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Blog | Alto Pharmacy

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.

To learn more, reach out any time through secure in-app 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.

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.

Just like the food in your refrigerator, medications are labeled with expiration dates. And while a bottle of forgotten ibuprofen in the medicine cabinet may not be as risky or as unpleasant as, say, a carton of forgotten milk, it’s important to regularly scan your medications and safely discard any that are too old — both for your health and safety and others.

What To Do With Expired or Unneeded Medication

Here’s more on the risks of expired medication and how to dispose of them. (Spoiler: safe disposal varies by medication.)

Why do I need to discard expired medication?

A medication’s expiration date marks the date at which a medication will begin to lose its full potency and safety. This may be due to a change in a medication’s chemical make-up or a weakening of its strength.

While many expired medications will not cause great harm, expiration dates are very important for certain medications. For instance, not only will an expired antibiotic lose its effectiveness, it may cause more serious illness and lead to antibiotic resistance. (As the term suggests, antibiotic resistance occurs when the bacteria that caused an infection become resistant to an antibiotic, making that infection more difficult to treat.)

Proper disposal of any unneeded medication is critical even if that medication has not formally expired. This prevents others from taking the medication, which is especially important with opioids, benzodiazepines, or other medications with the potential for dependency or misuse.

To find your medication’s expiration date, check the prescription label, bottle, or carton.

How do I safely dispose of expired or unneeded medication?

The best way to discard expired medication is through a medication take-back program. There are both permanent take-back collection sites and recurring events.

The Drug Enforcement Administration (DEA) has a search tool to help you find your nearest authorized collection site. You can also learn more about medication take-back days here.

If a medication take-back program isn’t an option, there are two methods for safe at-home disposal of your medications.

The U.S. Food and Drug Administration (FDA) has a “flush list” of medications that should be flushed down the sink or toilet as soon as they are no longer needed. This list includes medications that can cause harm to others, including opioids.

While flushing a medication always has the potential for environmental effects, research studies have found that the risk of leaving these medications accessible far outweighs any risks associated with flushing them.

Never flush a medication that is not included on the FDA’s list.

If your medication isn’t on the flush list and medication take-back isn’t possible, there are certain precautions to take when throwing it in the trash at home.

Mix medications with dirt, cat litter, used coffee grounds, or a similar substance. Never crush tablets or capsules.

Place the mixture in a sealed plastic bag or other container and put it into the trash.

Remove any personal information from empty medicine bottles or packaging and put it into the trash or, if recyclable, the recycling bin.

Inhalers for asthma and other respiratory conditions like chronic obstructive pulmonary disease (COPD) can cause environmental harm if punctured or burned in a fire or incinerator. Follow local regulations when discarding these devices and contact your area’s trash and recycling facility if needed.

Needles and other injection supplies used in the treatment of diabetes, infertility, and other health conditions also require safe disposal. (Such supplies are often referred to as sharps.) 

The best method for sharps disposal is to bring them to a designated collection site. Find a safe local disposal site here.

If a collection site isn’t an option, put your sharps into a strong plastic container and place it in the trash. Never recycle your sharps.

Our team can answer any questions you have about your medications. 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 treatment.

Diabetes is a complex and often misunderstood condition. One of the most important things you can do to manage or prevent it is to educate yourself about the facts. To help, we’ve debunked five common myths about type 2 diabetes and prediabetes.

Debunking Common Misconceptions About Type 2 Diabetes

Myth: Weight is the main risk factor for type 2 diabetes

Type 2 diabetes, the more common of the two main types of diabetes, develops gradually as the result of genetic, lifestyle, and environmental factors. (Type 1 diabetes is an autoimmune condition that most commonly develops in childhood.) Obesity is one of the type 2 diabetes risk factors that many people are familiar with, and there are several misconceptions about the relationship between diabetes and weight.

While being overweight or obese may increase a person’s risk of developing type 2 diabetes, it is not the only risk factor. Frequency of physical activity, genetics, and age are also contributing factors. Many people who are overweight or obese do not develop diabetes, and people who are at a healthy weight may develop the condition.

Diabetes is characterized by elevated levels of blood sugar, or glucose, a source of energy that carbohydrates are converted into during the process of digestion. This often leads to the misconception that eating sugar can directly cause diabetes, which is not the case.

Still, if you have prediabetes, it is often recommended to consume soda, sports drinks, and other sweetened or sugary beverages in moderation, as they do not contain any fat or protein to balance their carbohydrate content.

Myth: People with diabetes have to eat a special diet

Any time you digest carbohydrates, in the form of food or drinks, your body turns those carbs into glucose, causing your blood sugar levels to rise. For those without diabetes, the body’s natural insulin response helps to balance blood sugar levels. However, for those with diabetes, insulin resistance keeps blood sugar at a higher level.

For this reason, it is important that individuals with both prediabetes and type 2 diabetes are mindful of their carbohydrate intake. However, this doesn’t mean that you cannot consume bread, potatoes, pasta, or other foods that are high in carbs. Recent studies have found that eating a diet with a good balance of carbs, protein, and fat can help with blood sugar management.

If you have prediabetes or diabetes, work with your provider to develop a healthy, balanced meal plan that you can consistently follow.

1 in 3 U.S. adults have prediabetes, a health condition defined by higher than normal blood sugar levels that often precedes type 2 diabetes. If left untreated, prediabetes can lead to serious complications like heart disease and kidney damage.

While prediabetes is serious, it doesn’t need to result in diabetes. If you’ve received a diagnosis of prediabetes, work with your provider to prevent it from progressing into type 2 diabetes. Depending on your health history, that might mean increasing your physical activity, quitting smoking, or controlling blood pressure and cholesterol levels.

Myth: Taking insulin means you’re not managing your diabetes well

People with type 1 diabetes cannot produce any insulin on their own and rely on insulin therapy every day to maintain balanced blood sugar levels. Treatment is more varied for type 2 diabetes, which is characterized by insulin resistance.

Some people with type 2 diabetes are able to manage their condition with lifestyle changes alone while others need to take oral diabetes medications like metformin or insulin.

If you have type 2 diabetes and your doctor recommends adding insulin therapy to your treatment plan, it does not mean you haven’t done a good job of managing your blood sugar. An individual’s type 2 diabetes treatment needs may change with time; the condition is progressive for many, and often, the body gradually becomes less able to produce insulin on its own. 

We’re specialists in treatment for type 2 diabetes, and whether you’re beginning oral medications or transitioning to insulin, Alto’s pharmacists are here to support you on your health journey.

Additionally, we make it as simple as possible to stay on track with treatment, with free, same-day delivery right to your doorstep, temperature controlled packaging, and savings investigations.

Reach out via phone at 1-800-874-5881 or in-app messaging to learn how Alto can be a partner in your diabetes care.

Each year, February marks American Heart Month, an important reminder that heart disease is both prevalent and preventable.

Heart disease plays a role in 1 in 3 deaths in the United States every year. While several key risk factors aren’t controllable, including age and family history, your actions and habits can significantly affect your heart health. And since heart disease typically develops gradually, over the course of many years, prevention is important at every stage of life.

Small Changes for a Healthier Heart

Each year, February marks American Heart Month, an important reminder that heart disease is both prevalent and preventable.

Heart disease plays a role in 1 in 3 deaths in the United States every year. While several key risk factors aren’t controllable, including age and family history, your actions and habits can significantly affect your heart health. And since heart disease typically develops gradually, over the course of many years, prevention is important at every stage of life.

You’re probably already familiar with the importance of staying physically active — the American Heart Association (AHA) recommends at least 150 minutes of moderate-intensity physical activity a week — and smoke-free. Other habits can strengthen your heart, and many of them can easily fit into your day. The daily practices below can keep you on the path to a heart-healthy lifestyle for years to come.   

There are some well-documented heart-healthy food choices, like cutting down on saturated fats and trans fats.* But it isn’t just what you eat that matters — the timing of your meals may influence heart health, too.

Several research studies have found a link between good heart health and eating breakfast every day. Those who skip out on a morning meal may be more likely to have diabetes, heart disease, or high cholesterol.

When planning your breakfasts, prioritize heart-healthy staples like fruits, veggies, protein, and whole grains. Pro tip: add some almonds to your morning smoothie — consuming a daily serving of nuts like almonds, peanuts, and walnuts can help lower your cholesterol.

*Common sources of saturated fats include red meat and full-fat dairy products. To find out if a food contains trans fats, check the nutrition label for partially hydrogenated oils.

Here’s yet another reason to brush and floss every day. Good oral hygiene has the potential to lower your risk for cardiovascular disease, as numerous studies have found a link between oral health and heart health.

The underlying cause of this connection isn’t entirely understood, but some experts believe it may have to do with inflammation. Whatever the reason, be sure to brush with a fluoride paste for two minutes twice daily, and don’t forget to clean between the teeth with some diligent flossing!

Gratitude gets a lot of buzz these days — for good reason. Its effects go beyond mental health and into cardiovascular territory.

Negative thinking can lead to depression and inflammation, both of which have been linked to poor heart health. Regularly practicing gratitude can direct your thoughts into heart-healthier territory. Challenge yourself to write down 3-5 things you’re grateful for at the end of the day.

Warming up with a good soak in the tub isn’t just relaxing, it can also give your heart health a boost. One research study found that people who took a bath almost every day had a lower risk for overall heart health issues and strokes.

The reasoning? In dilating your blood vessels, high temperatures can help lower your blood pressure. Plus, hot baths can relieve stress, another common factor in the development of heart disease.

Heart-healthy living also includes staying well-rested. Numerous studies have identified a link between an individual’s sleep habits and their risk for heart disease. The reason? A state of deep sleep gives your heart a chance to recover from how hard it works every day. Your blood pressure drops and your heart rate slows when you enter a state of deep sleep.

Unfortunately, getting the CDC’s recommended seven hours of shuteye each night can be easier said than done. More than a third of adults report that they don’t sleep enough. The good news is that you can take small steps to improve your sleep hygiene.

As a starting point, try to separate screen time from bedtime. It’s best to step away from cell phones, tablets, and computers for at least 30 minutes before you hit the pillow. Not only do these devices stimulate your brain, they emit blue light, which can affect production of the sleep-regulating hormone melatonin.

At Alto, we make it easier to manage your risk for heart health issues like coronary artery disease, and to stay on top of cholesterol-lowering or blood pressure management medications. 

We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to offer your medications at the best price we can. And our team of pharmacists is available to chat whenever questions come up.

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

Some injectable fertility medications increase your levels of the pregnancy hormone, human chorionic gonadotropin (hCG). Ovarian hyperstimulation syndrome (OHSS) develops when the blood vessels in your ovaries have an abnormal response to the presence of hCG and leak fluid. The condition is characterized by pain and swelling in the ovaries and sometimes the abdomen.

What is Ovarian Hyperstimulation Syndrome?

Once considered a more common complication of IVF, OHSS cases have declined over the years. It currently affects less than 5% of all those who undergo the fertility treatment. Less than 1% of all individuals pursuing hormonal fertility treatments experience severe OHSS.

Let’s take a look at what causes this relatively rare IVF complication and how to prevent it during your cycle.

OHSS most often occurs as the result of injectable fertility medications used to stimulate egg growth and trigger egg release during IVF or egg freezing. Oral fertility medications are a less common cause of OHSS. It may also develop spontaneously in rare cases.

The following factors may increase your risk for OHSS, but they aren’t necessary for it to develop.

If you experience OHSS during one round of fertility treatment, you may be more likely to experience it again.

When OHSS develops during IVF, symptoms typically appear within a week of the first injection of stimulation medication. However, it may take two weeks or more for symptoms to develop.

Symptoms vary by the severity of the condition. Mild to moderate cases often include mild abdominal swelling, bloating, and nausea, as well as minor weight gain.

More severe cases include severe abdominal pain and swelling, bloating, and nausea, and much more noticeable weight gain. Difficulty breathing, blood clots, decreased urination, and impaired kidney function can also occur in these cases.

While the majority of OHSS cases are mild and don’t require treatment, tell your healthcare provider about any potential symptoms. They will require monitoring regardless of their intensity.

Without prompt, effective treatment, severe cases of OHSS can lead to serious complications, including a blood clot in the lungs or legs, or a ruptured ovarian cyst. Seek immediate care from your provider if at any point during your fertility treatment you have trouble breathing or feel pain or swelling in your legs or chest.

Doctors may recommend gonadotropin-releasing hormone (Gn-RH) antagonists or letrozole to treat moderate to severe symptoms of OHSS. These medications suppress ovarian activity.

In some cases, a doctor may recommend canceling treatment and starting a new cycle in the future after OHSS symptoms have resolved. Although this can be devastating, remember that many individuals and couples have eventual success with IVF after one or more canceled or unsuccessful cycles.

It may be an option to freeze embryos from IVF and finish the implantation at a later date after your body has recovered from OHSS.

Fortunately, there are steps you can take to lower the risk of OHSS during IVF. If you have any known risk factors, or if you experienced OHSS during a previous cycle, your provider may recommend one or more of the following adjustments to your treatment plan.

A medication called cabergoline is primarily used to prevent cases of OHSS during IVF. GnRH antagonists and letrozole are sometimes also used as preventative treatment.

Metformin — an oral diabetes medication that is sometimes used off-label to treat PCOS — can also be used to reduce the risk of OHSS in women with PCOS.

If you have high levels of estrogen or many developed follicles during IVF, your doctor may adjust the timing or duration of your medication schedule. A common practice is to stop the use of stimulation medications for several days before the trigger shot(s) to prevent further stimulation of a high follicle count.

Injecting the lowest effective dose of a fertility medication can also help prevent OHSS.

Your doctor may also recommend using an alternative medication such as leuprolide in place of an hCG trigger shot to prevent OHSS.

Choose a flexible and reliable pharmacy partner

Fertility treatment can be challenging, but we’ll be with you every step of the way. To ensure that your treatment plan is followed correctly, we offer free same-day delivery of your medications and fertility resources like personalized injection guide videos and one-on-one consultations with fertility-trained pharmacists.

Interested in learning more about how Alto can support your fertility treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

Antiviral medications have fueled many medical breakthroughs since they were first introduced in the 1960s to treat viruses. Not only are they currently helping to reduce severe cases of covid-19 and related hospitalizations, they have also made HIV a manageable chronic condition — and that’s only to name a few examples of the role they play in healthcare.

How Do Antiviral Medications Work?

Antiviral medications have fueled many medical breakthroughs since they were first introduced in the 1960s to treat viruses. Not only are they currently helping to reduce severe cases of Covid-19 and related hospitalizations, they have also made HIV a manageable chronic condition — and that’s only to name a few examples of the role they play in healthcare.

Take a look at how these medications treat and prevent viruses like Covid, the flu, HIV, hepatitis, and more. 

A virus is a germ that causes an illness. It cannot survive on its own. In order to replicate and spread, it must infect healthy cells in your body.

Well-known diseases caused by viruses include:

Viruses are distinct from bacteria. While antibiotics are highly effective at ending infections caused by bacteria, they cannot work on viruses. This is why the creation of antivirals was such an important medical advancement.

Antiviral medications help your body fight a virus by disrupting the infectious agent’s replication process. They function differently depending on which virus they’re targeting. When used to treat the flu or Covid, for instance, they can reduce the severity of symptoms and shorten the duration of the infection.

When treating chronic illnesses like HIV or herpes, antivirals cannot permanently end the infection. Rather, they lower the amount of the virus in your body — also referred to as your viral load — to control symptoms and prevent transmission.

When taken as prescribed every day, the antivirals used to treat HIV can help those with the condition maintain an undetectable viral load. This stops the progression of the illness and virtually eliminates the risk of transmitting it to others.

While they are not a substitute for vaccines, antivirals can also be used as a preventative measure against some viruses, as explained in more detail below.

The majority of antivirals are oral medications, but they can also be taken as an injection, intravenously, topically, or even as eye drops or an inhalant.

Many antivirals can safely be used by children as well as pregnant and breastfeeding individuals. Guidelines vary by medication. Consult with your provider about whether a specific antiviral is an option for you.

The duration and starting point of antiviral treatment varies by virus.

Tamiflu® and Paxlovid®, which treat the flu and Covid, respectively, are typically prescribed for several days. In some cases, it’s necessary to take them for a week or more.

These medications are most effective if taken within two days of infection. However, it may still be beneficial to take them after two days, especially if you are at risk for complications.

The following factors may increase your risk of complications from the flu and/or Covid.

Respiratory conditions such as chronic obstructive pulmonary disease (COPD)

Weakened immunity from illness or medications

Age - adults 65 and older and children under two are most vulnerable

The antivirals used to treat the Ebola virus — Inmazeb® and Ebanga® — are administered as a single intravenous infusion.

When used to treat chronic conditions such as HIV, hepatitis B or C, or herpes, antivirals must be taken on an ongoing basis, even in the absence of symptoms.

If you have received a diagnosis of a chronic condition caused by a virus, it’s important to begin treatment as quickly as possible to protect your health and others.

Some antiviral medications can protect against viral infections after potential exposure. PEP, or post exposure prophylaxis, is a medication taken within 72 hours of potential exposure to HIV to lower a person’s chances of contracting the virus. There are other medications that work similarly after potential exposure to the flu.

Antivirals may also be prescribed for individuals with HIV during pregnancy to prevent transmission from mother to baby. The baby will also likely receive antiviral treatment after it is born.

While some antivirals can prevent a person from getting infected by a virus after potential exposure, they are not a substitute for vaccines, which offer ongoing protection against viruses. 

Additionally, while other antivirals reduce the severity of symptoms, vaccines are even more of a safeguard against virus-related health complications, as they prevent the initial infection altogether.

Check with your doctor about which vaccines you need. For detailed vaccine recommendations by age group, reference the CDC’s recommended immunization schedules for children and adolescents and adults.

Managing any chronic condition is easier with a reliable pharmacy partner by your side. Our pharmacists have deep expertise in HIV treatment and prevention and can help you get started and stay on track with antiretroviral therapy as well as the preventative medication PrEP.

We will coordinate with your healthcare and insurance providers to ensure that you’re receiving the best option for your needs at the best price. Our pharmacists are also available to chat whenever questions come up about side effects or how to take your medication properly.

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

Take a look at how antiviral medications treat and prevent viruses like covid, the flu, HIV, hepatitis, and more. Read on here.

If you’ve ever been told not to eat a specific food while taking a medication, it was likely due to the possibility of a medication interaction.

Some medications work less effectively or cause unpleasant side effects when mixed with certain foods, beverages, vitamins, or supplements. (As you’ll learn below, sometimes taking a medication as prescribed means avoiding grapefruits.)

Medication Interactions, Explained

If you’ve ever been told not to eat a specific food while taking a medication, it was likely due to the possibility of a medication interaction.

Some medications work less effectively or cause unpleasant side effects when mixed with certain foods, beverages, vitamins, or supplements. (As you’ll learn below, sometimes taking a medication as prescribed means avoiding grapefruits.)

Several factors affect how a medication works, and interactions can happen between:

Most potential medication interactions are known. So as long as your provider is aware of your health history and all the medications you’re currently taking — including over-the-counter ones — you should be able to experience the benefits of your medications and avoid unnecessary side effects.

It’s also helpful to understand why these interactions occur. Below, you’ll find an overview of medication interaction basics. In addition, always ask your doctor or pharmacist as many questions as you need to in order to feel confident taking your medications.

Proteins in your liver called enzymes are responsible for helping your body absorb and process a medication. Sometimes a medication, vitamin, or supplement changes how these enzymes work.

If one medication causes enzymes to break down another medication more slowly, you may experience an interaction between the two medications. This can cause a medication to stay in your body for too long, or increase its quantity in your body. Both scenarios can lead to unwanted side effects or worsen side effects that you typically experience.

On the flip side, a medication interaction might cause enzymes to work faster, making medication pass through your body too quickly. In these types of medication interactions, you won’t experience a medication’s normal benefits, which can worsen symptoms of a health condition.

Other times, a food or supplement binds to an oral medication, preventing that medication from entering your bloodstream or lowering your blood levels of it.

Keep in mind that each person’s body and genetic makeup is unique. Your specific genes can profoundly impact how medications are metabolized and any resulting medication interactions.

A medication-medication interaction occurs when the combination of two or more medications produces an unwanted side effect. As an example, when the heart medication digoxin (Lanoxin®) is combined with another heart medication called amiodarone (Pacerone®), blood levels of digoxin may increase, resulting in side effects.

Other examples of medication-medication interactions include:

Anticoagulants and antibiotics/OTC pain relief: Antibiotics and many common pain relief medications including ibuprofen (Advil®, Motrin®) and naproxen (Aleve®) aren’t safe to combine with blood-thinning medications like warfarin (Coumadin®, Jantoven®), as they can increase the risk of bleeding.

Levothyroxine and omeprazole: The thyroid medication levothyroxine (Synthroid®) requires extremely precise dosing and other medications can easily alter blood levels of it. In particular, the heartburn medication omeprazole (Prilosec®) can decrease the body’s absorption of levothyroxine.

Diuretics and certain antidepressants: Diuretics, a class of blood pressure-lowering medications that includes chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®) and hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®), can lower sodium levels. Combining these medications with certain antidepressants including fluoxetine (Prozac®) and venlafaxine (Effexor XR®) can increase the risk of severely low sodium levels.

Even some of the most nutritious foods can pose health risks when combined with certain medications. For example, grapefruits and grapefruit juice can block the enzymes your body needs to break down cholesterol-lowering statins, leading to higher blood levels of the medication and a greater risk of side effects.

Some statins interact more strongly with grapefruits and grapefruit juice — like atorvastatin (Lipitor®), lovastatin (Mevacor®, and simvastatin (Zocor®) — while others, including fluvastatin (Lescol®) and pravastatin (Pravachol®), are less affected. If you have concerns about this potential medication interaction, speak with your doctor about your options.

Other common food-medication interactions include:

Warfarin and vitamin K-rich vegetables: The anticoagulant warfarin blocks the effects of vitamin K, which helps your blood clot. High intake of vitamin K-rich veggies like broccoli and spinach can make the medication less effective. Consult with your doctor about nutrition considerations when taking warfarin, and maintain a consistent diet.

Metformin and alcohol: Drinking heavily while taking the oral diabetes medication metformin can increase your risk of extremely low blood sugar. In rare cases, it can also cause a condition called lactic acidosis, in which too much acid accumulates in the bloodstream. Many people are able to safely drink in moderation while on metformin. The specific interaction of alcohol and metformin varies by individual. Consult with your doctor to determine what precautions you should take.

Dairy products and antibiotics: Milk, yogurt, cheese, and other dairy products can reduce the body’s absorption of certain antibiotics, including tetracycline, doxycycline, ciprofloxacin, and minocycline.

Dairy products and bisphosphonates: Dairy products can also reduce absorption of some oral bisphosphonates used to treat osteoporosis.

As a precaution against food-medication interactions, ask your doctor or pharmacist about the best ways to take your medication. The potential for these interactions doesn’t necessarily mean avoiding certain food or drinks altogether, but rather making small modifications or being mindful of when you eat or drink them. For example, it is typically recommended to consume dairy products at least three hours after taking an antibiotic.

Interactions between medication and a health condition

Doctors need to know your health history in order to safely prescribe a medication. Certain health conditions may increase a medication’s side effects, and some medications can worsen symptoms of a health condition.

Examples of interactions between a medication and health condition include the following. If you are concerned about the possibility of a medication-condition interaction, speak with your doctor about appropriate alternative medications.

Decongestants and hypertension: Some decongestants used to relieve colds, including pseudoephedrine (Sudafed®), can tighten blood vessels throughout your body, increasing blood pressure. If you have high blood pressure, look for decongestant-free cold medicines like Coricidin®.

Nonsteroidal anti-inflammatory drugs (NSAIDs) and hypertension: Nonsteroidal anti-inflammatory drugs (NSAIDs) including ibuprofen and naproxen can also increase blood pressure. Aspirin or acetaminophen (Tylenol®) is typically a better option for pain or fever relief for individuals with hypertension.

Beta blockers and asthma: Beta blockers, a medication class commonly used to lower blood pressure, can tighten airway muscles, potentially causing an asthma attack.

Acetaminophen and liver function issues: Your liver is critical in your body’s absorption of acetaminophen. If your liver function is impaired, the medication can accumulate in your bloodstream and further damage your liver. If you have any known issues with liver function, ask your doctor if acetaminophen is safe to take. They may recommend a lower dosage or suggest taking an alternative medication.

The best way to prevent any negative medication interaction is to make sure that anyone prescribing a medication for you is informed of your entire health history. This is especially important if you see multiple doctors, take multiple medications, or live with a chronic health condition.

When you are prescribed a medication, speak with your doctor or pharmacist about all the medications you take — both OTC and prescription — as well as supplements, vitamins, and herbs. They should also have a sense of your diet.

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