Medication List

Patient Information

• Name: [PATIENT FULL NAME]

• DOB: [DATE OF BIRTH]

• Allergies: [LIST ANY ALLERGIES HERE]

This Medication List is designed to help manage and keep track of all medications you are currently taking or have taken recently. Please bring this list to all your healthcare appointments.

Overview

This Patient Medication List Template is designed to ensure accurate and comprehensive medication management. It serves as a critical tool for patients, healthcare providers, and pharmacists to track current medications, dosages, frequency, and reasons for taking each medication. Additionally, it includes recently discontinued medications, providing a full medication history to avoid adverse drug interactions and to facilitate safe and effective treatment plans.

Current Medications

Medication Name	Dosage	Frequency	Reason for Taking
Lisinopril	10 mg	Once daily	High blood pressure
Metformin	500 mg	Twice daily	Type 2 diabetes
Atorvastatin	20 mg	Once daily at night	High cholesterol
Albuterol	As needed	Every 4-6 hours	Asthma (rescue inhaler)

Recently Discontinued Medications

Medication Name	Dosage	Frequency	Reason for Taking	Date Discontinued
Amoxicillin	500 mg	Every 8 hours	Bacterial infection	03/01/2024
Ibuprofen	400 mg	Every 4-6 hours as needed	Pain/Inflammation	02/15/2024

Notes and Instructions

• Lisinopril: Take in the morning to avoid nighttime urination. Report any signs of facial swelling or difficulty breathing immediately.

• Metformin: Take with meals to minimize gastrointestinal upset. Monitor blood sugar levels as directed.

• Atorvastatin: Avoid grapefruit and grapefruit juice during therapy. Regularly monitor cholesterol levels.

• Albuterol: Use as needed for wheezing or shortness of breath. If using more than usual, consult your healthcare provider.

Pharmacy Information

• Pharmacy Name: [Pharmacy Name]

• Phone: [Pharmacy Phone Number]

• Address: [Pharmacy Address]

Physician Information

• Primary Care Physician: [Physician Name]

• Specialist: [Specialist Type and Name, if applicable]

• Phone: [Physician Phone Number]

• Address: [Physician Address]

Additional Reminders:

• Always verify medication names, dosages, and frequency with your healthcare provider.

• Keep this list updated with any changes to your medication regimen.

• Share this list with all your healthcare providers, including specialists and pharmacists, to ensure coordinated care and to avoid medication errors.

• Review and update your medication list regularly, especially after any healthcare visits or changes in treatment.

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