Free Home Care Medication List Template
Home Care Medication List
A. Patient Information
-
Name: Karla Stewart
-
Date of Birth: January 1, 2050
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Allergies: Penicillin
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Primary Care Physician: [YOUR NAME], [YOUR EMAIL]
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Emergency Contact: Kent Stewart - Husband, 222 555 7777
B. Medication List
1. Prescription Medications
|
Medication Name |
Dosage |
Frequency |
Purpose |
Notes |
|---|---|---|---|---|
|
Lisinopril |
10 mg |
Once daily |
Hypertension |
Morning |
|
Metformin |
500 mg |
Twice daily |
Diabetes |
With meals |
|
Atorvastatin |
20 mg |
Once daily |
Cholesterol |
At bedtime |
|
Albuterol Inhaler |
2 puffs |
As needed |
Asthma |
- |
2. Over-the-Counter Medications
|
Medication Name |
Dosage |
Frequency |
Purpose |
Notes |
|---|---|---|---|---|
|
Ibuprofen |
200 mg |
Every 6 hours |
Pain relief |
With food |
|
Diphenhydramine |
25 mg |
Once daily |
Allergy relief |
At bedtime |
|
Multivitamin |
1 tablet |
Once daily |
Supplement |
With breakfast |
|
Calcium Carbonate |
500 mg |
Twice daily |
Bone health |
With meals |
3. Supplements
|
Supplement Name |
Dosage |
Frequency |
Purpose |
Notes |
|---|---|---|---|---|
|
Vitamin D |
1000 IU |
Once daily |
Bone health |
With breakfast |
|
Omega-3 Fish Oil |
1000 mg |
Once daily |
Heart health |
With water |
|
Probiotic |
1 capsule |
Once daily |
Digestive health |
Before meals |
|
Magnesium |
250 mg |
Once daily |
Muscle function |
With dinner |
C. Medication Administration Schedule
|
Time of Day |
Medications to be Taken |
|---|---|
|
Morning |
Lisinopril, Metformin, Multivitamin, Vitamin D |
|
Noon |
Metformin, Calcium Carbonate |
|
Evening |
Calcium Carbonate, Probiotic, Magnesium |
|
Bedtime |
Atorvastatin, Diphenhydramine, Ibuprofen (if needed) |
|
As needed |
Albuterol Inhaler, Ibuprofen (every 6 hours as needed for pain) |
D. Additional Notes
-
Ensure all medications are stored in a cool, dry place and out of reach of children.
-
Check expiration dates regularly and dispose of expired medications properly.
-
Keep this list updated with any changes in medications or dosages.
-
If you experience any side effects or adverse reactions, contact your healthcare provider immediately.
This Home Care Medication List is intended to assist in the safe and effective management of medications for individuals under home care. Regular reviews and consultations with healthcare professionals are recommended to ensure optimal treatment outcomes.
