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Resources for Affording HIV Medication

The HIV treatment and prevention landscape continues to evolve, with many effective medications. Antiretroviral therapy (ART), the frontline treatment for HIV since 1997, is a combination of medications that lower the amount of HIV in your bloodstream. When taken as prescribed every day, ART can help individuals with HIV achieve and maintain an undetectable viral load. As a result, more than half of all those living with HIV in the U.S. are not at risk of transmitting the virus to others.

On the prevention front, 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%.

For many individuals, cost is a barrier to both starting and continuing to take ART and PrEP as prescribed. Fortunately, HIV prevention medication and treatment continue to become more accessible, with generic PrEP options and expanded health insurance coverage of PrEP and ART. In addition, the following resources, including patient assistance programs and copay savings cards from medication manufacturers, can help reduce the cost of HIV treatment and prevention medication.

Read on to learn more about eligibility for these programs, and revisit our previous post on state-funded PrEP drug assistance programs.

Many pharmaceutical companies have patient assistance programs (PAPs) to offset the cost of prescription medications for individuals without insurance or with insufficient insurance coverage. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead, which offers the PAP outlined below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including PAPs.

Gilead's Advancing Access® Patient Assistance Program

Gilead's Advancing Access Patient Assistance Program provides medication free of charge to individuals without insurance who meet program eligibility criteria. There are several ways to learn if you are eligible:

Call 1-800-226-2056 (Monday-Friday, 9 am to 8 pm EST)

Print the enrollment form and submit it via fax

Copay savings cards from pharmaceutical manufacturers can help offset the cost of prescription medications for individuals with insurance. If Alto is your pharmacy partner for HIV treatment or prevention, your medication protocol may include medications manufactured by Gilead or ViiV Healthcare, which offer the copay savings cards below.

If your medications are manufactured by a different company, contact them directly to learn about any available financial assistance including copay savings cards.

Gilead’s Advancing Access copay savings card

Gilead also offers a copay savings card for individuals with insurance to reduce the cost of copays. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

Learn more about program eligibility and terms and conditions.

The ViiVConnect Savings Card Program helps eligible individuals with commercial insurance save on copay costs for select ViiV Healthcare medications. Those who are enrolled in any state or federally funded prescription medication program such as Medicare Part D and Medicaid, or who are in the Medicare Part D prescription coverage gap, are not eligible.

If you do not have insurance coverage of prescription medications, contact 1-844-588-3288 to learn about additional financial assistance opportunities from ViiV.

Created to help individuals living with chronic health conditions access the treatment they need, the PAN Foundation offers financial assistance for medication costs, copays, and insurance premiums.

Learn what financial assistance you are eligible for.

The Ready, Set, PrEP program provides PrEP at no cost to eligible individuals without insurance coverage of prescription medications.

Learn more about program eligibility and the application process.

Your financial well-being is our priority

At Alto, we understand how stressful it can be to navigate insurance coverage benefits and savings opportunities. We prioritize your financial wellness, working with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to make ART or PrEP as affordable as possible. In addition to automatically applying coupon savings, we’ll connect you with any outside programs that require you to apply directly.

We also offer free, same-day delivery to make it as easy as possible to stay on track with treatment, and our dedicated HIV support team is here to answer any questions you may have about ART or PrEP. Reach out any time via 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.

It’s understandable to feel overwhelmed after receiving a diagnosis of chronic obstructive pulmonary disease (COPD) — living with a chronic lung disease brings changes to many aspects of life. Many people don’t realize that the condition is highly treatable, and that there are things you can do to slow the progression of COPD. To help you better understand and manage your COPD, let’s take a look at five common misconceptions surrounding this lung disease.

Misconception About COPD

Chronic obstructive pulmonary disease refers to a group of progressive lung diseases. The two primary diseases under this umbrella are chronic bronchitis and emphysema. Most people with COPD have both conditions, but it’s possible to have just one.

Chronic bronchitis and emphysema affect the lungs in different ways. Chronic bronchitis causes inflammation in the airways leading to your lungs, which leads to a chronic cough and increased mucus. Emphysema destroys your lungs’ fragile air sacs, or alveoli, obstructing airflow. When alveoli become damaged, the lungs cannot fully expel air carrying carbon dioxide out of the body, so some of it remains trapped in your lungs. Oxygen-rich air is then blocked from entering the lungs, which causes gradually worsening shortness of breath.

COPD may not be curable, but it is highly manageable. There are many treatment options that can ease symptoms and improve your quality of life, while also preventing the condition from progressing into a more advanced stage. In addition to lifestyle changes, COPD treatment may consist of medications, supplemental oxygen therapy (typically used for COPD caused by emphysema), and surgery in more advanced cases.

Medications commonly used to treat COPD include bronchodilators, which relax the muscles around the airways to make breathing easier, and inhaled corticosteroids, which reduce inflammation in the airways and prevent COPD exacerbations, or flare-ups.

Other medications may be used to treat exacerbations or more severe cases of COPD, including oral steroids and phosphodiesterase-4 inhibitors.

3. After a COPD diagnosis, it’s too late to quit smoking.

There is never a bad time to stop smoking and quitting is the most important thing you can do to manage COPD. Since COPD is a progressive lung disease, symptoms gradually become more severe over time. While it’s true that you cannot reverse the damage to your lungs caused by smoking, you can prevent COPD from progressing into a more advanced stage by maintaining healthy lifestyle habits. In fact, many people with early-stage COPD are able to regain near-normal lung function after quitting tobacco use. Even if your COPD has already progressed to a more advanced stage, quitting smoking will help reduce symptoms and prevent flare-ups and other health complications.

If you are having trouble quitting, ask your doctor for smoking cessation resources. They may be able to prescribe nicotine replacement therapy to help with withdrawal symptoms and cravings. Watch our webinar for more on the role of smoking cessation in COPD treatment.

The lung damage caused by COPD can affect other areas of the body. The condition can increase your risk of developing heart disease or having a heart attack. It may also lead to pulmonary hypertension, a condition characterized by high blood pressure in the arteries that transport blood to your lungs. The risk of these potential health complications is one reason it’s so important to get an early diagnosis, and to follow the treatment plan your doctor recommends in order to slow progression.

People with COPD are also more likely to contract the flu or pneumonia — and to have more intense symptoms of these illnesses — so as part of your COPD treatment plan, stay current with your yearly flu and pneumonia vaccines.

Quite the opposite — regular physical activity is key to maintaining a good quality of life and living healthily with COPD. While it may seem counterintuitive to exercise when you’re short of breath, physical activity can make it easier to breathe in the long run by strengthening your respiratory muscles.

It’s important to take it slow and practice gentle exercises that don’t overexert your lungs. Your doctor can help you determine appropriate activities based on your experience of COPD.

You may also benefit from a pulmonary rehabilitation program, which helps many people with COPD manage their condition and improve their quality of life. Pulmonary rehabilitation is an outpatient exercise and education program where physical therapists, dietitians, and other healthcare professionals share breathing techniques, nutritional advice, exercise recommendations, and other strategies for living with COPD.

Let Alto Pharmacy support your COPD treatment

We’re here every step of the way to help you manage COPD symptoms and get the medications you need, with free same-day delivery and easy-to-use medication management reminders in our app.

And our team of pharmacists are always here to answer your questions by phone or in the Alto app. Reach out any time through in-app messaging or by phone at 1-800-874-5881.

Arteries are a critical part of your circulatory system, transporting blood and oxygen from the heart to the rest of the body. As you age, a variety of substances collectively referred to as plaque — including fats, cholesterol, and calcium — may accumulate in these blood vessels. A condition called atherosclerosis occurs when the buildup of plaque causes the arteries to narrow and obstructs overall blood flow throughout the body. It is a leading factor in the development of coronary artery disease, the most common type of heart disease.

Atherosclerosis, Explained

Many of the key risk factors of atherosclerosis can be managed, and there are effective treatment options that can prevent the condition from worsening. Here’s what to know about causes, symptoms, treatment, and prevention.

Atherosclerosis involves slow, progressive changes to the structure of your blood vessels. These changes typically intensify with age. As plaque accumulates, the walls of your arteries become thicker. This gradually narrows the channel within the artery through which blood flows, reducing the amount of oxygen and other nutrients that the rest of your body receives. In some cases, pieces of plaque can break off into the bloodstream and lead to the development of a blood clot.

There are arteries in nearly every part of the body, and three main types of arteries: elastic arteries, muscular arteries, and arterioles.

Elastic arteries come out of the heart and contain more elastic tissue than other types of arteries. Their flexibility allows them to receive blood at high pressure. Examples include the pulmonary artery and aorta.

Muscular arteries have less elastic tissue and more smooth muscle fiber, which allows them to expand and contract to control the flow of blood. Examples include the coronary and femoral arteries.

Arterioles are smaller vessels that branch out from the arteries and help distribute blood into microscopic capillaries.

Atherosclerosis is not limited to a certain area or type of artery. Plaque may develop in arteries in the heart, brain, pelvis, legs, arms, or kidneys. The type of artery affected in atherosclerosis can impact an individual’s symptoms, along with their risk for related health complications.

Different health conditions may arise depending on where plaque accumulates.

Coronary artery disease occurs when plaque accumulates in the arteries in or leading to the heart.

Angina, a type of chest pain, can also arise from plaque accumulation in the coronary arteries. It results from decreased blood flow to the heart muscle.

Carotid artery disease occurs when plaque accumulates in the neck arteries that deliver oxygen-rich blood to the brain.

Peripheral artery disease (PAD) occurs when plaque accumulates in the arteries in the arms and legs.

Kidney disease occurs when plaque accumulates in the renal arteries, which transport oxygen-rich blood to your kidneys.

In addition to the conditions above, extensive plaque accumulation can lead to other health complications, including heart failure, a heart attack, an abnormal heart rhythm, a stroke, and an aneurysm. Treatment can help slow the progression of atherosclerosis and prevent more serious complications.

Many factors play a role in the development of atherosclerosis, including the following.

Atherosclerosis is among the more common aging-related health issues. Your heart and blood vessels have to work harder as you age. These changes can stiffen the arteries, which makes it easier for plaque to accumulate in them.

Cholesterol is a waxy, fat-like substance that’s produced naturally by the liver and also found in certain foods. It isn’t inherently bad — your body needs a certain amount of cholesterol to produce cell membranes, hormones, and nutrients. However, high levels of low-density lipoprotein (LDL) cholesterol (“bad” cholesterol) can accumulate in the walls of your arteries and turn into plaque, factoring into a person’s risk for heart disease and stroke. (Conversely, a healthy level of high-density lipoprotein (HDL) cholesterol can potentially lower your risk for heart disease.)

Smoking damages your blood vessels and accelerates the buildup of plaque. It is a leading risk factor for peripheral artery disease. 80% of those with PAD are current or former smokers. Smoking is also associated with plaque accumulation in the aorta — the main artery of the body —  and in the coronary arteries.

High blood pressure strains and damages your coronary arteries, causing them to gradually narrow as plaque accumulates.

You may have a greater risk for atherosclerosis if you have diabetes or a family history of atherosclerosis. Physical inactivity and obesity also play a role.

Atherosclerosis symptoms typically do not appear until an artery has become severely narrow or clogged, to the point where blood flow is affected. There often aren’t noticeable symptoms of mild atherosclerosis. Symptoms of moderate to severe cases vary by the affected artery.

Atherosclerosis in coronary arteries: chest pain or pressure

Atherosclerosis in the arteries leading to your brain: sudden numbness or weakness in arms or legs, difficulty speaking, confusion, or drooping facial muscles

Atherosclerosis in the arteries in your arms and legs: pain in your legs while walking or decreased pressure the affected limb

Atherosclerosis in the arteries leading to your kidneys: high blood pressure or weakened kidney function

If you have any concerns about potential symptoms of atherosclerosis, contact your doctor as soon as possible for an evaluation.

Atherosclerosis cannot be reversed, but it is treatable. A heart-healthy lifestyle and medications can help slow the accumulation of plaque and prevent the condition from worsening.

Lifestyle changes such as quitting smoking, planning a heart-healthy diet, and exercising more frequently are often a first step in treating mild atherosclerosis. The American Heart Association suggests aiming for about 150 minutes a week of moderate-intensity aerobic activity. Building these healthy habits early on can also help prevent atherosclerosis from developing to begin with.

Your doctor may also recommend medications to prevent atherosclerosis from progressing further. The following medications are commonly used to treat atherosclerosis.

Statins such as atorvastatin and simvastatin act on the liver to prevent LDL cholesterol from forming and limit the overall amount of cholesterol circulating in your bloodstream.

Fibrates such as fenofibrate and gemfibrozil can raise HDL cholesterol and lower LDL cholesterol.

Niacin is a B vitamin that reduces the liver’s production of blood fats and can lower LDL cholesterol.

For more on cholesterol-lowering medications, read How to Manage High Cholesterol: Diet, Medications, and More.

Beta blockers such as metoprolol and carvedilol cause the heart to beat more slowly and less forcefully, lowering your blood pressure.

Calcium channel blockers such as amlodipine and diltiazem prevent calcium from entering the smooth muscle cells of the heart and blood vessels, which opens up narrowed blood vessels and lowers blood pressure.

ACE inhibitors such as lisinopril and benazepril block production of a hormone called angiotensin II, which causes blood vessels to narrow. This helps constricted blood vessels expand so that more blood can flow through.

Angiotensin II receptor blockers (ARBs) such as losartan and valsartan function similarly to ACE inhibitors and protect blood vessels from angiotensin II.

For more on blood pressure medications, read Common Types of Blood Pressure Medications.

Antiplatelet medications such as aspirin and clopidogrel may be prescribed to reduce your risk of blood clots.

Surgery may be necessary to treat severe cases of atherosclerosis, or if there is risk of serious damage to your muscle or skin tissue.

At Alto, we make it as simple as possible to manage your risk for chronic health conditions and to stay on top of your cholesterol-lowering or blood pressure medications. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

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

A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between outside germs and healthy cells and mistakenly attacks various tissues and organs throughout the body.

What is an autoimmune disease?

A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between germs and the body’s own cells and mistakenly attacks various tissues and organs.

There are more than 80 of these conditions, with variation in the affected area of the body; some of the most common autoimmune disorders involve the joints and muscles, digestive tract, nervous system, and skin. There is also significant variation in day-to-day life with autoimmune disorders. Some, like type 1 diabetes, require daily management, while others may have periods of intensified symptoms known as flare-ups. In all cases, there are treatment options that can reduce discomfort and help you experience a better quality of life. Here’s what to know about the most common types of autoimmune disorders.

Causes and symptoms of autoimmune disorders

Many autoimmune disorders do not have a specific known trigger, but the following factors may play a role in the development of certain conditions.

Genetics — some autoimmune disorders such as lupus and multiple sclerosis run in families and likely have a genetic component.

Sex — of the 23.5 million Americans living with an autoimmune disease, 78% are women. Specific autoimmune disorders that are more common in women than men include rheumatoid arthritis, psoriasis, celiac disease, inflammatory bowel disease, lupus and multiple sclerosis, among others.

Obesity — being overweight or obese may increase an individual’s risk of developing rheumatoid arthritis or psoriatic arthritis.

Smoking — research suggests a connection between cigarette smoking and lupus, rheumatoid arthritis, hyperthyroidism, and multiple sclerosis.

Medications — some medications including blood pressure medications, statins (which are commonly used to treat high cholesterol), and antibiotics may increase a person’s risk for certain autoimmune disorders. Consult with your doctor about medication side effects if you have concerns.

While exact symptoms and treatment options vary by condition, as explained in more detail below, there is also some overlap. Fatigue, joint pain and swelling, rashes and other skin issues, digestive issues, and swollen glands are common signs of a variety of autoimmune disorders.

Most autoimmune disorders do not have one single test to confirm or rule out a diagnosis. With the majority of these conditions, the diagnosis process involves several steps including a physical exam and multiple tests.

If you have potential symptoms of an autoimmune disease, a common first step is an antinuclear antibody (ANA) test. This is a blood test that checks for antinuclear antibodies, the type of antibodies that attack healthy cells. If you have a positive ANA result, your doctor will likely recommend additional tests to identify the specific autoimmune disease.

A negative ANA test does not necessarily mean that you do not have an autoimmune disease. If you have negative ANA results, your doctor may recommend additional tests for other antibodies or inflammation markers depending on your symptoms. Tests used to diagnose autoimmune disorders include:

An erythrocyte sedimentation rate (ESR) test — which examines how quickly your red blood cells sink to the bottom of a test tube — may be used to diagnose rheumatoid arthritis and lupus. Higher rates of settlement may indicate inflammation.

A c-reactive protein (CRP) test — which identifies your blood levels of CRP, an inflammation-linked protein produced in your liver — may be used to diagnose rheumatoid arthritis, lupus, and inflammatory bowel disease.

A rheumatoid factor (RF) test checks for rheumatoid factor, an antibody found in about 80% of individuals with rheumatoid arthritis.

Depending on your symptoms, your healthcare provider may refer you to one of the following specialists:

A rheumatologist who treats autoimmune disorders of the joints and muscles including rheumatoid arthritis and lupus.

A gastroenterologist who treats autoimmune disorders of the digestive system including Crohn’s disease, celiac disease, and ulcerative colitis.

An endocrinologist who treats autoimmune disorders of the endocrine system including Graves’ disease and Hashimoto’s thyroiditis.

A dermatologist who treats skin-related autoimmune disorders including psoriasis.

Common autoimmune disorders and treatment

These are some of the most common types of autoimmune disorders affecting individuals in the U.S. Symptoms, treatment, and diagnostic tests vary by condition.

Rheumatoid arthritis occurs when your immune system attacks the lining of your joints, causing pain and inflammation throughout your body. It is a progressive condition, and getting an early diagnosis and staying proactive about treatment can help prevent more severe damage to your joints.

Several medications may be used to reduce the pain and inflammation caused by rheumatoid arthritis, including over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®); acetaminophen (Tylenol®); and Janus kinase (JAK) inhibitors such as baricitinib (Olumiant®), tofacitinib (Xeljanz®), and upadacitinib (Rinvoq®). In addition, avoiding or reducing your intake of sugars and refined carbohydrates and gluten can also help reduce inflammation.

Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®) and injectable biologic DMARDs like etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®) are often prescribed to slow tissue damage.

Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks the pancreas with antibodies. This destroys the pancreas’s insulin-producing cells, so individuals with type 1 diabetes cannot produce any insulin and rely on daily insulin therapy to manage their blood sugar.

For more information on managing type 1 diabetes, read our previous blogs:

What’s the Difference between Type 1 and Type 2 Diabetes?

How to Live with Type 1 Diabetes at Any Age

Psoriasis is a skin disorder that occurs when inflammation caused by an immune response causes new skin cells to grow too quickly. It is characterized by thick patches of skin covered with white or silver scales, also referred to as plaques. There is a genetic component, and psoriasis often runs in families. 

Many individuals with psoriasis experience periodic flare-ups. While not all psoriasis flare-ups can be attributed to a specific cause, skin injury, stress, and cold weather are common triggers.

There are a variety of treatments for psoriasis, including steroid creams; anthralin (Drithocreme HP® and Zithranol®), an anti-inflammatory medication; moisturizers; UV light therapy; vitamin D3 ointment; and vitamin A creams.

Systemic lupus erythematosus (SLE), the most common type of lupus, affects many different parts of the body including the skin, joints, kidneys, brain, and heart. Common symptoms include joint pain and swelling, severe fatigue, and rashes. Without effective treatment, lupus can lead to other health complications over time, including blood clots and inflammation of the heart or kidneys, and increase your risk for a heart attack or stroke. Getting diagnosed early and starting treatment as soon as possible is critical to managing lupus.

Lupus treatment varies depending on the severity of symptoms and which part of the body is affected. Other-the-counter NSAIDs and oral corticosteroids including prednisone (Deltasone®, Prednicot®) may be used to treat joint pain and stiffness. Antimalarial medications including hydroxychloroquine (Plaquenil®) are often prescribed to reduce pain and inflammation, prevent flare-ups, and treat rashes.

Inflammatory bowel disease refers to several autoimmune diseases that affect the digestive tract including Crohn’s disease, which involves any part of the small or large intestine, and ulcerative colitis, which involves the colon, rectum, or both organs.

Common symptoms of both Crohn’s disease and ulcerative colitis include diarrhea, abdominal cramps, bloody stools, fever, fatigue, loss of appetite, and weight loss. Many individuals with these conditions experience periods of time without symptoms, also known as remission. Treatment options include the following:

Antidiarrheal and anti-inflammatory medications such as oral 5-aminosalicylates and corticosteroids

Immunomodulators, a group of medications that act on the immune system to reduce the inflammation that causes Crohn’s

Biologics, a group of medications that are derived from antibodies and used to prevent inflammation in more severe cases, such as adalimumab (Humira®), golimumab (Simponi®), infliximab (Remicade®), tofacitinib (Xeljanz®), ustekinumab (Stelara®), and vedolizumab (Entyvio®)

Other common autoimmune diseases include:

Multiple sclerosis, which affects the nervous system

Addison’s disease, which affects the adrenal glands

Graves’ disease, which affects the thyroid gland in the neck

Celiac disease, which affects the digestive tract

Living with any chronic condition is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in the treatment of autoimmune diseases and can answer any questions you may have, from medication side effects to non-pharmacological treatment options and navigating lifestyle changes. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.

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

Rheumatoid arthritis is an inflammatory autoimmune disorder in which your immune system mistakenly attacks the lining of your joints, leading to pain and inflammation throughout your body. While it can cause discomfort, there are many effective treatment options that can help reduce the frequency of flare-ups and prevent the condition from progressing to a more advanced stage.

Understanding Rheumatoid Arthritis

Rheumatoid arthritis is an inflammatory autoimmune disorder in which your immune system mistakenly attacks the lining of your joints, leading to pain and inflammation throughout your body. While it can cause discomfort, there are many effective treatment options that can help reduce the frequency of flare-ups and prevent the condition from progressing to a more advanced stage. Read on for information about rheumatoid arthritis symptoms and treatment.

Like all autoimmune disorders, rheumatoid arthritis occurs as the result of an improper immune response. However, the specific triggers of this response have not been identified. Evidence suggests that there is a genetic component; some individuals may be more sensitive to certain viruses and bacteria that can trigger rheumatoid arthritis, and having a family history of rheumatoid arthritis is a risk factor for the condition, especially if you smoke or are overweight.

Rheumatoid arthritis affects about three times as many women as men, potentially due to estrogen levels and sex differences in the physiological effects of stress. Women are also more likely to experience a more severe form of rheumatoid arthritis.

The condition often first develops during middle age, but it can affect anyone of any age. Children and adolescents under 16 may experience a form of arthritis called juvenile idiopathic arthritis (JIA).

Rheumatoid arthritis is characterized by inflammation and pain in the joints. In most cases, the pain happens on both sides of the body — a symptom that distinguishes rheumatoid arthritis from other types of arthritis. Some individuals also experience joint stiffness that intensifies in the morning and after periods of physical inactivity.

Early-stage rheumatoid arthritis often affects your smaller joints — for example, the joints between your fingers and hands and toes and feet — before spreading to the wrists, knees, ankles, elbows, hips, and shoulders. Additional symptoms may include fatigue, fever, loss of appetite, and a feeling of weakness.

Symptoms may vary by individual, and they can also fluctuate over time. Many people experience flare-ups in which symptoms intensify, followed by periods of mild symptoms or none at all.

As a progressive condition, rheumatoid arthritis can become more severe if untreated. The inflammation damages your joints, which can lead to chronic pain, balance issues, or misshapen joints. It can also lead to problems in other important organs like your lungs, heart, and eyes.

Getting an early diagnosis makes a big difference in the prognosis and effectiveness of treatment. If you have any concerns about potential rheumatoid arthritis symptoms, contact your doctor as soon as possible for an evaluation.

The diagnosis process often involves several steps. Your doctor will first ask about your medical history and your experience of rheumatoid arthritis symptoms. They will then conduct a physical exam of your joints, checking for swelling, redness, and limitations in movement. 

After your physical exam, your doctor may recommend blood tests to check for antibodies and inflammation markers linked to rheumatoid arthritis, including:

An erythrocyte sedimentation rate (ESR) test, which examines how quickly your red blood cells sink to the bottom of a test tube. Higher rates of settlement may indicate inflammation.

A c-reactive protein (CRP) test, which identifies your blood levels of CRP, an inflammation-linked protein produced in your liver.

A rheumatoid factor (RF) test, which checks for rheumatoid factor, an antibody found in about 80% of individuals with rheumatoid arthritis.

Imaging tests like ultrasounds, X-rays, and magnetic resonance imaging (MRI) scans may also be used to support a diagnosis.

Rheumatoid arthritis is not curable, but there are a variety of treatment options that can help you manage the condition and prevent severe tissue damage.

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®) can you help you manage pain and inflammation during flare-ups, as well as corticosteroids. Acetaminophen (Tylenol®) is also effective at reducing pain. Be sure to consult your doctor before taking any over-the-counter medication for an extended period of time.

Janus kinase (JAK) inhibitors such as baricitinib (Olumiant®), tofacitinib (Xeljanz®), and upadacitinib (Rinvoq®) can also help relieve pain and inflammation.

Other medications may be prescribed to slow the tissue damage caused by rheumatoid arthritis, including disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®), which prevent your immune system’s response to triggers. If a traditional DMARD is not effective, your doctor may prescribe an injectable biologic DMARD, which targets a more specific pathway in your immune system. Commonly prescribed biologic DMARDs include etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®).

Many individuals with rheumatoid arthritis use cold compresses and ice packs or hot compresses and warm showers to treat inflammation and pain during flare-ups. Some people prefer a balance of hot and cold treatments.

Making lifestyle adjustments can improve your quality of life and lower your risk for RA-related health complications. 

While rheumatoid arthritis can affect your mobility and limit certain forms of exercise, it’s important to stay physically active. Gentle exercise like water exercise, tai chi, yoga, and stretching can reduce joint pressure and expand your joints’ range of motion.

Nutrition and diet choices can reduce inflammation and help you maintain a healthy weight. Avoid or reduce your intake of foods that may contribute to joint pain and inflammation including sugars and refined carbohydrates and gluten. In addition, consume alcohol in moderation.

Avoiding smoking and getting enough rest are also part of managing rheumatoid arthritis and preventing related health issues.

Since rheumatoid arthritis affects your immune system, those living with the condition often have a higher risk for other infections. Vaccines for the flu, pneumonia, shingles, and COVID-19 can protect you against illness. Check with your doctor about which vaccines you need.

Life with rheumatoid arthritis is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in arthritis treatment and can answer any questions you may have, from medication side effects to non-pharmacological treatment options and navigating lifestyle changes. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.

Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart.

What to Know About Heart Failure

Heart failure, which affects approximately 6.2 million U.S. adults, can be a confusing term. Contrary to what many people assume, it does not mean that your heart no longer works, or has stopped beating, but rather that this vital organ cannot pump blood and oxygen as well as a healthy heart. While heart failure is a progressive condition with the potential for serious health complications, it can be managed through lifestyle changes and medication. Read on to learn about heart failure symptoms, causes, and treatment options.

In all cases of heart failure, the heart cannot deliver enough blood and oxygen to the rest of your body. Sometimes this is because weakened heart muscle leaves the heart’s main pumping chambers — the ventricles — unable to carry out their pumping function. This type of heart failure is called heart failure with reduced left ventricular function (HF-rEF). In other cases, the ventricles are too stiff to fill with enough blood between beats. This type of heart failure is called heart failure with preserved left ventricular function (HF-pEF).

Ejection fraction (EF) is an important measurement of heart function for those who have heart failure with reduced left ventricular function. Expressed as a percentage, EF measures the amount of blood pumped from the left ventricle when it contracts. An EF of 55 to 70% is considered a healthy range.

Since heart failure is a progressive condition, your EF gives your doctor insight into any changes in your heart function. An echocardiogram is the most common way to measure your EF, but a magnetic resonance imaging (MRI) scan or nuclear stress test may also be used.

Despite the importance of EF, it is not the sole determinant of heart function. Those who have heart failure with preserved left ventricular function may have a normal EF. These cases of heart failure are often caused by high blood pressure, which gradually thickens the ventricles. Stiff ventricles cannot relax enough to fill to their full capacity, which is why they do not pump out enough blood.

Heart failure can affect many other organs, including the lungs, liver, and kidneys. The potential for additional health complications increases as heart disease progresses, which is why it’s important to stay proactive about your health and follow your doctor’s recommendations for treatment.

Heart failure primarily occurs as the result of other health conditions that weaken or stiffen the heart. Coronary artery disease, the most common type of heart disease, is the leading cause of heart failure. The condition gradually narrows and thickens the arteries that supply your heart with blood and oxygen. Severe blockages in the arteries can prevent the heart from pumping enough blood, leading to the development of heart failure.

High blood pressure is another common cause of heart failure, particularly cases of heart failure with preserved left ventricular function (HF-pEF). If you have high blood pressure, your heart has to work harder to deliver blood to the rest of your body. Over time, this can make your left ventricle too stiff to properly pump out blood.

Both type 1 and type 2 diabetes are linked to heart failure, as high blood sugar can affect your blood vessels and cardiac nerves. Heart failure may also be caused by a variety of heart health conditions including cardiomyopathy, congenital heart disease, heart valve disease, and arrhythmias.

Lifestyle factors such as smoking, eating a high-cholesterol or high-sodium diet, heavy alcohol consumption, and a lack of physical activity may increase your risk for heart failure, especially if you have one of the conditions above.

These are some of the most common symptoms of heart failure:

Shortness of breath when exercising or lying down

Fatigue and a feeling of weakness in your legs

Swelling in your ankles, legs, and abdomen

A persistent dry, hacking cough or wheezing

There is a spectrum of severity of heart failure cases, and treatment varies by individual depending upon symptoms and heart function, as well as the underlying cause. If you have early-stage heart failure, your doctor may recommend lifestyle changes and prescribe medications that can alleviate symptoms and prevent the condition from progressing.

The following medication classes, many of which lower blood pressure, are commonly used to treat early stages of heart failure.

Angiotensin converting enzyme (ACE) inhibitors

Often used to treat high blood pressure, ACE inhibitors block production of a hormone that causes blood vessels to narrow, helping constricted blood vessels expand so that more blood can flow through.

Like ACE inhibitors, ARBs protect blood vessels from a hormone that causes them to narrow, lowering blood pressure.

Another medication class commonly used in the treatment of high blood pressure, beta blockers cause the heart to beat more slowly, which lowers your blood pressure and opens up your veins and arteries.

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart can beat with less force. This opens up narrowed blood vessels and lowers blood pressure.

If you have atrial fibrillation — an irregular heart rate condition — or another heart health condition, your treatment plan for heart failure may include anticoagulants, medications that reduce the blood’s ability to form new clots and prevent existing clots from growing.

Cholesterol-lowering medications such as statins may be used to treat those who have early-stage heart failure and high cholesterol.

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