HealthRX.com · Printable medication review sheet
Testosterone cypionate and prednisone medication review sheet
Use this sheet before a visit with your prescriber or pharmacist when you take testosterone cypionate and prednisone together. Fill it in by hand, bring it along, and track swelling, blood pressure and blood sugar between visits.
Medicines and prescribers
Write what is on your current labels or prescriptions.
Testosterone cypionate prescriberName and clinic
Testosterone cypionate scheduleHow and how often it is given, as prescribed
Prednisone prescriberName and clinic
Prednisone course start dateDate the course began
Prednisone planned end dateDate written on the prescription, if any
Pharmacy name and phoneThe pharmacy that fills each medicine
Gather before the visit
Bring this sheet and the items below.
- Bring all medicine bottles, pens and syringes you use at home
- List every other prescription, over the counter medicine and supplement
- Note the date and results of your last hemoglobin and hematocrit test
- Write down any recent blood pressure readings from home or the clinic
- Note whether you have diabetes or have been told your blood sugar is high
- Note any heart, kidney or liver conditions your prescriber already knows about
- Confirm with your pharmacist that both medicines appear on your profile
- Ask your prescriber whether a bone health assessment is planned
Weekly swelling, pressure and sugar log
Record readings on the same day each week, or when you notice a change.
| Date | Swelling or fluid | Blood pressure | Blood sugar | Other notes |
|---|---|---|---|---|
Questions to ask at the visit
- Does my prednisone course raise any concern with my testosterone cypionate?
- Which swelling or fluid changes should I report to you right away?
- How often should my blood pressure be checked while I take both medicines?
- Should my hemoglobin and hematocrit be checked, and when is the next test?
- How will you monitor my blood sugar while I am on prednisone?
- Do I need a bone density test or fracture-risk assessment?
- Which symptoms of a blood clot should prompt me to call you?
- Who should I contact after hours if a symptom comes up?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.