Medication log template
A medication log with each medicine, dose and the times of day across the week, a box to check each dose and a list of prescribers and pharmacy.
- πΊπΈ US format Β· Letter size
- Free
Fill in what you need. The preview updates as you type.
What you type is not saved on our server.
Not medical advice
This log is for your own records and for your doctor. It does not diagnose anything or replace medical advice. If a reading worries you, call your doctor.
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Medication Log
Week of October 5, 2026 to October 11, 2026
| Name | Jordan Lee | Allergies | Penicillin (rash) |
|---|---|---|---|
| Doctor | Dr. Casey Nguyen, (555) 010-0606 | ||
| Pharmacy | Hill Country Pharmacy, (555) 010-0707 | ||
1. My medications
| Medication | Dose | Prescribed by | Purpose | Pharmacy |
|---|---|---|---|---|
| Metformin | 500 mg | Dr. Nguyen | Blood sugar | Hill Country Pharmacy |
| Lisinopril | 10 mg | Dr. Nguyen | Blood pressure | Hill Country Pharmacy |
| Atorvastatin | 20 mg | Dr. Nguyen | Cholesterol | Hill Country Pharmacy |
| Vitamin D | 2, | Over the counter | Supplement | Β |
2. Daily check
| Medication (time) | Mon | Tue | Wed | Thu | Fri | Sat | Sun |
|---|---|---|---|---|---|---|---|
| Metformin 500 mg (8 am) | β | β | β | β | β | β | β |
| Metformin 500 mg (8 pm) | β | β | β | β | β | β | β |
| Lisinopril 10 mg (8 am) | β | β | β | β | β | β | β |
| Atorvastatin 20 mg (9 pm) | β | β | β | β | β | β | β |
| Vitamin D 2, | β | β | β | β | β | β | β |
Check the box when you take the dose. A missed dose stays empty; write why in the margin if it matters. Print a new sheet each week and keep the old ones until your next visit.
Not medical advice. Share with your doctor.
How to use it
List each medication with its dose, who prescribed it, what it is for and where you fill it. Then type the daily schedule: a medication and the times you take it, separated by commas. Each time becomes a row in the check grid, so Metformin at 8 am and 8 pm prints as two rows with a box for every day of the week.
Print a sheet for the week, put it where the pill bottles are and check a box as you take each dose. The list at the top doubles as the medication list a new doctor, pharmacist or emergency room asks for.
Things to watch
Include over-the-counter medicines, vitamins and supplements; interactions come from those too. Update the list whenever a dose changes and throw the old sheet away so nobody follows a stale one. If you care for a parent or child, write the caregiver's initials in the box instead of a check.
Calculators that go with this
Frequently asked questions
What if a medication is taken every other day or once a week?
Type it with its time like the others. On the days it is not due, draw a line through the box, or write the day in the time, for example Alendronate 70 mg | Saturday 7 am.
Can I use it for more than one person?
Print one sheet per person. The allergies line and the medication list belong to one patient, and a shared grid is how doses get mixed up.
Where does the medical history go?
On the medical history form template, which has a medication table with the same columns plus conditions, surgeries and family history for new patient paperwork.
Is what I type saved anywhere?
No. Everything stays in your browser and nothing is sent to our server. If you refresh the page it is gone, so print, save a PDF or download the DOCX when you are done.