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Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

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Blog | Alto Pharmacy

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. 

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 best price. 

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

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.

Editor’s Note: This post was originally published in September 2021 and has been updated for accuracy and completeness.

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 or through the Alto app, and will even remind you when your medications are due for a refill.

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

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.

Pharmacist discussing medication with patient

For nearly 50 years, RESOLVE — a national patient advocacy organization — has been both a go-to resource for individuals and couples experiencing infertility and a leading advocacy voice.

What to know about RESOLVE: The National Infertility Association

Infertility is often misunderstood and stigmatized, and it’s easy to feel isolated when you are experiencing difficulty starting a family. For nearly 50 years, RESOLVE — a national patient advocacy organization — has been both a go-to resource for individuals and couples experiencing infertility and a leading advocacy voice, helping pass laws across the country to make family building options more accessible.

Simeonne Bookal, Senior Manager, Access to Care, and Tracie Sullivan, Senior Manager, Grassroots Outreach, recently spoke with Alto about some of the challenges their organization has overcome, what’s coming up next, and why we need more honest conversations about infertility.

RESOLVE has supported individuals and couples through infertility challenges for nearly 50 years. What’s the biggest obstacle you’ve had to overcome as an organization?

Tracie: I focus on RESOLVE’s grassroots advocacy efforts and help lawmakers understand the challenges of family building and the need for legislation that removes barriers to family building options. I continue to see so much stigma and shame around infertility, even in 2021. Part of that comes from misconceptions about infertility and surrogacy.  

I would say, though, that we are generally moving in a positive direction, with greater awareness of infertility and all the accompanying challenges. In recent years, celebrities and other influencers have come forward and shared their experiences with infertility, which has opened the gate for more conversations.

Simeonne: To build on Tracie’s point, when public figures do come forward and share their experiences with infertility, it’s often after they’ve had a happy ending, not when they’re struggling the most. We’re continually trying to broaden the conversation so that people feel empowered to share when they’re in the most difficult part of their infertility journey. 

On a different note, the pandemic has been one of the biggest challenges we’ve had to tackle as an organization. For us, pivoting to virtual programming isn’t just about moving online, it’s about finding ways to offer the same quality of services and events as we did pre-pandemic. 

We’ve had success with virtual events, including our advocacy day and programming for National Infertility Awareness Week 2021. Many people have found our virtual support groups to be really accessible, and that’s been an opportunity for us to reconsider how we can most effectively bring people together.

What can we look forward to from RESOLVE in the near future?

Simeonne: Like many organizations, RESOLVE is invested in making our programming as inclusive and diverse as possible. Something I’m really excited about, which emerged from our conversations about inclusion and diversity, are more tailored support groups.

We recently launched a men’s support group and a BIPOC (Black, Indigenous, and People of Color) support group. I think we’ll continue to see a trend of more specific support groups over time, in recognition of how many different experiences of infertility exist.

What would you tell someone who’s nervous about joining an infertility support group?

Simeonne: Just give it a try. There’s no commitment required, and you can talk as little or as much as you want. It may feel intimidating to share something so personal with a group of strangers, but many people find it easier to discuss infertility in our support groups than with family and friends since you’re speaking with people who understand what you’re going through. 

Also, now is an ideal time to get started, since many of our groups are meeting virtually. You don’t even have to leave the house, you can just log on.

What’s happening in the legislative landscape in regards to family building opportunities?

Tracie: Right now, 19 different states have passed fertility insurance coverage laws, 13 of which include IVF coverage. (Editor’s note: Fertility insurance coverage laws require health insurance providers to offer coverage for diagnosing infertility and treatment. There is significant variation in state-level legislation, and not all states with fertility insurance coverage laws require health insurers to cover assisted reproductive technology (ART) procedures like IVF.)

And 11 states have fertility preservation laws that support people navigating medically-induced infertility, including cancer patients and survivors. (Editor’s note: Fertility preservation treatments like egg freezing and sperm freezing allow individuals to have biological children in the future after changes to their reproductive health. Many individuals living with health conditions that impact fertility explore these treatment options, as do others who wish to delay starting a family.)

RESOLVE is actively working to pass fertility insurance coverage laws in other states, and to improve the legislation that is already in place. For example, in some states with fertility insurance coverage legislation, there are restrictions to coverage access, including marriage requirements and five-year waiting periods for fertility treatment, which don’t align with current medical care standards. 

In other states, coverage is limited to diagnosis and testing and does not include treatment. We also support federal legislation that improves access to family building. Our goal is to make these benefits as inclusive and accessible to as many individuals and families as possible. 

We have a great resource on our website that explains more about infertility insurance and offers a state-by-state breakdown of fertility insurance coverage laws.

View RESOLVE’s guide to infertility coverage by state.

The financial cost of fertility treatment can feel overwhelming. Can you share any resources that help make fertility treatment more accessible?

Simeonne: There are many resources out there that can help alleviate part of the financial burden — from manufacturers’ patient assistance programs to scholarships, grants, and coverage at work programs — but it does require a bit of research. 

We have a list of infertility financing programs and services on our website, which includes some patient assistance programs, and another page with scholarships and grants that you can apply to. 

In addition, RESOLVE’s Coverage at Work initiative was created to support employees and employers in adding fertility insurance coverage to their companies’ healthcare plans.

Tracie: We’ve been happy to see that more employers are offering coverage, even in states that don’t have laws related to infertility coverage. If family building options aren’t covered through your employer’s healthcare plan, we always encourage people to ask for support. You’ll be helping many more people going through the same experience by bringing attention to the need for coverage.

View RESOLVE’s toolkit for employees seeking fertility insurance coverage.

What do you enjoy most about being a part of RESOLVE?

Simeonne: I feel grateful to work for an organization that’s making a direct impact in so many people’s lives. I love getting messages from support group members sharing what this resource means to them. I feel a greater connection to my work and a deeper sense of motivation knowing it touches so many people during a time in their life when it’s easy to feel alone. 

Tracie: I also love seeing the difference that RESOLVE makes for so many people. Many of the laws our community has helped advocate for take years to pass, but when they do, thousands of people get the coverage they need to start a family. And I feel lucky to work alongside such a passionate group. Many of our advocates are people who have completed their family building journeys but want to be there for others.

The importance of seeking support when experiencing infertility 

It is understandable to feel overwhelmed when navigating infertility and exploring your family building options. While each individual journey is unique, there are others willing to share their experience and offer support as you take the next steps to start a family. RESOLVE can help you connect with other individuals affected by infertility and explore your options for financing fertility treatment.

Search for a RESOLVE support group and learn more about how to seek fertility insurance coverage from your employer.

At Alto, we understand the complexities of fertility treatment and the challenges of infertility, and we are here to support you in starting a family if fertility medications become part of your path to parenthood. With Alto, you’ll never have to worry about whether medications will arrive on time, and you’ll have support at every step of the way — we offer a variety of resources including one-on-one consultations with fertility-trained pharmacists to ensure that you’re never alone in navigating fertility treatment.

Learn more at alto.com/fertility or reach out at any time by phone at 1-800-874-5881 or in-app messaging. 

About RESOLVE: The National Infertility Association

Established in 1974, RESOLVE: The National Infertility Association is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders. One in eight U.S. couples of childbearing age is diagnosed with infertility. RESOLVE addresses this public health issue by providing community to these women and men, connecting them with others who can help, empowering them to find resolution and giving voice to their demands for access to all family building options. For more information, visit www.RESOLVE.org.

RESOLVE: The National Infertility Association

The Providers Team at Alto is charged with building the tools and service components necessary to deliver an exceptional pharmacy experience for healthcare providers. Read on to learn more.

Get to Know the Team That Has Doctors Calling Alto “The Pharmacy of The Future”

Editor's Note: The post was updated on November 8, 2021 to reflect the rebrand of AltoMD to Alto Connect.

Alto Pharmacy’s mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. The healthcare professionals who prescribe medications to Alto and the clinical teams that support them are critical partners in making our mission successful. To this end, the Providers Team at Alto is charged with building the tools and service components necessary to deliver an exceptional pharmacy experience for healthcare providers.

Every day, clinical teams -  including prescribers and other clinical staff like nurses, practice coordinators, and billing specialists - spend hours tracking down insurance information, coordinating approvals and appeals, discussing options with their patients, and playing phone tag with pharmacies. The Providers Team enables these healthcare providers to spend more time on patient care and less time on back office tasks. 

Alto’s provider communications platform, Alto Connect, and related services, including insurance benefits coordination and prior authorization management, remove clinical blockers that traditionally slow down or prevent an individual’s access to treatment. Practices that share Alto with a majority of their patients can save three or more hours per day on pharmacy and insurance administration tasks, with less time spent waiting on hold, fewer faxes and improved employee satisfaction (not to mention happier patients!). 

Anu Kashyap, a Product Manager on the team says, “I joined Alto to make a contribution to people’s health using technology, and the Providers Team is working on specific, painful healthcare problems that are critical to solve. These challenges have been incredibly fulfilling to work on.”

How does the Providers Team play into the overall growth of Alto Pharmacy?

The Providers Team is fairly new, as they were originally part of a larger Growth team within Alto. Kjersten Elias, Engineering Manager, explains: “Alto's growth model is driven by conversations about pharmacy choice in the doctor’s office, and in the fall of 2020, we dedicated an engineering team to optimizing our product offerings and improving the experience for the healthcare providers having those conversations.”

Anu adds, “The key for our business’ continued growth is having healthcare providers trust that we are the best pharmacy for their patients and leverage us as their pharmacy of choice. This type of growth channel is much more powerful than anything direct to the consumer. We can only do this however, if our providers have an excellent experience with us, and we’ve only scratched the surface here.” 

Being part of a newer team has distinct advantages. Software Engineer Dereck Quock notes, “We have unique opportunities to modernize how we build apps and define our infrastructure and technical needs. With the freedom to utilize cutting edge tech and new frameworks, there is so much room for innovation.”

What is the culture of the Providers Team like?

The engineers each raved about a small-but-important recurring calendar invite each Friday: Team Time. This protected time is a space to catch up, banter about anything other than work, and, if folks are feeling brave, face off with Anu, former Teen Tournament champion, in a rousing game of Jeopardy.

It's not hard to see why Kjersten and her team light up when they talk about team culture. Amy Chen, a Software Engineer on the team, shared that  “Kjersten is an incredible manager. Everyone is empowered to ask for and share feedback, fine-tune our processes, and check in with each other.”

“When I joined, I could tell right away this team really lifted each other up and had each other’s backs,” said Dereck. “It’s one of the greatest teams I’ve worked on.”

The Providers Team is hiring! Learn more about open positions here.

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. 

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 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 or within the Alto app seven days a week

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

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.

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

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. 

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