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While there is no cure for pulmonary fibrosis, a combination of medications, oxygen therapy, and active lifestyle choices can slow the progression of the disease and reduce discomfort.

Pulmonary Fibrosis: What to Know About Symptoms and Treatment

Pulmonary fibrosis is a progressive, long-term lung disease in which the lungs become scarred, making it difficult to breathe. Though less common than other lung diseases, pulmonary fibrosis can lead to serious complications like pulmonary hypertension, respiratory failure, and lung cancer, so early detection and proactive monitoring of symptoms is critical.

While there is no cure for pulmonary fibrosis, a combination of medications, oxygen therapy, and active lifestyle choices can slow the progression of the disease and reduce discomfort. Read on to learn more about pulmonary fibrosis, including how to recognize and treat pulmonary fibrosis symptoms.

Pulmonary fibrosis scars and thickens the connecting tissue in the lungs and alveoli, which are delicate air sacs that transport oxygen into your bloodstream. Over time, the lung tissues grow thicker and it becomes more difficult for the alveoli to deliver oxygen into the body, making it increasingly challenging to breathe. As the disease progresses, you may experience shortness of breath more frequently during everyday activities.

The development of pulmonary fibrosis varies significantly in individuals. For some people, symptoms arise very quickly. For others, they may take years to develop.

While the severity of pulmonary fibrosis symptoms vary from one person to another, there are some common symptoms:

Widening and rounding of the tips of the fingers or toes

Some people with pulmonary fibrosis experience acute flare-ups in which symptoms such as shortness of breath intensify for several days up to several weeks. Medications including antibiotics and corticosteroids, which ease swelling and inflammation, may be used to treat these sudden spikes. Some people may also be placed on a ventilator during these flare-ups to assist with breathing.

As with COPD, smoking increases your risk of developing pulmonary fibrosis, but so do other factors like long-term exposure to pollutants and toxins, certain medical conditions and medications, and radiation therapy. Below are the most common risk factors for pulmonary fibrosis.

The aging of the lungs has been linked to higher susceptibility for respiratory diseases. While pulmonary fibrosis can affect infants and children, it primarily occurs in middle-aged and older adults. Most people with the condition develop it between ages 50 and 70.

While it’s possible for a non-smoker to develop the condition, pulmonary fibrosis is far more common in smokers. It may occur in people who also have emphysema, a lung disease that falls under the umbrella of COPD.

Jobs in mining, farming, and construction often involve long-term exposure to toxins such as silica dust, asbestos fibers, hard metal dusts, coal dust, and bird and animal droppings that damage the lungs. If you work in these fields, you may have a greater risk of developing pulmonary fibrosis.

While pulmonary fibrosis cases in women have increased in recent years, it continues to affect more men than women overall. This may be due in part to the fact that men are more likely than women to smoke and to work in the professional fields linked to pulmonary fibrosis.

Radiation treatments for lung cancer and breast cancer and certain chemotherapy drugs, including methotrexate and cyclophosphamide, may increase your risk of developing pulmonary fibrosis.

The extent of the damage to the lungs during radiation treatments depends on the following factors:

How much of the lung was exposed to radiation

In rare cases, other medications have been linked to pulmonary fibrosis, including heart medications like amiodarone, antibiotics like nitrofurantoin and ethambutol, and anti-inflammatory medications like rituximab and sulfasalazine. If you take any of these medications and have concerns, consult with your healthcare provider about potential risks. Be sure to follow your doctor’s recommendations, as abruptly stopping the use of a medication can be dangerous.

Researchers believe that there may be a genetic component to certain types of pulmonary fibrosis, as a small percentage of people living with the condition have at least one other affected relative. Research into possible genetic influences is ongoing. If someone in your family has had pulmonary fibrosis, speak with your doctor about your risk. They may refer you to a genetic counselor.

To determine if you have pulmonary fibrosis, your healthcare provider will ask about your medical history and conduct a physical exam to evaluate symptoms. They may use a stethoscope to listen for abnormal sounds such as crackling when you breathe.

It can be challenging to diagnose pulmonary fibrosis since symptoms overlap with those of other lung diseases. Your doctor may order additional tests, such as blood and imaging tests, pulmonary function tests, and, in some cases, a biopsy to rule out other illnesses and confirm a pulmonary fibrosis diagnosis.

There are a variety of treatment options to alleviate your pulmonary fibrosis symptoms and help you maintain a healthy and active life. Your doctor may recommend one or more of the following common treatments.

There are two primary medications that slow the progression of lung scarring and preserve lung function: pirfenidone (Esbriet®) and nintedanib (OFEV®). Both medications are similarly effective at treating symptoms and improving lung capacity.

Common side effects of pirfenidone include:

Difficulty falling asleep or staying asleep

Common side effects of nintedanib include:

Consult with your healthcare provider about the potential risks and benefits of treating pulmonary fibrosis with pirfenidone or nintedanib, and make sure they are aware of any other medications you take.

Oxygen therapy transports more oxygen into your lungs, increasing your tolerance for physical activity and helping you stay active. It can be administered in a hospital during flare-ups or at home. If you have a home oxygen delivery system, your doctor will likely also prescribe a portable device to use when you are on the go. There are different devices for oxygen therapy. Your doctor will recommend one based on several factors including lung function and lifestyle.

Pulmonary rehabilitation is a program of education and exercise classes, typically in a group setting, aimed at improving lung function and reducing symptoms. In these programs, nurses and respiratory therapists share important information about managing pulmonary fibrosis and teach you how to conserve your energy and increase your level of fitness.

A lung transplant, in which a damaged lung is replaced with a healthy lung from a donor, is a treatment option for some individuals with pulmonary fibrosis. While it can improve your breathing capacity and tolerance for physical activity, a lung transplant is a major procedure with risks of complications. 

In determining if you are eligible for a lung transplant, your healthcare provider will consider multiple factors such as whether you are in overall good physical health aside from your pulmonary fibrosis and if you have any other life-threatening conditions.

Pulmonary fibrosis can make it difficult to recover from other infections, so it’s important to take steps to boost your immunity and avoid getting sick. In addition to practicing good hygiene and maintaining a healthy distance from anyone who’s sick, stay current on your annual pneumonia and flu vaccinations, and practice healthy habits like staying active, eating well, and avoiding cigarette smoke.

How Alto can support your pulmonary fibrosis treatment

We make it as easy as possible to follow the treatment your doctor has recommended through free hand-delivery of your medication, automatic savings investigations, and easy medication management tools through our website and app. And our team of pharmacists is always here to answer your questions by phone, text, or chat.

Reach out via text or phone at 1-800-874-5881 or in-app messaging to learn how Alto can support your pulmonary fibrosis treatment plan.

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.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

EMD Serono has several patient assistant programs designed to reduce the cost of fertility treatment, including special opportunities for military veterans and cancer survivors.

A Guide to EMD Serono’s Financial Assistance Programs for Fertility Medication

Fertility preservation treatments like egg freezing and IVF are significant investments, both emotionally and financially. Fertility medications used to support egg production, retrievals and implantations often contribute to these expenses. 

At Alto, we support your financial well-being alongside your physical health, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make your medications as affordable as possible. In addition to automatically applying any coupon savings, we’ll connect you with any outside programs that require you to apply directly.

If Alto is your fertility pharmacy, your fertility medication protocol likely includes medications manufactured by EMD Serono. EMD Serono has several patient assistant programs designed to reduce the cost of fertility treatment, including special opportunities for military veterans and cancer survivors.

Read on to learn more details about eligibility for EMD Serono patient assistant programs and how to apply. You can also read our previous post on managing the costs of fertility treatment to learn about Alto’s additional financial support for fertility treatment and medications.

The EMD Serono Compassionate Care program provides income-based assistance for fertility medications that aren’t covered by insurance. Eligibility is based on your annual gross household income, number of people in your household, and cost of living and poverty index in your geographic area. 

Eligible individuals can save 10% or 50% off of the following medications:

Gonal-f® RFF* Redi-ject™ pen 300 IU, 450 IU and 900 IU

Gonal-f® Multi-Dose vial 450 IU and 1050 IU

The program is available for multiple cycles each calendar year. You must reapply each year.

View additional program details and apply here.

The EMD Serono Compassionate Corps program provides free medication to eligible, uninsured veterans injured in the line of duty or their spouses. To be eligible, you must be a retired military veteran or the spouse of a veteran who meets the following criteria:

Is infertile due to a service-related injury

Is not privately or publicly insured for infertility medications

Has been diagnosed by a physician as infertile and requiring in-vitro fertilization (IVF)/assisted reproductive technology (ART)

Is not eligible for coverage under the Fertility Veterans Act

The program is available for up to two cycles per calendar year. You must reapply each year.

Download the Compassionate Corps application.

If you’re a veteran who does not qualify for Compassionate Corps, you may still be able to receive 25-75% off of your fertility medications through the Compassionate Care program.  

Certain types of cancer can affect fertility in both men and women, whether it’s due to the removal of organs related to reproduction or a change in hormone levels following treatment. If you are considering starting a family after your cancer treatment, fertility preservation options can make it easier to conceive.

To help ease the financial burden of this process, EMD Serono donates fertility medications to eligible cancer survivors diagnosed during their reproductive years through the Livestrong Fertility Discount program.

Start the application process on Livestrong’s website to learn if you are eligible.

A fertility pharmacy partner you can rely on

Alto is here to make your experience with fertility preservation treatments as stress-free as possible. We offer free same-day delivery of your medications and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

Our team of fertility specialists is happy to create  a price quote  specific to your medication protocol. Please contact us at care@alto.com or complete the form online to get a quote started.

Editors's note: this post was originally published in August 2021 and has been updated for accuracy and completeness.

EMD Serono’s Financial Assistance Programs for Fertility Medication

Despite the initial challenges of a type 1 diagnosis, managing your child’s diabetes does get easier. Here’s an overview of the information you need to manage your child’s diagnosis.

How to Manage Your Child’s Type 1 Diabetes Diagnosis

Your child’s type 1 diabetes diagnosis affects the entire family. As a parent, it’s understandable to feel overwhelmed as you get up to speed on their treatment plan, including insulin therapy,  blood glucose testing, and coordinating with your insurance provider.

“There’s so much information thrown at you right away, and we didn’t know what we didn’t know,” shared Lucinda, a Partnership Manager at Alto whose 5-year-old son was diagnosed with type 1 diabetes last year. “Insurance coverage is particularly complicated with diabetes, even for someone who works in healthcare like me, because you’re dealing with so many medications and supplies that aren’t commonly prescribed.”

Despite the initial challenges of a type 1 diagnosis, managing your child’s diabetes does get easier. By staying on top of daily blood sugar management and surrounding your family with a strong support system, your child will be able to have a healthy, active life — and you will be able to find some peace of mind. Here’s an overview of the information you need to manage your child’s type 1 diabetes diagnosis

Type 1 diabetes is an autoimmune disease in which the body mistakenly destroys the pancreas’s insulin-producing cells. Your body needs insulin to properly convert a simple sugar known as glucose into energy. Without insulin, blood sugar levels rise in people with type 1 diabetes, which can cause life-threatening health complications if untreated.

While type 1 diabetes can be diagnosed in adults, the majority of cases develop during childhood (the condition was once referred to as juvenile diabetes). In some cases, symptoms appear in children less than a year old.

Blood sugar levels typically rise very quickly as the condition develops. Some of the common initial symptoms of type 1 diabetes include increased thirst, frequent urination, extreme hunger, weight loss, and fatigue. Your child may feel very sick within two to three weeks following the onset of the condition.

Insulin therapy is the cornerstone of treatment for type 1 diabetes. Since individuals with type 1 diabetes don’t produce any insulin at all, they need to take insulin every day to maintain healthy blood sugar levels.

Insulin is most commonly administered with a syringe, but additional methods of delivery include insulin pumps and pens. There are five main types of insulin categorized by how quickly they work and how long they last: rapid-acting, regular or short-acting, intermediate-acting, long-acting, and ultra long-acting. 

It’s important to work with your child’s healthcare provider to find the right insulin dosage, as taking too much or too little can cause rapid changes in blood glucose levels. Many people with diabetes need to take a combination of rapid or short-acting and long-acting insulins throughout the day. This best replicates the natural actions of a normally functioning pancreas, which releases a continual supply of insulin with additional bursts when you eat.

Read our previous blog to learn more about getting started with insulin therapy.

The goal of insulin therapy is to keep your child’s blood sugar in a healthy range. For people without diabetes, a typical blood sugar range is 70 to 125 mg/dL when fasting. People with diabetes should typically try to stay between 70 to 180 mg/dL. 

Your child’s healthcare provider will let you know what your child’s blood sugar target range is. Individual blood sugar targets will vary depending on factors like age, physical activity, and the severity of the condition. It will likely change as your child grows.

Daily testing is the only way to ensure that your child’s blood sugar is within their target range. It will also offer insight into how food and physical activity affect your child’s blood sugar levels throughout the day.

As with insulin therapy, checking your child’s blood sugar using a blood glucose meter will become routine. You will likely need to check and record your child’s blood sugar several times throughout the day, including before meals and snacks, before and after exercise, and before bed. Logging results from blood sugar tests is very important for noticing patterns and determining if any adjustments to your child’s treatment are necessary. Apps like Glucose and mySugr are helpful tools that allow you to identify trends over time.

Your doctor will advise you on your child’s individual needs with blood sugar monitoring. You may have to check their blood sugar levels more frequently when they are sick, if their routine changes, or if they start a new medication. A continuous glucose monitoring (CGM) device, which measures blood sugar every few minutes through a temporary or implanted sensor inserted under the skin, is helpful for individuals who need to monitor blood sugar levels more closely. Consult with your child’s healthcare provider about whether or not a CGM device is appropriate.

Carbohydrates increase blood sugar levels more than any other nutrient, so monitoring how many carbs your child consumes every day is another important aspect of blood sugar management.

Advanced meal planning is important, as your child’s daily insulin dosage is based on their insulin-to-carb ratio. They should be able to eat a variety of foods so long as you carefully plan out meals and spread their carb intake throughout the day.

Your child’s healthcare provider can help you determine your child’s target carb ratio. While this is a healthy baseline to aim for, blood sugar naturally fluctuates throughout the day. There may be times when additional carbs are needed to treat low blood sugar, or when extra insulin is required to bring high blood sugar levels down.

By no means should a type 1 diabetes diagnosis prevent your child from staying active. In fact, exercise offers individuals with type 1 diabetes additional benefits like lowering blood sugar and improving insulin sensitivity. 

However, exercise may sometimes cause a drop in blood sugar levels, so it’s important to check blood sugar levels beforehand. Stock up on carbohydrate-rich snacks such as dried fruits, trail mix, or granola bars to treat low blood sugar, keeping in mind that physical activity is often more unplanned and spontaneous with children and adolescents than it is with adults. 

The American Diabetes Association recommends giving 5-15 grams of carbs, depending on your child’s age and weight, for every 30 minutes of sustained physical activity in tandem with frequent monitoring of blood sugar levels.

Low blood sugar is also known as hypoglycemia. For many individuals with diabetes, hypoglycemia occurs when their blood sugar is less than 70 mg/dL. However, diabetes treatment plans are individualized, and your child may have a different blood sugar target range, so be sure to consult with your child’s physician.

There are many reasons why blood sugar may fall, including not eating enough, exercising too much, taking too much insulin, or not taking insulin at the right time. Initial signs of hypoglycemia include feeling sweaty, shaky, and hungry. As blood sugar drops further, additional symptoms include feeling weak, having difficulty walking or seeing clearly, getting disoriented, and having seizures.

If you notice any of these symptoms in your child, check their blood sugar and treat immediately with fast-acting sources of glucose, including fruit snacks, juice boxes, glucose tabs, or glucose gels. In cases of severe hypoglycemia — 55 mg/dL or less for many individuals with diabetes — glucagon can be used to restore blood sugar.

On the other end of the spectrum, a blood sugar of 180 mg/dL or higher is usually considered hyperglycemia or high blood sugar. It frequently occurs when too little insulin is taken for the amount of carbs consumed, but factors like illness, stress, and hormonal changes can also lead to hyperglycemia. Common signs include extreme thirst, frequent urination, or increased hunger.

If you notice any of these hyperglycemia symptoms in your child, check their blood sugar levels and follow the treatment plan your doctor has recommended, which may include a dose of rapid acting insulin, water, or other carbohydrate-free beverages.

A crucial step to preparing for emergency hypoglycemia or hyperglycemia is informing your child’s school of their type 1 diabetes diagnosis. View the JDRF’s back to school checklist for more on what your child’s teachers should know.

You never have to be alone on this journey. In addition to your child’s clinical team, other parents of children with diabetes, who know exactly what you’re going through, are a powerful resource. And for Lucinda and her family, growing a strong support network has been invaluable.

“Your child’s diabetes diagnosis changes everything in your life, and that’s the part that people don’t always get to discuss at the doctor’s office,” she said. “I wish I had known to connect with other parents of children with type 1 diabetes immediately.”

Visit the caregiving section of the American Diabetes Association’s online Support Community to start building your own network of parents who are also managing their children’s diabetes.

It’s also important to have a pharmacy that will advocate for your child’s care, as the condition involves a steep learning curve with medications and supplies.

“I never felt supported by a pharmacy until I used Alto for my son’s diabetes medications,” Lucinda said. “Questions about insurance coverage are handled seamlessly, and as a busy working mom, it’s so helpful to be able to quickly schedule a delivery in the app.”

She added, “With diabetes, any pharmacy missteps like improper medication packaging or storage can be life-threatening. It brings me so much peace of mind to know that I never have to worry about that with Alto.”

A diabetes pharmacy partner you can rely on

Alto is with you every step of the way in managing your child’s diabetes. We make it simple to follow the treatment plan your child’s doctor recommends, with proper packaging of temperature-controlled medications and free same-day delivery right to your doorstep.

We also offer extra support to address the challenges that are specific to managing diabetes, like getting started with insulin therapy. Our pharmacists are available to walk you through your child’s first insulin doses and discuss any symptoms or side effects to determine if an adjustment is needed.

And since a diabetes diagnosis brings lots of new insurance terminology related to your child’s medications and supplies, we compiled a guide that breaks down the key insurance terms you’re likely to encounter. We’ll tackle the administrative legwork, too, coordinating with your doctor’s office and submitting any necessary paperwork, so that you can focus on your child’s care instead of phone calls with your insurance provider.

Get started or learn more about Alto by reaching out at any time via text or phone at 1-800-874-5881, or in-app messaging.

We answer common questions about insurance coverage for prescription medications, including how we go above and beyond to ensure that you’re receiving your medications on time and at the lowest price possible.

How does Alto Pharmacy work with insurance?

Getting the medication you need often involves more than just receiving a prescription from your doctor and filling it at a pharmacy. And navigating the complexities of insurance coverage, from copays and deductibles to formularies and medication tiers, can be a particularly big source of stress.

A great pharmacy partner makes sure you’re never alone in working through the details of your insurance plan’s pharmacy benefits. At Alto, we tackle all of the insurance-related legwork for you and give you the information you need to understand the process.

Below, we’ve answered some common questions about insurance coverage for prescription medications, including how we go above and beyond to ensure that you’re receiving your medications on time and at the lowest price possible.

How do I know how much my medication will cost at Alto?

When you get started with Alto, we’ll automatically pull in any insurance information we can find. If you have additional coverage, just let us know and we’ll add it to your profile. For each prescription, we’ll check with your primary (and secondary) insurance plan to pull your copay amount — the amount you owe out of pocket for your medications — including any possible savings. (More about that below!)

Sometimes paying cash for your medications, separate from insurance benefits, will be cheaper than your copay. If that’s the case, we’ll let you know the different pricing options so you can make an informed choice.

By checking every available savings option, automatically, every time! Unlike traditional pharmacies, Alto is proactive about applying potential sources of savings like manufacturer coupons, patient assistant programs, and copay cards wherever applicable. We’ll automatically start looking for these opportunities the minute we receive your prescription, and we’ll keep you informed of any savings options that require you to apply directly with the program or manufacturer.

Learn more about how Alto saves you money on your prescriptions.

Here’s another way we’re different from traditional pharmacies: we’ll continue searching for less expensive medication options even after we’ve researched savings opportunities.  You’re in the driver’s seat, and if you would like support in identifying other medication options that may be covered by your insurance at better rates, we’ll work with your doctor to evaluate those choices.

Insurance companies categorize medications into tiers based on various factors such as whether the medications are generic or brand-name and how frequently they are prescribed. Medications in higher tiers generally include non-preferred brands and specialty medications for rare conditions, and these typically cost more than medications from a lower formulary tier.

Keep in mind that generic medications use the same active ingredients as their brand-name counterparts, and they must meet the same standards for safety, quality, and results in order to get FDA approval.

I’ve heard of an insurance “formulary.” What does that mean?

Every health insurance plan has a list of covered generic and brand-name medications, called a formulary, which you can locate online or by calling your plan. It includes the tiers mentioned above, indicating which medications are preferred by your insurer and therefore offered at a lower out-of-pocket cost.

When deciding whether to renew your current health insurance coverage or select a different plan for the new year, you may want to check the formularies to determine if your current medications will be covered. Read our previous blog to learn more about what to consider when reviewing insurance coverage options every year.

What if my insurance denies coverage of my medication?

If a medication isn’t on the formulary at all, you may have the option of submitting a prior authorization to prove the medical necessity of the medication and gain coverage from your insurance plan.

If a prior authorization is needed, we can work with your doctor to submit the necessary paperwork. We’ll keep both you and your doctor in the loop throughout the process so you know the current status of the request until your insurance provider has made a decision. If your prior authorization request is denied, we will work with your doctor to either process an appeal or find a different treatment option.

Read our previous post, ‘What is a Prior Authorization?’ to learn more about how Alto can help you navigate this process.

A pharmacy partner that’s always on your side

At Alto, we go above and beyond to help you stay on track with your doctor’s recommendations, getting you the medication you need at the best price possible.

Switch to a better pharmacy for free same-day delivery and support with insurance and savings opportunities. Reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

How Does Alto Pharmacy Work with Health Insurance? We Answer Your Top Questions.

How Alto Pharmacy works with health insurance

How does Alto Pharmacy work with insurance? We answer your top questions.

What Updated CDC Guidelines Mean for PrEP Access

For the first time since 2017, the U.S. Centers for Disease Control and Prevention (CDC) is updating its guidelines for PrEP, a medication that can lower risk of sexual transmission of HIV by 99% when taken daily. The new guidelines — which inform local healthcare policies and doctors’ decision-making processes — address key barriers to PrEP access, including a lack of provider awareness about PrEP and patient reluctance to disclose sexual activity or drug use. 

Moving forward, the CDC has recommended that healthcare providers share information about PrEP with any patient who is sexually active, and that any patient can receive a prescription for PrEP if requested.

Here is some additional context about the forthcoming updates, which should go into effect before the end of the year, pending revisions based upon feedback from experts.

According to the Human Rights Campaign, 1 in 3 healthcare providers has not heard about PrEP. There are countless others who are aware of the medication but don’t have all the facts.

Under current guidelines, many doctors only share information about PrEP with patients who presently have multiple partners or a partner who is HIV-positive or unsure of their HIV status. In reality, more people could benefit from PrEP, including those who are single and sexually active.

Some healthcare professionals also falsely believe that PrEP and condom use are mutually exclusive. Many people have felt shamed when asking for PrEP due to their healthcare provider’s stigmatized perceptions of traditional PrEP users. 

Under the new, soon-to-be-implemented federal guidelines for PrEP, anyone who is sexually active should receive PrEP information from their healthcare provider, including adolescents. Given that many traditional sex education programs in schools throughout the U.S. aren’t providing LGBTQIA+ youth with the resources they need to stay safe and healthy, the new guidelines are an important step toward more inclusive sexual education.

Opening up the conversation about HIV prevention to more individuals aligns with what Dr. Lisa Sterman, MD, MPH, shared during a conversation with Alto in October 2020.

“A lot of people may think, ‘I’m not at risk’ or, ‘that’s not my group of people,’” Sterman said. “The way I teach it is: if you’ve ever had sex, you’re at risk for HIV. If you’ve ever shared drug needles, you’re at risk for HIV. Everyone should know their status.”

Addressing fear of discrimination or stigma at the doctor’s office

Under current CDC guidelines, patients must share personal details about their sexual health or drug use with their doctors to get a PrEP prescription. However, many people at risk of contracting HIV don’t feel like they can speak openly with their healthcare providers, particularly LGBTQIA+ people of color, who face multiple forms of discrimination. 

Too often, this leads to negative health outcomes and disparities in HIV rates. The CDC’s new proposed guidelines for PrEP account for the fact that some patients may not feel comfortable disclosing personal information about their sexual health or drug use. 

While conversations between doctors and patients about PrEP will initially cover a patient’s sexual health history, the CDC is recommending that any patient can receive a prescription for PrEP if requested. This means that you can get PrEP without disclosing personal information related to your risk for HIV, another big step forward for PrEP access and HIV prevention.

There are more FDA-approved medication options for PrEP than ever before: Truvada®, Descovy®, and a generic for Truvada, which became available in October 2020. The following resources can connect you with a provider who will prescribe PrEP for you:

Alto will coordinate with your doctor and your insurance provider to ensure you’re receiving the best PrEP option for your needs at the most affordable price. And you can connect directly with pharmacists who have expertise in HIV prevention and treatment through phone, text, or within the Alto app.

Reach out any time to get started via text or phone at 1-800-874-5881, or in-app messaging.

With effective treatment, including blood pressure medications, you can live an active life. Learn about the common blood pressure medications and their side effects.

Common Types of Blood Pressure Medications

High blood pressure, which affects nearly half of all U.S. adults, occurs when the force of the blood flowing through your arteries is consistently too high, forcing the heart to work harder. Over time, high blood pressure can damage major organs including the heart, brain, kidneys, and eyes and lead to life-threatening issues like heart disease, heart attack, and stroke.

With effective treatment, including both heart-healthy lifestyle habits and prescription blood pressure medications, you can control your blood pressure and live an active life. There are a variety of blood pressure medications, and it may take some time for you and your doctor to determine the best treatment for your needs. The good news is that with so many available and effective medications, you’re likely to find one that’s right for you. Read on to learn more about the most common classes of blood pressure medications and their side effects.

Diuretics lower blood pressure by helping the body get rid of excess sodium and water, reducing the volume of fluid in blood vessels. They are often a frontline treatment for high blood pressure, as research studies have found them to be one of the most effective blood pressure medication classes at preventing stroke and heart attack fatalities.

Diuretics commonly used to treat high blood pressure include:

Chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®)

Hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®)

Common side effects of diuretics include dehydration, thirst, low sodium levels, headaches, and dizziness. In some cases, drinking more fluids isn’t enough to treat dehydration. Contact your doctor if you experience severe thirst, mouth dryness, or constipation; if your urine is a deep yellow; or if you have a bad headache. Taking multiple medications may exacerbate these side effects. To minimize medication interactions, speak with your doctor about the ideal timing of doses for each medication.

Some diuretics decrease your potassium levels, in which case you may experience weakness, leg cramps, or fatigue. Eating potassium-rich foods can help combat these side effects. Consult with your doctor about taking potassium supplements if you experience any of these symptoms.

Diuretics may increase blood sugar levels in people with diabetes. Adjusting your diet or the dosages of your diabetes medication(s) often addresses this issue. Learn more about how Alto can support your diabetes treatment.

Beta blockers cause the heart to beat more slowly and less forcefully, lowering your blood pressure. They also help improve overall blood flow by opening up your veins and arteries.

Beta blockers commonly used to treat high blood pressure include:

Common side effects from taking beta blockers include:

Beta blockers may block signs of low blood sugar such as a rapid heart rate in people with diabetes. If you have diabetes and take insulin, it’s important to check blood sugar levels often while taking beta blockers.

These medications may also affect your cholesterol and triglyceride levels. Most often, they cause a modest increase in triglycerides, a type of fat found in your blood, and a slight decrease in HDL (high-density lipoprotein), or “good” cholesterol. These changes are usually temporary.

Beta blockers aren’t typically used by people with asthma, as they may trigger severe asthma attacks. Abruptly stopping use of beta-blockers may increase your risk of a heart attack or other health complications, especially if you have been taking the medication for a long time. Consult with your healthcare provider about the potential risks and benefits of treating your hypertension with beta-blockers.

ACE inhibitors lower blood pressure by blocking production of a hormone called angiotensin II, which causes blood vessels to narrow. These medications help constricted blood vessels expand so that more blood can flow through.

ACE inhibitors commonly used to treat high blood pressure include:

A chronic dry, hacking cough is one of the most common side effects of ACE inhibitors, affecting as many as 35% of people who take these medications. Researchers aren’t entirely sure why some people experience this side effect and not others, but the following factors may contribute to it:

Gender — women tend to be more susceptible

Studies have found that a combination of two or more of the factors above is needed to produce the side effect.

Cough medicines typically aren’t effective at treating an ACE inhibitor-related cough. In some cases, this side effect may improve on its own. If you are experiencing a cough from taking ACE inhibitors, the best course of action is to discuss the pros and cons of switching to another medication with your doctor.

Additional possible side effects of ACE inhibitors include:

ACE inhibitors can harm both mother and baby during pregnancy. If you’re taking an ACE inhibitor and think you might be pregnant, speak with your doctor immediately.

Like ACE inhibitors, angiotensin II receptor blockers (ARBs) also protect blood vessels from the hormone angiotensin II. Angiotensin II must bind with a receptor site to constrict blood vessels. ARBs block the receptors to prevent blood vessels from tightening, which lowers blood pressure.

ARBs commonly used to treat high blood pressure include:

ARBs may produce harmful interactions with other medications. This medication class should not be taken with an ACE inhibitor, as the combination can lead to a greater risk for low blood pressure, kidney damage, and high potassium levels. Speak with your doctor before taking painkillers like ibuprofen or naproxen, as these medications may interact with ARBs to increase your potassium levels.

ARBs are not safe to take during pregnancy, as they can severely harm a developing fetus. If you think you might be pregnant, consult with your doctor immediately.

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels. Decreasing the calcium in these cells makes the heart beat with less force, opening up narrowed blood vessels and lowering blood pressure.

Calcium channel blockers commonly used to treat high blood pressure include:

Diltiazem (Cardizem CD®, Cardizem SR®, Dilacor XR®, Tiazac®)

Verapamil (Calan SR®, Covera HS®, Isoptin SR®, Verelan®)

Possible side effects of calcium channel blockers include:

The body releases hormones called catecholamines in response to stress. When these hormones bind to parts of cells called alpha-receptors, blood vessels narrow, causing the heart to beat faster and more forcefully. This leads to an increase in blood pressure.

Alpha blockers prevent catecholamines from binding to alpha-receptors so that blood can flow more freely, which also helps the heart beat more normally. This helps control blood pressure.

Alpha blockers commonly used to treat high blood pressure include:

Possible side effects of alpha blockers include:

A drop in blood pressure when you stand up

Consult your doctor about the potential risks and benefits of taking an alpha blocker. These medications have been known to interact with other medications like beta blockers, calcium channel blockers, and medications for erectile dysfunction, increasing or decreasing their effects. Make sure your doctor is aware of any other medications you take.

When combined, alpha blockers and beta blockers prevent catecholamine hormones from binding to both alpha and beta receptors. These medications decrease the constriction of blood vessels and make the heart work less forcefully.

Alpha-beta blockers commonly used to treat high blood pressure include:

Common Types of Blood Pressure Medications 

With effective treatment, including both heart-healthy lifestyle habits and prescription blood pressure medications, you can control your blood pressure and live an active life. Read on to learn more about the most common classes of blood pressure medications and their side effects.

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