My Medications List

Name __________________________________________________________________

Physician’s Name _____________________________ Phone ___________________

Here’s how to find out if your particular combination of medications is safe:

1. List all medicines you’re taking, including over-the-counter medicines,

vitamins, and herbal supplements.

2. Review your medications list with your doctor at least once a year.

3. Ask your doctor to explain each medicine:

Why you’re taking it

How long you can expect to take it

Any possible side effects

Name of Medicine

Dose

Directions of use Reason for taking it

Notes

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Parent category: Medical