Your current medicines, on one page
A medication list answers “What am I taking now?” A dose log answers “When did I take it?” This template gives you a single list of your current medicines. For day-by-day notes, use the separate medication log.
The FDA recommends including prescription and nonprescription medicines, vitamins and supplements, with each product’s name, strength and instructions. Check the label and the instructions you received; ask your pharmacist or prescriber about anything unclear.
My medication list
| Name, form and strength | Amount, schedule and instructions | What I take it for | Notes or questions |
|---|---|---|---|
Copy the instructions you were given. Add another sheet if you need more space.
How to fill it in
- Write the full product name. Include the strength and form shown on the label, such as a tablet, capsule or liquid. The strength on the package and the amount you were told to take are separate details.
- Copy your current instructions. Include how much, when and any directions you were given. Leave uncertain details as questions to confirm.
- Add vitamins, supplements and medicines without a prescription. Use another row for each product.
- Add a date to your list. Review it whenever your treatment changes and before your next appointment. Keep older versions dated so you can tell them apart.
Use the print button to print the list or save it as a PDF from your browser. If you prefer your phone’s notes app, use “Copy template” and repeat the medicine entry as needed. The template has six rows; print an extra copy if you need more room.
Bring your questions alongside the list
Use the last column for anything you want to clarify, such as which instructions are current. You can bring the list to your doctor or pharmacist and work through the questions together.
If you also want to describe something you noticed during the week, our symptom diary has space for dates, context and the effect on your day.
Want to keep track between appointments?
The list gives you an overview. EntreConsultas, our app in development, is designed for the details that come up between visits: when you took a medicine, how your focus and energy varied, and what you want to ask next time.
EntreConsultas lets you keep your medication history and questions on your phone, with no account required. Premium adds a PDF that brings together the entries and questions you choose. This printable list is free to use.
The first app release is planned for iPhone, with an English interface. You can add a medication manually if it is not listed. The built-in catalog currently covers Brazilian products. Explore EntreConsultas.