Tracking your meds: primer for talking with your healthcare provider
Primer for talking with your healthcare provider
Tracking your meds
If you take dietary supplements, complete the chart below and share
it with your doctor, nurse, pharmacist, or caregiver.
In the chart, include multiple, single or combination vitamins,
minerals, or herbal or botanical supplements (see list at bottom).
Name–
Date–
List the supplements that you take, how often you take them, and
why you take them.
Example: calcium Once a day 50 mg support healthy bones
1.
2.
3.
4.
5.
Are you currently taking or have you recently taken any
over-the-counter medications (eg, aspirin, cold medicine, stool
softener, pain reliever, etc.) Yes– No– (if yes list below)
1.
2.
3.
4.
5.
Just like prescription and over-the-counter drugs, side effects
can happen with dietary supplements. These might include headache,
insomnia, rash, upset stomach, vomiting, weakness or fatigue. If
you think you’ve had a reaction to a dietary supplement, write it
here
Multiple vitamin/mineral
Vitamin B Complex
Vitamin C
Vitamin D
Vitamin E
Calcium
Fiber
Folic acid
Zinc
Iron
Beta-carotene
Omega 3 fatty acids
Botanicals/other
Acidophilus
Black cohosh
Ginger
Evening primrose oil
Echinacea
Garlic
Ginkgo biloba
Fish oil
Glucosamine/chondroitin
Sulphate
St. John’s wort
Saw Palmetto
Source: Geriatrics is proud to present this information as a public
service. This material is excerpted from the US Food and Drug
Administration’s Center for Food Safety and Applied Nutrition,
Office of Nutritional Products, Labeling, and Dietary Supplements:
Dietary Supplements: Tips for Older Dietary Supplement Users,
available at: http://www.cfsan.fda.gov/~dms/ds-savv2.html.
COPYRIGHT 2005 Advanstar Communications, Inc.
COPYRIGHT 2005 Gale Group
