Medication Chart



Prescription Medications

| | | | |

|Start |Name of Medicine |Prescribed By |Dose |

|Date |Brand name | |(mg, units, puffs, drops) |

| |Generic name too if available | | |

|Antacids |Laxatives | | |

|Aspirin/other pain, headache, |Sleeping pills | | |

|or fever | | | |

|Cold/cough medicines |Vitamins, minerals | | |

|Diet pills |Others (list below): | | |

| | | | |

Developed by the Massachusetts Coalition for the Prevention of Medical Errors

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