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Medication Tracker

Track medications, changes, questions, side effects, and refill needs so everyone is working from the same list.

Privacy-friendly: no account, no email, and no personal information submitted to this site.

Parent / patient name
Date last updated
Primary caregiver
Primary pharmacy
Primary doctor

Bring this tracker to doctor visits, hospital follow-ups, medication reviews, and family meetings. Use it to keep medication information in one place, notice changes, prepare questions, and help caregivers work from the same list.

This tracker is for organizing information and questions. It is not medical advice. Do not stop, start, or change medication without asking the doctor, pharmacist, or care team.

Do not write Social Security numbers, insurance IDs, prescription numbers, passwords, portal credentials, or full account information on this tracker.

Section 1

Current Medications

Use this section for prescribed medications the person currently takes.

Medication NameWhy It Is TakenPrescribing DoctorDosageWhen TakenPharmacyNotes

Current medication notes:

Section 2

Over-The-Counter Medications

Examples: pain relievers, allergy medicines, sleep aids, antacids, cold medicines, creams, eye drops, or laxatives.

NamePurposeFrequencyNotes

Over-the-counter medication questions:

Section 3

Vitamins And Supplements

Families often forget supplements during medication reviews. Include vitamins, minerals, herbal products, powders, gummies, and teas if used.

NamePurposeFrequencyNotes

Supplement questions:

Section 4

Medication Changes

Use this after hospitalizations, doctor visits, specialist visits, urgent care visits, or pharmacy reviews.

DateMedicationWhat ChangedWhyWho Made The Change

Notes about recent changes:

Section 5

Medication Questions For The Doctor Or Pharmacist

Use this space to prepare questions. Do not answer these without the doctor, pharmacist, or care team.

Prompts:

  • Has anything changed?
  • Are there duplicates?
  • Could any medications affect balance?
  • Could any medications affect memory?
  • Could any medications affect sleep?
  • Could any medications affect appetite?
  • Could any medications affect mood or behavior?
  • Could any medications interact with other medicines, food, alcohol, or supplements?
  • Is anything no longer needed?
  • Are any doses being missed?
  • Are there lower-cost alternatives?
  • Should any medication be reviewed after a hospitalization?

Questions:

Notes from the appointment:

Section 6

Refill Tracking

MedicationRefill Needed ByPharmacyNotes

Refill concerns:

Section 7

Side Effects And Concerns

Use this section to track observations. Do not assume a medication caused the concern. Bring notes to the doctor or pharmacist.

Examples: dizziness, falls, confusion, fatigue, appetite changes, sleep changes, mood changes, stomach problems, rash, pain, weakness, or missed doses.

DateConcernMedication SuspectedNotesFollow-Up Needed

Questions about concerns:

Section 8

Hospital Or Emergency Visit Medication Review

Medication lists often change after hospital stays. Verify changes with the care team and pharmacy.

FieldInformation
Hospital / facility
Date
Medication list reviewed? Yes No Unsure
New medications added? Yes No Unsure
Medications stopped? Yes No Unsure
Follow-up needed? Yes No Unsure

What changed?

Who should verify the list?

Follow-up appointment:

Final Page

Medication Review Checklist

Before the next appointment or review, check:

  • Current medication list reviewed.
  • Pharmacy verified.
  • Supplements reviewed.
  • Recent changes recorded.
  • Refill dates checked.
  • Side effects discussed.
  • Hospital changes reviewed.
  • Questions prepared for next appointment.
Next medication review date
Person responsible for next update

Notes:

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