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MEDICATION QUESTION GUIDE
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Ask your health care provider these questions about each new
medicine which is recommended or prescribed. Write the answers in the
spaces provided.
Use a separate sheet for each medicine.
Name of Medicine______________________________________
What are the brand and generic names of the medicine? Can I
use a generic form?
What is the medicine for and what effect should I expect?
Does this drug replace any other medicine I have been using?
How and when will I use it, what amount will I use, and for
how long?
What do I do if I miss a dose?
Should I avoid any other medicines, (prescription or
over-the-counter), dietary supplements, drinks, foods or activities while
using this drug?
When should I notice a difference or improvement? When should
I report back.
Will I need to have any testing to monitor this drug's
effects?
Can this medicine be used safely with all my other
medications and therapies? Could there be interactions?
What are the possible side effects? What do I do if a side
effect occurs?
How and where do I store this medicine?
Where and how can I get written information about this
medicine? What other sources of information can I use to learn about this
medicine?
Call 1-888-INFO-FDA or go to http://www.fda.gov/cder/consumerinfo/active_member.htm
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Consumer Education
FDA/Center for Drug Evaluation and Research
Last Updated: October 09, 2001
Originator: OTCOM/DLIS
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