HomeMy WebLinkAboutquestions-for-my-doctor-and-pharmacistQUESTIONS FOR MY DOCTOR OR PHARMICIST:
1. Please check my current medications list on reverse. Will this new medicine
interact with other medicines I use?
2. What does this medicine do and how should I use it?
3. Are any side effects likely? Should I expect to feel any different while taking this
medicine? What can I do to reduce the chance of side effects?
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4. When should the medicine be reviewed or stopped?
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5. May I increase or decrease the dose? If so, under what circumstances?
6. What exactly does “as needed” mean?
7. May I ever change dosage times, or skip days? If so, under what circumstances?
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8. What should I do if I miss a dose?
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9. What food, drink, activity or storage might affect how well this medicine works?
10. Is it OK to lie down after taking this medication?
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11. Is a Physician’s Insert available for this drug? (If so, ask for and hold on to this
reference in case any uncommon side effects emerge.)
IF YOU HAVE TROUBLE READING YOUR MEDICATION LABEL ASK YOUR DOCTOR TO
REQUEST THAT THE PHARMACIST PRINT THE DIRECTIONS IN LARGE TYPE.
List any medications that you are allergic to_____________________________________
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Name______________________________________
CURRENT MEDICATIONS LIST
*Be sure to include over the counter medications and herbal remedies*
Medication
Dosage
Number
of Pills
per dose
Reason for Taking
When to
Take
Questions
or
Comments
Adapted from THE CAREGIVERS HANDBOOK, courtesy of Robert S. Stall, M.D. 8/09