HealthRX.com · Printable medication review sheet
AOD peptide and warfarin interaction review sheet
Use this sheet to record every medicine, supplement and AOD peptide product you use, then take it to your prescriber or pharmacist. It helps you raise the unknown interaction with warfarin and track INR results.
Medicines and products in use
Write what you take now. Include anything obtained without a prescription.
Warfarin prescriber nameDoctor or clinic that manages warfarin
Warfarin product nameAs printed on the bottle or label
AOD peptide product nameAs printed on the packaging
Where the AOD peptide was obtainedShop, clinic or website name only
Date the AOD peptide was started
Date the AOD peptide was stoppedWrite not stopped if still in use
Other supplements or botanicalsList each one by name
Gather before the visit
Bring these items so the review can be complete.
- Bring the warfarin bottle and any written warfarin instructions.
- Bring the AOD peptide packaging or a photo of its label.
- List every botanical, vitamin or supplement you take.
- Note the date and result of your most recent INR check.
- Confirm whether your prescriber knows you are using the AOD peptide.
- Check with your pharmacist whether they can review all products together.
- Write any bleeding, bruising or dark stool you have noticed.
Questions to ask your prescriber or pharmacist
- Does my warfarin plan need more frequent INR checks while I use the AOD peptide?
- Can you record my current INR result in the log below today?
- Which signs of bleeding should I report to you right away?
- Does the pharmacy have any interaction records for the AOD peptide with my medicines?
- Should we discuss stopping the AOD peptide before my next INR check?
- Which of my other medicines could change my INR if I start or stop them?
- What other options for weight concerns would you discuss with me?
INR and product change tracking
Record each INR result and any product you start, stop or change.
| Date | INR result | Product or change | Checked by |
|---|---|---|---|