HealthRX.com · Printable side-effect diary
Low-dose naltrexone side effect timing diary
Use this diary to record when side effects from low-dose naltrexone start, how long they last and what you noticed. Bring it to your prescriber or pharmacist. The article notes no delayed-onset pattern is established.
Medicine and starting details
Copy these from your prescription label or pharmacy paperwork.
Date you first started this medicineDay, month and year
Dose written on your prescriptionCopy exactly as written
Opioid medicines now or recently stoppedNames and stop dates if known
Side effect diary
Write one row for each effect you notice, including ones that seem unrelated.
| Date noticed | Effect in your words | Time after a dose | How strong it felt | When it ended |
|---|---|---|---|---|
Before your visit
- Bring this diary and the bottles or boxes of every medicine you use
- Confirm the exact name and strength on your current label
- Note any dose changes and the dates they happened
- List any missed doses and the days they occurred
- Check with your pharmacist which cough or cold products you have used
- Write down any new symptom that started weeks after your first dose
Questions to ask at the visit
- Which side effects should I report to you, and how quickly should I report them?
- Could an effect that starts weeks after my first dose be linked to this medicine?
- What is the plan if I miss a dose or stop treatment?
- Is any liver check planned, and how will it be arranged?
- Does this medicine interact with my thyroid medicine or other prescriptions?
- Which warning signs would mean I should contact you or seek urgent care?
- Can you check my list of over-the-counter products against this medicine?
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.