Expires 04/01/2021

Specialty Pharmacy

We're here to support you through COVID-19 with free home delivery.

Your partner in navigating the ins and outs of prescriptions — at no extra cost.

Alto Pharmacy Technician

Alto Pharmacist

Our mission at Alto is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it.

Services that reduce travel and encourage social distancing are now more essential than ever, not only for vulnerable populations but all of us as members of our communities. Alto’s free same-day doorstep delivery ensures you have safe and reliable access to medications in this time of uncertainty. 

Hear first-hand from members of the Alto technology teams.

Alto / Blog

Our pharmacists share a few tricks that can save money, time, and avoid confusion later on. Let’s walk through the ideal prescription experience one step at a time. 

How to be a prescription overachiever!

You’ve just been handed a new prescription by your doctor. While you could have it sent to the nearest pharmacy, pay what they tell you is owed, and take the medication without question, a prescription overachiever knows a few tricks that can save money, time, and avoid confusion later on. 

If straying from business as usual sounds like a hassle, we’ll let you in on a little secret. We consider ourselves the ultimate prescription overachievers—nothing brings us more joy than taking care of the details for you. From savings investigations to free drop-offs, there are some serious perks on the table. Let’s walk through the ideal prescription experience one step at a time. 

Don’t let the concept of “doctor knows best” deter you from asking questions. Every time you get a new prescription you should be sure you understand what, how, and why. 

You’ll always have access to a team of experts at Alto, but it’s still important to have this initial conversation with your doctor. If you’re unsure what you should be asking, here’s a solid start: 

Why is this medication the best choice for me?

What would happen if I don’t take my medication correctly?

Don’t be afraid to seek as much clarity as you need. This information will help you stick to your plan and there are no wrong questions when it comes to your health. 

2. Decide where and how to get your prescription filled 

While you could take your prescription to the nearest pharmacy and wait in line, a busy retail atmosphere may prevent you from getting much one-on-one time with your pharmacist. Mail-order options offer convenience but can be problematic if you need your prescription right away. Thankfully, at Alto, we’ve built a better pharmacy experience.

Ask your doctor to send your prescription directly to us and we’ll reach out to set up your account. As soon as your medication is ready, we’ll send you a text or give you a call to schedule your free delivery. As a full-service pharmacy, we can fill all medications, including specialty, over-the-counter, brand, and generic. And you’ll have access to a team of experts who’d be happy to answer questions and discuss your concerns. 

According to a recent report from the Organization for Economic Cooperation and Development, on average, Americans spend about $1,200 on prescription drugs a year. However, if you know where to look, there are opportunities to get a better deal. Every time you send a new prescription to Alto, our team works tirelessly behind-the-scenes to find you the best price. We’ll automatically look for any savings, including prescription discounts, coupons, and assistance programs, then show you which option provides the lowest possible cost. If it turns out that paying out of pocket is cheaper than going through insurance, we’re going to let you know. So far, we’ve saved our patients more than $23 million on their medications. 

Now that you have your prescription in hand, it’s a good idea to review the details. Should you take it on an empty stomach or with a meal? Are there special instructions to keep in mind or side effects to expect? Understanding the facts can go a long way in reducing your risk of adverse effects. If any questions still linger, our patient care pharmacists are a simple text or phone call away. 

Whether you thrive on responsibility or you’re more of the “wing it” type, it never hurts to enlist a little help in sticking to your plan. Setting a recurring alarm will ensure you never miss a dose, so we went ahead and included one within the Alto app. If your prescription is ongoing, you can use calendar alerts to help you remember your refills or simply leave it to us! We’ll automatically reorder your medication before you run out and get in touch to schedule delivery. 

Questions may come up in the days and weeks to come, so be sure to have your healthcare provider’s contact information handy. If you experience any unusual symptoms or are unsure if a certain supplement will interact with your medication, don’t hesitate to check in with your doctor or the team at Alto.

Remember—being a prescription overachiever might sound like more work, but you don’t have to put in the extra effort when you have Alto on your side. We thrive on handling the details so you can stay focused on your health. 

Curious if your prescription could cost you less? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-588 or download the mobile app for secure messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options.

IVF Medications: Schedule and Side Effects Explained

IVF, or in vitro fertilization, is one form of treatment that may help those experiencing infertility to conceive. In fact, at least 8 million babies born today are a result of this procedure. That’s remarkable when you consider the first successful IVF procedure was only conducted in 1978.  

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options. Let’s take a closer look at how one might arrive at each step. 

What Medications Should I Expect with IVF? 

The IVF process itself requires considerable IVF medication use on a precisely timed schedule. For these reasons, it’s important to understand what you might be prescribed as well as any potential IVF medication side effects. 

On the first day of a patient’s menstrual cycle they will typically call to schedule a “baseline” visit for Day 3 of their cycle. This appointment includes an ultrasound and bloodwork. After this visit, if approved, patients will start hormone injections (commonly referred to as “stimulation meds” or “stims”). 

These injections stimulate egg production so a woman’s body produces many follicles in a cycle, not just one (follicles house eggs that contain all the hormones and fluids needed to make an egg mature). Patients with one or more follicles already grown may need to wait until their next period cycle or use a different protocol. 

Stims are typically injected between 6-9PM daily at a consistent time. 

Supportive/adjunctive medications include: 

Omnitrope -  A growth hormone whose main purpose is to help improve the quality of eggs. Not every patient will see this on their protocol. Typical use cases include poor responders to stimulation medications and women who have a decreased ovarian reserve.

As a result of injections it is normal for patients to experience soreness or mild bruising at the site of injection. Bloating, cramping, headaches, breast tenderness and in some cases, temporary allergic reactions are also common side effects. 

During this period patients will continue stims and may start what is known as “antagonists” to prevent premature ovulation (i.e. once eggs are released into the pelvic cavity they cannot be retrieved). These types of medications block the hormone (gonadotropin-releasing hormone-GnRH) that causes eggs to be released from the ovaries. 

Regular monitoring visits will likely include additional ultrasounds and bloodwork and occur around days four and six and every other day after. Visit results will then determine if nightly doses need to be changed or if an antagonist is necessary. In these cases, patients will often have leftover medications or need refills. 

Side effects are similar to those experienced during days one to four. Some patients also experience what is known as ovarian hyperstimulation syndrome (OHS). In this instance there is an overproduction of follicles that can cause extreme swelling or pain in the ovaries. Depending upon the severity, treatment may be cancelled until a future cycle. 

Patients will receive a final ultrasound and bloodwork to confirm if the follicle pack has reached maturity. If so, a “trigger shot” is assigned approximately 35-36 hours before retrieval to stimulate final growth spurt and ovulation. 

Trigger shots are hormones that support the normal development of an egg in a woman's ovary, essentially triggering the egg to go through a final growth spurt, and stimulate the release of the egg during ovulation from the follicles within 36 hours. 

In most cases, patients will discontinue all other medications and are given a deep sedation for the 15-45 minute retrieval process. Following the procedure it’s normal to feel mild cramping or experience some vaginal spotting. 

Keep in mind that follicles may be empty at the time of retrieval or contain an immature egg. This means the number of eggs retrieved after egg retrieval may be lower than the number of follicles seen on the ultrasound or based on bloodwork.

Sperm is collected according to clinic protocol or donor sperm is thawed at the time of egg retrieval.

The retrieved eggs and sperm are combined and monitored for signs of fertilization as the embryo(s) divides into a small cluster of cells.

The quality of embryos are given a grade, often using a common A-D rubric with A = excellent quality, D = poor quality to determine the likelihood of a successful implantation.

“Fresh” transfer: For patients who are seeking to transfer their eggs immediately after retrieval, the embryo can be transferred in 2 different stages of its lifecycle:

1) They can be transferred on approximately day 2 or 3 after fertilization when it is in its cleavage stage.

2) They can be transferred between days 5-7 after fertilization when it is in its blastocyst stage.

The best appearing embryos are then deposited into the uterine cavity using a catheter. Patients may experience cramping, bloating and spotting following this procedure. 

“Frozen” transfer:  In some scenarios for egg freezing, i.e. planning for the future, the embryos are not transferred immediately. In this instance, because the technology does not currently exist to keep an embryo viable outside of the womb for an extended amount of time, embryos are frozen through a process called vitrification. 

After transfer (0-1 days post retrieval), progesterone supplements provide hormonal support for successful attachment of the embryo to the uterine lining using vaginal, oral, or injectable progesterone and in some cases, a combination of methods. Common medications include: 

Progesterone capsules, suppositories, lozenges

And finally - within 12 days to two weeks a blood sample is taken to determine if the transfer resulted in a successful pregnancy. This test measures the hCG (human chorionic gonadotropin) levels, often referred to as the “pregnancy hormone,” which indicates cells are forming in the placenta to nourish the fertilized egg.

Despite how involved IVF medications might be, know that you are not alone in this journey. Alto’s dedicated fertility pharmacists are here to help answer your questions and work with your physician to ensure your IVF treatment plan is followed properly. To learn more visit us at alto.com/fertility or reach out via phone, text or the app. We’re here for you from your first cycle to your last and everything in between. 

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Our hearts work so hard for us. Is there a way we can return that effort and hopefully keep them beating for a long time to come? We answer this question and more as we explore your top heart health FAQs.

Your Top 5 Questions About Heart Health, Answered!

The human heart is astonishingly tireless. Over an average lifetime, it will beat 2.5 billion times and pump out millions of gallons of blood. With such an impressive output, it’s amazing it doesn’t malfunction more often. However, as exceptionally reliable as our hearts may be, they’re still susceptible to wear and tear. Heart disease is the leading cause of death in the United States, although the CDC estimates that it’s 80% preventable. 

What is the link between cholesterol and heart health?

Cholesterol gets a bad rep, but it isn’t inherently bad. Our bodies need it to build cells. We produce enough cholesterol on our own, but we also take it in when we eat animal products like meat and dairy. Additionally, foods that are high in saturated and trans fats can stimulate our bodies to make more cholesterol than we need. 

When there’s too much cholesterol in our blood it can build up in our artery walls, limiting or even blocking the flow of oxygen-rich blood to the heart. Even worse, if a chunk breaks off and blocks an artery that leads to the heart or brain, a heart attack or stroke may occur. 

The American Heart Association recommends having your cholesterol levels tested every 4 to 6 years unless your doctor determines that you should check more frequently. High cholesterol can be addressed through diet and lifestyle changes or your doctor may prescribe a cholesterol-lowering drug, such as a statin. 

We need the sodium in salt to live. But, as is often the case, we can have too much of a good thing. Excess sodium causes the body to hold on to more fluid. More water in the bloodstream increases the volume of blood, which in turn increases blood pressure. High blood pressure can put a strain on our heart and is a major risk factor of heart disease, so make sure your doctor checks yours regularly.

Most Americans consume far more sodium than they need. The American Heart Association recommends no more than 2,300 mg of sodium per day, which is equivalent to one teaspoon of salt. Some of the biggest hidden-sodium culprits are processed meats, canned foods, frozen dinners, and prepared sauces and condiments. If you’re seeking convenience, look for an option that’s labeled “low sodium.” 

How do I make heart-healthy food choices?

Beyond reducing sodium, The American Heart Association recommends including plenty of vegetables, fruits, and whole grains at every meal. A high-fiber diet has been shown to reduce the risk of heart disease.

Limiting saturated and trans fats will have the biggest impact on lowering your cholesterol. Try to choose skinless poultry, fish, and legumes over red meat and stick to low-fat dairy when you can. You’ll also want to favor nontropical vegetable oils like olive, corn, or canola over saturated oils like coconut or palm and avoid hydrogenated margarine and shortening. There are plenty of ways to substitute ingredients in your favorite meals to make them better for your heart.

Finally, while there are many vitamins and supplements out there claiming to promote heart health, studies on some, such as calcium and vitamin E, have been conflicting. After completing a review of the relevant research, a team of researchers at Johns Hopkins cautioned against relying on supplements. Physician Edgar R. Miller III, M.D., Ph.D., summed up their findings by saying, “The bottom line is, we don’t recommend supplements to treat or to prevent cardiovascular disease.” One possible exception is omega-3 fatty acids, however Miller recommends dietary sources such as fish or walnuts. 

What lifestyle choices will help keep my heart healthy?

We’ve already discussed the importance of monitoring your blood pressure and cholesterol levels as well as reducing sodium intake and choosing heart-healthy foods. Here are three more ways to give your heart a boost. 

Quit smoking: According to the CDC, smoking is a major cause of heart disease, accounting for about a quarter of all related deaths in the United States. It’s not easy, but you can give up cigarettes for good—the American Heart Association provides some helpful tips. 

Don’t forget your cardio: Activities like walking, running, swimming, and biking will help to condition your heart and lungs. Try to get your heart rate up by exercising at a moderate intensity for at least 2-3 hours per week. How do you know if you’ve hit the sweet spot in terms of intensity? Well, the CDC explains that the “talk test” can help. You’ll know you’ve reached moderate intensity if you can comfortably talk but not sing. 

Manage stress: Research suggests that high levels of cortisol from long-term stress can increase cholesterol, blood sugar, and blood pressure—all common risk factors for heart disease. Plus, some of the unhealthy ways we deal with stress, like smoking and comfort foods, are contributors as well. For a more positive outlet, The American Heart Association suggests these stress-busting activities. 

What are the warning signs of a heart attack?

Though we’re used to seeing dramatic depictions in the movies, not all heart attacks occur with sudden intensity. Many come on gradually with only mild discomfort, but that doesn’t make them any less dangerous. 

According to the American Heart Association, chest discomfort—whether tightness, pressure, squeezing, or pain—is a major symptom to watch out for. The sensation may even radiate across your arm, back, neck, or jaw. Another major warning sign is shortness of breath, which can occur with or without chest discomfort. Additional symptoms of a heart attack include sweating, nausea, vomiting, or lightheadedness. 

If you experience these symptoms or any unusual sensations in your chest, call 911 right away. Getting immediate medical care could save your life. Every minute matters, so even if you’re not sure, don’t hesitate to get help. 

Staying curious about the many facets of heart health could help you live a longer, healthier life. Your heart needs your help maintaining its steady, life-giving pulse. Ask your doctor how you can reduce your risk of heart disease and make sure to get your blood pressure and cholesterol levels checked regularly. At Alto, we’re specialists in cardiac medications, so if you need a prescription to take care of your heart, we’ll be here to take care of you. 

Switch to Alto and you’ll always have a team of experts on your side. We’re available from 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text, or the app.

We don’t know exactly what COVID-19 will mean for this year’s cold and flu season, but it’s safe to say we should double down on our usual protective measures. Our pharmacists share their best tips for ensuring you stay healthy this fall.

Immunity-Boosting Tips for Fall

If you’re looking ahead to this year’s cold and flu season with uncertainty, you’re not alone. On the one hand, we’re wearing masks and social distancing. That should help, right? But on the other hand, we have another serious virus to contend with this season. According to Harvard Health Publishing, there are two main reasons we get sick more often in winter: we spend more time indoors with other people, and some viruses, like the flu, can stay airborne longer in colder weather. 

We don’t know exactly what COVID-19 will mean for this year’s cold and flu season, but it’s safe to say we should double down on our usual protective measures. That means washing our hands frequently, wearing a mask, social distancing, avoiding touching our face while we’re out and about, and getting a flu shot. It also means staying home when we experience cold symptoms to avoid spreading any type of virus. Preventing exposure is by far the best way to keep from getting sick. Despite our best efforts, however, illness-causing intruders can sometimes sneak past our defenses. It’s then that our immune systems must step up and fight.

Your immune system is an intricate network of organs, cells, and proteins that work together to defend the body from infection and disease. Due to its complexity, it’s better to focus on living a healthy lifestyle in general than to pin your hopes on a single supplement or superfood. That being said, recent research points to a few specific strategies that seem to hold promise in shoring up the body’s defenses. Let’s explore four healthy habits that might be worth adding to your immunity arsenal this fall.

Night owls, take note. Here’s one more reason to prioritize sleep—it’s a seriously powerful immune booster. According to the National Sleep Foundation, lack of sleep causes the body to make fewer cytokines, a specific protein that targets inflammation and infection. Plus, when you’re fatigued, your body releases stress hormones to keep you alert, which is known to have an immune-suppressing effect. Recent research has even revealed that sleep can enhance the efficiency of T-cells, a type of white blood cell that plays a critical role in fighting infection. In fact, a 2015 study found that people who slept seven hours or more every night were four times less likely to catch a cold than those who slept less than six. 

When it comes to immunity, we tend to think of bacteria as the bad guy. But we now know that nearly 70% of our immune system is located in our digestive tract and the beneficial bacteria and microorganisms in our gut play an important role in defending us from illness. In one study, workers who were given a daily dose of the probiotic Lactobacillus reuteri took 55% less sick days due to gastrointestinal or respiratory tract infections, suggesting it may be worth tending to our microbiota during cold and flu season. The simplest way to introduce more good bacteria into your body is by eating fermented foods like yogurt, sauerkraut, miso, and kombucha. Additionally, a diet rich in fiber and complex carbohydrates can help keep these friendly bacteria fed. 

As we journey toward winter and the days grow shorter and colder, we inevitably spend less time in the sun. Without direct sunlight on our skin, our body can’t produce vitamin D—one of the most important nutrients for our immune system. About 40% of U.S. adults are thought to be deficient in vitamin D and it’s not found in many foods, so it’s something you’ll want to consider supplementing throughout the colder months. Studies have found that taking this immune enhancer daily significantly reduces the risk of getting sick with the common cold or flu. The recommended daily dose is 600 IU for children and adults aged 1 to 70 years and 800 IU for people over 70.

Exercise is one of the best ways to increase circulation, which helps infection-fighting white blood cells and antibodies travel where they’re needed. A good sweat can also reduce the levels of immune-suppressing stress hormones in the body and increase overall health and vitality. A study following 1,000 people during the fall and winter months found that those who exercised at least five days a week were nearly half as likely to develop an upper respiratory infection as those who were sedentary. Plus, when regular exercisers did get sick, their symptoms were greatly diminished. Just be aware that when it comes to exercise, more isn’t always better. Don’t go so hard that you over stress your body; aim for 30-60 minutes of moderate exercise every day. 

While these immune-boosting strategies are helpful at any time of year, fall is an especially important time to put them into play. We want our bodies’ defenses to be as strong as possible to guard against viral invaders and help us rebound more quickly if we do catch a cold or flu.

Remember—the best way to stay healthy this season is to limit your chances of being exposed to a virus. If you start feeling sick, help keep others safe by staying home and reporting your symptoms to your doctor. Mild symptoms can usually be treated with simple rest and self-care, however, if your doctor prescribes an antiviral medication, there’s no need to drag yourself out of bed. We’ll hand-deliver it to your door for free. 

Alto can make the whole prescription process easier. Let us show you how. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-588 or download the mobile app for secure messaging.

If generic and brand-name medications work the same way, what accounts for the disparity in price? Let’s unravel the facts to discover how this system works. 

What’s the Difference between Generic and Brand-name Medications?

What’s the difference between generic and brand-name medications? 

We tend to feel mistrustful of anything we deem a “knockoff,” assuming we’ll end up with a lesser version of the real thing. With “we get what we pay for” a familiar refrain, we learn to associate better quality with a higher price. So when it comes to generic medications, which can cost 85% less than their brand-name counterparts, it’s no wonder we may cast a suspicious eye. However, unlike a bootleg movie or copycat handbag, generic medications are tightly controlled by the FDA, ensuring they offer the same safety, quality, and results.

Is a generic medication exactly the same as the brand-name version?

According to the FDA, “Generic medicines use the same active ingredients as brand-name medicines and work the same way, so they have the same risks and benefits as the brand-name medicines.” In order to get approval, a generic medication must have the same dosage, strength, safety, manufacturing standards, quality, and effectiveness, and it even needs to be administered in the exact same way.

There is some room for variability between the different versions, however. As C. Michael White, Pharm.D., Professor and Head, Department of Pharmacy Practice, University of Connecticut, explained in an article for the Huffington Post, “the [generic] pill needs to get you within 10 percent above or below the blood concentrations achieved with the brand for the FDA to approve the generic, and in reality, they only usually vary by 3-4 percent in one direction or another. So yes, they are very similar in terms of the active ingredient...Most people will never notice a difference.” According to the FDA, this level of variability is unlikely to have an impact, and could also occur between two batches of the same brand medication. 

Additionally, the inactive ingredients, or the ones with no therapeutic purpose, may differ. Manufacturers might use different binding materials, dyes, and preservatives, but they must prove to the FDA that they’re safe. It is possible, however, that you could be sensitive or allergic to something that’s in one particular version but not another.

How do the different versions come about?

When a brand-name medication enters the market, it is protected by patents and granted a period of exclusivity. In other words, the company that first created the medication has the sole right to sell it for a certain period of time. It takes an incredible amount of money to develop a new medication and see it through the necessary clinical trials—it’s estimated between $2-3 billion per new drug—so this helps drug companies recoup some of that cost. 

Most drugs are granted protection from competition for 5 years, though it can be more or less under certain circumstances. Once the period of exclusivity expires, generic versions of the medication are allowed to seek approval from the FDA to enter the market. 

Why are the generic versions so much cheaper?

Generic medications usually (but not always) cost much less than their brand-name counterparts because they do not have to repeat the expensive research and clinical trials that brand-name drugs undergo to prove they’re safe and effective. Plus, once one or more generic versions enter the market, competition can help drive down the prices. 

So a generic medication can really achieve the same effect for a fraction of the price?

In most cases, yes. According to Harvard Health Publishing, “The bulk of research out there shows that taking the no-name brand not only saves you money, but also provides you with a medication that is just as effective as the original.”

That being said, individual sensitivities can vary, so listen to your body and always report side effects to your doctor. 

If you’re prescribed what is known as a “narrow therapeutic index drug (NTI),” your doctor may recommend that you stick to the brand-name version. That’s because small changes in blood concentration can either render these medications ineffective or possibly cause harm. If you are taking an NTI, such as certain antiseizure medications and blood thinners, it doesn’t mean that you can’t switch to a generic version if it’s available. You’ll want to fully discuss it with your doctor and ensure that you’re closely monitored if you’re cleared to make the switch. 

And again, it’s possible to have sensitivities to a specific version of your medication. If you experience side effects after switching to a generic drug, you may want to consider resuming the brand-name version or trying another generic option. 

Unless your doctor has specified that your prescription is only for the name-brand medication, your pharmacist can suggest a generic option instead. Your insurance company may even require that you take the less expensive generic option or pay the difference for the brand-name version. The team at Alto will always help you find the best price for your prescription by presenting you with all of the options. If you’re curious about whether a generic version is available for any of your current prescriptions, we’d be happy to talk it through with you. Our pharmacists are just a chat, text, or phone call away.

In the world of prescription medications, “brand-name” doesn’t mean better. Most of the time, you can achieve the exact same results for a fraction of the price with a generic drug. According to a report by the IQVIA Institute, generics account for approximately 90% of all prescriptions but only about 20% of the overall costs. They estimate that generic medications saved the U.S. healthcare system $1.67 trillion from 2007 to 2016. If you’re cleared to take a generic version of your prescription, you can do so with full confidence—and hopefully some hefty savings. 

Did you know Alto will conduct price investigations for you? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881 or download the mobile app for secure messaging.

If you’ve been stuck in a cycle of wired nights and exhausted days, your body and mind need help remembering how to relax. These strategies can help you break free from unhealthy sleep patterns and finally get some solid shut-eye. 

Too stressed to sleep? These strategies can help.

Stress and sleep can form a pretty vicious cycle. No matter how physically exhausted we feel when our heads hit the pillow, we just can’t seem to quiet our racing minds. Then, after tossing and turning our way through the night, we’re way too fatigued to function at our best. This leads to more anxiety...and on and on and on. 

Right now, it’s not just the usual looming deadlines and relationship flare-ups that are keeping us up at night. As we head into fall, our schedules start overflowing, we worry about getting sick, and we often begin getting less sunlight and fresh air. Plus, with the upcoming time change, we’ll lose an hour of much-needed sleep. If your stress level is at an all-time high, you’re not alone. This year, we’re facing a global pandemic, widespread economic uncertainty, and completely upended social norms and routines. 

Stressors like these send our bodies into “fight or flight” mode. Normally, this state of hyperarousal fades away once the threat is gone. But chronic stress causes our nervous system to continually work on overdrive, pumping out hormones that keep us revved up and alert even when it’s time to sleep. 

In the world of mindfulness, we hear a lot about “present moment awareness.” That’s because it’s the one place your stress doesn’t live. If you’re anxious about something, you’re either fixating on a past scenario or worrying about a future event. You’re so stuck looking forward or backward that you can barely focus on the task at hand. The practice of mindfulness is meant to break these toxic thought patterns by helping you become aware of when you’ve drifted from the present moment. In this way, it can actually stop stress in its tracks. 

Try listening to a guided mindfulness meditation as you transition out of “work mode” in the evening or while lying in bed if you can’t sleep. The Insight Timer app is a fantastic resource for free meditations, or try Calm, one of the most popular apps for meditation and sleep. Remember—you can’t change the past or control the future, no matter how many times you turn a situation over in your mind. Your best bet is to try to live where your stress cannot. 

If you often find yourself dreaming about a stressful project or jolting awake with a worrisome thought, a simple journaling practice can help. If your mind is swirling with worries as you fall asleep, you could be carrying that mental load into your dream state. Before you go to sleep, spend some time writing out whatever is on your mind. List out items on your to-do list and journal about any anxieties from your day. The simple act of writing it down will signal to your brain that it’s okay to let it go. That way, your brain can go about its nightly tasks and leave you to sleep in peace.  

According to the American Psychological Association, the body tenses up during a stressful event as a way of protecting us from pain or injury. With chronic stress, however, our muscles never drop their guard and remain continuously tightened. If you’ve ever woken up stiff and groggy after a full night’s sleep, your tense muscles could be the culprit. Try gently encouraging them to relax with a simple nightly body scan. 

Focus your attention on an area of your body and mentally tell it to soften and relax. Begin with the area behind your eyes, followed by your jaw, your neck, and each of your shoulders. Continue like that, relaxing one area of your body at a time. You may find you drift off effortlessly before you’ve made it all the way through. 

It’s important to set up a relaxing atmosphere that will prime your body and mind for deep sleep. Turn off your electronics and keep the lights dim as you get ready for bed. If you sleep near a window, make sure that your curtains are drawn to shield you from any outside light or simply hang a blanket or sheet. The National Sleep Foundation recommends keeping the room temperature between 60 and 67 degrees Fahrenheit for the most sleep-conducive environment. 

If you’re in a busy house or area, white noise or ambient music can help mask any disturbances. The Relax Melodies app lets you create your own unique mix of relaxing music and sound, and the Slumber app has a whole library of sleep-inducing stories and soundscapes. Lastly, if you really want to set the mood for sleep, try a diffuser or pillow mist with relaxing essential oils such as lavender or chamomile. Details like these will be especially helpful as you adjust to the time change at Daylight Savings Time. When your mind associates your bedroom with the feeling of being drowsy, you can hit the pillow a little earlier throughout the week and still easily fall asleep. 

Stress can be tricky, so you may need to experiment a bit to find what works for you. If you just can’t seem to break the cycle and a lack of sleep is negatively impacting your mental health, talk to your doctor. There are therapies and medications that can help with insomnia and other sleep disorders. If your doctor does recommend a prescription sleep aid, we’ll be here to help. Let our team take care of the details while you focus on rest.

Ready to take the stress out of your prescriptions? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

Too Stressed to Sleep? These Strategies Can Help. 

We want to support you in preparing for your best health. PrEP, or pre-exposure prophylaxis, is an HIV prevention method that's available by prescription. Learn more about who should take it, how effective it is, and possible side effects.

All about PrEP for HIV Prevention

PrEP, or pre-exposure prophylaxis, is an HIV prevention method that's available by prescription. It isn’t a vaccine, though its purpose is similar. It’s a pill that’s taken every day to protect you from infection if exposed. 

With consistent use, the medicine remains present in the bloodstream of an HIV-negative individual. Then, if they’re exposed to HIV, it will block the invading virus from spreading throughout their body. 

According to the CDC, PrEP has been shown to reduce the risk of getting HIV from sex by 99% with consistent use. And it can even reduce the risk for intravenous drug users by 74% if taken daily.

Anyone who is HIV-negative and at risk for HIV infection can choose to take PrEP. PrEP may be right for you if you have a partner who is HIV positive or you do not know their HIV status, are a man having sex with men, are a trans masculine person having sex with men, are a trans feminine person having sex with men, have sex without condoms, are a sex worker, use injection drugs, or are concerned about HIV infection. Your healthcare provider can let you know if PrEP is the right choice for you.

There are currently two FDA-approved medications for PrEP: Truvada® and Descovy®. Both are oral medications that are only available by prescription. Your doctor will let you know which is best for you. Since PrEP should only be taken by those who are HIV-negative, you will need to take an HIV test before you can receive a prescription and also every three months while you’re taking it. You will also need to take a general blood test every six months. Staying on PrEP is a commitment, but these follow-up appointments are crucial for your health. 

Not all providers and health clinics offer PrEP,  but HIV.gov maintains an HIV Services Locator that will help you find a provider near you. 

Telemedicine is an option that can also make the process more accessible—and many more healthcare providers are offering remote consultations. Telehealth services allow you to schedule a phone or video consultation with your healthcare provider then use at-home test kits to complete any required testing through the mail. Talk to your healthcare provider to learn more about this possibility. 

PrEP is usually covered by most insurance plans, including Medicaid. There are also patient assistance programs that can help you access PrEP at a low cost or even free. The Gilead Advancing Access® program offers a copay coupon card for those with insurance and a Medical Assistance Program for those who are uninsured. They’ll help you find out if you’re eligible and may be able to suggest alternative sources of financial support if you are not. If you’re not sure if your insurer will cover your prescription, our team is here to help. We can inquire on your behalf and ensure you get the lowest price. 

Some people may experience side effects like nausea, diarrhea, headaches, and dizziness, however, they usually subside over time. Serious side effects aren’t common, but you should tell your provider if you notice any unusual symptoms. Your doctor will also be monitoring your blood work.

No—and this is important. PrEP needs time to build up in your bloodstream before it can effectively fend off an HIV infection. It will take a period of continuous use (usually at least one week or one month) before it is fully effective, so talk with your doctor about your specific time frame. If you’re engaging in sexual activity, be sure to use another form of protection in the meantime. You can also speak with a pharmacist at Alto if you have questions about how your medication works. 

And remember—if PrEP isn’t taken every day, there may not be enough of it present in your body to prevent infection. It’s extremely important to be consistent. Also, PrEP only protects against HIV infection, so you’ll need to continue using condoms to protect against other sexually transmitted infections (STIs). 

We recommend talking it over with your provider. If they do write you a prescription for PrEP,  the team at Alto can support you through the process of obtaining your medication. Our pharmacists are always here to answer your questions, from how to take it to what to do if you miss a dose. We’ll also deliver your prescription for free, send you quarterly lab reminders, and show you how to use the Alto app to set up daily reminders to take your pill. 

If it’s right for you, the decision to take PrEP is an important commitment to your health and well-being. We’ll be here to make sure the next steps are as easy as possible. 

We want to support you in preparing for your best health. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881, or download the mobile app for secure messaging.

Since 2016, Alto has supported over 20,000 patients through their fertility journey. In this post we'll provide guidance on how to select the right fertility pharmacy. In addition, we'll share the benefits of selecting Alto as your fertility pharmacy. 

What to Consider When Selecting a Fertility Pharmacy

Your Choice of Fertility Pharmacy Matters

Chances are if you’re reading this you’ve made a decision to undergo fertility treatment or know someone who might be soon. To begin with, know that you are not alone. Approximately 1 in 8 women in the US are affected by infertility, and more than 20,000 women have now decided to have their eggs frozen. 

Since 2016, Alto has supported over 20,000 patients through their fertility journey, and several team members have gone through the journey themselves. We know this can be an emotionally, financially, and physically challenging experience. That’s why we believe choosing the right pharmacy can help you avoid additional stress caused by waiting for hours on hold, tracking down your medication delivery, and navigating insurance benefits.

Think of your pharmacy as an extension of the care you receive from your physician. You wouldn’t choose just any fertility clinic, right? The same goes for where you choose to receive your fertility medications. Fertility treatment is stressful enough. Your pharmacy partner should provide the reassurance and reliability you deserve.  

In this post we'll share guidance on how to select the right fertility pharmacy. First, we’ll explain why it's important to use a pharmacy with a strong fertility focus (versus any neighborhood or mail-order pharmacy). And since not all fertility pharmacies are the same, we’ll also offer five considerations to make sure you have the smoothest experience possible. Finally, we’ll share the benefits of selecting Alto as your fertility pharmacy. 

At a minimum, credible and experienced fertility pharmacies will employ:

An expert clinical team: This includes pharmacists who are knowledgeable on and experienced with the medications and dosing unique to fertility treatments.

Temperature controlled packaging: Medications can go bad if they are not shipped or stored at the proper temperature. Fertility pharmacies will provide the appropriate packaging to ensure your medications arrive in good condition. This is especially important in warm climates. 

Proper supplies: Fertility pharmacies will be familiar with the variety of needles/syringes that you may need for your injection. This is crucial because it can be stressful if incorrect supplies are included which may lead to a missed dose. In addition, supplies such as alcohol swabs and disposal containers should always be included.

Learn more: [The View From Both Sides of the Fertility Pharmacy Experience]

Here are five additional things you should consider when selecting a pharmacy partner: 

1) Easy, proactive communication - After your clinic sends your prescription to the pharmacy you’ll likely have questions related to insurance, what to expect when receiving your medications, and most importantly, when they will be ready. For that reason it’s important to take into account what types of communication are offered - phone, text, email, mobile app - and typical response times and operating hours. Pharmacies with weekend/evening support hours are most beneficial in ensuring you’ll get live support when you actually need help.

2) Affordability assistance - Fertility benefits are confusing and it can be hard to understand just how much you’ll need to spend on medications. Most fertility pharmacies will work with leading financing and loan providers and can administer manufacturer discount programs if asked. A great fertility pharmacy will go above and beyond to connect you with financial assistance programs for qualifying prescriptions.

3) Local, timely delivery - Your medication protocol can change even after you start your injections - perhaps your physician wants to add a different trigger shot to prevent over-stimulation or decides to add days to your schedule because of the rate at which your follicles are growing. You can avoid these stressful situations if you select a pharmacy that is local and can promise fast same-day delivery. The last thing you need to worry about is mail-order delays or waiting in line at a pharmacy for hours. 

4) Pharmacist support - You’ll most likely have questions about your fertility medications (i.e. How do I know I’m injecting correctly? My clinic just changed my medications, what do I do?) so think of your fertility pharmacist like an extension of your #TTC community in that they should be an advocate on your side. Make sure the pharmacy you choose offers support and expert resources like guidance on injections, tools for managing your protocol and help understanding medication options - including late at night and on the weekends!

5) Community reviews - Just like you researched clinic and physician reviews, you should do the same with your pharmacy choice. Head to Yelp, Facebook, and any other feedback platform that showcases patient testimonials. Pharmacy experience matters but so does the experience of others. See if any reviews or blogs exist that mention specific fertility pharmacies. You’ll thank yourself (and those before you) for taking the time to do your due diligence. 

The fertility team at Alto will reach out as soon as we get your prescription so you don’t have to worry about waiting on hold or standing in line at a pharmacy. We’ll proactively investigate your insurance coverage, provide options to maximize your benefits and offer qualifying rebate programs. 

And because we know you’re busy with life, we offer a mobile app that allows you to securely schedule your delivery or message a pharmacist if you aren’t able to call us. You can take care of your pharmacy needs wherever you are and on your schedule. Alto pharmacists are always available until 9 pm each night (including weekends) to answer questions. 

When it comes to the time sensitive nature of your treatment, being locally-based makes a critical difference. Medications may be increased, decreased, or stopped altogether. At Alto, patients always receive free, same-day delivery by our own Alto courier team, even on weekends. 

We also offer the ability to select the 2 to 3-hour delivery window that works best for you either at home or work. Once your delivery is scheduled you’ll receive text updates along the way so you know exactly when your courier will arrive.

Your medications are packaged to give you the necessary information to avoid common mistakes (e.g.which meds go into the fridge). And Alto’s dedicated fertility pharmacists are always just a phone call or text away to answer your questions about injections, supplies, and more. So if you're about to inject and suddenly forget something, you don't need to wake up your physician - you can give us a call.

We’ll also follow up with you to remind you about qualifying rebates and provide instructions on how to apply. Our patients find this especially helpful given they have enough to remember. 

Sam shares why serving fertility patients is so rewarding

The team at Alto is ready to be your partner through it all, from your first cycle to your last. Questions about using Alto? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends. 

What to Consider When Selecting a Fertility Pharmacy 

When it comes to critical pharmacy needs, patients with diabetes often feel like they’re navigating the complexities of their care paths with very little control or clarity. That’s why we feel it’s important to highlight how Alto can help provide relief in managing your medications.  

The Best Pharmacy for Your Diabetes Care

Millions of Americans suffer from endocrine disorders, caused when hormone levels are either too high or too low or when the body doesn’t react to hormones the way it’s supposed to. Some of the most common endocrine disorders include Type 1 and Type 2 Diabetes (which affect over 30 million Americans), thyroid disorders (over 20 million Americans) and osteoporosis (10 million Americans). When it comes to critical pharmacy needs, patients with endocrine disorders often feel like they’re navigating the complexities of their care paths with very little control or clarity. With so many medications, prescriptions are often filled at different times, resulting in numerous trips to the pharmacy and disruptions to daily life. That’s why we feel it’s important to highlight how Alto can help provide relief in managing your medications.  

Meet Josh. Josh has Type 2 diabetes, an endocrine disorder that affects the way his body processes blood sugar (glucose). He visits his local pharmacy two-to-three times a week to pick up his various medications and medical supplies, which are each filled at different times. When he’s at the pharmacy, he is faced with long drive-thru lines or crowded store aisles and phones ringing off the hook. There have been times when Josh has arrived to pick up one of his medications or his insulin pump only to find out that they are no longer covered by his health insurance. Along with the burden of scheduling various pick-ups and dealing with unexpected costs, Josh worries there will be a time when he needs one of his critical medications, and he won’t be able to reach his pharmacist for help. 

Many of the brand-name medications commonly prescribed to diabetes patients simply aren’t covered by health insurance plans or come with strange restrictions. Patients can arrive at their pharmacy to find that their medication is only covered for their first “x” doses, or in some cases, not covered at all. Left with the stressful decision of whether to pay higher-than-expected prices or return home empty-handed this can often deter treatment from starting on time.

No guaranteed access to medication or their pharmacist

People living with diabetes often suffer from multiple comorbidities, increasing the complexity and number of their medications. With so many medications, prescriptions are often filled at different times, resulting in numerous trips to the pharmacy and disruptions to daily life. Retail pharmacists can be difficult to get a hold of, especially with the increasingly long lists of administrative tasks they are asked to complete. Diabetes medications are critical: missing one dose or experiencing one contraindication can be life-threatening. Added time spent waiting for a pharmacist to answer can be stressful and, in some cases, dangerous.

Doctors are often kept in the dark along with their patients when it comes to costs and insurance- based restrictions on medications. The current system is designed such that doctors often have to perform investigative work and complete prior authorizations with insurance in order to get a patient’s medication covered, meaning hours of extra calls and paperwork. When someone like Josh has an issue with the cost of their medication, they can’t simply swap it out for a new one. They have to connect with their doctor who can perform the necessary research to find them a new medication.

At Alto, we believe that everyone deserves exceptional pharmacy care. We are here to reduce the stress and confusion that comes with navigating insurance, and we offer transparent, consistent communication so you always understand your options. Our specialty pharmacy team will help sync your many medications into one delivery, get you set up on automatic refills, and work with your doctor on any prior authorizations needed for your medications.

Our pharmacists and billing specialists work with doctors and health insurers proactively to ensure the medications you are prescribed will be covered. We take on the investigative work and communicate the cost upfront so there are no surprises. We ensure you get the best prices on your medications - including branded oral and injectable medications - and we automatically apply any coupons or copay cards.

We’ve created a team of patient care pharmacists who are solely dedicated to answering questions and walking patients through their medications, so you’ll never spend 40 minutes waiting on hold. We provide real-time support via our mobile app or over the phone seven days a week, including evenings. If you have questions around a refill or need a refresher on injection instructions, you have direct access to help.

We deliver medications directly to your doorstep - for free! - and eliminate those dreaded, numerous trips to the pharmacy with crowded aisles, long wait times and no sense of privacy.

With Alto you’re always in control over when you want to receive your medications. Simply choose the delivery window that’s best for you and track your courier in real time. 

Ready to get started or want to learn more about Alto? Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; reach out via phone, text or the app.

Erik Gregorio Cruz, Micaela Moss, and Jordane Thomas joined Alto this summer as the company’s first engineering interns! Here they share their learnings, accomplishments, and their advice for future Alto interns.

How to Make the Most of Your Engineering Internship — Advice From Alto's First Interns

Erik Gregorio Cruz, Micaela Moss, and Jordane Thomas joined Alto this summer as the company’s first engineering interns! In their three months with us they blazed the trail for future Alto interns while adjusting to a new norm of fully remote work during the global pandemic. Here they share their learnings, accomplishments, and advice for future Alto interns.

Coming out of a bootcamp program rather than a traditional Computer Science degree program, Micaela hoped to find a company open to non-traditional educational paths. “I know that a company that is welcoming of bootcamp grads values diversity, inclusivity, and mentorship.” 

For Erik, it came down to his interview experience: “Everyone seemed to really enjoy their experience and really believed in the mission they were working on.” Micaela agreed, adding that it also ultimately came down to the people for her. “You can tell a lot about a company’s culture based on what the people who interview you are like,” she said. “From the recruiter to the engineers, everyone was incredibly friendly and a joy to interact with.”

What was the most fun moment of your internship? (That is, assuming you had fun!)

Virtual team lunches were a highlight for all 3 interns. However, one special moment during Micaela’s internship actually came from resolving a ticket that involved writing an end-to-end (E2E) test—something she was not looking forward to. “I was dreading it for two reasons: First, I do not particularly enjoy writing tests—I’d rather write the code that passes them—and second, I had never worked with Cypress before. Several hours later, after reading lots of documentation, studying previously written E2E tests, and getting stumped by a hidden selector, I managed to write the test. When I finally ran it and got to watch the video as it clicked on buttons and filled out inputs, I became instantly enchanted. I may have run it several more times just to watch it, smiling like a goofball, knowing that this test that I had created would be run every time code was pushed and merged.” 

In addition to their respective engineering managers, whom the interns had weekly 1:1s with, each intern was also assigned a dedicated mentor, who committed at least 5 hours a week of dedicated support to their interns over Slack and Zoom. Mentors were able to provide historical and business context, help interns get ramped up on Alto’s tech stack, codebase, and tools, and pair program as needed. “Working with my mentor definitely made me more productive,” said Jordane.

The mentors added that working with the interns actually helped them improve their ability to articulate technical concepts, as well as their ability to talk through technical challenges with others more effectively in their day to day work.

What was it like interning during the pandemic and being fully remote?

“I found myself setting up ‘Hey, there’s a pandemic, and this is crazy, so let’s get introduced virtually, maybe?’ meetings,” said Micaela. “Although, as someone who is horrible with names, it is worth noting that a silver lining to being entirely remote is having everyone’s name in the corner of their zoom video. That, and sweatpants everyday!” 

Blog

How to Be a Prescription Overachiever!

IVF Medications: Schedule and Side Effects Explained

Your Top 5 Questions About Heart Health, Answered!

Immunity-Boosting Tips for Fall

What’s the Difference between Generic and Brand-name Medications?

Too Stressed to Sleep? These Strategies Can Help.

All about PrEP for HIV Prevention

What to Consider When Selecting a Fertility Pharmacy

The Best Pharmacy for Your Diabetes Care

How to Make the Most of Your Engineering Internship — Advice From Alto's First Interns

Managing Your New Diabetes Diagnosis

Concerned about Mail Delays Tying up Your Prescriptions? There’s a Better Way.

Switch to a better pharmacy.