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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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Alto Pharmacy is thrilled to announce that The Honorable Alex M. Azar II, the 24th Secretary of the U.S. Department of Health and Human Services, has joined our board of advisors. Read more here.

Alto Welcomes Secretary Alex M. Azar II to Board of Advisors

Alto Pharmacy is thrilled to announce that The Honorable Alex M. Azar II, the 24th Secretary of the U.S. Department of Health and Human Services, has joined our board of advisors. 

Since its formation in 2020, the Alto board of advisors has provided the company with strategic guidance and helped ensure that our efforts are both impactful and efficient, with services grounded in the highest standards of operational excellence. Secretary Azar brings deep experience in both public health and the private sector, and his personal commitment to the health of all Americans mirrors Alto’s mission and focus on patient outcomes. 

During his tenure as Secretary, Secretary Azar led the historic transformation of the healthcare system in the United States and the HHS’s response to the unprecedented COVID-19 pandemic. He was the architect of Operation Warp Speed, delivering COVID-19 vaccines and therapeutics in record time, and led a team of more than 85,000 employees. Among many other accomplishments, Secretary Azar drove efforts to reduce drug prices, increase private insurance options, bring transparency of price and quality information to healthcare, expand telehealth, enable healthcare provider collaborative care models and remove regulatory barriers to low-cost, high-quality care. 

He has also played significant roles on the global health stage and championing the U.S.’s global health security efforts, including representing the U.S. in the World Health Assembly, working with the WHO to end Ebola outbreaks in the Democratic Republic of the Congo, chairing the most active G7 health ministerial in history in 2020, and convening and leading western hemisphere coordinated efforts to assist with the Venezuelan refugee crisis.

In addition to his public sector work, Secretary Azar served for ten years at Eli Lilly and Company, including five years as president of Lilly USA, LLC, its largest affiliate. He serves on several corporate and advisory boards and is a part-time Adjunct Professor of Business and Senior Executive-in-Residence at the University of Miami Herbert Business School. 

“Alto is honored to welcome Secretary Alex M. Azar II to our board of advisors,” said Alicia Boler Davis, CEO of Alto Pharmacy. “Secretary Azar is one of the most tenured experts in public and private healthcare, and his career-long commitment to improving public health perfectly reflects our top founding value – to put patients first. We are grateful for his service and are excited to leverage his deep experience and learnings as we continue to grow.” 

“Alto’s commitment to its mission of fulfilling medicine’s true purpose — to improve quality of life — for everyone who needs it sets it apart from other pharmacies,” said Secretary Azar. “I’ve dedicated my career to developing solutions for providing and enhancing healthcare outcomes for all, and I look forward to working with the Alto team and the board of advisors to continue doing just that.

Many people take more than one prescription medication to manage a chronic health condition, or multiple conditions. According to the Centers for Disease Control and Prevention, 24% of Americans take three or more medications, and 42% of all adults age 65 and older take five or more prescription medications.

How to Manage Multiple Prescriptions

It can be challenging to manage multiple prescriptions, from remembering to take each dose on time and staying on top of refills, to preventing interactions and side effects. If you take multiple medications, here are some tips to help you stay on track with treatment.

Keep all of your healthcare providers on the same page.

If you see different specialists for different conditions, it’s important that each of them is familiar with your entire medication regimen, including over-the-counter medications or supplements. This is so that they can treat you as effectively as possible, providing insight into the cause of any side effects you may be experiencing and helping you avoid medication interactions.

Make a list of all the prescription medications, over-the-counter medications, and supplements you take, including the dosages, and bring it with you to each doctor’s appointment.

Educate yourself about each medication you take.

Another reason to make a detailed list of all your medications: to ensure you understand what each is used for. Many people find it easier to stay on top of their full regimen when they know why each medication matters.

Informing yourself about your medications can also help you prevent medication interactions and side effects. You should always know the answers to the following questions about any medication you take — your pharmacist is a great resource for information.

Can I take this medication with other medications?

Should I avoid certain foods or drinks when taking this medication?

Are there known potential medication interactions? If so, what signs should I watch for?

Remember, too, that taking a medication as prescribed often means more than simply taking the medication. In many cases, medication therapy also includes testing and clinical monitoring. If you aren’t sure about the details of your treatment plan, including what lab work your medication requires, don’t hesitate to ask your care team for clarification.

Fill your prescriptions at a single pharmacy.

There are many reasons to have a single pharmacy partner. Consolidated medication records allow your pharmacist to offer more effective consulting about interactions and side effects, and to collaborate more easily with your care team.

Filling all your prescriptions at one pharmacy may also simplify medication management. At Alto, we offer a free medication bundling service that syncs your refills so that you receive all your medications in one easy recurring delivery.

Create your preferred medication reminder system.

Medication errors, like missing a dose or taking an extra one, are more common with the more medications you take. There are a variety of tools to help you remember when to take your medication.

Pill organizers, which have compartments for different medications, allow you to quickly determine whether or not you’ve already taken your dose. There are both daily and weekly pill organizers; the best option for you depends on personal preference and how many medications you take.

When using a pill organizer, make a dosage schedule with clear descriptions of each pill to avoid mixing up medications.

Consider setting alarms to help you remember when it’s time for a dose. The Alto app includes custom medication reminders. Many people also find it helpful to link the act of taking their medication to another daily activity, like brushing their teeth or eating breakfast.

It’s also important to find your preferred system for remembering refills. Our app’s medication management features include auto refills and medication bundling.

If you aren’t using a medication management app, check your prescription labels regularly to see how many refills are remaining. Take note of when you will need to call or visit your doctor for a refill and mark it on your calendar.

Checking prescription labels also helps ensure that you aren’t taking expired medication!

Taking multiple medications may increase the possibility of more serious side effects. Even if you experience side effects, you should never stop taking a medication without first consulting your doctor. Rather, keep a log of side effects and discuss them with your doctor. They may be able to recommend adjusting your dosage or safely switching to an alternative medication.

Review your medications with a provider at least once a year.

Treatment needs may evolve with time. To ensure that you are still receiving the best treatment for your needs, review your medication list with a provider at least once a year. This is also an opportunity to discuss any concerns and adjust dosages if necessary.

In addition to an annual review, you should also review your medication regimen with a healthcare professional if you receive a new diagnosis or experience new symptoms of an existing health condition.

Try the Alto app for easy medication management

The Alto app gives you control and convenience in managing your medications, with auto refills, medication bundling, and custom dosing reminders. You can also chat with expert pharmacists to get the answers you need about your treatment, even during nights and weekends.

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.

Today, Alto was named to the 2023 CNBC Disruptor 50. This annual list celebrates the most innovative and game-changing private companies across various industries. We are grateful to be included among these incredible companies, and humbled by this recognition of our business model, operations, and value proposition.

Alto Named to 2023 CNBC’s Disruptor 50 List

At Alto, our mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. By putting patients first, we’re increasing accessibility to medicine, improving prescription adherence and making a meaningful difference in the lives of patients. 

Today, Alto was named to the 2023 CNBC Disruptor 50. This annual list recognizes private companies that are chasing some of the market’s biggest opportunities, and growing despite a tough capital markets environment and slowing economy. We are grateful to be included among these incredible companies, and humbled by this recognition of our business model, operations, and value proposition.

Despite the challenging economic headwinds that all industries are facing, we’ve remained competitive, agile, and committed to delivering outstanding patient care. Just last year, we launched Essentials from Alto, allowing customers to purchase pharmacy items along with their prescription medication in the Alto pharmacy app. This provides even more access to individuals who are disabled, lack physical mobility, or otherwise can’t reach a pharmacy. 

As we celebrate this achievement, we are also mindful of the challenges that lie ahead. The healthcare industry is complex, and there is still much work to be done to ensure that every patient receives the care they deserve. But with our innovative offerings and unwavering commitment to our customers, we are confident that we can make an even bigger difference. 

Alto Named to 2023 CNBC Disruptor 50 List

Mental health disorders are among the most common health issues, affecting more than 1 in 5 U.S. adults. But despite how widespread these challenges are — and despite greater awareness of them in recent years — the stigma of mental illness remains a significant problem, one that keeps many people from seeking vital support. Of all the U.S. adults living with a mental health disorder, more than half don’t receive treatment.

Breaking the Stigma of Medication For Mental Health Disorders

Anxiety, depression, bipolar disorder, and other mental health disorders are medical conditions. Treating them with medication is no different than lowering cholesterol levels with statins or maintaining balanced blood sugar with insulin. However, there are many misconceptions and negative connotations unique to mental health treatment.

No one should be discouraged from seeking the treatment that they need to feel their best. Here are a few reasons why there is no shame in taking medication for a mental health disorder.

Taking medication doesn’t mean you’re unable to manage your health on your own.

Despite the benefits of psychiatric medication, many people consider it a last resort to explore only after trying therapy and lifestyle habits like mindfulness and exercise. Often, this stems from a misconception that those who take medication for a mental health disorder aren’t working hard enough to manage their problems.

Living with a mental health condition looks different for everyone. While some people are able to manage symptoms of depression or anxiety with therapy and lifestyle changes alone, others need a treatment plan that includes medication.

Given how difficult it can be to seek a mental health diagnosis — not to mention to share your feelings openly with a healthcare professional — taking medication is not at all a sign of weakness. It reflects a commitment to your health and wellness, one to be proud of.

Keep in mind, too, that medication and therapy aren’t mutually exclusive tools, and in deciding to take medication, you’re not choosing between the two. Far from a substitute for therapy, medication is in some cases necessary for therapy to be impactful. For example, many people with a depressive disorder find that they need to first address symptoms with medication in order to benefit from therapy sessions. Research has also affirmed this approach: some studies have found that a combination of therapy and medication is more effective at treating depression and eating disorders than either individual treatment.

It isn’t “taking the easy way out.”

Many who equate medication use with weakness see this treatment option as putting a band-aid over a problem, or taking the easy way out. On the contrary, psychiatric medications are far from a quick fix. Medication therapy can take time and a fair amount of trial and error.

With many of these medications, it can take several weeks or more before you experience the benefits. For example, many selective serotonin reuptake inhibitors (SSRI) — a type of medication commonly used to treat depression and anxiety — take two weeks to begin to have a therapeutic effect, and up to six weeks to reach a full therapeutic effect. This is why it’s important to be patient when starting a new medication, and to continue to take it as prescribed even if you don’t feel like it’s working. If you have concerns after several weeks, speak with your provider.

Also, while a medication may be able to relieve symptoms of a mental health disorder, it is not a cure. Rather, it is often what allows many people to do the challenging work of managing an ongoing condition.

Psychiatric medication is a valid and effective treatment option for a medical condition.

Mental health disorders are medical conditions with physiological components. They are frequently rooted in genetics or an imbalance of chemicals in your brain. Many psychiatric medications adjust the balance of your brain chemistry to relieve symptoms of depression or anxiety. For example, SSRIs like sertraline (Zoloft®), fluoxetine (Prozac®), and escitalopram (Lexapro®) increase serotonin levels. Serotonin and norepinephrine reuptake inhibitors (SNRIs) — another group of medications that includes venlafaxine (Effexor®) and duloxetine (Cymbalta®) — increase serotonin and norepinephrine.

Another common misconception about psychiatric medications is that they will alter your personality or make you less “you.” Many people who take medication find that they actually feel more like themselves with treatment — symptoms of mental health disorders can greatly interfere with your relationships and work and keep you from experiencing a full life.

Like most medications, some medications for anxiety, depression, and other mood disorders do have the potential for side effects. There are a variety of medication options for these conditions, so if you have concerns about side effects associated with one option in particular, your provider can help you explore alternatives.

Keep in mind that each person’s response to medication is unique. If you know someone who had side effects from one medication, it doesn’t mean that you will have the same experience.

A combination of medication and therapy can be an effective treatment option for many mental health disorders. Like determining the best medication for your symptoms, finding the right therapist can take time. Here are some tips.

If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point.

Look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator.

Some therapists offer sliding scale fees to make sessions more affordable.

If you are having thoughts of suicide, need emotional support, or are concerned for a loved one, the 988 Suicide and Crisis Lifeline is available 24 hours a day, seven days a week.

Taking care of your mental health is easier with a reliable pharmacy on your side. Our pharmacists can answer any questions you may have about your medications, and we offer same-day delivery and medication management tools like reminders and auto refills in our app.

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

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.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions. Read on.

Medication Shortages, Explained | Alto Pharmacy

Few things are more frustrating — or frightening — than being unable to access the medication your doctor has prescribed. But it has become a common experience in recent years, as medication shortages remain a persistent healthcare challenge in the U.S. And if you take medication, you may be familiar with the panic of struggling to find enough of what you need.

Not only are these shortages incredibly frustrating and debilitating, they are also confusing and unpredictable, arising seemingly at random, and with little known about an anticipated resolution.

While Alto will always go above and beyond to bring you your medications without delay, these shortages are beyond our control, and we share your frustrations and concerns. To provide more clarity and context as to why these shortages occur — and why, unfortunately, there are few short-term solutions — we’ve compiled answers to some of the questions we hear most frequently.

Like every pharmacy across the country — as well as many around the world — Alto has been affected by medication shortages in the last few years. Each pharmacy’s stock fluctuates in tandem with demand, so if you call multiple pharmacies, it’s possible that one will have a greater supply of an affected medication than another on any given day. But ultimately, no pharmacy is immune to these challenges, and if a medication is in short supply, each pharmacy may feel the impact at some point.

If Alto currently does not carry your medication and you would like to transfer your prescription to another pharmacy, be sure to call that new pharmacy to confirm availability of your medication — medication shortages often impact most pharmacies within a specific region. 

The causes of medication shortages are complex, with multiple, and often intersecting, factors at play.

Any issues that affect the production of a medication may lead to reduced supply. This includes disruptions to manufacturing, like when Hurricane Maria damaged production sites in Puerto Rico in 2017.

Covid is another example of how a natural disaster or global crisis can disrupt medication production. The United States relies heavily on other countries for the raw ingredients needed to manufacture a medication.* This leaves us incredibly vulnerable to changes in workforce capacity or manufacturing activities overseas.

*As of 2019, only 28% of our country’s supply of active pharmaceutical ingredients (APIs) — the substances directly responsible for a medication’s therapeutic benefits — were manufactured domestically.

Even when manufacturing circumstances are ideal, rising demand for a medication can lead to low supply. This winter’s difficult cold and flu season, with high cases of Covid, the flu, and R.S.V., contributed to a decreased supply of children’s formulations of ibuprofen, acetaminophen, and several commonly prescribed antibiotics.

Adderall®, a stimulant used to treat attention-deficit/hyperactivity disorder, is another medication whose demand has increased in recent years. Prescriptions for the medication increased by 15.1% in 2020, in comparison to a 7.4% increase in 2019. This comes after a surge in new ADHD diagnoses, which more than doubled between 2007 and 2016 and continue to rise. Worker shortages and production delays experienced by Teva, a leading manufacturer of Adderall, have added additional pressure and compounded the challenges.

High demand has also contributed to recent shortages of the diabetes medications Ozempic® and Wegovy®,  as they have been increasingly prescribed for weight loss.

Addressing increased demand is often easier said than done. Most generic manufacturers decide how much of a medication to produce at the beginning of the year, with virtually no flexibility, so it isn’t an option to simply make more. This is why there is often a seasonal pattern to shortages, with many intensifying at the end of the year.

In the case of Adderall, a Schedule II controlled substance, the Drug Enforcement Administration (DEA) imposes strict production quotas to prevent misuse. With quotas based on estimates, our manufacturing system isn't prepared to respond to unexpected factors like the recent rise in ADHD diagnoses. 

Why are shortages happening more frequently?

Medication shortages are in the headlines more these days, but they are not a new occurrence. They have steadily increased since 2006, becoming a public health crisis in more recent years. The American Society of Health-System Pharmacists (ASHP) reports that, at the end of 2022, ongoing and active shortages were the highest they’ve been since 2014.

The growing intensity of these shortages reflects the strain that Covid put on our entire healthcare system — which we still haven’t fully recovered from — along with other unpredictable healthcare patterns, like growing demand for ADHD medications.

Are certain medications more likely to be affected than others?

Ultimately, any medication can go into shortage, but some types are more prone to recurring supply chain issues.

Medication shortages frequently occur with commonly used (and low-profit) generic medications — like the antibiotic amoxicillin — as pharmaceutical companies have little financial incentive to produce more of them.

Some injectable generics are especially vulnerable to shortages. Fewer manufacturers make these medications, so any production disruption can become a larger issue.

The Adderall shortage illustrates that low stock of a single medication can create a class-wide issue. For many people with ADHD, switching to another medication has proven challenging, as alternatives grow scarce too. This is also the case with Ozempic and other diabetes medications.

Medication shortages are rooted in factors that are far beyond any one person’s control, and unfortunately, there is little we can do to prevent them. Industry experts have proposed solutions, including ramping up domestic production of key pharmaceutical ingredients and building a more resilient medical supply chain. These aren’t quick fixes, and government action is needed for meaningful progress.

What can I do to navigate a medication shortage?

While many medication shortages are unavoidable, there are steps you can take to potentially minimize their stress and impact.

You can track medication shortages on the U.S. Food & Drug Administration or ASHP websites to learn more about a medication’s supply.

To give yourself more time to figure out a short-term solution — such as switching to an alternative medication — refill your medication as far in advance as you can. In some cases, it may be possible to get a 90-day supply of your medication, though this isn’t always an option for controlled substances, and your insurance plan may also limit coverage of refills.

If your medication is in scarce supply, speak with your doctor about alternatives. In addition to taking a different medication, you may be able to switch to a different dose or formulation. Many medications require that you safely taper off of them, which is another reason it’s important to stay on top of refills and ideally learn about supply issues before the last minute.

If an alternative medication costs more or is not covered by your insurance plan, there are resources to help alleviate some of the burden, including coupons, manufacturer-sponsored copay cards, and patient assistance programs. Alto is here to support your savings investigations, and we also suggest reaching out to your insurance provider and verifying your plan’s details — they may be required to cover a branded option if a generic is unavailable.

Our team can answer any questions you have about your medications. We also offer same-day delivery and medication management tools like reminders and auto refills to make it as simple as possible to stay on track with treatment.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions.

The time to prepare for seasonal allergies is earlier than you might expect, as taking medications before everything is in bloom can help significantly to control symptoms. This year, you may want to consider ramping up your prevention efforts even earlier than usual: one consequence of climate change and rising temperatures worldwide is a longer growing season and higher levels of pollen in the air.

Why It’s Never Too Early to Prepare for Seasonal Allergies

The commonly used over-the-counter (OTC) medications below can help make allergy season more manageable — and many are available for purchase at the Essentials Store in our app! To browse the selection, tap the "Store" icon along the bottom of the Alto mobile app or the "Store" icon in your account on desktop.

Over-the-counter allergy medications to take preventatively

Nasal corticosteroid sprays prevent inflammation to reduce allergy symptoms such as stuffiness, sneezing, and a runny nose. Common OTC options include:

When taken in advance, these medications can potentially prevent the onset of allergy symptoms altogether. Many health experts suggest taking them about four weeks before the official start of allergy season, the specific timing of which depends on where you live.

For many people who experience seasonal allergies, symptoms typically first appear when trees start to release pollen in late winter and early spring. However, this pattern is changing as winter temperatures rise, and the timing of pollination also varies by region. To make the best plan, check local pollen levels and consult with your provider.

These medications block histamine, a chemical that your immune system releases during an allergic reaction. You may take them up to two weeks before the start of allergy season, as a preventative measure, but they can also be taken on an as-needed basis if you experience symptoms. They offer fast relief, taking anywhere from 15 minutes to two hours to go into effect.

Some antihistamines, including Benadryl® (diphenhydramine), can cause drowsiness and are not recommended to take before driving or other activities that require your attention.

The following antihistamines are less likely to cause drowsiness:

Not all allergy medications can be taken preventatively. While decongestants like Afrin® (oxymetazoline) and Sudafed® (pseudoephedrine) are effective at relieving congestion, they should only be taken on a short-term basis. Longer-term use may worsen allergy symptoms.

When to see a specialist for allergy symptoms

Remember that it may take time and a bit of trial and error to find the best relief for your allergies. If you experience regular symptoms after exploring a few options, work with your provider to find the best solution for your needs.

You may benefit from consulting a specialist such as an allergist or immunologist. These healthcare professionals can help identify more specific allergy triggers. They can also facilitate even more treatment options, including a preventative treatment called immunotherapy, which exposes you to allergens so that you become less sensitive to them. Immunotherapy comes in the form of both allergy shots and sublingual tablets placed beneath the tongue.

Stock up on allergy medications at the Alto Essentials Store

Purchase allergy season essentials like Claritin, Flonase, Zyrtec, Allegra and more right from your Alto account! You can order Essentials products whenever you need them, or add them to your next prescription delivery.

If your allergy symptoms persist even after preventative steps and exploring OTC options, we can support your treatment plan. We’ll coordinate with your doctor and insurance to offer your medications at the best price we can find, and our expert pharmacists are available via in-app messaging to answer any questions you may have about symptoms or side effects.

Some prescription medications used to treat chronic conditions or manage pain also carry the potential for dependence and misuse. These medications fall into a different category than most and are classified as controlled substances.

Managing a Prescription for a Controlled Substance

The distinction between controlled and non-controlled substances is an important one, as controlled substances are more heavily regulated than other prescription medications. There are limits on refills, and additional steps may also be required to get your prescription. Specific restrictions depend on factors such as your insurance plan’s benefits and the laws in your state. For example, many insurance providers limit the quantity of a controlled medication that they will cover over a given period of time.

Read on to learn how to manage your prescription for a controlled substance.

Controlled substances are regulated under federal law. The category includes both prescription medications and illegal drugs.

These substances are further categorized into five schedules, based on factors including their medical use, safety, and potential for misuse or dependency, with Schedule I substances being the most regulated.

Schedule I substances have no currently accepted medical use and are defined by the U.S. Drug Enforcement Administration (DEA) as having a high potential for misuse. Substances categorized into this schedule include heroin, ecstasy, and marijuana.

Schedule II substances are defined by the DEA as having a high potential for misuse and severe psychological or physical dependence. Substances categorized into this schedule include both illegal drugs such as cocaine and methamphetamine as well as prescription medications such as meperidine (Demerol®), oxycodone (OxyContin®), fentanyl, Dexedrine®, Adderall®, and Ritalin®.

Schedule III substances are defined by the DEA as having a moderate to low potential for physical and psychological dependence. Substances categorized into this schedule include some codeine-containing products, like Tylenol® with codeine; ketamine; anabolic steroids; and testosterone.

Schedule IV substances are defined by the DEA as having a low potential for misuse and a low risk of dependence. Substances categorized into this schedule include alprazolam (Xanax®), diazepam (Valium®), lorazepam (Ativan®), zolpidem (Ambien®), and Tramadol (ConZip®, Ultram®).

Schedule V substances are defined by the DEA as having an even lower potential for misuse than Schedule IV substances. Substances categorized into this schedule contain limited quantities of certain narcotics, including Robitussin AC®, Lomotil®, Motofen®, Lyrica®, and Parepectolin®.

Under federal law, there is a 30-day limit on the supply of any controlled substance. Additional federal restrictions on filling or refilling controlled substances vary by schedule. Some states may have additional restrictions or requirements for filling a controlled substance prescription. Here’s a brief overview.

No refills are allowed for schedule II substances. A new prescription from your healthcare provider is required for every fill.

Some states require a hand-written prescription with a provider’s signature.

Some states have expiration dates for Schedule II prescriptions, but there isn’t a federal law.

You are allowed to refill a prescription for these medications with a provider’s authorization.

If your provider has authorized refills, you are typically allowed up to five refills in six months. After five refills, a new prescription is required.

A prescription for a Schedule III, IV, or V medication expires after six months. After six months, a new prescription is required regardless of how many refills are left.

Tips for safe use of a controlled medication

If you are prescribed a controlled substance, it is especially important to keep track of your medication supply and take your medication only as directed. Never adjust the frequency or dose of your medication without consulting your provider. Make sure that anyone who prescribes a medication for you is aware of any other medications you take.

Be aware that some providers ask patients to sign a written agreement to ensure safe use of controlled substances like pain medication. These agreements may require that you only fill your prescription at one pharmacy and don’t take controlled substances prescribed by another provider.

Filling a prescription for a controlled substance at Alto

Given the additional regulations of controlled substances, these medications are currently not eligible for auto refills or medication bundling at Alto. Your convenience and safety is our priority, and we hope to expand these services to include controlled substances in the future.

Delivery of these medications requires a signature from you or an authorized signer. To add an authorized signer to your Alto account, head to Account > Delivery Addresses > Edit Address > Delivery Instructions in the Alto app.

In states where a written prescription is required to fill a controlled medication, these prescriptions cannot be transferred to Alto from another pharmacy.

Our team can answer any questions you have about your prescriptions. We also offer free, same-day delivery and medication management tools like reminders and auto refills to make it as simple as possible to stay on track with your treatment.

With the discovery of antibiotics in the 1920s, once fatal illnesses including bacterial pneumonia, meningitis, and strep throat became curable. These life-saving medications remain in wide use today, treating severe infections or reducing the severity of symptoms.  

It’s very important to take antibiotics as prescribed. Like many powerful treatments, they have both benefits and risks. Improper or unnecessary use can cause avoidable side effects or make an antibiotic ineffective over the long term.

Read on to learn more about antibiotics and how to take them safely. 

How Do Antibiotics Work?

With the discovery of antibiotics in the 1920s, once fatal illnesses including bacterial pneumonia, meningitis, and strep throat became curable. These life-saving medications remain in wide use today, treating severe infections or reducing the severity of symptoms.  

It’s very important to take antibiotics as prescribed. Like many powerful treatments, they have both benefits and risks. Improper or unnecessary use can cause avoidable side effects or make an antibiotic ineffective over the long term.

Read on to learn more about antibiotics and how to take them safely. 

Antibiotics help your body fight a bacterial infection. Some completely kill the bacteria that caused the infection while others slow the bacteria’s growth. They are primarily derived from bacteria and fungi.

The age of antibiotics began with the Scottish physician Alexander Fleming’s accidental discovery of penicillin in 1928. Upon returning to his lab after a vacation, he observed that the emergence of mold appeared to inhibit the growth of staphylococcus, the bacteria that causes staph infections.

That mold was the origin of penicillin, the first type of antibiotic used in medicine. It became available for treatment in 1942, ushering in a new era of public health.

Antibiotics may be taken orally, as a tablet, capsule, or liquid; topically, as a cream or ointment; or intravenously. The majority are only available with prescription, but some topical antibiotics are available over the counter.

Most antibiotics are taken for 7-14 days. They begin to work immediately, but it typically takes at least several days before their benefits are experienced. The specific timing varies by antibiotic.

While antibiotics are a powerful treatment for bacterial infections, they are not appropriate for all illnesses. Overuse of antibiotics has become a growing concern in recent decades. The Centers for Disease Control and Prevention (CDC) estimates that about one-third of all antibiotic use in the U.S. is unnecessary.

Antibiotics are only effective against infections caused by bacteria. This includes many ear infections, strep throat, urinary tract infections (UTIs), and some sinus infections.

They are not effective against viral infections, including:

All cases of a sore throat except strep throat

The symptoms of viruses and bacterial infections frequently overlap. Receiving an accurate diagnosis is important for reducing antibiotic overuse. Your healthcare provider can identify the cause of your illness and recommend appropriate treatment.

Examples of commonly prescribed antibiotics

There are more than 100 antibiotics currently available to treat bacterial infections. Here’s an overview of the most commonly prescribed antibiotic classes, as well as potential side effects and medication interactions.

Penicillins such as penicillin V, penicillin VK, amoxicillin, dicloxacillin, and ampicillin are often used to treat strep throat, staph infections, skin conditions, ear infections, and kidney infections.

Potential side effects include nausea, diarrhea, abdominal pain, and headaches. Some people have an allergic reaction to penicillin, experiencing rashes, hives, and difficulty breathing. Seek emergency medical treatment if you experience the above signs of an allergic reaction after taking a penicillin.

Potential medication interactions include oral birth control and warfarin (Coumadin®, Jantoven®).

Cephalosporins such as cephalexin, cefaclor, and cefdinir are often used to treat skin infections, soft tissue infections, sinusitis, UTIs, and other bacterial infections.

These medications are frequently prescribed for those who are allergic to penicillins. However, other antibiotics including cephalosporins can also cause allergic reactions. Be sure to tell your doctor and pharmacist about any suspected medication allergies, even if you think it’s unrelated.

Anti-inflammatory tetracyclines such as doxycycline, minocycline, and tetracycline are often used to treat chest, urethral, and pelvic infections as well as inflammatory skin conditions, including acne and rosacea. Doxycycline is one of the most common treatments for lyme disease.

These medications, particularly doxycycline, may inflame or irritate the esophagus. Sitting or standing upright when taking doxycycline can help prevent this side effect, as well as staying hydrated. Doxycycline is also known to cause photosensitivity, making individuals more susceptible to sunburn, so it is often recommended to avoid sun exposure during treatment.

Minocycline is associated with more side effects than doxycycline, including autoimmune reactions, dizziness, and headaches.

Tetracyclines have been known to interact with diuretics, lithium, anticonvulsants, colestipol, and oral birth control.

Anti-inflammatory macrolides such as erythromycin, clarithromycin, and azithromycin are often used to treat skin conditions such as acne and rosacea; respiratory infections; and chlamydia. They are frequently prescribed for those who are allergic to penicillins or cephalosporins. 

These medications are known to interact with a variety of medications, including calcium channel blockers, anticoagulants such as warfarin, the heart medications amiodarone and digoxin, tricyclic antidepressants, anticonvulsants, benzodiazepines, lithium, and others.

Fluoroquinolones such as ciprofloxacin, moxifloxacin, and levofloxacin are often used to treat UTIs, bowel infections, and pneumonia, as well as more serious bacterial infections or infections that don’t respond effectively to other treatments. They have a high potential for antimicrobial resistance, which means they can lose their effectiveness over time as bacteria develop the ability to fight them. For this reason, it is especially important that these medications are taken only when needed.

In rare cases, fluoroquinolones may cause serious side effects, including tendon rupture and heart conditions. Older adults are most vulnerable to these effects. Always speak with your doctor about the risks and benefits of a potential medication.

Sulfonamides, or sulfa medications, such as sulfamethoxazole, sulfadiazine, and sulfasalazine are used to treat a wide range of bacterial infections. The combination of sulfamethoxazole and trimethoprim (Bactrim®) is one of the most common treatments for UTIs.

Common topical forms of sulfonamides include sulfacetamide and silver sulfadiazine.

Food, other medications, and supplements may affect the absorption of some antibiotics, particularly tetracyclines, macrolides, and fluoroquinolones.

To prevent interactions and side effects associated with these antibiotics, speak with your doctor or pharmacist about the best way to take your medication. Here are some helpful questions to ask:

Can I take this antibiotic with other medications?

Should I avoid certain foods or drinks when taking this antibiotic?

After taking this antibiotic, how long should I wait before eating?

Antimicrobial resistance occurs when bacteria become resistant to an antibiotic, making certain infections more difficult to treat.

This is a natural process to an extent, as bacteria constantly search for new ways to fight an antibiotic — as do fungi for antifungal medications — but inappropriate use of antibiotics is a leading cause of resistance.

The most impactful step you can take to prevent resistance is to take antibiotics only when necessary. Never use them for viral infections including the cold, flu, or a sore throat that isn’t strep.

Always take an antibiotic exactly as prescribed. This includes:

Even if you feel better after several days, it’s important to continue taking the medication for as many days as your doctor has prescribed. Taking medication shorter or longer than directed may also contribute to resistance.

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