diff --git a/src/lib/ai/coach/__tests__/outbound-guard.test.ts b/src/lib/ai/coach/__tests__/outbound-guard.test.ts
new file mode 100644
index 000000000..1c71d24fa
--- /dev/null
+++ b/src/lib/ai/coach/__tests__/outbound-guard.test.ts
@@ -0,0 +1,92 @@
+import { describe, it, expect } from "vitest";
+
+import {
+  screenCoachReply,
+  coachOutboundFallback,
+  COACH_OUTBOUND_DOSE_BLOCK_EN,
+  COACH_OUTBOUND_DOSE_BLOCK_DE,
+  COACH_OUTBOUND_RISK_BLOCK_EN,
+} from "@/lib/ai/coach/outbound-guard";
+
+describe("screenCoachReply — dose-prescription", () => {
+  const blocked = [
+    "You should step up to 2.4 mg next week.",
+    "Consider increasing to 10 mg.",
+    "I'd recommend a 0.5 mg dose to start.",
+    "Erhöhe auf 7,5 mg, sobald du dich daran gewöhnt hast.",
+    "Du kannst die nächste Stufe 5 mg ausprobieren.",
+    "Lower your dose to 1.0 mg.",
+  ];
+  for (const reply of blocked) {
+    it(`blocks: ${reply.slice(0, 32)}`, () => {
+      const d = screenCoachReply(reply);
+      expect(d.block).toBe(true);
+      expect(d.reason).toBe("dose_prescription");
+    });
+  }
+
+  const allowed = [
+    "You're on week 3 of 7.5 mg, and your weight is tracking down.",
+    "Your snapshot shows you take 5 mg daily — adherence looks steady.",
+    "Dein Snapshot zeigt 7,5 mg in Woche 3 — die Einnahmetreue ist gut.",
+    "Talk to your prescriber about whether your dose is still right.",
+  ];
+  for (const reply of allowed) {
+    it(`allows factual mention: ${reply.slice(0, 32)}`, () => {
+      expect(screenCoachReply(reply).block).toBe(false);
+    });
+  }
+});
+
+describe("screenCoachReply — risk score", () => {
+  const blocked = [
+    "Your 10-year cardiovascular risk is about 12%.",
+    "That puts your stroke risk at 8%.",
+    "Your ASCVD score suggests elevated risk.",
+    "Dein 10-Jahres-Risiko liegt bei etwa 14%.",
+    "Das ergibt ein Risiko von 12% in den nächsten Jahren.",
+  ];
+  for (const reply of blocked) {
+    it(`blocks: ${reply.slice(0, 32)}`, () => {
+      const d = screenCoachReply(reply);
+      expect(d.block).toBe(true);
+      expect(d.reason).toBe("risk_score");
+    });
+  }
+
+  it("allows a plain percentage that is not a risk claim", () => {
+    expect(
+      screenCoachReply("Your adherence was 92% over the last 30 days.").block,
+    ).toBe(false);
+  });
+});
+
+describe("screenCoachReply — clean replies", () => {
+  it("passes a grounded, non-prescriptive reply", () => {
+    const reply =
+      "Your systolic is averaging 128 mmHg this week, 4 below your monthly mean. Nice and steady — keep the routine going.";
+    expect(screenCoachReply(reply).block).toBe(false);
+  });
+  it("passes an empty reply through (handled upstream)", () => {
+    expect(screenCoachReply("").block).toBe(false);
+  });
+});
+
+describe("coachOutboundFallback", () => {
+  it("returns localised dose-block copy", () => {
+    expect(coachOutboundFallback("dose_prescription", "en")).toBe(
+      COACH_OUTBOUND_DOSE_BLOCK_EN,
+    );
+    expect(coachOutboundFallback("dose_prescription", "de")).toBe(
+      COACH_OUTBOUND_DOSE_BLOCK_DE,
+    );
+  });
+  it("returns risk-block copy and rides EN for non-de locales", () => {
+    expect(coachOutboundFallback("risk_score", "en")).toBe(
+      COACH_OUTBOUND_RISK_BLOCK_EN,
+    );
+    expect(coachOutboundFallback("risk_score", "fr")).toBe(
+      COACH_OUTBOUND_RISK_BLOCK_EN,
+    );
+  });
+});
diff --git a/src/lib/ai/coach/outbound-guard.ts b/src/lib/ai/coach/outbound-guard.ts
new file mode 100644
index 000000000..1470b3d59
--- /dev/null
+++ b/src/lib/ai/coach/outbound-guard.ts
@@ -0,0 +1,148 @@
+/**
+ * v1.18.10 (HIGH-2) — Coach OUTBOUND safety screen.
+ *
+ * `detectRefusal()` guards the INBOUND channel (the user's message) only. The
+ * model's reply was tokenised and streamed verbatim with no equivalent
+ * server-side check, so a dose-prescription ("step up to 2.4 mg") or a
+ * fabricated risk score in the assistant turn reached the user unfiltered. The
+ * GLP-1 dose-safety contract and grounding block are composed into the Coach
+ * system prompt, but those are instructions, not enforcement.
+ *
+ * The chat route already buffers the full reply before streaming (the provider
+ * clients return the body in one shot, then `tokeniseForStreaming` chunks it
+ * for the UI), so the practical screen runs on the assembled reply BEFORE
+ * persistence and streaming. On a trip the route swaps in a safe fallback turn
+ * — the user sees a calm "talk to your prescriber" message, never the
+ * fabricated/prescriptive text.
+ *
+ * Posture, mirroring the inbound detector:
+ *  - Pattern-based + deterministic, so it is cheap and auditable; an LLM judge
+ *    would itself be promptable.
+ *  - Errs toward catching: the dose-prescription patterns are tight (a verb +
+ *    a target dose with a unit), so an ordinary "you're on 7.5 mg this week"
+ *    factual restatement (which the contract explicitly PERMITS) does not trip
+ *    — only an imperative to change the dose does.
+ */
+import type { Locale } from "@/lib/i18n/config";
+
+/** Why the outbound reply was blocked, for the Wide-Event annotation. */
+export type CoachOutboundReason = "dose_prescription" | "risk_score";
+
+export interface CoachOutboundDecision {
+  /** True when the assembled reply must be replaced with the fallback. */
+  block: boolean;
+  /** Which screen tripped — drives Wide-Event metadata. */
+  reason: CoachOutboundReason | null;
+}
+
+/**
+ * Dose-prescription patterns. Each requires a CHANGE verb + a target dose with
+ * a unit, so a factual restatement of the current step ("you are on 7.5 mg",
+ * "week 3 on 7.5 mg") — which the GLP-1 contract permits — does not match,
+ * while an imperative ("step up to 2.4 mg", "increase to 10 mg", "erhöhe auf
+ * 7,5 mg") does. The unit set covers the GLP-1 + general oral-dose vocabulary.
+ */
+const DOSE_UNIT = "(?:mg|mcg|µg|ml|units?|ie|i\\.e\\.|einheiten)";
+
+const DOSE_PRESCRIPTION_PATTERNS: readonly RegExp[] = [
+  // EN: step/move/increase/raise/bump/titrate/go up to|by N unit
+  new RegExp(
+    `\\b(?:step|move|increase|raise|bump|titrat\\w*|go|ramp|push|up)\\s+(?:it\\s+)?(?:up\\s+|your\\s+dose\\s+)?(?:to|by)\\s+[\\d.,]+\\s*${DOSE_UNIT}\\b`,
+    "i",
+  ),
+  // EN: lower/reduce/cut/drop/decrease/back off to|by N unit
+  new RegExp(
+    `\\b(?:lower|reduce|cut|drop|decrease|back\\s+off|taper)\\s+(?:it\\s+|your\\s+dose\\s+)?(?:to|by)\\s+[\\d.,]+\\s*${DOSE_UNIT}\\b`,
+    "i",
+  ),
+  // EN: consider/try/should/recommend ... N unit dose
+  new RegExp(
+    `\\b(?:consider|try|you\\s+should|i'?d?\\s+recommend|i\\s+suggest)\\b[^.?!]{0,40}\\b[\\d.,]+\\s*${DOSE_UNIT}\\b`,
+    "i",
+  ),
+  // DE: erhöhe/steigere/geh hoch auf|um N unit
+  new RegExp(
+    `\\b(?:erhöh\\w*|steiger\\w*|setz\\w*\\s+(?:hoch|rauf)|geh\\w*\\s+(?:hoch|rauf))\\s+(?:auf|um)\\s+[\\d.,]+\\s*${DOSE_UNIT}\\b`,
+    "i",
+  ),
+  // DE: reduziere/senke/verringere auf|um N unit
+  new RegExp(
+    `\\b(?:reduzier\\w*|senk\\w*|verringer\\w*|nimm\\s+(?:weniger|runter))\\s+(?:auf|um)\\s+[\\d.,]+\\s*${DOSE_UNIT}\\b`,
+    "i",
+  ),
+  // DE: nächste Stufe / nächste Dosis N unit (recommend-shaped)
+  new RegExp(
+    `\\bn[äa]chste\\s+(?:stufe|dosis)\\b[^.?!]{0,30}\\b[\\d.,]+\\s*${DOSE_UNIT}\\b`,
+    "i",
+  ),
+];
+
+/**
+ * Risk-score fabrication patterns: the Coach is grounded on the snapshot and
+ * must never invent a computed clinical risk percentage / score. A "10-year
+ * cardiovascular risk of 12%" or a fabricated "your risk score is 8/10" is a
+ * number the server never computed and the snapshot never carried.
+ */
+const RISK_SCORE_PATTERNS: readonly RegExp[] = [
+  // EN: <N>% (cardiovascular|heart|stroke|mortality|...) risk
+  /\b\d{1,3}\s*%\s+(?:risk|chance|probability|likelihood)\b/i,
+  /\b(?:risk|chance|probability|likelihood)\s+(?:of|is|at)\s+(?:about\s+|roughly\s+|~)?\d{1,3}\s*%/i,
+  /\b(?:10[- ]year|ten[- ]year|lifetime)\s+(?:cardiovascular|cardiac|heart|stroke|mortality|cvd|ascvd)\s+risk\b/i,
+  /\b(?:framingham|ascvd|score2?|qrisk)\b/i,
+  // DE: Risiko von N% / N% Risiko
+  /\brisiko\s+(?:von|bei|liegt\s+bei)\s+(?:etwa\s+|ungefähr\s+|~)?\d{1,3}\s*%/i,
+  /\b\d{1,3}\s*%\s+(?:risiko|wahrscheinlichkeit)\b/i,
+  /\b(?:10[- ]jahres|zehn[- ]jahres|lebenszeit)[- ]?(?:risiko)\b/i,
+];
+
+/**
+ * Screen an assembled assistant reply. Runs the dose-prescription patterns
+ * first (highest medical-safety leverage), then the risk-score patterns.
+ */
+export function screenCoachReply(reply: string): CoachOutboundDecision {
+  const text = reply ?? "";
+  if (text.trim().length === 0) {
+    return { block: false, reason: null };
+  }
+  for (const pattern of DOSE_PRESCRIPTION_PATTERNS) {
+    if (pattern.test(text)) {
+      return { block: true, reason: "dose_prescription" };
+    }
+  }
+  for (const pattern of RISK_SCORE_PATTERNS) {
+    if (pattern.test(text)) {
+      return { block: true, reason: "risk_score" };
+    }
+  }
+  return { block: false, reason: null };
+}
+
+/**
+ * Safe fallback copy when the outbound screen trips. de/en carry a native
+ * body; the other UI locales ride the EN body (the Coach itself replies in
+ * de/en, so this is the consistent posture with the inbound refusal copy).
+ * Exposed as constants so server-only code (tests, logs) can pin the wording.
+ */
+export const COACH_OUTBOUND_DOSE_BLOCK_EN =
+  "I can't suggest a specific medication dose or a change to one — dose decisions belong with your prescribing clinician. I can help you read what your own data shows around your medication; ask me about that and I'll stay grounded in your numbers.";
+
+export const COACH_OUTBOUND_DOSE_BLOCK_DE =
+  "Eine konkrete Medikamenten-Dosis oder eine Dosisänderung kann ich nicht vorschlagen — solche Entscheidungen gehören zu deiner behandelnden Ärztin oder deinem Arzt. Gerne helfe ich dir, das zu lesen, was deine eigenen Daten rund um deine Medikation zeigen; frag mich danach, dann bleibe ich bei deinen Zahlen.";
+
+export const COACH_OUTBOUND_RISK_BLOCK_EN =
+  "I can't put a number on a clinical risk like that — it isn't something your tracked data lets me compute, and an invented figure would be misleading. I can walk you through what your own measurements are doing instead; ask me about a specific metric.";
+
+export const COACH_OUTBOUND_RISK_BLOCK_DE =
+  "Eine solche klinische Risikozahl kann ich nicht angeben — deine erfassten Daten lassen das nicht berechnen, und ein erfundener Wert wäre irreführend. Stattdessen kann ich dir zeigen, was deine eigenen Messwerte machen; frag mich nach einer konkreten Metrik.";
+
+/** Resolve the localised fallback copy for a tripped outbound screen. */
+export function coachOutboundFallback(
+  reason: CoachOutboundReason,
+  locale: Locale,
+): string {
+  const de = locale === "de";
+  if (reason === "dose_prescription") {
+    return de ? COACH_OUTBOUND_DOSE_BLOCK_DE : COACH_OUTBOUND_DOSE_BLOCK_EN;
+  }
+  return de ? COACH_OUTBOUND_RISK_BLOCK_DE : COACH_OUTBOUND_RISK_BLOCK_EN;
+}