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

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

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

How Do Antibiotics Work?

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

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

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

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

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

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

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

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

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

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

They are not effective against viral infections, including:

All cases of a sore throat except strep throat

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

Examples of commonly prescribed antibiotics

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Common topical forms of sulfonamides include sulfacetamide and silver sulfadiazine.

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

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

Can I take this antibiotic with other medications?

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

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

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

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

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

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

Always take an antibiotic exactly as prescribed. This includes:

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

Liquid antibiotics often have specific storage instructions. Some require refrigeration while others should be stored at room temperature. Be sure to safely discard any remaining medications. Expired liquid antibiotics should never be used.

A better pharmacy makes all the difference

Our pharmacists are here to provide any information you need to take your antibiotics safely, including how to prevent medication interactions or side effects. Plus, we’ll hand-deliver your medications right to your doorstep — for free. 

To get started, reach out through 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.

Pneumonia is a lung infection in which the air sacs in both or one of the lungs are inflamed, leading to difficulty breathing and other symptoms including a cough, fever, and chills. There is a wide spectrum of severity of pneumonia cases — symptoms can range from mild to much more critical. Infants, young children, adults over 65, and people with weakened immune systems are among the most vulnerable to complications.

Read on for a closer look at symptoms, causes, and treatment options.

What to Know About Pneumonia

Pneumonia is a lung infection in which the air sacs in both or one of the lungs are inflamed, leading to difficulty breathing and other symptoms including a cough, fever, and chills. There is a wide spectrum of severity of pneumonia cases — symptoms can range from mild to much more critical. Infants, young children, adults over 65, and people with weakened immune systems are among the most vulnerable to complications.

Read on for a closer look at symptoms, causes, and treatment options.

There are several types of pneumonia, categorized by cause. The three main types are bacterial pneumonia, viral pneumonia, and mycoplasma pneumonia.

Bacterial pneumonia is the most common — and often the most serious — type of pneumonia. It may be caused by various bacteria, most commonly Streptococcus pneumoniae. It typically develops when the body has been weakened by illness, age, or impaired immune system functioning, which allows the bacteria to enter your lungs.

The following factors can increase a person’s risk for bacterial pneumonia:

Having an existing respiratory disease or viral infection

Viral pneumonia accounts for about a third of all pneumonia cases. It may be caused by various viruses, including the flu.

This less common form of pneumonia — also referred to as atypical pneumonia or walking pneumonia — is caused by the Mycoplasma pneumoniae bacterium. Symptoms are typically mild.

Symptoms vary by pneumonia type. Bacterial pneumonia is typically the most severe and requires medical care more frequently than viral pneumonia. Common symptoms may include:

Rapidly increased breathing and heart rate

Bluish lips or nail beds due to low oxygen in the blood

These symptoms may develop gradually or suddenly.

Viral pneumonia symptoms typically develop over the course of several days. Initial symptoms often resemble those of the flu, including:

These symptoms often intensify within several days. Later symptoms may include:

If you suspect that you or your child may have pneumonia, it’s important to seek medical care right away rather than waiting for symptoms to become more noticeable. If you are in one of the more vulnerable groups — over 65 or immunocompromised, for example — seeking medical attention is even more critical due to the possibility of complications.

A doctor may be able to diagnose pneumonia based on your health history and a physical exam. The diagnosis process can also include one or more of the following tests:

A chest X-ray, which shows the severity of inflammation in the lungs

Blood tests, which can confirm the infection and identify the underlying cause

A sputum culture, or a mucus sample, which also helps identify the cause of the infection

A pulse oximetry, which measures how much oxygen is in your blood

A chest CT scan, which shows a better view of the lungs and can identify potential complications. This is most commonly used for individuals who may be more vulnerable to complications.

A bronchoscopy, a procedure that offers a view into the airways of the lungs. It is often reserved for more severe or treatment-resistant cases.

Pneumonia treatment can help end the infection and prevent related health complications. The specific course of treatment your doctor recommends will depend on which type of pneumonia you have, the severity of your symptoms, and your personal health history.

Bacterial pneumonia is treated with antibiotics. These medications cure bacteria-caused infections by either killing the bacteria or keeping the bacteria from growing.

The most effective antibiotic to treat bacterial pneumonia depends on your age and health history. These are some of the most commonly prescribed:

Amoxicillin and clavulanate (Augmentin®)

If you are prescribed an antibiotic, it’s important to take it for the full duration. Though you may feel better within a few days of treatment, stopping the medication prematurely can cause the infection to return.

If your pneumonia was caused by a virus, your doctor may prescribe an antiviral medication such as oseltamivir (Tamiflu®), zanamivir (Relenza®), or peramivir (Rapivab®). These medications help your body fight off the virus, reducing symptoms and shortening the duration of the infection.

Not all cases of viral pneumonia require antiviral treatment, however, and symptoms can often be managed by:

Taking acetaminophen (Tylenol®) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin®, Advil®) to control a fever

Consuming an adequate amount of fluids to loosen phlegm

Drinking warm beverages and using a humidifier to help open the airways in your lungs

In addition, allow your body to get as much rest as possible and avoid any form of cigarette smoke, including secondhand smoke.

Always consult your doctor before taking cough medicines to treat pneumonia symptoms, as coughing helps your body clear the infection. If your cough is interfering with your sleep, your doctor can recommend appropriate ways to manage it.

More severe cases of pneumonia, especially bacterial pneumonia, may require hospitalization. If you are hospitalized for pneumonia, you may receive oxygen therapy or intravenous medications, including antibiotics. Your treatment may also include breathing exercises that can loosen the fluids in your lungs.

Individuals with heart conditions or respiratory conditions.

Staying on track with immunizations is one of the most impactful steps you can take to prevent pneumonia. Since the flu is a common cause of viral pneumonia, getting your annual flu shot can also protect your lungs from infection.

The pneumococcal vaccine offers protection against a common type of bacterial pneumonia. This vaccine is especially important for children under the age of five, adults ages 65 and older, and people with certain health conditions that increase the risk of pneumonia complications such as chronic obstructive pulmonary disease (COPD). 

Check with your doctor about which vaccines you need.

Our pharmacists can answer any questions you may have about your medications, and we offer free same-day delivery and medication management tools like reminders and auto refills in our app.

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

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.

For many individuals, the journey of living with type 2 diabetes starts early. Once referred to as adult-onset diabetes due to its prevalence among middle-aged and older Americans, the condition has become more common in children, adolescents, and young adults, due in part to growing childhood obesity rates. While some aspects of type 2 diabetes management, like glucose monitoring and healthy lifestyle choices, are important for all age groups, other parts of treatment may change with time. Here’s a snapshot of what type 2 diabetes may look like at each stage of life and tips for living with the condition.

Managing Type 2 Diabetes at Any Age

All type 2 diabetes treatment plans include healthy eating, frequent physical activity, and blood sugar monitoring regardless of age. Depending on a child or adult’s blood sugar levels and overall health, they may also need diabetes medication or insulin therapy to supplement these lifestyle changes. In addition to insulin, two other diabetes medications may be used to treat type 2 diabetes during childhood: metformin, an oral medication, and liraglutide, an injectable medication.

Younger children will need assistance with blood sugar monitoring, and if your child takes insulin, they will also need help with insulin administration. It’s important that teachers or other school staff are able to provide support during school days. Make sure that someone at the school is prepared to administer glucagon if your child’s blood sugar falls below a healthy range (known as hypoglycemia).

Inform your child’s teacher and/or other school staff of your child’s type 2 diagnosis before classes begin. Be sure to discuss daily treatment needs like blood sugar monitoring, insulin therapy, or other medication needs, as well as how to spot the signs and symptoms of low blood sugar. The American Diabetes Association (ADA) has resources that can help you start these conversations.

Living with type 2 diabetes as a young child can be emotionally challenging. It often helps to build connections with other children who are on the same journey. Explore programming for children with type 2 diabetes, like the ADA’s summer camps.

If your child is overweight, their doctor may recommend that you focus on slowing weight gain rather than losing weight since they are still growing. Follow your doctor’s recommendations and look for simple but impactful changes, like swapping carbohydrate-rich foods for a snackable fruit or vegetable, or trading soft drinks and fruit juices for water.

Whether you’ve had type 2 diabetes since childhood or are newly diagnosed, living with the condition as a young adult requires you to take an active role in the management of your health. It’s important to build a relationship with a care team that you trust to avoid any gaps in your treatment. Depending on your treatment plan, you may also have to learn about the logistics of filling prescriptions, ordering diabetes supplies, and coordinating with your insurance company.

Taking on additional responsibilities and navigating life more independently doesn’t mean that you’re completely on your own in managing your diabetes. If parents or another relative previously helped you with blood sugar monitoring, scheduling doctor’s appointments, or other aspects of care, use them as a resource during this transitional period as you become more confident managing your health. You may also want to expand your support system by working with a certified diabetes educator or connecting with other young adults living with type 2 diabetes.

Make sure you understand how other health issues can affect diabetes. For example, the common cold or flu can impact your calorie intake and blood sugar levels, so it’s important to be prepared to manage other illnesses. Alcohol safety is also extra important when living with type 2 diabetes, as alcohol is a factor in your blood sugar levels. For those taking insulin, be mindful of how alcohol use affects insulin therapy.

Build a diabetes care team you trust. In addition to seeing a primary care physician for general health issues, search for an endocrinologist who specializes in diabetes treatment.

Familiarize yourself with all aspects of managing type 2 diabetes, from navigating health insurance to monitoring blood sugar. Consider working with a certified diabetes educator. These are healthcare professionals with extensive knowledge of the condition who can offer individualized support. You can also search for a diabetes education program.

Find opportunities to connect with other young adults learning how to manage type 2 diabetes, like the Beyond Type 2 community.

The progression of type 2 diabetes varies significantly by individual. While many individuals are just beginning the journey of living with the condition in their 30s or 40s, diabetes management may feel like second nature for those who were diagnosed at an earlier age. It’s also possible for a person’s treatment needs to evolve at this stage of life. If lifestyle changes and other medications are effective, you may be tapering off of insulin. Conversely, you may need to begin taking additional medications, such as insulin, in order to manage your diabetes even more effectively. As always, follow your care team’s recommendations for your specific needs.

Regardless of what type 2 diabetes looks like for you, one thing’s for certain: it’s important to stay on top of your care and put your health first even when life is at its busiest. Make sure there’s plenty of room in your calendar for physical activity and doctor’s appointments. If you take insulin, find the right delivery method for your schedule and lifestyle. Many people who work long days in a physical setting find insulin pumps and pens convenient as they eliminate the need to remember the timing of injections.

If you are considering starting a family, your doctor can help you plan to have a healthy pregnancy. Get clarity on your A1C targets — your average blood sugar levels over several months — and how long to maintain them before pregnancy. Once you become pregnant, make a doctor’s appointment as soon as possible to learn about any potential changes to your treatment plan.

Revisit your fitness routine, if needed, to find the right activities for your schedule. If you find it challenging to fit enough exercise into your life — ideally 150 minutes of moderate-intensity aerobic activity per week — try to fit shorter bursts of physical activity into your day. 

If you take insulin, consult with your doctor about insulin delivery options to find the best fit for your needs.

Choose a diabetes pharmacy partner that simplifies your treatment. At Alto, we consolidate all of your medications and supplies into a single monthly delivery, and our mobile app can help you manage all of your diabetes needs in one place.

Preventative care and healthy lifestyle choices take on additional importance when you’re living with diabetes, which increases your risk for other chronic conditions like heart disease, high blood pressure, high cholesterol, and dementia.

Many older adults with diabetes also have high blood pressure, which is linked to a higher risk for strokes and heart attacks as well as vision and kidney function. Stay on top of key numbers like your blood pressure and cholesterol levels, and follow your doctor’s recommendations for treatment. You may also want to ask your doctor about additional screenings related to your mental health or cognitive health, as older adults with diabetes are more likely to experience depression or cognitive impairment. (If caring for an older adult with diabetes, watch for the signs of depression and dementia.)

Stay current with vaccines, including the annual flu shot and the pneumonia vaccine. If you are unsure which vaccines you need, ask your doctor.

Ask your doctor about the recommended frequency of screenings for other health conditions, including cancer screenings and kidney function tests.

Find a loved one to help with insulin administration and recording blood sugar readings, if needed.

Managing diabetes is easier at any age with the right pharmacy partner by your side. The Alto app can help you manage all of your diabetes needs in one place, and our dedicated diabetes support team is here to offer guidance and make sure you have everything you need for your treatment.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881 to learn how we can support your diabetes care.

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.

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

Vaccines — which were first developed in 1796 for smallpox and continue to evolve with new research and technology — build on your immune system’s natural function to protect you from serious diseases. Just like white blood cells and the other components of your immune system, vaccines help you develop immunity, but without the initial illness and risk of health complications. Here’s a look at how vaccines work.

The Science Behind Vaccines

Your immune system has a natural way of defending you from the viruses and bacteria that cause illness. As these germs multiply rapidly and infect your body, an army of white blood cells fights back, producing antibodies that attack the invaders.

The first time you are infected by a specific virus or bacteria, your immune system often cannot destroy the germ quickly enough to prevent you from becoming sick. After you’ve recovered, certain immune cells hold onto the memory of the infection. This allows them to mobilize quickly if they encounter the same germ again, preventing illness in the future. Immunity, your body’s resistance to certain types of infection, is the outcome of this process.

To understand how vaccines work, it’s helpful to know how your immune system naturally fights an infection. B-lymphocyte white blood cells produce blood proteins called antibodies, which attack antigens — the part of the invading germ that triggers an immune response. T-lymphocyte white blood cells attack already infected cells in the body. After the infection has ended, a few T-lymphocytes, or memory cells, remain to ensure a fast immune response should the same germ reappear.

Vaccines imitate infections, triggering the process of building immunity to a specific disease without causing illness. Your immune system responds to these imitation infections the same way it would to an actual infection. Detecting antigens from the vaccine, your immune system produces antibodies and T-lymphocyte cells. The imitation infection leaves your body with T-lymphocyte memory cells and B-lymphocytes, which will know how to quickly fight that antigen in the future. This prevents you from becoming sick if you are exposed to the virus or bacteria that cause the disease.

It typically takes several weeks for your body to produce T-lymphocyte and B-lymphocyte cells in response to a vaccine, which is why in most cases you will not immediately develop immunity. This means that you could become infected with a disease and develop symptoms shortly after vaccination, so it’s important to take necessary precautions until you become fully immune to the virus or bacteria. The healthcare professional administering your vaccine will inform you of the anticipated timeline for immunity.

Sometimes the imitation infection created by a vaccine causes mild symptoms such as a fever. These side effects are normal and indicate that your body is building immunity.

While all vaccines arrive at the end result of immunity, there are several paths for getting there. When deciding which type of vaccine to create for a disease, researchers consider a variety of factors, including the immune system’s response to the germ that causes the disease, the population likely to receive the vaccine, and the regions of the world where it will be used. These are the seven types of vaccines commonly used in the U.S.

Live vaccines use a weakened version of the living virus or bacteria that causes a disease. They are most similar to the natural infection and produce long-lasting immunity. The weakened form of the germ does not lead to serious disease, like that caused by the wild form of the germ, for most individuals with strong immune systems. However, live vaccines aren’t safe for those who are immunocompromised, including children undergoing cancer treatment. Examples of live vaccines include the measles, mumps, and rubella (MMR) vaccine and the chickenpox vaccine.

Inactivated vaccines are produced by inactivating, or killing, the germ that causes a disease. Examples include the polio, hepatitis A, and flu vaccines. They don’t provide as strong of immunity as live vaccines, so additional doses, also referred to as booster shots, are often needed for ongoing protection.

Toxoid vaccines target a toxin, a harmful substance produced by a germ, rather than the entire germ itself. They contain a weakened version of the toxin to be targeted called a toxoid, which teaches your immune system how to fight off the natural toxin. Similar to the germs used in live vaccines, toxoids are weakened to a point where they do not cause illness. These vaccines are used to prevent diseases caused by toxin-producing bacteria such as diphtheria and tetanus.

Subunit vaccines use portions of a virus or bacteria called subunits rather than the entire germ. Vaccines for diphtheria, tetanus, and pertussis, or whooping cough, are combined into the DTaP vaccine. The pertussis component is a subunit vaccine.

Conjugate vaccines fight a specific type of bacteria whose antigens are more difficult for a child’s immune system to detect due to their outer coating. The vaccines link the coating to stronger antigens that the immune system can more easily respond to. Like subunit vaccines, these vaccines are more targeted and only use part of the germ. Examples of conjugate vaccines include the haemophilus influenzae type B (Hib) vaccine.

Viral vector vaccines produce immunity to a virus by using a modified version of a different virus to deliver instructions to your immune cells. The modified version of the other virus is referred to as a vector virus. Recent Ebola vaccines have used this technology, and the Johnson & Johnson COVID-19 vaccine is also a viral vector vaccine.

mRNA vaccines help your body produce a protein that triggers an immune response and the development of antibodies. This technology was used to create the Pfizer-BioNTech and Moderna COVID-19 vaccines.

Read ‘What the COVID-19 Vaccine Means for Those With HIV’

All vaccines in the United States require approval by the Food and Drug Administration (FDA) and are held to rigorous safety and effectiveness standards. The vaccine approval process starts with lab tests, which may take years in some cases. The FDA analyzes the results to determine if the vaccine should be tested with people. If the vaccine moves forward, the next step is clinical trials where the vaccine is tested on volunteers.

Clinical trials typically begin with a smaller group of 20 to 100 volunteers before including thousands more. The trials gather information about vaccine safety, the typical immune response, and dosing. If any safety concerns emerge during this stage, the FDA must address them before it can authorize the vaccine.

Vaccine manufacturers are required to continuously monitor vaccine safety after approval and test every batch produced to ensure effectiveness, quality, and purity. These test results are reviewed by the FDA, which also conducts an inspection of the factory where the vaccine was produced. If you experience severe side effects after vaccination, contact your healthcare provider so that they can report potential concerns to the Centers for Disease Control and Prevention (CDC)’s vaccine monitoring database.

COVID-19 mRNA vaccines were developed and approved more quickly than a typical vaccine given the urgent nature of the pandemic. This expedited timeline was made possible by significant investment from governments and companies in the vaccine development process and decades of research on mRNA vaccine technology. These vaccines were as thoroughly vetted for quality and safety as any other vaccine.

Many vaccines are received during childhood, like the polio, chickenpox, and MMR vaccines, but there are others you may need as an adult. The CDC recommends the zoster vaccine, which prevents shingles, for adults ages 50 and older and the pneumonia vaccine for those over 65. Other vaccines may be recommended based on additional factors including job or school requirements, travel, and health conditions. Check in with your doctor about which vaccines you need.

The CDC also recommends an annual flu vaccine for everyone 6 months and older. New versions of flu vaccines are developed annually in anticipation of circulating flu virus strains, so health experts recommend getting one every year to prepare for cold and flu season. It’s especially important to be proactive about flu vaccination if you are over the age of 65 or have a chronic condition such as COPD or diabetes.

For detailed vaccine recommendations by age group, reference the CDC’s recommended immunization schedules for children and adolescents and adults.

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