Main Content
Top of the page
List each medicine that you take. Be sure to include over-the-counter medicines, herbs, vitamins, and other natural health products.
Use this as a guide when you fill out the chart.
Keep this master list of medicines up to date. Review it with your doctor at each visit. At the bottom, list medicines that you're allergic to or that you've stopped for other reasons.
Medicine name
Doctor's name
Pharmacy
Date started
Reason to take
Dose
When to take
Side effects to look for
Type of reaction, such as a rash or breathing difficulties
Current as of: September 25, 2023
Author: Healthwise StaffClinical Review BoardAll Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
Author: Healthwise Staff
Clinical Review BoardAll Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.