It may be helpful to keep a note of what medication you are taking. You can print off this form and fill it in. Keep it handy in case you ever need to discuss your medication with anyone.
Name:_______________________________________________________________________
Address: ___________________________________________________________________
DOB: ________________________________________________________________________
GP name: ____________________________________________________________________
Date: _______________________________________________________________________
| Drug | When do you take it (✔) | ||||
|---|---|---|---|---|---|
| Your drug name | Dosage (mg) | Breakfast | Lunch | Dinner | Bedtime |
| Antiplatelet drugs: take to reduce blood clotting | |||||
| Statins: take to lower cholesterol | |||||
| Anticoagulation therapy: take to reduce the risk of blood clots that could cause another stroke | |||||
| Blood Pressure medication: to lower blood pressure | |||||
| Other: | |||||
| Other: | |||||
Download My medicines sheet [.pdf, 118 KB]