diff --git a/src/app/api/medications/[id]/route.ts b/src/app/api/medications/[id]/route.ts
index da7612a17..13417b366 100644
--- a/src/app/api/medications/[id]/route.ts
+++ b/src/app/api/medications/[id]/route.ts
@@ -1134,6 +1134,9 @@ export const PUT = apiHandler(
             active: existing.active,
             asNeeded: existing.asNeeded,
             trackIntake: existing.trackIntake,
+            // v1.42.2 — switching automatic recording on or off is a change
+            // to how doses are recorded, so the row names it.
+            autoMarkTaken: existing.autoMarkTaken,
             endsOn: existing.endsOn,
           },
           after: {
@@ -1142,6 +1145,7 @@ export const PUT = apiHandler(
             active: medication.active,
             asNeeded: medication.asNeeded,
             trackIntake: medication.trackIntake,
+            autoMarkTaken: medication.autoMarkTaken,
             endsOn: medication.endsOn,
           },
         }),
diff --git a/src/app/api/medications/route.ts b/src/app/api/medications/route.ts
index d6de31e15..e2fd46d76 100644
--- a/src/app/api/medications/route.ts
+++ b/src/app/api/medications/route.ts
@@ -491,7 +491,13 @@ async function postMedication(request: NextRequest): Promise<Response> {
   await auditLog("medication.create", {
     userId: user.id,
     ipAddress: getClientIp(request),
-    details: { medicationId: medication.id, name },
+    details: {
+      medicationId: medication.id,
+      name,
+      // v1.42.2 — a medication created with its doses recorded
+      // automatically says so in its audit row.
+      autoMarkTaken: medication.autoMarkTaken,
+    },
   });
 
   annotate({
diff --git a/tests/integration/medication-auto-mark-taken.test.ts b/tests/integration/medication-auto-mark-taken.test.ts
index a0e80eb67..cb79cb58f 100644
--- a/tests/integration/medication-auto-mark-taken.test.ts
+++ b/tests/integration/medication-auto-mark-taken.test.ts
@@ -377,6 +377,58 @@ describe("auto-mark-taken pass", () => {
       select: { autoMarkTaken: true, autoMarkTakenSince: true },
     });
     expect(off).toEqual({ autoMarkTaken: false, autoMarkTakenSince: null });
+
+    // Each flip is named in the audit row with what it was before; the
+    // re-save that left it on names no change to it.
+    const audits = await prisma.auditLog.findMany({
+      where: { userId, action: "medication.update" },
+      orderBy: { createdAt: "asc" },
+      select: { details: true },
+    });
+    const details = audits.map(
+      (a) =>
+        JSON.parse(a.details ?? "{}") as {
+          fields: string[];
+          previous: Record<string, unknown>;
+        },
+    );
+    expect(details).toHaveLength(3);
+    // Two of the same timestamp: matched by content, not order.
+    const flips = details
+      .filter((d) => d.fields.includes("autoMarkTaken"))
+      .map((d) => d.previous.autoMarkTaken)
+      .sort();
+    expect(flips).toEqual([false, true]);
+    const resave = details.find((d) => d.fields.includes("name"));
+    expect(resave?.fields).not.toContain("autoMarkTaken");
+  });
+
+  it("the create audit row says whether doses are recorded automatically", async () => {
+    const prisma = getPrismaClient();
+    const userId = await makeUser();
+    const route = await import("@/app/api/medications/route");
+    at("2026-06-10T10:00:00.000Z");
+    const res = await (route.POST as Handler)(
+      new NextRequest("http://localhost/api/medications", {
+        method: "POST",
+        body: JSON.stringify({
+          name: "Vitamin D",
+          dose: "1 capsule",
+          autoMarkTaken: true,
+          schedules: [{ windowStart: "19:00", windowEnd: "19:00" }],
+        }),
+        headers: { "content-type": "application/json" },
+      }),
+      { params: Promise.resolve({}) },
+    );
+    expect(res.status).toBe(201);
+    const audit = await prisma.auditLog.findFirstOrThrow({
+      where: { userId, action: "medication.create" },
+      select: { details: true },
+    });
+    expect(JSON.parse(audit.details ?? "{}")).toMatchObject({
+      autoMarkTaken: true,
+    });
   });
 });