diff --git a/src/components/medications/__tests__/medication-card-symmetry.test.tsx b/src/components/medications/__tests__/medication-card-symmetry.test.tsx
new file mode 100644
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+++ b/src/components/medications/__tests__/medication-card-symmetry.test.tsx
@@ -0,0 +1,319 @@
+import { describe, expect, it } from "vitest";
+import { renderToStaticMarkup } from "react-dom/server";
+import { QueryClient, QueryClientProvider } from "@tanstack/react-query";
+
+import { I18nProvider } from "@/lib/i18n/context";
+import { MedicationCard } from "@/components/medications/medication-card";
+import {
+  Glp1MedicationCard,
+  type Glp1Medication,
+} from "@/components/medications/glp1-medication-card";
+
+/**
+ * v1.4.37 W4b — symmetry contract between the generic medication card
+ * (Ramipril/non-GLP-1) and the GLP-1 variant (Mounjaro). Marc reported
+ * during the v1.4.37 UX audit that the two cards "felt different"
+ * even though both should read as the same row shape. These tests pin
+ * the load-bearing structural seams so a future refactor can't quietly
+ * regress the parity.
+ *
+ * What we assert:
+ *   1. Header `actions` cluster — both cards always render `History`
+ *      and `Pencil` icon buttons. The Mounjaro card optionally renders
+ *      an additional kebab when `onLogSideEffect` is wired; absent the
+ *      prop the headers are byte-shape equivalent.
+ *   2. Category-label badge — both cards consult the same
+ *      `getMedicationCategoryLabel` lookup. No card hard-codes the
+ *      `medications.treatmentClassGlp1` string into the slot.
+ *   3. Take-now status pill — when the current time is inside a
+ *      configured schedule window and `lastTakenAt` is null/older, both
+ *      cards render the `medications.takeNow` localised text.
+ *   4. Primary actions row — exactly two buttons (Eingenommen /
+ *      Übersprungen). The side-effect quick-log lives in the header
+ *      overflow when wired, not in this row.
+ *   5. Purple dose accent — both cards render
+ *      `font-medium text-purple-400` on the upcoming schedule dose.
+ */
+
+function makeClient(): QueryClient {
+  return new QueryClient({
+    defaultOptions: {
+      queries: { retry: false, gcTime: 0, staleTime: Infinity },
+    },
+  });
+}
+
+function render(
+  node: React.ReactNode,
+  client: QueryClient,
+  locale: "en" | "de" = "en",
+) {
+  return renderToStaticMarkup(
+    <I18nProvider initialLocale={locale}>
+      <QueryClientProvider client={client}>{node}</QueryClientProvider>
+    </I18nProvider>,
+  );
+}
+
+function seedCompliance(client: QueryClient, medId: string) {
+  client.setQueryData(["medications", medId, "compliance"], {
+    compliance7: { rate: 90, streak: 0, totalExpected: 7, taken: 6 },
+    compliance30: { rate: 88 },
+  });
+}
+
+function seedGlp1Details(client: QueryClient, medId: string) {
+  client.setQueryData(["medications", medId, "glp1-details"], {
+    doseChanges: [],
+    recentIntakes: [],
+    inventory: null,
+  });
+}
+
+/**
+ * Schedule that fires every day of the week from 00:00 to 23:59 so
+ * the SSR snapshot always lands inside the current window regardless
+ * of the host clock — pinning the "take now" pill assertion.
+ */
+const allDayWindow = {
+  windowStart: "00:00",
+  windowEnd: "23:59",
+  label: null,
+  daysOfWeek: null,
+};
+
+const ramipril = {
+  id: "med-ramipril-1",
+  name: "Ramipril",
+  dose: "5 mg",
+  category: "BLOOD_PRESSURE",
+  treatmentClass: undefined as string | undefined,
+  active: true,
+  notificationsEnabled: true,
+  pausedAt: null,
+  lastTakenAt: null,
+  todayEventCount: 0,
+  schedules: [
+    {
+      id: "s-ramipril-1",
+      ...allDayWindow,
+      dose: "5 mg",
+    },
+  ],
+};
+
+const mounjaro: Glp1Medication = {
+  id: "med-mounjaro-1",
+  name: "Mounjaro",
+  dose: "7.5 mg",
+  category: "HORMONE",
+  treatmentClass: "GLP1",
+  dosesPerUnit: 4,
+  active: true,
+  notificationsEnabled: true,
+  pausedAt: null,
+  lastTakenAt: null,
+  todayEventCount: 0,
+  schedules: [
+    {
+      id: "s-mounjaro-1",
+      ...allDayWindow,
+      dose: "7.5 mg",
+    },
+  ],
+};
+
+describe("medication card symmetry — Ramipril vs Mounjaro", () => {
+  it("both cards render History + Pencil header buttons", () => {
+    const client = makeClient();
+    seedCompliance(client, ramipril.id);
+    seedCompliance(client, mounjaro.id);
+    seedGlp1Details(client, mounjaro.id);
+
+    const ramiprilHtml = render(
+      <MedicationCard medication={ramipril} onEdit={() => {}} />,
+      client,
+    );
+    const mounjaroHtml = render(
+      <Glp1MedicationCard medication={mounjaro} onEdit={() => {}} />,
+      client,
+    );
+
+    for (const html of [ramiprilHtml, mounjaroHtml]) {
+      expect(html).toContain("lucide-history");
+      expect(html).toContain("lucide-pencil");
+    }
+  });
+
+  it("neither card paints a kebab when no overflow prop is wired", () => {
+    // Symmetry default: without onLogSideEffect, the Mounjaro header
+    // shape matches the Ramipril header exactly (history + edit only).
+    const client = makeClient();
+    seedCompliance(client, ramipril.id);
+    seedCompliance(client, mounjaro.id);
+    seedGlp1Details(client, mounjaro.id);
+
+    const ramiprilHtml = render(
+      <MedicationCard medication={ramipril} onEdit={() => {}} />,
+      client,
+    );
+    const mounjaroHtml = render(
+      <Glp1MedicationCard medication={mounjaro} onEdit={() => {}} />,
+      client,
+    );
+
+    for (const html of [ramiprilHtml, mounjaroHtml]) {
+      expect(html).not.toContain('aria-label="More options"');
+    }
+  });
+
+  it("Mounjaro gains a kebab when onLogSideEffect is supplied (GLP-1-only)", () => {
+    const client = makeClient();
+    seedCompliance(client, mounjaro.id);
+    seedGlp1Details(client, mounjaro.id);
+
+    const html = render(
+      <Glp1MedicationCard
+        medication={mounjaro}
+        onEdit={() => {}}
+        onLogSideEffect={() => {}}
+      />,
+      client,
+    );
+
+    expect(html).toContain('aria-label="More options"');
+  });
+
+  it("category label uses the shared category-map lookup on both cards", () => {
+    const client = makeClient();
+    seedCompliance(client, ramipril.id);
+    seedCompliance(client, mounjaro.id);
+    seedGlp1Details(client, mounjaro.id);
+
+    const ramiprilHtml = render(
+      <MedicationCard medication={ramipril} onEdit={() => {}} />,
+      client,
+    );
+    const mounjaroHtml = render(
+      <Glp1MedicationCard medication={mounjaro} onEdit={() => {}} />,
+      client,
+    );
+
+    // Ramipril → BLOOD_PRESSURE → "Blood Pressure".
+    expect(ramiprilHtml).toContain("Blood Pressure");
+    // Mounjaro → HORMONE → "Hormones".  The card must NOT hard-code
+    // the treatment-class label into the slot any more.
+    expect(mounjaroHtml).toContain("Hormones");
+    expect(mounjaroHtml).not.toContain("GLP-1 injection");
+  });
+
+  it("both cards render the take-now pill when inside the current schedule window", () => {
+    const client = makeClient();
+    seedCompliance(client, ramipril.id);
+    seedCompliance(client, mounjaro.id);
+    seedGlp1Details(client, mounjaro.id);
+
+    const ramiprilHtml = render(
+      <MedicationCard medication={ramipril} onEdit={() => {}} />,
+      client,
+    );
+    const mounjaroHtml = render(
+      <Glp1MedicationCard medication={mounjaro} onEdit={() => {}} />,
+      client,
+    );
+
+    for (const html of [ramiprilHtml, mounjaroHtml]) {
+      expect(html).toContain("Take now");
+      // Coloured-pill contract — the in_window pill class carries
+      // the success token, not the warning token.
+      expect(html).toContain("text-success");
+    }
+  });
+
+  it("primary actions row carries exactly two buttons on both cards", () => {
+    const client = makeClient();
+    seedCompliance(client, ramipril.id);
+    seedCompliance(client, mounjaro.id);
+    seedGlp1Details(client, mounjaro.id);
+
+    const ramiprilHtml = render(
+      <MedicationCard medication={ramipril} onEdit={() => {}} />,
+      client,
+    );
+    const mounjaroHtml = render(
+      <Glp1MedicationCard
+        medication={mounjaro}
+        onEdit={() => {}}
+        onLogSideEffect={() => {}}
+      />,
+      client,
+    );
+
+    for (const html of [ramiprilHtml, mounjaroHtml]) {
+      // Taken / Skipped — and no third in-row button.  We assert the
+      // primary-actions buttons via icon class names since those
+      // surface on both cards.
+      expect(html).toContain("lucide-check");
+      expect(html).toContain("lucide-skip-forward");
+    }
+    // The Stethoscope glyph is GLP-1-only; SSR doesn't open the
+    // Radix Portal so even when wired the menu item is hidden from
+    // the initial markup. The primary row must NOT carry it.
+    expect(mounjaroHtml).not.toMatch(
+      /class="[^"]*flex[^"]*gap-2[^"]*"[^>]*>[\s\S]*?lucide-stethoscope/,
+    );
+  });
+
+  it("purple dose accent surfaces on the upcoming schedule dose on both cards", () => {
+    // Pin the asymmetry from the v1.4.37 UX audit (item 11): the
+    // GLP-1 card historically lacked the purple accent. Both cards
+    // must now stamp the same `text-purple-400` token on the
+    // schedule dose. We render at a window that's NOT currently
+    // active so the "next intake" line (which carries the accent)
+    // surfaces instead of the take-now pill.
+    const futureWindow = {
+      windowStart: "01:00",
+      windowEnd: "02:00",
+      label: null,
+      daysOfWeek: null,
+    };
+    const ramiprilFuture = {
+      ...ramipril,
+      schedules: [
+        {
+          id: "s-ramipril-future",
+          ...futureWindow,
+          dose: "5 mg",
+        },
+      ],
+    };
+    const mounjaroFuture: Glp1Medication = {
+      ...mounjaro,
+      schedules: [
+        {
+          id: "s-mounjaro-future",
+          ...futureWindow,
+          dose: "7.5 mg",
+        },
+      ],
+    };
+
+    const client = makeClient();
+    seedCompliance(client, ramiprilFuture.id);
+    seedCompliance(client, mounjaroFuture.id);
+    seedGlp1Details(client, mounjaroFuture.id);
+
+    const ramiprilHtml = render(
+      <MedicationCard medication={ramiprilFuture} onEdit={() => {}} />,
+      client,
+    );
+    const mounjaroHtml = render(
+      <Glp1MedicationCard medication={mounjaroFuture} onEdit={() => {}} />,
+      client,
+    );
+
+    // Both surfaces carry the purple token on the upcoming dose.
+    expect(ramiprilHtml).toContain("text-purple-400");
+    expect(mounjaroHtml).toContain("text-purple-400");
+  });
+});