HealthRX.com · Printable question sheet
Provigil and testosterone questions to bring to your prescriber
Use this sheet before a visit when you take Provigil (modafinil) and a testosterone product. Fill in your medicines, gather your records, write down questions about blood pressure, hematocrit and warfarin, and track readings between visits.
Your medicines and prescribers
Copy the names exactly as they appear on your labels or pharmacy printouts.
Provigil (modafinil) prescriber nameDoctor or clinic that writes this prescription
Provigil dose and how often you take itCopy from the label
Testosterone product name and formFor example injection, gel or patch
Testosterone prescriber and injection scheduleWho prescribes it and when you get it
Warfarin or other blood thinner, if anyWrite none if you do not take one
Other medicines and supplementsInclude anything bought without a prescription
Gather before the visit
Bring these so the visit does not depend on memory.
- Bring the current Provigil and testosterone labels or pharmacy printouts
- Bring a list of every medicine and supplement you take
- Note your most recent blood pressure readings and the dates
- Bring your latest hematocrit or hemoglobin results if you have them
- Write down any sleep apnea treatment you use, such as CPAP
- Confirm which pharmacy fills each prescription
- Check whether any test dates were set at your last visit
Questions to ask your prescriber or pharmacist
- Is there a listed interaction between Provigil and my testosterone product?
- Does my testosterone product affect how my Provigil works, or the reverse?
- How often should my blood pressure be checked while I take both?
- How often should my hematocrit be checked, and what result would change my plan?
- If I take warfarin, how often should my INR be checked?
- Should my birth control plans change while I take Provigil?
- What signs should make me call the clinic before my next visit?
Blood pressure and hematocrit tracker
Record readings between visits and bring this page to your appointment.
| Date | Blood pressure reading | Hematocrit or hemoglobin result | Notes |
|---|---|---|---|
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.