Melanoma Treatment Schedule and Medication Guide

Patient Information

Name: _________________________ Date: __________________________ Oncologist: ____________________

Treatment Protocol

Oral Medications

• Medication Name: ________________
• Dosage: ________ mg
• Frequency: □ Once daily □ Twice daily □ Other: _______
• Take with: □ Food □ Empty stomach
• Time(s): □ Morning □ Evening □ Other: _______

Injectable Medications

• Medication Name: ________________
• Dosage: ________ mg/mL
• Frequency: □ Weekly □ Bi-weekly □ Monthly
• Administration site rotation:
  • Upper arms
  • Thighs
  • Abdomen

Important Reminders

Side Effect Monitoring

• Record any skin changes
• Monitor for fever above 100.4°F (38°C)
• Track fatigue levels
• Note any new pain

Emergency Contacts

• Oncology Office: ________________
• After Hours: ____________________
• Emergency Room: ________________

Medication Calendar

Month: ________________

Laboratory Schedule

• Blood work frequency: __________________
• Imaging schedule: ______________________
• Next appointment: ______________________

Keep this schedule updated and bring to all appointments