Senior Impact

Medication Checklist

List your medications here, then keep this list in your purse or wallet. You can also make copies of your list to keep at home or work or to give to family members. Take it with you to your doctor appointments and review the list with a pharmacist.

  Drug A Drug B Drug C
What is the brand name of the drug?      
What is the generic name?      
What is the strength (dose)?      
Why am I taking it?      
How many should I take?      
How often must I take it?      
How long must I take it?      
Will there be side effects? What are they?      
Are there side effects I should report to my doctor immediately?      
Should I take it with meals?      
Are there driving or other restrictions?      
Will it interact with other meds or with alcohol?      
Is there anything else I should know about taking this drug?      
Note any medication allergies: