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Bedtime progesterone with NMN or NR: drowsiness and dizziness diary
Record when you take progesterone and your NAD+ precursor, then score next-morning drowsiness, dizziness and sleep for the first two weeks of the combination. Bring it, with your liver test results, to the clinician who prescribes your hormone therapy.
What you take and when
Progesterone product, dose and routeoral capsule or vaginal
Scheduleevery night, or only on set days of each cycle
Clock time you take progesterone
NMN or NR product and amount per day
Clock time you take NMN or NR
Anything else that can make you sleepysleep aids, benzodiazepines, gabapentin, alcohol
Daily diary for the first two weeks of the combination
Score each from 0 (none) to 3 (severe). Note any night you took progesterone late or skipped it.
| Date | Progesterone time | NMN or NR time | Drowsy next morning (0-3) | Dizzy (0-3) | Sleep quality (0-3) | Notes |
|---|---|---|---|---|---|---|
What the Prometrium label says
- Take the capsule at bedtime: some women become very drowsy or dizzy after taking it.[1]
- It can cause passing dizziness and drowsiness, so take care with driving or operating machinery.[1]
- Blood levels peak within 3 hours of an oral dose.[1]
- Food increased how much of a 200 mg dose was absorbed, compared with taking it fasting.[1]
- With estrogen and an intact uterus, the label dose is 200 mg at bedtime for 12 days in a row of each 28-day cycle.[1]
- Ketoconazole and other inhibitors of the liver enzyme CYP3A4 may raise progesterone levels.[1]
- Known liver disease or liver dysfunction is a reason not to use Prometrium.[1]
Call your healthcare provider right away
- Extreme dizziness or drowsiness with blurred vision, slurred speech, trouble walking, confusion, feeling drunk, fainting or shortness of breath, which a few women have had early in treatment.[1]
- Changes in vision or speech, a sudden severe headache, severe chest or leg pain, dizziness with faintness, or vomiting.[1]
Liver tests
The page suggests a baseline panel and a repeat at 3 to 6 months when the two are combined long term.
| Test | Baseline date and result | Repeat date and result | Lab's normal range |
|---|---|---|---|
| ALT | |||
| AST | |||
| Bilirubin |
Questions for the clinician who prescribes your hormone therapy
- Should my progesterone stay at bedtime and NMN or NR move to the morning?
- If I feel drowsy during the day, would vaginal progesterone suit me better?
- Do any of my other medicines add to sedation or strongly affect CYP3A4?
- Which liver tests should we run, and when should we repeat them?
- What would make you want me to stop NMN or NR?
Sources for the facts on this sheet
- Acertis Pharmaceuticals, LLC, via DailyMed. Prometrium (progesterone, USP) capsules: prescribing information and patient information. Effective 2026-07-23. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=1cf237ff-c4f8-4faa-a7aa-77599c856889
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.