Medication lists: the most valuable single document

Of everything in a personal health file, the medication list is used most often and gets wrong most often. It deserves particular attention.

What belongs on the list

• Generic name of each medicine.
• Strength with units.
• Dose and frequency.
• Route: oral, injected, inhaled, topical.
• What it is for.
• When it was started.
• Who prescribed it.

The indication matters because it lets a new clinician judge whether the medicine is still appropriate.

Include everything, not only prescriptions

• Over-the-counter medicines taken regularly.
• Vitamins and supplements.
• Herbal products.
• Eye drops, creams and inhalers.
• Injections given at intervals.
• Anything taken occasionally but regularly.

Eye drops and topical products are the most frequently omitted, and some are absorbed systemically enough to matter.

Why generic names matter

• They are internationally standardised.
• Brand names vary by country.
• The same brand can contain different ingredients in different markets.
• A pharmacist abroad may not recognise your brand.
• Generic names allow substitution to be checked.

The third point is the dangerous one. Assuming a familiar brand contains the same drug abroad is not safe.

Units and strengths

• Units differ between countries for some measures.
• Write strength per dose unit clearly.
• Distinguish between the amount per tablet and the amount per dose.
• Note modified-release formulations explicitly.

The last point matters clinically. A modified-release product is not interchangeable with an immediate-release one of the same strength.

Allergies and adverse reactions

• List the medicine and the reaction that occurred.
• Distinguish true allergy from side effect.
• Note the severity and timing.
• Include reactions to contrast agents and anaesthetics.
• Note anything you were told to avoid and why.

The distinction in the second point has real consequences. Recording nausea as an allergy can deny you an effective medicine unnecessarily.

Medicines you have stopped

• Keep a separate section for discontinued medicines.
• Note why each was stopped.
• This prevents retrying something that failed.
• It also flags reactions.
• Keep it clearly separate from the current list.

The separation matters. A combined list handed over in an emergency invites the wrong medicines being given.

Reconciliation at transitions

• Hospital admission and discharge are high-risk points.
• Medicines are often changed during a stay.
• Changes are not always explained clearly.
• Ask explicitly what changed and why.
• Update your list before leaving.

Discrepancies between discharge prescriptions and prior medicines are well documented and common.

Questions to ask at discharge

• Which medicines have been stopped?
• Which are new and for how long?
• Which doses have changed?
• Should I restart anything I was taking before?
• Who reviews this next?

The fourth question addresses a frequent gap: medicines paused during admission and never formally restarted.

Practical formats

• A printed card in your wallet.
• A photograph on your phone.
• A note on the lock screen for emergencies.
• A copy with a family member.
• A copy in your main health file.

Redundancy is appropriate here, because this is the document most likely to be needed when you cannot speak for yourself.

Photograph the packaging

• Solves identification problems abroad.
• Shows manufacturer and formulation.
• Useful if the written name is ambiguous.
• Update when products change.

Travelling with medicines

• Keep in original labelled packaging.
• Carry the prescription or a doctor's letter.
• Split supply between bags.
• Check import rules for controlled categories.
• Account for time zone changes in dosing schedules.

The last point is worth planning for medicines with strict timing, particularly insulin and some others.

Timing and schedules

• Note which medicines must be taken with food and which without.
• Note any that must be separated from others.
• Note any requiring specific timing relative to sleep.
• Record what to do about a missed dose.

The last item is worth asking about for each medicine, because the correct action varies and guessing can double a dose.

Medicines requiring monitoring

• Some need regular blood tests to guide dosing.
• Record which tests and at what interval.
• Note recent results and target ranges.
• This information is essential if care transfers.

Without it, a new clinician must either repeat testing or dose blind, and neither is ideal.

Injectable and specialist medicines

• Note storage requirements, particularly refrigeration.
• Note the device or delivery system used.
• Note where supplies are obtained.
• Plan supply continuity before travel or relocation.

Cold chain requirements complicate travel and should be planned rather than improvised at the airport.

Reviewing the list periodically

• Ask whether each medicine is still needed.
• Ask whether any could be stopped or reduced.
• Watch for medicines added to treat side effects of others.
• Longer lists carry higher interaction risk.

The third pattern is worth watching for. A medicine prescribed to counter another medicine's effect sometimes outlives the reason it was started.

Involving a pharmacist

• Pharmacists can review a list for interactions and duplication.
• They can identify unfamiliar products.
• They can advise on timing and administration.
• A review is often free and takes little time.

An annual review is a low-effort, high-value habit, particularly for anyone taking several medicines.

When a medicine is unavailable abroad

• Ask the prescriber for an equivalent before travelling.
• Local pharmacists can often identify alternatives.
• Switching between similar drugs needs clinical oversight.
• Do not simply stop a medicine because it is unavailable.

The last point is the important one. Abrupt discontinuation carries its own risks for several drug classes.

Helping someone else manage their medicines

• Keep a single shared list rather than several versions.
• Agree who updates it after appointments.
• Use a pill organiser if timing is complex.
• Watch for duplication when several prescribers are involved.
• Bring the list to every appointment.

Duplication arises easily when different specialists prescribe without seeing each other's additions, and a single list is the main defence.

Summary

Use generic names, because brands differ between markets and can refer to different ingredients. Include everything, especially eye drops, supplements and topical products, which are the most commonly omitted. Distinguish true allergy from side effect, since mislabelling can deny you a useful medicine. And ask at discharge what was stopped, started and changed, because that transition is where lists most often go wrong.

Câu hỏi thường gặp