Free Migraine Medication List Template
Migraine Medication List
Prepared by: [YOUR NAME]
Introduction:
This Migraine Medication List is designed to assist in the management of migraine treatment. It provides essential details about prescribed medications to ensure effective symptom relief and patient well-being.
Patient Details:
|
Field |
Information |
|---|---|
|
Patient Name |
Joanne Galindo |
|
Date Created |
July 3, 2050 |
|
Doctor |
Dr. Roger Head |
|
Contact Information |
roger@email.com | +1-330-401-3236 |
|
Pharmacy |
Maple Leaf Pharmacy |
|
Pharmacy Contact |
+1-330-703-7969 |
Medication Details:
|
Medication |
Dosage |
Frequency |
Instructions |
|---|---|---|---|
|
Sumatriptan (Imitrex) |
50 mg |
As needed, up to 2 times a day |
Take at onset of migraine symptoms. Do not exceed 200 mg in 24 hours. |
|
Propranolol (Inderal) |
80 mg |
Once daily |
Take in the morning with food. |
|
Topiramate (Topamax) |
100 mg |
Twice daily |
Take morning and evening with plenty of water. |
|
Rizatriptan (Maxalt) |
10 mg |
As needed, up to 3 times a day |
Take at onset of migraine. Do not exceed 30 mg in 24 hours. |
|
Amitriptyline (Elavil) |
25 mg |
Once daily at bedtime |
Take before bedtime. Avoid driving or operating machinery. |
|
Metoclopramide (Reglan) |
10 mg |
As needed for nausea |
Take up to 4 times a day as needed for nausea relief. |
|
Naproxen (Aleve) |
250 mg |
As needed, up to twice daily |
Take with food. Do not exceed 500 mg in 24 hours. |
|
Magnesium Oxide (Mag-Ox) |
400 mg |
Once daily |
Take in the evening with food. |
|
Coenzyme Q10 (CoQ10) |
100 mg |
Once daily |
Take with a meal. |
Important Reminders:
-
Keep medications in a cool, dry place.
-
Take medications with food to minimize stomach upset.
-
Follow up with doctor every 3 months for medication review.
-
Report any unusual side effects or symptoms promptly to your healthcare provider.
-
Carry a list of medications during travel or emergency situations.
This Migraine Medication List is intended to support effective treatment management and ensure continuity of care.
