HealthRX.com · Printable side-effect diary
Prometrium mood change diary for your prescriber visit
Use this sheet to record mood, irritability, low mood, dizziness and drowsiness while taking oral micronized progesterone (Prometrium) at bedtime. Bring the completed log and the questions to your prescriber or pharmacist. It is a record only and does not replace medical advice.
Your Prometrium medicine details
Copy these from your bottle and prescription label.
Prometrium strength on labelWrite the strength exactly as printed
Estrogen taken with it, if anyName of the conjugated estrogens or other estrogen product
Bedtime dose time you useThe time you usually take the capsule
Date you started Prometrium
Prescriber and pharmacy phone
Daily mood and drowsiness record
Write one row each day. Note how strong each symptom felt, using your own words.
| Date | Mood changes | Dizziness or drowsiness | Dose taken at bedtime | Other notes |
|---|---|---|---|---|
Before you see your prescriber or pharmacist
- Bring your Prometrium bottle and any estrogen product you take
- List every prescription medicine you take, including any antidepressant
- Write down over the counter products and supplements you use
- Note whether any symptom started near the time you began Prometrium
- Note any driving or machinery use since dizziness or drowsiness began
- Confirm the bedtime timing on your prescription label
Questions to ask your prescriber or pharmacist
- Could my mood changes be linked to Prometrium or to the estrogen I take with it?
- Is there a labeled reason to change the timing of my bedtime dose?
- Does my label list any interaction with the antidepressant I take?
- Would a lower strength or a different regimen be an option for me?
- What symptoms should prompt me to call you the same day?
- Should I keep taking Prometrium while we review these symptoms?
- Can you check whether any medicine I take affects how Prometrium is broken down?
- Who should I contact if dizziness or drowsiness affects my daily activities?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.