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Insulin pumps have become increasingly widespread in diabetes treatment in recent years due to their convenience and ease of use. Read on for more information about these devices.

The Role of Insulin Pumps in Diabetes Treatment

Both type 1 and type 2 diabetes involve complications with the body’s production of insulin, a hormone produced in the pancreas that converts sugar into energy. People living with type 1 diabetes do not produce any insulin at all, so they have to take insulin every day to keep their blood sugar levels in a healthy range.

Insulin therapy may also play a role in managing type 2 diabetes, since individuals with the condition do not produce a sufficient amount of insulin to regulate blood sugar levels. However, some individuals with early-stage type 2 diabetes are able to manage their blood sugar with other medications and healthy lifestyle habits — make sure to consult with your doctor on the best course of treatment given your needs.

There are several methods available for delivering insulin into the body, including syringes,  insulin pumps, and pens. Insulin pumps have become increasingly widespread in diabetes treatment in recent years due to their convenience and ease of use.

There are a variety of insulin pump options to choose from. Read on for more information about these devices.

What is an insulin pump and how does it work?

An insulin pump is a small electronic device that delivers doses of insulin at specific times. It mimics the activities of a normally functioning pancreas by delivering small, continuous doses of insulin throughout the day and surges of insulin while you eat. You set the schedule, and it is easy to make adjustments if your dosage changes or if you eat or exercise more than usual on any given day.

While an insulin pump’s consistent delivery of insulin is effective in keeping your blood sugar levels within a healthy range, it is still important to check your blood sugar throughout the day using either a blood glucose meter or a continuous glucose monitor (CGM). Some newer insulin pumps are connected to a CGM, which allows for both automated glucose monitoring and insulin delivery.

Many people who use insulin pumps find them to be more convenient than insulin injections, particularly while on the go. Insulin pumps offer the flexibility to work, socialize, or engage in just about any other activity without stepping aside to give yourself an insulin injection. And their automated, adjustable delivery makes it simple to maintain healthy blood sugar levels: not only do you not have to worry about missing a dose, but you can easily add, remove or modify a dose depending on your calorie intake and level of physical activity.

Most insulin pumps are designed to store dosing data, so you and your doctor’s office will have easy access to details about your insulin regimen should you need to make any adjustments to your treatment plan. 

Depending on the type of insulin pump you have, the device may be able to streamline other aspects of diabetes management. In addition to the automated blood sugar readings offered by CGM-connected pumps, some pumps have tools to help with carbohydrate counting. (Monitoring how many carbohydrates you consume is an important aspect of diabetes management as they increase your blood sugar, and your daily insulin dosage depends on your insulin-to-carb ratio.)

Insulin pumps deliver very precise doses of insulin, so there is a low risk of complications. However, it’s important to make sure you know how to properly set up your pump and to continually monitor your blood sugar levels. Your doctor or a diabetes educator can help you get started.

Choosing between an insulin pump and other delivery methods is ultimately a matter of personal preference, but they are often a good fit for children and anyone who has had difficulty remembering the timing of their insulin injections. You may also want to consider using an insulin pump if you absorb food slowly or if you often experience low blood sugar as a result of insulin use (also referred to as an insulin reaction or hypoglycemia). Consult with your doctor to choose the best insulin delivery method for your individual health needs.

Many women who are pregnant or trying to conceive also benefit from the consistent and precise delivery of an insulin pump, as blood sugar management is especially critical while your baby’s major organs develop. If you are pregnant or thinking of becoming pregnant, you may want to ask your doctor if an insulin pump is right for you.

There are two main types of insulin pumps: tubed insulin pumps (sometimes referred to as traditional insulin pumps) and insulin patch pumps. Tubed insulin pumps deliver insulin from a delivery chamber — in this case a container located within the pump — into a tube inserted beneath your skin, usually on the abdomen. (A healthcare professional like your doctor or a diabetes educator can show you how to insert the tubing.) Manufacturers of commonly used tubed insulin pumps include Medtronic and Tandem®.

Insulin patch pumps combine the delivery chamber and tube into a single “pod” placed on your skin with an adhesive patch. Insulin patch pumps do not have any external tubing and are controlled wirelessly. Commonly used patch pumps include Omnipod® and V-Go®.

You can put a tubed insulin pump in your pocket, on your belt, or attach it to a strap beneath your clothes. Insulin patch pumps are most commonly placed directly on your stomach or arm. Both types of insulin pumps require you to change the tubing or pods every one to three days. A diabetes educator or healthcare provider can answer any questions and help you become more comfortable using the device.

What to consider when deciding to use an insulin pump

When talking to your doctor, here are some considerations that may help you determine if an insulin pump is the most convenient way to manage your blood sugar, or your child’s.

An insulin pump may feel slightly more complex than injections, as it involves frequent interactions with technology. Your diabetes care team can help you become more comfortable with the device.

You will need to verify which type of pump(s) your insurance plan covers and decide if those options are the right fit for your needs and budget.

Whether you go with a tubed or patch pump, you’ll have an electronic device attached to your skin, which may take some getting used to. There are lots of ways to make them less visible, if that’s a concern.

If you’re still unsure, remember that you’re allowed to change your mind! While insulin pumps are most commonly used on a continuous basis, the device is not permanently attached to your body, and some people switch to injections for certain periods of time. 

For example, some children with diabetes may use an insulin pump during the school year but take insulin via injections during the summer. There is room for flexibility as long as you discuss your plan with a healthcare professional and follow their recommendations.

Most insurance plans have separate medical and pharmacy benefits. In most cases, professional services provided by your doctor will fall under medical benefits while prescription diabetes medications — including insulin — will fall under pharmacy benefits. 

Pumps, CGMs, and supplies like test strips will likely be covered under a third type of benefits: the Durable Medical equipment (DME) section of your policy. There may be restrictions on the brands or suppliers that are available, and it’s important to check with your specific policy to understand what will be covered and under which sections.

Tubeless patch pumps like Omnipod® and V-Go® are often covered with your pharmacy benefits. If that’s the case, Alto may be able to help you get started with your insulin pump. We will work with your insurance (if applicable) and any third party savings programs so that you can get your insulin pump at the lowest possible price.

A diabetes pharmacy partner you can rely on

At Alto, we believe a pharmacy should be a partner in your diabetes care. We have a dedicated diabetes support team to ensure that you have everything you need to follow through on your individualized treatment plan. Reach out any time via text or phone at 1-800-874-5881, or in-app 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.

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.

September 27 is National Gay Men’s HIV/AIDS Awareness Day, an important reminder that the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) disproportionately affect gay and bisexual men.

National Gay Men's HIV/AIDS Awareness Day

September 27 is National Gay Men’s HIV/AIDS Awareness Day, an important reminder that the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) disproportionately affect gay and bisexual men. In 2019, these individuals accounted for 69% of new HIV diagnoses in the U.S.

The high rates of HIV and AIDS among these individuals date back to the origins of the epidemic in the 1980s and 90s, in part because the virus transmits more easily through anal sex than vaginal sex. And this deep-rooted prevalence of HIV and AIDS in LGBTQ+ communities perpetuates a cycle: since HIV and AIDS are historically more common among gay and bisexual men, other gay and bisexual men face a higher risk of contracting it.

In recent years there has been significant progress toward reducing the annual infection rate. New cases of HIV among gay and bisexual men ages 13-24 dropped by 33% between 2015-2019. But there’s still much more progress to be made. Several factors contribute to HIV’s continued disproportionate impact upon gay and bisexual men, including ongoing stigma around HIV — which can deter people from seeking HIV prevention services and testing — race/ethncity discrimination, and disparities in healthcare access.

Even as HIV cases continue to decline and more effective treatment options allow individuals with the virus to have active, full lives, it’s important to stay vigilant about testing and prevention services. 

An estimated 1.2 million people in the U.S. are living with HIV, and about 13% of them aren’t aware of their HIV status. According to the CDC, nearly 40% of new HIV infections are transmitted by people who do not know that they have the virus.

Getting tested is the only way to know your HIV status. It’s free, it’s confidential, and it’s one of the most important things you can do to protect your health and the health of potential sexual partners.

If your test results are positive, there are effective treatment options that can keep you healthy. Antiretroviral therapy (ART) is a combination of medications that reduce the amount of HIV in your bloodstream (known as your viral load). When taken every day as prescribed, ART can help you reach an undetectable viral load. Maintaining an undetectable viral load can keep your immune system strong and prevent you from transmitting the virus to others.

It’s important to start ART as soon as possible, so reach out to your healthcare provider right away if you’ve tested positive for HIV. Delaying treatment can put you at a greater risk for developing AIDS or transmitting the virus to others.

If your test results are negative, you can continue to protect your health by using condoms and taking an HIV prevention medication called PrEP if you and your doctor decide it’s right for you.

PrEP, or pre-exposure prophylaxis, can lower risk of sexual transmission of HIV by 99% when taken daily and reduces the risk of getting HIV from intravenous drug use by about 74%. PrEP may be right for you if you have a partner who is HIV-positive or unsure of their HIV status, or if you have multiple partners. 

In recent years, PrEP has become even more accessible, with generic medication options and expanded health insurance coverage of PrEP. In addition, a handful of states, including California and Colorado, recently passed legislation that allows pharmacists to prescribe the HIV prevention medication. Pharmacists at Alto’s California locations are now able to prescribe PrEP (see our free, same-day prescription delivery areas here).

The following resources can connect you with a provider who may prescribe PrEP:

Using PEP for emergencies and accidental exposures

There’s another HIV prevention medication to be aware of: PEP, or post-exposure prophylaxis, which is taken within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. 

PEP can be prescribed by a healthcare provider at emergency rooms, sexual health clinics, community-based health centers, and, in some states, pharmacies. The sooner you begin taking PEP, the more effective it is at blocking the virus, so if you have been exposed to HIV after standard working hours, visit your nearest hospital’s emergency department as soon as possible.

PEP is only for emergencies and accidental exposures. If you anticipate ongoing risk of exposure to HIV, consider asking your doctor about taking PrEP for long-term protection.

The HIV prevention landscape is regularly evolving, and we have an extensive library of PrEP, PEP, and HIV-focused content to help you understand and access HIV prevention medications and services. Consult with a healthcare provider to make the best decisions for your needs.

Here are just a few of the resources we offer:

Getting PrEP for HIV prevention at an affordable cost

Expanded PrEP access at pharmacies: What to know

What updated CDC guidelines mean for PrEP access

What to Know About State-Funded PrEP-DAP Programs

Alto can help you navigate HIV treatment and prevention medication

Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started with antiretroviral therapy, PrEP, or PEP. We will coordinate with your doctor and your insurance provider to ensure that you’re receiving the best option for your needs at the bestprice. Pharmacists at our California locations are also able to prescribe PrEP and PEP.

To learn more, reach out any time via text or phone at 1-800-874-5881, or in-app messaging.

When there are issues with your heart’s electrical signals it may beat too quickly, too slowly, or irregularly. This is called an arrhythmia. Learn more about the primary types of arrhythmias and the medications most commonly used to treat them.

Medications Commonly Used to Treat Arrhythmias

While a resting heart rate — the number of times your heart beats per minute when you’re at rest — will vary from one individual to the next, the healthy range for an adult is between 60 and 100 beats per minute. However, when there are issues with your heart’s electrical signals, which trigger each individual heartbeat, your heart may beat too quickly, too slowly, or irregularly. This is called an arrhythmia.

The best course of action depends on the type of arrhythmia you have and your overall health. Many cases of mild arrhythmias do not require any treatment. But your doctor may recommend medication to control or resolve your arrhythmia if there is a risk that your arrhythmia could cause more serious heart health issues.

Below, we explain more about the primary types of arrhythmias and the medications most commonly used to treat them.

Arrhythmias are categorized by the speed of the resulting heart rate and the area of the heart in which they originate.

A tachycardia is a fast heart rate, typically over 100 beats per minute when you’re at rest. There are many different types of tachycardias, including the following:

Atrial fibrillation is a rapid heart rate caused by irregularities in the electrical signals in the heart’s upper chambers, or atria. The condition may be temporary in some cases, but it often requires retreatment. It has been linked to more serious health issues including strokes.

Ventricular tachycardia is a rapid but steady heart rate caused by irregular electric signals in the heart’s lower chambers, or ventricles. The condition may lead to health complications depending on your overall cardiovascular health.

A bradycardia is a slow heart rate, typically under 60 beats per minute when you’re at rest. There are several types of bradycardias, including:

Sick sinus syndrome is a condition in which your sinus node — the heart’s natural pacemaker — doesn’t properly send electrical signals, causing your heart rate to beat slowly. (In some individuals, sinus node problems may result in a heart rate that alternates between too slow and too fast, which is also called bradycardia-tachycardia syndrome.)

Heart block, or atrioventricular block, is a condition in which electrical signals running through the atria don’t reach the ventricles. There’s a wide range in the severity of heart blocks, so they are subclassified into first-degree (mildest), second-degree, and third-degree (complete) heart blocks.

It’s also possible to experience a premature heartbeat, which often feels like a skipped heartbeat but is actually an additional beat. Premature heartbeats may occur when you are at rest, or they may be caused by stress, physical exertion, or stimulants like caffeine or nicotine.

For many individuals, premature heartbeats do not lead to more serious health problems, but it may trigger a more persistent arrhythmia in others. If you have a preexisting heart disease, you are more likely to experience complications as the result of a premature heartbeat.

Monitoring your heart rate and diagnosing an arrhythmia

Regularly monitoring your heart rate and heart rhythm can help you identify any potential issues in advance and avoid more serious health complications. Read our previous blog, ‘What Your Heart Rate Can Tell You About Your Health’ for additional guidance on measuring your resting heart rate. And if you have any concerns about your heart rate, consult with your doctor for an evaluation of any heart-related health issues.

To make a formal diagnosis of an arrhythmia, your doctor may use one or more tests to capture your heart’s rhythm. The process often begins with an electrocardiogram (ECG), a test performed in your doctor’s office in which patches attached to various places on your chest, arms, and legs record your heart’s activity.

If you have a chronic, consistent arrhythmia, the ECG may accurately capture your arrhythmia. However, if your arrhythmia is less frequent, an ECG may not necessarily give your doctor the information needed for a diagnosis. If that’s the case, they may recommend additional tests, including monitors you can use at home to record your heart’s activity over a longer period of time.

Treating an arrhythmia with antiarrhythmics

Antiarrhythmics help restore a regular heart rhythm by acting on the electrical currents that cause your heart to beat. They are most commonly used to treat tachycardias or premature heartbeats, and the majority are taken orally as a pill on an ongoing basis.

These are some of the most commonly prescribed antiarrhythmics and their side effects:

Amiodarone works by slowing down your heart’s nerve activity. It will likely take several weeks of amiodarone use before you experience the medication’s full effects.

It isn’t uncommon to experience nausea, vomiting, constipation, loss of appetite, abdominal pain, or a combination of these effects from taking amiodarone. For that reason, your doctor may recommend that you take amiodarone with meals.

Additional side effects include tremors, lack of coordination, weakness, fatigue, and difficulty sleeping. If any of these are severe or long-lasting, or if you experience more serious side effects such as abdominal swelling or painful breathing, contact your doctor right away.

Flecainide is typically started in the hospital if you are admitted for an arrhythmic-related health issue so that your doctor can closely monitor your response to it. It comes in tablet form and is usually taken twice a day. If you experience an upset stomach from the medication, your doctor may recommend that you take it with food or milk.

Flecainide is most effective when there is a constant level of it in your bloodstream so it’s important that you take it exactly as directed by your doctor. Abruptly stopping use of flecainide can cause serious health complications, so be sure to follow your doctor’s recommendations and consult with them if you have any concerns.

Common side effects of flecainide include nausea, vomiting, or diarrhea; loss of appetite; tremors; blurred vision; sleep disruptions; weakness; and dizziness or faintness. Contact your doctor if these side effects are severe or long-lasting. If you experience any severe side effects such as chest pain, yellow eyes or skin, fever, or difficulty breathing, contact your doctor as soon as possible.

Standing up slowly from sitting or lying down can alleviate dizziness and drowsiness caused by the medication. You should also ask your doctor if there are any activities to avoid while taking this medication given these side effects.

Propafenone acts on the heart muscle to improve your heart rhythm. It is typically taken three times a day. You may begin taking it in the hospital so that your doctor can observe how it affects you.

To maintain a consistent level of propafenone in your bloodstream, it’s important to follow your healthcare provider’s recommendations and to take the medication exactly as prescribed. If you have any concerns about taking this medication, consult with your doctor, as abruptly stopping use of propafenone may lead to an irregular heartbeat. One exception is if you experience excessive drowsiness or a slow or irregular heartbeat, in which case you should stop taking the medication right away and contact your doctor.

Side effects are less common with propafenone than with other antiarrhythmics. However, you may experience nausea, vomiting, constipation, diarrhea, loss of appetite, stomach cramps, weakness or muscle aches. Contact your doctor if you have any concerns about these side effects.

Ask your doctor about any possible food restrictions or necessary changes to your diet, as potassium can interact with propafenone.

Dronedarone is primarily recommended for individuals who have previously had atrial fibrillation but now have a normal heart rhythm. It can reduce the likelihood of being hospitalized for the condition in the future.

Your doctor will likely consider your overall health when determining if dronedarone is a good fit for you, as the medication may increase your risk for complications of other heart conditions. It is not typically recommended for individuals who have severe heart failure or worsening heart failure symptoms, or if your atrial fibrillation has remained consistent.

This medication has been known to interact with other medications, including other heart rhythm medications; antiviral medications like ritonavir; certain antibiotics including clarithromycin and telithromycin; certain antidepressants including amitriptyline, clomipramine, and nefazodone; antifungal medications like itraconazole, ketoconazole, and voriconazole; and antipsychotic medications like chlorpromazine, fluphenazine, and thioridazine. Make sure your doctor is aware of any medications you take.

Antiarrhythmics may also be administered intravenously in the hospital during a medical emergency. Ibutilide (Corvert®) and lidocaine (Xylocaine®) are two of the most commonly used antiarrhythmics that are administered through an IV.

General guidance about antiarrhythmic use

There are some general practices to follow when taking any medication in this class to avoid more serious health complications and manage side effects:

Inform your doctor of any underlying health conditions you have, as these may interact with your medication, especially kidney disease, congestive heart failure, liver disease, diabetes, or respiratory disease.

Your doctor may recommend exams, electrocardiograms (ECGs), and blood tests to monitor the medication’s effectiveness. Stay current with these follow-up appointments and lab work. 

Use caution when driving, particularly while you are still adjusting to the medication, and ask your doctor if there are any activities that you should avoid.

Depending on the type of arrhythmia you have and your overall health history, your doctor may also recommend calcium channel blockers or beta blockers. Here’s what to know about these medication classes.

If you have chest pain or high or low blood pressure in addition to your arrhythmia, your doctor may prescribe a calcium channel blocker. Commonly used to treat high blood pressure, calcium channel blockers open up narrowed blood vessels, allowing for more blood to flow to your heart. They are also used to treat arrhythmias since the opening of blood vessels can also slow your heart rate.

Most calcium channel blockers prescribed for arrhythmias are taken orally as pills, but some of them may be taken intravenously, which is when a medication is sent directly into your veins using a needle or a tube, typically in a hospital or doctor’s office.

Calcium channel blockers commonly used to treat arrhythmias include:

Common calcium channel blocker side effects include dizziness, constipation, and headaches. More severe side effects include rash or swelling in your legs and feet. Contact your doctor if you have any concerns about these side effects.

Beta blockers are commonly used to treat high blood pressure. Since they cause the heart to beat more slowly and less forcefully, they are also effective at treating tachycardias.

Beta blockers commonly used to treat tachycardias include:

Common beta blocker side effects include cold hands, fatigue, headache, and weight gain. They may also affect your digestive system.

If you have diabetes and take insulin, it’s important to check your blood sugar levels often while taking beta blockers as beta blockers may block typical signs of low blood sugar such as a rapid heart rate. Beta blockers are not typically used by people with asthma, as they may trigger severe asthma attacks.

If your arrhythmia puts you at a greater risk for blood clots or a stroke caused by a blood clot, your doctor may add an anticoagulant to your medication protocol. These medications reduce the blood’s ability to form new blood clots and prevent existing clots from growing. They will not address your arrhythmia, however, so they are typically taken in combination with one of the medications described above.

Choose a pharmacy that never skips a beat

At Alto, we’re committed to making it as simple as possible to manage your arrhythmia and strengthen your heart. We offer free same-day delivery and medication management tools like reminders and auto refills in our app. And our team of pharmacists is always here to answer your questions by phone, text, or chat, and will even remind you when your medications are due for a refill.

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

Pharmacist discussing medication with patient

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG).

Get to Know Alto Auténtico, our Latinx ERG

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG)*. Below, Robert Barahona, Provider Success Specialist and co-leader of Alto Auténtico, shares more about the group’s origins, current initiatives, and plans for the future.

Robert: “Auténtico” means authentic in Spanish, and authenticity is central to the ERG’s mission. The group was created to ensure that Alto’s Latinx team members have a presence and a voice within our company culture, and that they are supported in their professional development with meaningful opportunities to grow at Alto.  

Robert: Our focus is both internal and external. In addition to developing a Latinx community at Alto, we also shape Alto’s product and services so that we’re better serving our Latinx users (more about that later). Much of that work involves building awareness of Latinx history and cultural contributions, as well as bringing attention to negative stereotypes that we want to dismantle.

We use holidays and events like Day of the Dead (November 1st and 2nd) and Cesar Chavez’ birthday (March 31) to share educational resources with our team members. On Cinco de Mayo, we hosted a Zoom happy hour and a taco lunch for all our pharmacies.

For last year’s Hispanic Heritage Month, we invited Dr. Robert Rodriguez, the president of diversity consulting firm DRR Advisors and a thought leader in Latinx talent management, to speak at Alto. He shared about his own journey of repressing his background to assimilate in the workplace to fully embracing his heritage and empowering other Latinx employees to be their authentic selves.

How are we celebrating Hispanic Heritage Month this year?

Robert: We’re focusing on celebrating Latinx intersectionality. It’s important to recognize the diversity within Latinx culture and the important perspectives of Latinx women, LGBTQ+ individuals, and those of mixed heritage, including our Black and Asian members who also identify as Hispanic or Latinx. Every week during Hispanic Heritage Month, we’re educating the full Alto team about a specific group within the broader Latinx community, with resources for additional learning.

What can team members look forward to from Alto Auténtico in the future? 

Robert: We’re really excited to continue to help shape Alto’s services and resources for customers, making our offerings as inclusive as possible. We’re currently working with the operations, product, and marketing teams to establish a bilingual team to support Spanish-speaking individuals using our pharmacy delivery services across all of our communities. 

We’re also launching a mentorship program in which Alto’s junior Latinx team members will be paired with senior Latinx team members for coaching sessions. This is another important step in continuing to invest in our Latinx team members’ professional development.

How can allies recognize Hispanic Heritage Month?

Robert: Great question! I think learning is key. Simply taking the time to educate yourself about the Hispanic and/or Latinx experience — particularly about our diversity as a group — goes a long way toward building trust, which is key to true allyship.

Interested in learning more about the Alto Auténtico employee resource group? Reach out to altoautentico@alto.com and visit alto.com/careers to learn more about our open roles. 

*ERGs are meant to empower community groups within an organization by directly linking decision makers and implementing policies that support the group’s specific needs. The groups often center around a shared identity or experience and focus on building community, providing support, and contributing to its members’ personal and professional well-being. By creating an open forum for employees to come together, discuss challenges and opportunities, and foster a sense of belonging, ERGs help both individuals and organizations thrive.

In celebration of Hispanic Heritage Month, which takes place from September 15 - October 15 every year, Alto is highlighting the important work of Alto Auténtico, our Latinx employee resource group (ERG)

PEP is a medication you can take within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. Read on to learn more about who is eligible for it and when to use it.

What to Know About Using PEP to Prevent HIV Infection

PEP, or post exposure prophylaxis, is a medication you can take within 72 hours of potential exposure to HIV to lower your chances of contracting the virus. While some research indicates that this groundbreaking medication may be able to lower your risk of HIV infection by up to 80%, it is only effective when taken as prescribed and is not intended to be a method of ongoing, recurring HIV prevention (see our article on PrEP to learn more about long-term preventative options).

Read on to learn more about what PEP is (and what it isn’t), who is eligible for it, and when to use it.

PEP is a medication regimen that you begin taking as soon as possible after potential exposure to HIV and continue with for at least 28 days. It typically consists of three medications: Truvada® (emtricitabine/tenofovir) with either Tivicay® (dolutegravir) or Isentress® (raltegravir). Your healthcare provider will recommend the best medication regimen for your health needs during your consultation.

These medications are antiretrovirals, a type of medication that blocks various stages of a virus’ life cycle. In this case, PEP prevents HIV from spreading throughout your body. Taking PEP medications as prescribed throughout the entire 28-day duration is critical to its effectiveness.

It’s important to reach out to a healthcare provider or pharmacist to start PEP as soon as possible if you believe you were exposed to HIV. The virus spreads very quickly — typically within 24 to 36 hours of exposure — and it is recommended to begin taking PEP within 72 hours, or three days, of potential exposure. 

And the sooner you begin your PEP regimen within that 72-hour window, the more effective the medication is at blocking the virus. If your potential exposure to HIV falls outside of that 72-hour window, you should still seek medical attention as soon as possible for further evaluation.

PEP may cause some side effects such as nausea, vomiting, diarrhea, and fatigue, however these are mild in most cases. Be sure to inform your healthcare provider of any other medications you currently take, as these may interact with PEP.

If you experience a rash or fever while taking PEP, you should contact your doctor as soon as possible, as these may indicate the early stages of HIV.

PEP works most effectively for people who may have been exposed to HIV within the last three days. That primarily includes anyone who had unprotected sex with or who shared needles or other drug paraphernalia with someone who may have HIV. It is also recommended in instances of sexual assault or if you used a condom that broke while having sex with someone who may have HIV.

PEP baseline testing and ongoing monitoring

Recommended baseline screening for PEP includes a rapid HIV test, kidney and liver function tests, a pregnancy test for women of reproductive age who aren’t using birth control, and screening for sexually transmitted infections (STIs). However, if baseline screening isn’t available when you reach out to a healthcare provider or pharmacist to start PEP, they will likely advise you to take your first dose before you complete the tests, in the interest of starting PEP as soon as possible. Additional HIV testing is recommended at 30 days and 90 days after the potential exposure to confirm your HIV status.

In all states, any licensed doctor or nurse can prescribe PEP. And in a growing number of states, including California, Colorado, and Nevada, pharmacists are also allowed to prescribe PEP. (If you live in California, an Alto pharmacist can prescribe PEP for you after a phone consultation.)

Since the medication should be taken as soon as possible after exposure, PEP is commonly prescribed by emergency room doctors. It is also available at many sexual health clinics and community-based health centers, but if you have been exposed to HIV after standard working hours, you should visit your nearest hospital’s emergency department as soon as possible.

PEP isn’t an ongoing method of HIV prevention

PEP is only for emergencies and infrequent exposures, as it is not 100% effective in preventing HIV even when taken as prescribed. It should not be considered a substitute for proven methods of long-term HIV prevention, including condoms and/or taking PrEP, a medication that can lower your risk of sexual transmission of HIV by 99% when taken daily. It is also important to continue using condoms during your 28-day course of PEP.

If you have had several potential exposures to HIV, speak with your doctor about potentially taking PrEP to prevent HIV infection in the long term.

Alto can help you navigate PEP or PrEP access

Alto pharmacists at our California locations are able to prescribe PEP. We will work with your insurance (if applicable) and any third party savings programs so that you can get PEP at the lowest possible price. 

There are several patient assistance programs designed to reduce the cost of PEP for individuals without insurance, including Gilead’s Advancing Access Program and ViivConnect. If you’re eligible, we’ll automatically enroll you in these programs as soon as we receive your prescription.

We can also help you get started with PrEP if you and your doctor decide that it’s right for you. In addition to support with navigating insurance and patient assistance programs, you can expect:

Discrete, private packaging and free, same-day delivery

Med syncing support to eliminate extra deliveries each month and in-app reminders to stay on track

Pharmacists directly available through phone, text or within the Alto app seven days a week

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

September is Pulmonary Fibrosis Awareness Month, an annual month of education and action to bring attention to chronic lung disease.

Pulmonary Fibrosis Awareness Month: Understanding the Lung Disease

September is Pulmonary Fibrosis Awareness Month, an annual month of education and action to bring attention to chronic lung disease. A 2020 survey conducted by the Pulmonary Fibrosis Foundation found that 86% of Americans did not know the symptoms of pulmonary fibrosis, which affects more than 130,000 people in the United States. 

This lack of awareness may stem from the fact that pulmonary fibrosis presents with symptoms similar to more common respiratory conditions like COPD, as well as the fact that pulmonary fibrosis is a group of many lung diseases.

Greater education around this progressive lung disease is critical: the more you know how to recognize the signs of pulmonary fibrosis, the more likely you are to receive a diagnosis at an earlier stage, should you be affected. Better understanding of pulmonary fibrosis starts by simply knowing the facts, so, take a few minutes to learn more.

There are more than 200 types of pulmonary fibrosis. In each type, the lungs become scarred, making it difficult to breathe. Unlike COPD and some other lung diseases, pulmonary fibrosis falls under the umbrella of interstitial lung disease. Pulmonary fibrosis damages interstitial lung tissues, which are the cells that fill the space between blood vessels and other structures inside the lungs like the trachea and bronchial tubes.

Another way that pulmonary fibrosis differs from COPD is that it has a wider range of causes beyond cigarette smoking alone. Long-term exposure to pollutants and toxins, certain medical conditions and medications, and radiation therapy can also play a role in causing pulmonary fibrosis.

The most common type of pulmonary fibrosis is idiopathic pulmonary fibrosis (IPF), which literally means pulmonary fibrosis of an unknown cause. While doctors are unable to isolate a single cause of the condition in these cases, the following risk factors may increase your chance of developing IPF:

A diagnosis of a condition that often co-occurs with pulmonary fibrosis (also referred to as a comorbidity) such as acid reflux, sleep apnea, or pulmonary hypertension

While researchers continue to work toward a cure, a combination of medications, oxygen therapy, and active lifestyle choices can slow the progression of pulmonary fibrosis. Getting diagnosed at an early stage is key to a better prognosis.

These are the most common symptoms of pulmonary fibrosis:

Since many of these symptoms overlap with those of COPD and other lung diseases, additional tests, including blood and imaging tests and pulmonary function tests, are often needed to confirm a pulmonary fibrosis diagnosis. Your doctor may also take into account the presence of the known risk factors mentioned above when determining if you have pulmonary fibrosis, including any related health conditions.

A long-term lung disease like pulmonary fibrosis may affect you both physically and emotionally, and it’s important to surround yourself with support. In addition to having a strong care team, there are many opportunities to connect with other individuals living with the condition, who understand your experience better than anyone.

The Pulmonary Fibrosis Foundation offers both virtual and in-person support groups. The PFF also has a phone group for all members of the pulmonary fibrosis community called PFF Voices, where you can discuss any pulmonary fibrosis-related topic or concern. The group meets on the third Thursday of every month.

The American Lung Association’s Better Breathers Club has a variety of resources for individuals living with lung diseases, including virtual meetings. The ALA also supports free online communities on Inspire.com that offer peer-to-peer support for people living with lung diseases, and there is a group specifically focused on living with pulmonary fibrosis. You need to create an Inspire.com account to access the group.

If you are caring for someone with pulmonary fibrosis, there are also resources to help you navigate your loved one’s treatment needs.

Read the Pulmonary Fibrosis Foundation’s suggestions for caregivers.

The PFF also offers a phone group created specifically for caregivers called PFF Caring Conversations, where you can share your experiences as a caregiver. The group meets on the first Tuesday of every month.

The American Lung Association supports an Inspire.com group for pulmonary fibrosis caregivers called Caring for Pulmonary Fibrosis. You need to create an Inspire.com account to access the group.

Alto is here for you, too. We want to make it as easy as possible to follow the treatment your doctor has recommended, so we offer 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.

Heart-healthy living is a lifelong practice. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life.

How to Prevent Heart Disease at Any Age

You may associate heart disease with aging, and for good reason — individuals age 65 and older face a higher risk for the condition. This stems in part from how aging-related changes in your body overlap with risk factors for heart disease. For example, your arteries and heart muscle stiffen with age, making it more difficult to pump blood well during exercise.

Still, it’s never too early to prioritize a heart-healthy lifestyle. As heart disease-linked conditions like diabetes and high blood pressure grow increasingly common among young adults, many people are now becoming at risk for heart disease at an earlier age. 

And even if you are young and in good overall health, the choices you make today can affect your heart health for years to come. Cardiovascular health issues like heart attacks, strokes, and heart failure often stem from a lifetime’s worth of health choices, including many you have control over.

Since heart-healthy living is a lifelong practice, it may feel more manageable if you set specific goals and priorities impactful for your age group. To help you get started, we’ve compiled a list of the top heart disease prevention actions to tackle during each decade of life. This is intended to be a high-level guide to prevention, so consult with your healthcare provider about more targeted priorities based on your individual health needs.

2. Search for a primary care provider if you don’t have one

3. Find your favorite physical activity and develop a fitness routine

You’re out in the real world, exploring what you want your life to look like. It’s normal to experience some anxiety during this exciting but nerve-racking time. Your cardiovascular health may not be top of mind as you navigate a stressful job search, adjust to the pressure of beginning a career, or start a family, but taking several heart healthy actions during this decade of life will put you on the right track early on.

Focus on building a foundation for a healthy lifestyle. That means quitting smoking if you currently smoke, figuring out which physical activities work for you, and getting in the practice of staying up to date with yearly doctor’s appointments. If you don’t already have a primary care provider, now’s the time to search for one.

1. Create a weekly routine that makes time for exercise

2. Prioritize your mental health — whatever that looks like for you

3. Contact relatives to build your family medical tree

There’s a good chance your calendar’s looking pretty packed these days. Momentum in your career may come with more responsibilities and later nights in the virtual or physical office. And for those who already have a family, or are thinking of starting one, maintaining work-life balance may be a challenge.

As you continue to build on the foundation you set in your twenties, here are three new action items to add to your health routine. First, remember your favorite physical activity? Make sure there’s a block of time in your schedule for it each week.

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