HealthRX.com · Printable medication review sheet
Adderall XR stopping review sheet for prescriber visits
Use this sheet to record your Adderall XR history, note the stopping situations named in the Adderall tablet label, and track mood, sleep, appetite and movement changes before and after any change in dose. Bring it to your prescriber or pharmacist.
Current Adderall XR details
Copy these from your bottle and your latest prescription label.
Medicine name and strengthAs printed on the capsule label
How you take it nowDescribe the schedule in your own words
Prescriber name and phone
Pharmacy name and phone
Date you started Adderall XR
Reason it was prescribed
Any seizure, psychotic or manic symptoms in the pastWrite yes or no and details
Gather before the visit
Items to have ready so the stopping plan can be discussed accurately.
- Bring the Adderall XR bottle or a photo of its label
- List every other medicine and supplement you take
- Note any medicine you take that affects serotonin
- Write down how long you have taken Adderall XR
- Check with your pharmacy for a full medication list
- Note any past withdrawal-like changes after missed or reduced doses
- Bring your tracking log from the past weeks
- Confirm who to call if you have a seizure or new unusual thoughts
Daily mood, sleep and movement tracker
Record each day, including whether you took your medicine that day.
| Date | Mood and energy | Sleep | Appetite | Movement or agitation | Notes |
|---|---|---|---|---|---|
Questions to ask your prescriber or pharmacist
- Does the Adderall tablet label apply to my Adderall XR capsules?
- What stopping plan do you recommend for my situation?
- Which mood, sleep or movement changes should I report to you?
- What should I do if I miss a dose while stopping?
- Who should I contact after hours if symptoms are severe?
- Which of my other medicines could interact with stopping?
- Should I keep a daily log, and how should I send it to you?
- How will we check my progress and when is the next visit?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.