HealthRX.com · Printable side-effect diary
Testosterone injection site reaction diary for TRT
Use this sheet to record redness, pain, bruising or other reactions after each testosterone injection, including Depo-Testosterone, Azmiro or Xyosted. Bring the completed log to your prescriber or pharmacist.
Product and injection details
Copy these from the label or pharmacy box.
Testosterone product nameWrite the name exactly as printed on the label
Route written on the labelFor example deep gluteal intramuscular or subcutaneous abdomen
Prescriber or clinic nameWho prescribed this product
Pharmacy name and phoneWhere the product was filled
Who gives the injectionYourself, a partner or a healthcare professional
Injection and reaction record
Write one row for each injection and any reaction that follows.
| Date | Site used | Reaction seen | Size or feel | Days it lasted |
|---|---|---|---|---|
Before the visit
- Bring the product box or label that shows the route
- Gather the completed record and this sheet
- List any other medicines or supplements you take
- Note any leg pain, swelling, warmth or redness and when it began
- Note any sudden shortness of breath and the date it started
- Check with your pharmacist which allergies or ingredients are on file
Questions to ask your prescriber
- Which injection site reactions are expected with my product?
- Does my product use the same route the label describes for me?
- Which symptoms should I report to you straight away?
- Would a different testosterone product change the reactions I see?
- How should I record and report a reaction that does not go away?
- Should we review my records at my 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.