Free template · Family & Caregiving

Medication schedule chart

A clear chart of every medicine, its dose, when it is taken and any instructions. Keep it by the medicines, bring it to appointments, and give a copy to anyone who helps.

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MedicineWhat it's forDoseMorningMiddayEveningBedtimeWith food?Prescribed byNotes
Example: Metformin 500 mgBlood sugar1 tablet✓✓With mealsDr RahmanExample only, not advice

How to use it

  1. Write down every medicine, including over-the-counter medicines, vitamins and supplements. The U.S. National Institute on Aging recommends keeping such a list and sharing it with your doctor and pharmacist.

  2. Tick the times of day each one is taken and note special instructions from the label.

  3. Update the chart whenever a medicine or dose changes, and date it at the top.

Sources

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