HealthRX.com · Printable medication review sheet
Healing peptide BPC and TB medication review sheet
Use this sheet to list each healing peptide product and every medicine you take, then bring it to your prescriber or pharmacist. No human interaction data exists for these peptides, so write down what you use.
Peptide product you use
Copy wording from the vial or box exactly as printed.
Peptide names on the labelWrite each name exactly as printed
Seller or sourceName of vendor or clinic
Batch or lot codeCopy from the vial or box
Amount per vialCopy the wording from the label
How it is givenRoute and site as you use it
Date you startedWrite the month and day
Research use only wordingWrite yes or no and where it appears
Gather before the visit
- Bring the vial, box and any paper that came with the product
- Bring a full list of prescription medicines you take
- List over-the-counter pain relievers, sleep aids and vitamins you use
- Note any supplements or other peptide products used in the same period
- Confirm with your pharmacist which medicines you fill there
- Check with your prescriber whether they know about the peptide use
- Write down any blood thinner, antidepressant or antipsychotic you take
Ask your prescriber or pharmacist
- Is there any tested interaction between these peptides and my current medicines?
- Does the lack of human interaction data change how you review my medicine list?
- Could my blood thinner be affected if I use any peptide product?
- Would an NSAID pain reliever be affected if I use a healing peptide?
- Should I stop any medicine while I review this list with you?
- What should I do if I notice a new skin or gum change after using a peptide?
Peptide use and medicine log
Write one row each time you use a peptide product or take a medicine you list.
| Date | Product used | Other medicine taken | Changes noticed |
|---|---|---|---|
This sheet records information for a conversation with your prescriber or pharmacist. It does not replace their instructions or the medication's prescribing information.