injection, when levels peak — 1 to 3 days after semaglutide and about a day after tirzepatide.21 Writing down "day 1" or "day 5" next to each symptom turns a vague impression into a pattern you can see — and show.

How to fill it in

  • Write it when it happens, or the same evening. Memory rounds everything off by the time of the appointment.
  • Day 0 is dose day; count up from there. For daily tablets, note the time of the tablet instead.
  • Severity 0–5: 1 is noticeable, 3 is getting in the way of the day, 5 is the worst you can imagine.
  • "What I ate or did before" catches triggers — a large or fatty meal, alcohol, a missed meal, poor sleep.
  • "What helped" is for you, and for your prescriber: smaller meals, a walk, a particular food, time.

There is space at the foot of the page to rate food noise, appetite and energy daily as well — see food noise for why that is worth doing.

The warning signs on the page

The diary is for ordinary, expected side effects. The box on the page repeats the signs the patient medication guides say should not be written down and waited out:12 severe stomach pain that will not go away; vomiting or diarrhoea that will not stop; upper stomach pain with fever or yellowing of the skin or eyes; and swelling of the face, lips, tongue or throat or trouble breathing. For those, contact a clinician promptly or get emergency help.

Common questions

What should I record about side effects?
What it was, when it started, how bad it was on a 0–5 scale, how many days it was since your dose, what you had eaten or done beforehand, and what helped. That is exactly what the diary asks for.
Should I report side effects to anyone else?
Tell your prescriber or pharmacist first. You can also report suspected side effects to the FDA through MedWatch, or in the UK through the MHRA Yellow Card scheme.34
Is this the same as the app?
It records the same things. The app adds the arithmetic — lining symptoms up against doses automatically and summarising them for an appointment.

Sources

  1. Tirzepatide injection for weight management and obstructive sleep apnoea — US prescribing information DailyMed, US National Library of Medicine, version published 2 September 2026
  2. Semaglutide injection and tablets for weight management — US prescribing information DailyMed, US National Library of Medicine, version published 30 June 2026
  3. MedWatch — report a side effect to the FDA US Food and Drug Administration
  4. Yellow Card — report a suspected side effect (UK) Medicines and Healthcare products Regulatory Agency

Written by the Cafeity team from the sources listed here. Figures from prescribing information are quoted as the label states them; trial results are averages from those trials, not predictions for any one person. This page has not yet been reviewed by a clinician — see the editorial policy for how pages are researched and corrected.