Keep a complete list of every medication, supplement, and over-the-counter product you take. Bring this list to every appointment — every doctor needs to see it.
Current Prescription Medications
| Medication Name (Brand / Generic) |
Dose |
How Often / When |
Prescribing Doctor |
Purpose |
Start Date |
Side Effects I Notice |
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Hormone Therapy / Cancer-Specific Medications
| Medication Name |
Type (injection / pill / implant) |
Dose |
Frequency |
Start Date |
Next Due Date |
Side Effects I Notice |
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Over-the-Counter Medications
| Medication Name |
Dose |
How Often |
Purpose |
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Supplements, Vitamins, and Herbal Products
Important: Always tell your doctor about every supplement you take. Some supplements can interfere with cancer treatments or affect lab results.
| Product Name |
Dose |
How Often |
Purpose |
Doctor Aware? (Y/N) |
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Allergies and Medication Reactions
| Medication / Substance |
Type of Reaction |
Severity (mild / moderate / severe) |
Date of Reaction |
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Medications I Have Stopped
| Medication Name |
Dose |
Reason Stopped |
Date Stopped |
Stopped by Which Doctor |
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Injection / Infusion Schedule
For patients receiving hormone injections, chemotherapy infusions, or other scheduled treatments.
| Medication |
Dose |
Frequency |
Date Given |
Next Due |
Location / Clinic |
Notes |
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Pharmacy Information
Tips for Managing Your Medications
- Keep one updated list — this document — and bring it to every appointment with every doctor.
- Use a pill organizer if you take multiple daily medications.
- Set phone alarms for medications that must be taken at specific times.
- Do not stop or change any medication without talking to your doctor first.
- Report all supplements to your oncologist — some can interfere with treatment.
- Refill medications early — do not wait until you run out.
- Store medications properly — some require refrigeration (especially injections).
- If you miss a dose, call your doctor or pharmacist for guidance — do not double up.
- Keep an emergency medication card in your wallet (see Appendix L).