Colorectal Cancer Treatment Schedule and Medication Guide

Patient Information

Name: _______________________ Medical Record #: ____________ Oncologist: __________________

Treatment Protocol

Chemotherapy Schedule

• Cycle Length: _____ days
• Total Planned Cycles: _____
• Current Cycle: _____

Daily Medication Schedule

Morning (Time: _____)

• Anti-nausea medication: __________________
• Chemotherapy pills (if prescribed): __________________
• Supplements: __________________

Afternoon (Time: _____)

• Anti-nausea medication: __________________
• Pain medication (if needed): __________________

Evening (Time: _____)

• Anti-nausea medication: __________________
• Chemotherapy pills (if prescribed): __________________

Important Medications

Primary Chemotherapy Drugs

1. Drug Name: __________________

   • Dosage: __________________
   • Frequency: __________________
   • Special Instructions: __________________

2. Drug Name: __________________

   • Dosage: __________________
   • Frequency: __________________
   • Special Instructions: __________________

Side Effect Management

Contact Your Healthcare Team If You Experience:

• Fever above 100.4°F (38°C)
• Severe nausea/vomiting
• Unusual bleeding
• Severe diarrhea
• Difficulty breathing

Appointment Schedule

Next appointment: //____ Time: : AM/PM

Notes

Emergency Contacts

Oncology Nurse: __________________ After Hours: __________________ Emergency Room: __________________