Shop Alto Essentials to add pharmacy products to any delivery!

Your partner in navigating the ins and outs of prescriptions — at no extra cost.

Alto Pharmacy Technician

Alto Pharmacist

It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

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. 

Be Part of a Great Place to Work — Join Our Team

Hear first-hand from members of the Alto technology teams.

Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

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.

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.

Egg freezing, a fertility preservation treatment that allows you to store unfertilized eggs for potential use in the future, has grown increasingly popular throughout the past decade. Between 2010 and 2016, the number of U.S. women who pursued the treatment increased by 880%. The trend has continued, with the Centers for Disease Control and Prevention (CDC) reporting that 123,304 egg freezing cycles were successfully completed in 2020 alone.

What to Consider Before Freezing Your Eggs

While egg freezing is a worthwhile experience for many women and people assigned female at birth, it is a deeply personal decision. There are many factors to consider as you evaluate if it’s right for you, including your individual health, finances, and family building goals.

Informing yourself about the process is a critical first step. Here’s an overview of what egg freezing entails — physically, emotionally, and financially.

Egg freezing is an option for anyone interested in preserving their fertility for personal or medical reasons.

All people with ovaries are born with the total amount of eggs they’ll ever produce — about a million on average. Each person’s egg count decreases with time. While only one egg matures enough to be released from the ovaries during a typical menstrual cycle, thousands of follicles, or potential eggs, are lost each time your body prepares for ovulation. As a result, the quantity and quality of eggs start to steadily decline in the early 30s, with a more significant decline from the mid 30s on.

Though many women successfully conceive naturally after 35, there is a correlation between pregnancy rates and age. By allowing you to try to conceive at a later age with eggs collected earlier, successful egg freezing offers a more flexible timeline for family building, and, in many cases, peace of mind. While many pursue the process with clarity about their reproductive goals — and the intention of a future pregnancy — others are undecided about having children and simply wish to leave their options open.

Egg freezing is also an option for people whose fertility may be impacted by medical factors like the following:

Cancer treatment: Some cancer treatments, including chemotherapy, radiation therapy, hormone therapy, and surgery of a reproductive organ, can impact a person’s fertility. For this reason, many women of reproductive age choose to freeze their eggs before starting treatment.

Other health conditions: Many individual health factors can influence fertility. Treatment for conditions like endometriosis or benign tumors may include removal of the ovaries. Women with a family history of ovarian cancer may pursue elective removal of the ovaries.

Gender-affirming surgery or treatment: The biological process of transitioning can permanently or temporarily impact a person’s ability to conceive. Many transgender men and transmasculine people freeze their eggs prior to hormone therapy or surgery. 

An egg freezing cycle is physically demanding, with self-administered injections and a minimally invasive procedure to retrieve your eggs.

In most cases the process begins with a transvaginal ultrasound, which allows your doctor to estimate your egg quantity. The following blood tests can provide additional information about the number of eggs in your ovaries:

The anti-mullerian hormone (AMH) test measures your body’s levels of a hormone associated with ovarian reserve. It is a good indicator of egg quantity, but not egg quality.

The follicle stimulating hormone (FSH) blood test measures your body’s levels of another hormone associated with your ovarian reserve.

Test results can also help your doctor predict your body’s response to fertility medications and tailor your treatment plan accordingly.

After the initial ultrasound and blood work, your doctor will prescribe stimulation medications to spur the growth of follicles, fluid-filled sacs in your ovaries that potentially contain an egg. These are some of the medications you may take during this stage:

These medications are typically taken as nightly injections.

Most ovulation suppression medications are typically introduced around days 5-10. These medications prevent premature ovulation — the body’s natural release of eggs from the ovaries — so that your doctor can retrieve as many eggs as possible.

These are some of the medications you may take at this stage:

Cetrotide/Fyramedel™ (ganirelix acetate)

While leuprolide is considered a suppression medication, it is typically started at least a week prior to stimulation medications.

Once your eggs have sufficiently developed, your doctor will schedule 1-3 trigger shots to give your eggs a final growth spurt and trigger release.

Medications used for trigger shots include:

If your body doesn’t respond to the stimulation medications or you have a decreased ovarian reserve, your doctor may add one of the following ancillary medications to your protocol to increase your chances of success.

Omnitrope® — a growth hormone whose main purpose is to help improve the quality of eggs

Microdose leuprolide injections — a lower dosage of leuprolide used to boost ovarian response to stimulation medications

The final step in a successful cycle is egg retrieval. In this minimally invasive procedure, your doctor will gently guide a thin needle through your vaginal wall and use suction to draw the eggs from the follicles. Your eggs will then be stored in a facility for however long you choose to.

While the retrieval itself takes 15 to 45 minutes, you should plan to be at the clinic for several hours. Many people find it helpful to have a friend or family member accompany them to the clinic for support before and after.

Each cycle typically takes 10-14 days from the beginning of medication use to egg retrieval. You will have regular doctor’s appointments for additional ultrasounds and blood work while taking stimulation and ovulation suppression medications. Your doctor may adjust medication dosages based on your hormone levels.

If and when you decide to use your frozen eggs, they will be thawed, fertilized with sperm, and implanted into your uterus through the process of in vitro fertilization (IVF).

For some women, it is a viable option to freeze embryos, or fertilized eggs. There are several reasons a person might opt to freeze embryos:

Some studies have found that frozen embryos have a higher thaw survival rate than frozen eggs. 

Embryos can undergo genetic testing, so you can learn of any chromosomal abnormalities before freezing them. 

You will also know that you are freezing an egg healthy enough for successful fertilization.

However, this option requires you to decide whose sperm to use early on in the process.

Your doctor may recommend that you stop taking hormonal birth control before your egg freezing cycle, as it may affect fertility assessment results as well as your body’s response to fertility medications. Non-hormonal forms of birth control, like a copper IUD, should not interfere with the egg freezing process.  

What else should I consider before freezing my eggs?

The egg freezing process affects both the mind and body, with physical and emotional side effects. While each person responds differently to the treatment, certain symptoms are common, including:

Injection site reaction (soreness, redness, or mild bruising)

Changes in mood such as heightened sensitivity, irritability, euphoria, or depression due to elevated estrogen levels

Alto’s fertility-trained pharmacists can help you navigate egg freezing side effects, with availability on nights and weekends.

Different injectable fertility medications require different administration methods. Most injections are administered subcutaneously around the abdomen. Intramuscular injections are typically administered in the upper, outer part of the buttocks, which can be more difficult to reach when self-injecting.

If your protocol includes intramuscular injections, consider asking for assistance from your partner, a friend, or a family member. If you need to self-administer, try standing in front of a mirror for a better view of the injection site. You can also ask a nurse or another clinic staff member to circle the injection site on your body so that you can find it more easily.

Like any medical procedure, egg freezing has the potential for some complications. Egg retrieval may cause bleeding and infection, though this is unlikely to occur in most cases.

One rare, but serious, complication of the process is ovarian hyperstimulation syndrome (OHSS), an abnormal reaction to stimulation and trigger medications. It is characterized by pain and swelling in the ovaries and sometimes the abdomen. OHSS is treatable, but there are times when a doctor will recommend ending treatment and starting a new egg freezing cycle in the future.

While many women successfully conceive with frozen eggs, it’s important to remember that fertility preservation treatment does not guarantee a successful pregnancy. There are many steps between egg retrieval and pregnancy, including successful thawing, fertilization, implantation, and continued embryo development.

It may also take several cycles to retrieve your target number of eggs, which your doctor will advise you on. An average of 10-15 eggs are needed to achieve a successful pregnancy. Depending on your age and reproductive health, your doctor may recommend freezing more eggs to increase your chances of successfully conceiving.

Not everyone who freezes their eggs will use them. Some women go on to conceive naturally while others decide not to pursue parenthood. As part of your planning, consider what you would do with unused eggs or embryos. Your options include donating them to a person or couple experiencing infertility or to researchers, or having them appropriately discarded by a clinic or storage facility.

Donating eggs will require additional blood work and testing prior to your cycle. Ask your clinic for additional information if you are interested in this option.

Before deciding to pursue egg freezing, it’s important to know how you will pay for the treatment. Egg freezing costs are ongoing, including not only the fertility medications, testing, blood work, and procedures, but also storage fees and in vitro fertilization. (Many clinics store eggs for up to a year as part of the cost of an egg freezing cycle. If your clinic offers this service, you will need to select another storage vendor after a year.)

The total cost of egg freezing depends on various individual factors. Your reproductive health and your age can influence how many egg freezing cycles your doctor recommends. Egg storage duration depends on your personal family building timeline.

It may not be possible to predict the exact total cost of egg freezing, but identifying your reproductive goals and learning more about your reproductive health can help you arrive at a solid estimate. An initial consultation with a fertility clinic is often a helpful first step, providing additional insight into personal health factors.

Some health insurance plans offer partial or full coverage of egg freezing-related costs, including medications and IVF. Note that most insurance plans have separate medical and pharmacy benefits. In most cases, professional services provided by your doctor or clinic will fall under medical benefits, and fertility medications will fall under pharmacy benefits.

A growing number of employers offer egg freezing coverage as part of employee benefits, separate from health insurance. If your employer doesn’t currently cover egg freezing, don’t be afraid to ask. RESOLVE: The National Infertility Association has resources to help you start the conversation.

Some fertility clinics offer financing and payment plans to help you manage or lower egg freezing costs. As you explore your options for clinics, we suggest asking these questions:

Based on my specific treatment plan, what is the typical all-inclusive cost?

What is included in the treatment cost and what is not?

Is a year of egg storage included in an egg freezing package?

Can you provide a detailed list of procedures and costs?

What is the typical cost of fertility medications for my treatment plan?

Additionally, some fertility medication manufacturers offer patient assistance programs to alleviate the cost of these expenses. If Alto is your fertility pharmacy, you are likely taking medications manufactured by EMD Serono or Ferring Pharmaceuticals. Both manufacturers have programs that lower the cost of fertility treatment.

Learn how to apply for EMD Serono’s financial assistance programs.

Learn how to apply for Ferring Pharmaceuticals’ financial assistance programs.

Alto is committed to helping you save as much as possible on your fertility medications. Free same-day delivery makes it easy to manage last-minute changes to your treatment plan, preventing fertility medication waste. We also search for savings options and connect you with programs that require you to apply, like the patient assistance programs above.

A pharmacy partner for your fertility journey

Egg freezing can be a challenging journey, but Alto is 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 treatment? Request a price quote online or reach out through secure in-app messaging or by phone at 1-800-874-5881.

A healthy pregnancy begins well in advance of trying to conceive. Preconception health planning sets you up to feel your best while growing a baby, allowing you to work towards health goals and manage preexisting conditions that could potentially result in complications.

How to Have the Healthiest Pregnancy Possible

It can also help you make any necessary changes to your treatment plan — for example, if you take a medication that is considered unsafe during pregnancy, your doctor can help you safely transition to an alternative.

Below, we break down some of the most important steps to take as you focus on your health and wellness while building or growing your family.

1. Consult your doctor about your health history

As you begin to plan for a baby, schedule a doctor’s appointment to identify any health issues that can impact pregnancy — whether it’s your first, second, third, or fourth.

While chronic health conditions like diabetes, hypertension, thyroid disease, and asthma are sometimes linked to pregnancy complications, you can prevent health challenges during pregnancy by staying proactive about treatment. For those with diabetes, this means working with your provider to maintain healthy blood sugar levels before trying to conceive. The same goes for hypertension and blood pressure levels.

Read Navigating Pregnancy With Type 1 or Type 2 Diabetes

Be sure to discuss any past pregnancy complications, if relevant. Experiencing certain complications in a first pregnancy can increase your risk of having them again in a later pregnancy. These complications include:

This does not mean that a recurrence is inevitable. Proactively managing your risk before and during pregnancy is the most important thing you can do to prevent these complications.

You should also share any health issues that you experienced during postpartum, including mental health challenges.

Changing a medication regimen or treatment plan

A pre-pregnancy care checkup is also an opportunity to discuss potential changes to your treatment plan. Bring all medications you are currently taking with you to this appointment, including vitamins and herbal remedies.

Never stop taking a prescribed medication without first consulting your doctor. Many medications cannot be abruptly discontinued and require you to slowly titrate, or taper off, over a period of time

It is recommended to focus on preconception health at least three months prior to pregnancy. However, everyone has unique health needs, and you may need more time to prepare for a healthy pregnancy. Try, as much as possible, to be patient and give your body the time and space it needs.

2. Get all recommended vaccines and screenings

At the beginning of your family building journey, ask your doctor which vaccines are recommended for your age. Certain infections or illnesses can cause birth defects or pregnancy complications. Many of these can be prevented with vaccines. And since illness-fighting antibodies can pass through the placenta, vaccinated individuals can pass along immunity to their growing baby in the womb.

It’s important to stay up to date since the recommended timing of vaccines varies. Not all can be given during pregnancy while others can. Your doctor can clarify which vaccines are recommended before pregnancy, during pregnancy, and after delivery. (Two of the most important vaccines for pregnant women, the flu vaccine and the Tdap vaccine (tetanus, diphtheria, pertussis), can be safely administered during pregnancy.)

Additionally, sexually transmitted infections (STIs) including HIV, HPV, and viral hepatitis can cause pregnancy complications and harm a developing fetus. Fortunately, treatment can prevent transmission to a baby. Screening for these infections is a critical step in planning for a healthy pregnancy.

3. Take steps to live your healthiest life

In the months before trying to conceive, revisit your health habits and make any changes to your routine or lifestyle that can support the healthiest pregnancy possible. There are several key areas to focus on.

Several nutrients are especially important to consume in the months before pregnancy. 

The American College of Obstetricians and Gynecologists recommends taking a prenatal vitamin with at least 400 micrograms of folic acid every day for at least a month before pregnancy through the first trimester. This important nutrient supports a baby’s growth and development and can prevent certain birth defects.

Depending on your health history and previous pregnancies, your provider may advise you to increase your intake of folic acid with an additional supplement.

(You can add prenatal vitamins to your next Alto delivery!)

Calcium helps build a developing fetus’s bones and teeth. Dairy products including milk, cheese, and yogurt are the primary sources of calcium, but you can also get this nutrient from other sources including:

If you are concerned about your calcium intake, ask your doctor about calcium supplements.

Iron also helps support a healthy pregnancy. Some prenatal vitamins include iron. It can also be found in the following iron-rich foods:

In addition, be sure to eat foods that support your body’s absorption of iron, including the following fruits and veggies, which are rich in vitamin A and beta-carotene:

If you have anemia, your doctor may recommend additional iron supplements.

An omega-3 fatty acid called DHA, or docosahexaenoic acid, is important for fetal growth and development. It can be found in some foods such as fatty fish. Depending on your diet, your doctor may recommend taking supplemental DHA before and during pregnancy and in the postpartum period. Some prenatal vitamins contain DHA, but not all, so be sure to check the ingredient list.

Since heavy caffeine consumption can affect fertility, it is recommended to reduce your intake to 200-300 mg per day.

Aim for about 150 minutes of moderate physical activity per week, incorporating some muscle-strengthening exercises.

Being underweight or overweight can cause health issues during pregnancy. Try to reach and maintain a healthy weight in the months before trying to conceive. Your provider is an important resource and can advise you on whether your weight may impact your pregnancy.

Smoking, drinking alcohol, and using certain drugs — including misusing prescription medication — can cause serious health issues during pregnancy like preterm birth and birth defects. When planning for a future pregnancy, do not be afraid to ask for any support needed to give up harmful behaviors. Your provider can offer resources. 

It’s also important to avoid secondhand smoke during pregnancy.

Genetics are a factor in your baby’s health and the progression of your pregnancy. Prior to pregnancy, discuss your family’s health history as well as your partner’s with your provider. This allows them to identify any genetic risk factors.

Some couples and individuals may be referred to a genetic specialist for reasons such as the following:

A family history of a genetic condition, birth defect, chromosomal disorder, or cancer

Two or more pregnancy losses or a stillbirth

Having given birth to a child with a genetic condition, birth defect, or intellectual disability

These risk factors do not guarantee that your baby will develop a health condition or that you will have a complicated pregnancy. Genetic testing can determine the likelihood of passing on a genetic issue to a child. A genetic specialist can help you understand your options for testing.

5. Prioritize your partner’s health as well

Preconception health concerns both parents. Male partners should also take steps to become as healthy as possible, which will improve their own reproductive health and fertility. This includes limiting their alcohol intake, quitting smoking or using harmful substances, and eating a healthy diet. (These lifestyle factors have been linked to issues with sperm production.)

Other important steps for male partners to take before trying to conceive include getting screened for STIs and consulting with a provider about family health history and medication use.

Alto Pharmacy can support you in preparing for a healthy pregnancy, however that looks for you. From delivering prenatal vitamins straight to your doorstep, supporting you in managing a chronic condition, or helping you navigate fertility treatment, we make it as simple as possible to focus on your health.

We offer free, same-day delivery and in-app medication management tools like reminders and auto refills. Additionally, our pharmacists are available to answer any questions you may have about medications or side effects.

The HIV prevention medication PrEP — short for pre-exposure prophylaxis — has played a critical role in reducing the number of new HIV infections in recent years. It is highly effective when taken as prescribed every day, lowering the risk of sexual transmission and intravenous drug transmission by 99% and 74%, respectively.

What to Know About PrEP Follow-Up Appointments and Testing

Staying on track with PrEP treatment includes not only taking the medication as prescribed, but also regularly attending all follow-up appointments and completing recommended lab tests. Here’s an overview of ongoing medical care related to PrEP.

Note that PrEP is distinct from PEP — post-exposure prophylaxis — a prevention medication for emergencies and accidental exposures. Learn more about PEP.

If you think PrEP may be right for you, make an appointment with your doctor or other healthcare provider as a first step. (Check with your provider about the possibility of telehealth appointments, if interested.) They can write you a prescription for PrEP and conduct an HIV test, which is required to begin taking the medication.

If you do not have a provider or are unable to get a prescription from your doctor, the following resources can connect you with a provider who will prescribe PrEP for you:

There are several FDA-approved oral medication options — Truvada®, Descovy®,  and a generic for Truvada — and as of December 2021, PrEP is now available as an injectable treatment option called cabotegravir (Apretude®).

For those who find it difficult to remember to take a pill every day, the injectable form may make it easier to stay on track with PrEP treatment. However, oral PrEP continues to offer highly effective prevention for anyone at risk of HIV infection.

Always consult with a doctor if you are interested in switching from one form of PrEP to another.

What is the typical schedule of medical appointments when taking PrEP?

Work with your provider to determine the frequency of your follow-up appointments. A typical schedule often consists of the following:

First follow-up appointment between 2-4 weeks

Ongoing follow-up appointments every three months

What happens at the initial intake appointment?

Blog

Medication Shortages, Explained

Managing a Prescription for a Controlled Substance

What to Consider Before Freezing Your Eggs

How to Have the Healthiest Pregnancy Possible

What to Know About PrEP Follow-Up Appointments and Testing

How Alto Lowers the Cost of Fertility Treatment Through Better Medication Management

The Evolution of HIV Medication

The Medicare Donut Hole, Explained

Why We Switched to React Query for Managing Server State

Resources for Affording HIV Medication

Hello, Long Island!

Two Engineering Interns Weigh In: What to Expect From Your Alto Internship

Switch to a better pharmacy.