Frequently Asked Questions

For any additional questions, please reach out to [email protected]. We can also be reached by phone at (888) 798-8686, Monday – Friday, 9:30am-5pm EST.

About Roman

Who is Roman for?

Roman is for adults who are experiencing erectile dysfunction, hair loss, premature ejaculation, cold sores, or genital herpes and prefer to receive treatment from the comfort of their home.

Do I need a prescription to use Roman?

No, you do not need a prescription. The physicians on the Ro platform WILL write a prescription if they deem it safe and appropriate after your online visit.

Can I use any pharmacy?

Yes. If you choose the Roman Pharmacy Network, we’ll ship your medication to you directly in our discreet packaging, for free. We also offer customer support 365 days a year. You can always use your own pharmacy, although it can be twice the price. It’s also important that your pharmacy is able to receive e-prescriptions and that it’s part of the Surescripts Network. (The Surescripts Network includes 95% of pharmacies across the country).

Why is Roman only available in certain states?

In order to prescribe medicine, a physician has to be licensed in the state where the patient is located. So, Roman is only available in the states where physicians on the Roman platform are licensed. But we’re expanding rapidly. If we’re not available in your state, please email [email protected] and we’ll put it at the top of our to-do list.

Who are the doctors on the Ro platform?

All of the physicians on the Ro platform are U.S. licensed physicians. Each doctor undergoes an extensive background check and license verification process. 

When you message or talk with a physician on the Roman platform you can see their resume, medical license, and credentials anytime you want. Just click on their name in the messaging thread in your account and take a look.

Roman also has a medical advisory board that includes a former surgeon general, world-renowned clinical directors, and medical leaders in fields including psychology, relationship counseling men’s health, sexual health, neurology, pulmonology, male infertility, addiction, urology, pathology, and family medicine. Learn more about our medical team here.

Is my information safe?

We take your privacy and the security of your information very seriously. We’ve designed the Ro platform to comply with all relevant privacy laws and have implemented strict security protocols to protect your information.

Please read our Privacy Policy for more details.

Who is Ro?

Ro is the healthcare company that makes Roman. We are a direct-to-consumer telehealth company that handles everything from diagnosis to the convenient delivery of medication. Learn more about Ro.

Telehealth

Do I need to see a doctor in-person to use Roman?

In order to receive treatment from Roman, you need to have seen a physician within the last 3 years. If you haven’t been to the doctor in the past three years you’re not a good fit for Roman’s service.

Is it legal to prescribe medication online?

Yes. Roman has built telemedicine technologies to enable physicians to practice medicine and take care of patients remotely. Every doctor you interact with is licensed to prescribe medicine and treat patients in your state and complies with all governing medical laws in the US.If you have feedback about the platform or a complaint regarding a physician on the Roman platform, please email [email protected].

Is this a safe way to receive treatment?

Yes. Telemedicine is safe and effective—as long as patients answer questions truthfully, accurately, and completely. It’s also important that you only upload pictures of yourself and your ID (not someone else), and that you take those pictures during the online visit. Doctors are only effective when they have accurate, current information about your case—both in telemedicine and in-person visits.

Physicians on the Roman platform depend solely on the information you provide during your visit and via secure chat, phone, or video. They have no way of externally verifying the information you provide. In addition, if prescribed medicine, it’s necessary to read the personalized treatment plan your doctor created before taking any medication. Only by reading this information in its entirety and fully understanding the content can you adequately weigh the risks and benefits of the treatment.

How quickly will a doctor review my initial history?

After your online visit a doctor will complete their initial review of your medical history within 24 hours.

If you’ve been waiting longer than this, please email [email protected] and we’ll take care of it.

Does Roman replace my primary care physician?

Roman is a complement to—not a replacement of—your primary care physician (PCP). So it’s important to keep your PCP and any other physicians involved in your care, up to date with your care in the Roman network. You can head to your account and message the medical support team any time you want to share your medical information with your PCP or other doctors.

Does everyone have the chance to talk to a doctor?

Absolutely. After you complete your initial dynamic onboarding you can message a physician any time you have a question. Also, if you want to chat with the doctor via a secure phone call or video chat, message our medical support team and we’ll make it happen.

Can I video chat with a doctor?

After you’ve finished your initial online visit, and a physician has decided you’re a good candidate for telemedicine, you can speak with a physician via messaging, phone call, or a video conference any time you like.

Is a video chat required?

It depends. Certain states require a video chat with your doctor. After your initial onboarding, a physician will reach out with the appropriate next steps.

It’s an emergency, what do I do?

In an emergency, please call 911 immediately.

Why do you need a picture of my ID and separate picture?

Your doctor will need to confirm your identity before treating you via telemedicine. In order to confirm your identity, we need two photos:

1. A photo of your government-issued ID

Must include:

– First & Last name

– Photo

– DOB

– ID expiration date (cannot be expired)

2. A clear photo of your face

Cannot include:

– Sunglasses, hats, or other facial obstructions

– Family photos

– Filters

– Pictures of a picture

We’ll use these photos only to confirm that the pictures match each other. If you have any questions about how to upload your photos please email [email protected]

Cost, Pricing & Services

How much does a doctor’s visit cost?

Your online visit costs $15. This doesn’t include the cost of your medication (if prescribed). If a physician determines you’re not a good candidate for telemedicine, you’ll get a full refund for your online visit.

Is Roman covered by insurance?

Services on the Roman platform are not covered by insurance, but the $15 online visit is less than most co-pays.

How do I pause or cancel my orders?

Our shipments come either Monthly or Quarterly (every 3 months) depending on what you choose during your Online Visit. If regular shipments are not right for you, you can also switch to On-Demand shipments after you receive your first order. Additionally, you can pause or delay individual shipments.

We send email reminders 24 hours prior to processing a refill to allow for any adjustments.To make updates to your plan or pause/cancel any orders, please see the ‘Plan Details‘ section of your My Ro portal.

Can I return my shipment?

Unfortunately we cannot accept returns of prescription products for reuse or resale, and all sales are final. However, if you feel we have made an error in the filling of your prescription, please contact us at [email protected].

How much does the medication cost?

If prescribed, the cost of treatment depends on the type of medication and the amount of medication you receive. Prices at your local pharmacy may vary and are often twice the cost of the Ro Pharmacy Network.

When am I charged for the medication?

You’re only charged for the medication after a physician has approved a personalized treatment plan. If you’re unsuitable for telemedicine, you’ll be refunded for your online visit ($15). Once your account is created you can log into your My Ro to review plans details and shipping frequency.

Do I need to be home to sign for my order?

Signatures are not required upon delivery for the convenience of our members.

When will I receive my order?

Once your order is shipped you will receive an email link to track your shipment. All orders are shipped 2 Day Air to ensure medication is received as soon as possible.

Orders are only able to be shipped on weekdays; orders placed after 5 PM will ship next day.

Erectile dysfunction

How does ED treatment work on the Roman platform?

Roman uses telemedicine technology to provide a discreet, convenient, and affordable way for you to receive erectile dysfunction treatment from a U.S. Licensed physician. All without leaving the couch. Complete the dynamic onboarding, submit your photo, ID, and recent blood pressure reading, and our physicians will determine if you’re a candidate for telemedicine.

Erectile dysfunction is often a symptom of a more serious underlying condition—like heart disease, diabetes, high blood pressure, or even depression. That’s why we strongly recommend optional laboratory tests.

These tests aren’t required to receive treatment on the Roman platform. But they help identify the underlying cause of your ED. We want you to get the most comprehensive treatment possible. That’s why we’ll analyze your results for free. Just send us your most recent blood test and we’ll add it to your account information to help our physicians give you the most comprehensive care from the convenience of your phone.

It might sound funny but regular erections are a great barometer of your overall health. Learn why paying attention to the strength and frequency of your erection might actually save your life.

Which medications do doctors on the Roman platform prescribed for ED?

The American Urological Association claims that oral PDE-5 inhibitors should be offered as the “first line of therapy for erectile dysfunction.” So that’s what we do.

Physicians on the Roman Platform prescribe the most common PDE-5 oral medications which include:

Is ED medication effective?

Viagra’s FDA approved prescribing information claims that “82% of patients reported an improvement in their erections.” Other PDE-5 inhibitors (Cialis, Levitra) showed similar results.

Oral ED medication is generally considered extremely effective and studies show it works on the majority of men. But ED medication doesn’t work for everyone. It’s important to note that everyone’s reaction to a medication is unique.

Your Roman physician may recommend trying the medication multiple times under different circumstances. They may also increase your dose, depending on your reaction to the medication and any side effects. If you’ve been prescribed ED medication on the Roman platform, please contact a physician on from your account page if you have any questions.

Can a doctor diagnose erectile dysfunction remotely?

Yes, in most cases. Erectile dysfunction can be diagnosed by a physician based on a patient self-reporting their symptoms and medical history.

Physicians on the Roman platform use telemedicine technologies to diagnose ED in the same way they diagnose patients in-person. Doctors ask you questions to evaluate your symptoms and make sure it’s safe and appropriate to prescribe ED medication. The physicians on the Roman platform use your answers to diagnose your condition and create a treatment plan. That’s why it’s vital you answer each question to the best of your knowledge and ensure that every communication with your physician is truthful, accurate, and thorough.

In addition, it’s strongly recommended that you let your physician order laboratory tests to assist in trying to understanding the cause of your ED. These tests are optional and not a requirement for receiving treatment, but more information is always useful for diagnosis and treatment.

Why do I need to know my blood pressure to get an ED prescription?

Your blood pressure is an important part of determining whether it’s safe for you to take ED medication. It can be dangerous to take ED medication if your blood pressure is above or below a certain value.

To complete a comprehensive medical history during your online visit, you need to enter your most recent blood pressure reading within the last 6 months. If you haven’t had your blood pressure taken within the last 6 months, you can get a free blood pressure reading at thousands of locations across the country.Enter your location into higi or Pursuant Health to find a place near you that offers free, clinically verified blood pressure readings.

How do I take my blood pressure at home?

If you’re measuring your blood pressure at home, make sure the device has been “clinically validated.” You can purchase a device online or at your local pharmacy. We recommend an upper arm cuff over a wrist or finger blood pressure monitor.

Before taking your blood pressure, it’s important to avoid the following factors that may cause your blood pressure to temporarily rise:

  • Cold temperatures
  • Exercise
  • Caffeine
  • Stress
  • Smoking
  • Certain medications (check the label on your device)

When you’re ready, find a quiet place and sit for 5-10 minutes. Make sure you’re relaxed and have recently urinated (a full bladder can affect your reading). Roll up your sleeve so that your arm is bare. Apply the cuff on your upper arm and following the directions on the device.

Please make sure to take at least two readings. Enter the higher of the two readings during your online dynamic visit.

Do you offer alternative treatments for erectile dysfunction?

Oral ED medications are extremely effective, but they don’t work for everyone.

Other treatment options for ED include lifestyle improvements (like exercise, diet, quitting smoking, and limiting alcohol use), surgery, penile vacuum pumps, and other ED medications. Every treatment comes with risks and benefits that you should fully understand before moving forward with any treatment plan.

Currently, the only erectile dysfunction treatment we offer are oral PDE-5 inhibitors in the form of:

If you’d like to pursue alternative ED treatment, we recommend speaking with a physician in-person. Contact our team at [email protected] and we can recommend a doctor in your area.

How does my order ship?

Orders ship in discreet boxes, with all medication in single use packs. These single use packs are not child proof. Child proof packaging is available upon request by emailing [email protected].

Orders are shipped 2 Day Air to ensure medication is received as soon as possible. Postal Boxes and Mail Forwarding addresses will receive standard postal shipping and not 2 Day Air at this time.

Where can I get my blood pressure measured for free?

Enter your location into higi or Pursuant Health to find the nearest location to get a free, clinically verified blood pressure reading. Higi Stations are available free of charge at Rite Aids nationwide, and Pursuant Health stations are available free of charge at Walmarts nationwide.

What type of ED medication do you prescribe?

According to the American Urological Association, oral PDE-5 inhibitors should be offered as the “first line of therapy for erectile dysfunction.” So that’s what physicians on the Roman platform use to treat ED. The most common PDE-5 oral medications they prescribe are:

Hair loss

How does hair loss treatment with Roman work?

We use telemedicine technology and U.S. licensed physicians  to provide hair loss treatment that’s reliable, convenient, and discreet.

It starts with your dynamic online visit. Your Roman-affiliated doctor needs to know about your health (current prescriptions, lifestyle, habits, medical history, and symptoms) and see pictures of your current hair loss. They also need to see an official ID to confirm your identity. They review everything, determine if telemedicine is safe for you , and either approve your treatment request or follow up within 24 hours.

If you qualify, our doctors will provide a diagnosis and prescribe the right course of treatment to help you stop hair loss—and you may even regrow hair.

If approved, your FDA-approved medication will come with a  treatment plan with a great deal of information about hair loss. It is important you take the time to read it all.

What type of hair loss treatment do you prescribe?

Our physicians may prescribe finasteride (generic Propecia) to treat male pattern hair loss (androgenic alopecia). This medication helps patients maintain the hair they have or possibly even regrow some hair they have lost.

You can also get minoxidil (generic Rogaine), an over-the-counter topical treatment, to slow or even stops hair loss at the crown of the head.

Your doctor may recommend the use of finasteride combined with minoxidil.

Finasteride is not appropriate for all men and should never be used by women or handled by pregnant women. To learn more about who should not use finasteride and the potential side effects, please see the FAQ below regarding side effects and the important safety information.

Is hair loss treatment effective?

Hair loss treatment can work to preserve hair and possibly even regrow hair. In one study, Finasteride was effective at stopping hair loss in 83% of men compared to 28% for the placebo group.

Finasteride is not appropriate for all men and should never be used by women or handled by pregnant women. To learn more about who should not use finasteride and the potential side effects, please see the FAQ below regarding side effects and the important safety information.

How long does it take for hair loss treatment to work?

Finasteride and minoxidil typically take 3 to 4 months of daily use to start seeing visible changes. It can take up to a year to see the maximum results. As long as you don’t experience side effects, it’s best to continue medication for one full year before deciding on whether the medication is doing all it can for you. Like all medications, finasteride and minoxidil will work differently for different people.

IMPORTANT SAFETY INFORMATION

Are there side effects or hair loss medication?

The most common side effects associated with minoxidil are local skin irritation. Systemic side effects are rare as less than 2% of it gets absorbed.

Like most medications, finasteride is not safe for everyone. In clinical trials, less than 2% of men experienced sexual dysfunction due to Finasteride. In addition, finasteride can lower serum prostate-specific antigen and may increase the risk of high-grade prostate cancers. If you decide to seek care through Roman, your Roman-affiliated physician will be available to answer your questions about side effects. Finasteride is not approved for use in women, and pregnant women should not handle finasteride. To learn more about risks associated with the use of finasteride, please see IMPORTANT SAFETY INFORMATION.

Just as no drug works on everyone, no drug is 100% safe, and finasteride is no exception. Becoming familiar with the possible side effects will help you identify if you are one of the men who experiences them. If you do, you should stop immediately and inform your doctor.

Do I need to take a photo of my hair?

Yes. During your online doctor visit, we’ll ask you to take and upload a few photos. This helps your physician determine the appropriate treatment option.

How much does the online visit cost?

Your online visit costs $15. This doesn’t include the cost of your medication (if prescribed). If a physician determines you’re not a good candidate for telemedicine, you’ll get a full refund for your online visit.

Is Roman covered by insurance?Services on the Ro platform are not covered by insurance, but the $15 online visit fee is less than most co-pays.

How much does the medication cost?

If prescribed, the cost of treatment depends on the type of medication and the number of doses you receive. Finasteride plans are $0.67 per day, minoxidil plans are $0.53 per day, and when ordered together, the combination is $1.17 per day [when you select a quarterly plan]. Prices at your local pharmacy may vary and are often twice the cost of the Roman Pharmacy Network.

When am I charged for this medication?

You’re only charged for the medication after a physician has approved your personalized treatment plan. If you’re unsuitable for telemedicine, you’ll be refunded for your online visit ($15).

Premature ejaculation

How does P.E. treatment work with Roman?

We use telemedicine technology and U.S. licensed doctors to provide premature ejaculation treatments discreetly, conveniently, and inexpensively.

It starts with your online doctor visit. Your doctor needs to know about your health (e.g., your medications, lifestyle issues, prior surgeries) and how P.E. affects you. They also need to see a personal ID to confirm your identity and know who they will be helping. They review everything, determine if you’re a candidate for telemedicine and, if so (most people are), they will craft a personalized treatment plan.

Their treatment plan will include a great deal of information about P.E. It is important you take the time to read it all. You will be better prepared to manage your condition as a partner—and not just a patient.

If you qualify, our doctors will provide a diagnosis, behavioral therapy tips and prescribe the right course of treatment to help you last longer during sex.

What is P.E.?

One of the problems with the diagnosis and treatment of PE is that until recently there has not been agreement on what constitutes premature ejaculation. Many men believe they orgasm more quickly than they should only to discover that their time to orgasm is well within the average range. Other men might orgasm in 2 minutes but find it is neither a cause for concern for them nor for their partner.

  1. According to the International Society of Sexual Medicine (ISSM) premature ejaculation is a male sexual dysfunction characterized by the following: Ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience—Lifelong Premature Ejaculation (LPE), OR a clinically significant reduction in latency time (time it takes to reach orgasm after engaging in sex), often to about 3 minutes or less–Acquired Premature Ejaculation (APE);
  2. The inability to delay ejaculation on all or nearly all vaginal penetrations; and
  3. Negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

All three elements must be included for PE to be diagnosed. Men with PE generally fall into two groups: those who have it from their first sexual experience and those who develop it later. The good thing is that many of the interventions work for both groups.

Another definition of PE that has been suggested by the World Health Organization (WHO) is “persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it, over which the sufferer has little or no voluntary control which causes the sufferer and/or his partner bother or distress.” This second definition is more flexible. It is also inclusive of gay men and their partners, which is a welcome addition to the definition.

Is P.E. medication effective?

Although no single treatment works for everyone, most men can be treated successfully. Just be sure to stay in touch with your physician. There are multiple medications that can be tried, different topical therapies, and varied techniques that can be used alone or in unique combinations. Some people see immediate results. Others will find they need to try a few different methods before finding the right solution. If things don’t go as planned or if you experience an adverse side effect, don’t give up. You have options and we are here to help you find the best solution.

What type of PE medication do Roman-affiliated physicians prescribe?

In addition to behavioral tips, there are several medication options that your doctor may recommend, depending on your unique health situation.These include the most effective treatments recommended by the American Urological Association.

The simplest effective treatment is usually the best choice, so your provider will try to prescribe the medication that is most likely to work well for you. Based on your feedback, however, your management may change over time by switching to another medication choice or using a combination of agents. Some men use an oral medication and apply a topical anesthetic that they then cover with a condom. They get the sensations they want, experience the prolonged pleasure of an extended sexual experience, and orgasm at a time both they and a partner find satisfying. For other men, such a combination is overkill. That is why your personal experience is so important.

Learn more about P.E. treatment

What is off-label prescribing?

The FDA requires that drugs go through a clinical testing process to establish that they’re safe and effective to treat a particular condition. Healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient. This type of prescribing is called “off-label” prescribing. Off-label prescribing practices are sometimes validated by clinical experience and research and may be a widely recognized clinical practice. Roman-affiliated providers have the discretion to prescribe certain drugs off-label based a patient’s unique medical history, symptoms, and preferences.

Why can P.E. and Erectile Dysfunction (E.D.) be treated with the same medication?

What is most interesting is that ED often is an underlying cause of PE. Sometimes, the same stress that causes either one can cause both. However, ED itself can begin a cascade of changes that results in PE. This is because men with ED often attempt to keep themselves erect by vigorously stimulating themselves, and this intense stimulation can inadvertently result in PE. When the erection is supported by sildenafil or tadalafil, vigorous stimulation is often not needed to maintain an erection. With less vigorous stimulation, men gain more control over the timing of their ejaculation.

Are there side effects of P.E. medication?

The medications available for treating P.E. work for the vast majority of patients and they usually do so without causing side effects. However, just as no drug works on everyone, no drug is 100% safe, and these treatments are no exception. Becoming familiar with the possible side effects will help you identify if you are one of the men who experience them. If you experience an adverse side effect, don’t give up. You have options and we are here to help you find the best solution.

What are the non-prescription options for treating P.E.?

Your physician may recommend a combination of medication and behavioral therapy tips to deal with P.E. No two people are alike, and it may take some time and experimentation to find the methods that work best for you. Some men experience significant improvement with learned techniques so medication isn’t for everyone.

Some recommended techniques include:

Topical Anesthetics: Topical anesthetics can be applied to the penis just before sexual activity. They come as creams, lotions, or sprays and are available over-the-counter. The advantage of topical applications is that the side effect rate is low and they are effective to some degree in almost everyone to decreasing sensation and prolonging the time before ejaculation.

Condoms: Condoms can help with PE by decreasing penile sensitivity and have the added benefit of reducing the likelihood of transmission of sexually transmitted infection or unwanted pregnancy. Using a spray, cream, or lotion with a condom is surprisingly effective for some men. It delays orgasm, gives some men just the right amount of pleasurable sensation, and when used with a topical anesthetic prevents the spread of the anesthetic to a partner.

Behavioral modification: The squeeze and start-stop techniques are 2 different strategies that can be practiced during masturbation or sexual activity and, over time, can improve control over the timing of ejaculation.

Psychotherapy: Counseling, whether in person, by telephone, or by text messaging, may increase the likelihood of success for some patients. The reality is that men who have had lifelong issues have often suffered silently with a burden that weighs on them every time they consider developing a physical and emotional attachment to another person. They face disappointing the very person they hope to please the most. For many men, it terminates relationships before they begin and can lead to isolation and a loss of companionship. Men with PE face increased risks of divorce and relationship stress, often more as a result of the emotional consequences of having PE than from the PE itself. Uncovering the reasons the PE developed are as important as breaking the cycle with medical interventions.

Also, psychotherapy can be enormously helpful in restoring a man’s sense of value and worth beyond the ability to delay an orgasm, which often restores their capacity to experience sex as they had before PE developed.

Combination Therapy: Any of the above treatments can be combined with any one or more of the other treatments. Although it’s often best to keep things simple, the good news is that combination therapy can help treat men who don’t respond satisfactorily to single mode therapies.

How much does a doctor’s visit cost?

Your online visit costs $15. This doesn’t include the cost of your medication (if prescribed). If a physician determines you’re not a good candidate for telemedicine, you’ll get a full refund for your online visit.

Is Roman covered by insurance?

Our services are not covered by insurance, but the $15 online visit is less than most co-pays.

How much does the medication cost?

If prescribed, the cost of treatment depends on the type of medication and the number of doses you receive. Check out the current Roman Pharmacy Network prices. Prices at your local pharmacy may vary and are often twice the cost of the Roman Pharmacy Network.

When am I charged for this medication?

You’re only charged for the medication after a physician has approved a personalized treatment plan. If you’re unsuitable for telemedicine, you’ll be refunded for your online visit ($15).

Cold sores

How does cold sore (oral herpes) treatment with Roman work?

We use telemedicine technology and U.S. licensed doctors to provide cold sore treatments discreetly, conveniently, and inexpensively.

It starts with your online doctor visit. Your doctor needs to know about your health (e.g., your medications, lifestyle issues, prior surgeries) and how cold sores affect you.

They also need personal ID so they know who they will be helping in the coming year. They review everything, determine if you’re a candidate for telemedicine and, if so (most people are), they will craft a personalized treatment plan.

Their treatment plan will include a great deal of information about oral herpes. It is important you take the time to read it all. You will be better prepared to manage your condition as a partner—and not just a patient.

If you qualify, our doctors will provide prescribe the right course of treatment to help you take control of cold sore outbreaks.

What type of cold sore medication do you prescribe?

Our Physicians prescribe Valacyclovir (generic Valtrex) to treat cold sores (oral herpes). When used properly, this medication can abort an outbreak at the first sign that one is coming on or lessen its severity.

IMPORTANT SAFETY INFORMATION

Is cold sore medication effective?

Cold sore (oral herpes) medication is available, and it works extremely well. But it requires you to dedicate the time to learn about your condition and work with your physician to craft the ideal, personalized treatment plan.

When you do, you’ll be able to identify your specific symptoms (prodrome) and use your medication to shorten or stop the outbreak from occurring.

IMPORTANT SAFETY INFORMATION

What are the side effects of cold sore medication?

What follows is a summary and does not include every side effect possible.

Common side effects include headache, feeling sick, dizziness, vomiting, diarrhea, skin reaction after exposure to sunlight (photosensitivity), rash, or itching (pruritus).

Uncommon side effects include feeling confused, seeing or hearing things that aren’t there (hallucinations), feeling very drowsy, tremors, or feeling agitated, shortness of breath (dyspnea), stomach discomfort, rash, sometimes itchy, hive-like rash (urticaria), low back pain (kidney pain), blood in the urine (hematuria), reduction in the number of blood platelets which are cells that help blood to clot (thrombocytopenia), reduction in the number of white blood cells (leucopenia), increase in substances produced by the liver

Rare side effects include unsteadiness when walking and lack of coordination (ataxia), slow, slurred speech (dysarthria), fits (convulsions), altered brain function (encephalopathy), unconsciousness (coma), confused or disturbed thoughts (delirium), kidney problems where you pass little or no urine. Lastly, watch out for a severe allergic reaction (anaphylaxis). These are rare in people taking Valtrex. Anaphylaxis is marked by the rapid development of flushing, itchy skin rash, swelling of the lips, face, neck, and throat—causing difficulty in breathing (angioedema), fall in blood pressure leading to collapse. If any of these occur, get emergency treatment immediately

IMPORTANT SAFETY INFORMATION

Can a doctor treat cold sores remotely?

Yes. Our doctors can prescribe medication and help you dial in the most effective treatment plan for your unique needs.

Physicians on the Ro platform use telemedicine technologies to treat cold sores in the same way they treat patients in-person. Doctors ask you questions to evaluate your symptoms and make sure it’s safe and appropriate to prescribe cold sore medication. The physicians on the Ro platform use your answers to assess your condition and create a treatment plan. That’s why it’s vital you answer each question to the best of your knowledge and ensure that every communication with your physician is truthful, accurate, and thorough.

Do I need to take a photo of my cold sore outbreak?

No

Why is the medication for oral and genital herpes the same?

Though they infect different parts of the body, cold sores (oral herpes) and genital herpes are caused by the same virus. There are two strains of the herpes virus; cold sores are more frequently caused by HSV-1, while genital herpes is more commonly associated with HSV-2. Both strains of the virus can be effectively treated using the same medication.

How much does a doctor’s visit cost?

Your online visit costs $15. This doesn’t include the cost of your medication (if prescribed). If a physician determines you’re not a good candidate for telemedicine, you’ll get a full refund for your online visit.

Is Roman covered by insurance?

Our services are not covered by insurance, but the $15 online visit is less than most co-pays.

How much does the medication cost?

If prescribed, the cost of treatment depends on the type of medication and the number of doses you receive. Check out the current Roman Pharmacy Network prices. Prices at your local pharmacy may vary and are often twice the cost of the Roman Pharmacy Network.

When am I charged for this medication?

You’re only charged for the medication after a physician has approved a personalized treatment plan. If you’re unsuitable for telemedicine, you’ll be refunded for your online visit ($15).

Genital herpes

How does genital herpes treatment with Roman work?

We use telemedicine technology and U.S. licensed doctors to provide genital herpes treatments discreetly, conveniently, and inexpensively.

It starts with your online doctor visit. Your doctor needs to know about your health (e.g., your medications, lifestyle issues, prior surgeries) and how genital herpes affects you.

They also need personal ID so they know who they will be helping in the coming year. They review everything, determine if you’re a candidate for telemedicine and, if so (most people are), they will craft a personalized treatment plan.

Their treatment plan will include a great deal of information about genital herpes. It is important you take the time to read it all. You will be better prepared to manage your condition as a partner—and not just a patient.

If you qualify, your doctor will provide a diagnosis and prescribe the right course of treatment to help you take control of herpes outbreaks.

What type of genital herpes medication do you prescribe?

Our Physicians prescribe Valacyclovir (generic Valtrex) to treat genital herpes. When used properly, this medication can help prevent and clear up herpes outbreaks.

IMPORTANT SAFETY INFORMATION

Is genital herpes medication effective?

Genital herpes medication is available, and it works extremely well. But it requires you to dedicate the time to learn about your condition and work with your physician to craft the ideal, personalized treatment plan.

When you do, you’ll be able to identify the first indication of your specific symptoms (prodrome) and use your medication to shorten or stop the outbreak from occurring.

IMPORTANT SAFETY INFORMATION

What are the side effects of genital herpes medication?

What follows is a partial summary and does not include every side effect possible.

Common side effects include headache, feeling sick, dizziness, vomiting, diarrhea, skin reaction after exposure to sunlight (photosensitivity), rash, or itching (pruritus).

Uncommon side effects include feeling confused, seeing or hearing things that aren’t there (hallucinations), feeling very drowsy, tremors, or feeling agitated, shortness of breath (dyspnea), stomach discomfort, rash, sometimes itchy, hive-like rash (urticaria), low back pain (kidney pain), blood in the urine (hematuria), reduction in the number of blood platelets which are cells that help blood to clot (thrombocytopenia), reduction in the number of white blood cells (leucopenia), increase in substances produced by the liver

Rare side effects include unsteadiness when walking and lack of coordination (ataxia), slow, slurred speech (dysarthria), fits (convulsions), altered brain function (encephalopathy), unconsciousness (coma), confused or disturbed thoughts (delirium), kidney problems where you pass little or no urine. Lastly, watch out for a severe allergic reaction (anaphylaxis). These are rare in people taking Valtrex. Anaphylaxis is marked by the rapid development of flushing, itchy skin rash, swelling of the lips, face, neck, and throat—causing difficulty in breathing (angioedema), fall in blood pressure leading to collapse. If any of these occur, get emergency treatment immediately


IMPORTANT SAFETY INFORMATION

Can a doctor treat genital herpes remotely?

Yes. If your genital herpes has been diagnosed by a physician, our doctors can prescribe medication and help you dial in the most effective treatment plan for your unique needs.

Physicians on the Ro platform use telemedicine technologies to treat you in the same way they treat patients in-person. Doctors ask you questions to evaluate your symptoms and make sure it’s safe and appropriate to prescribe medication. The physicians on the Ro platform use your answers to assess your condition and create a treatment plan. That’s why it’s vital you answer each question to the best of your knowledge and ensure that every communication with your physician is truthful, accurate, and thorough.

Do I need to take a photo of my genital herpes outbreak?

No. But you do need to have your genital herpes previously diagnosed by a physician.

Why is the medication for oral and genital herpes the same?

Though they infect different parts of the body, cold sores (oral herpes) and genital herpes are caused by the same virus. There are two strains of the herpes virus—cold sores are more frequently caused by HSV-1, while genital herpes is more commonly associated with HSV-2. Both strains of the virus can be effectively treated using the same medication.

How much does a doctor’s visit cost?

Your online visit costs $15. This doesn’t include the cost of your medication (if prescribed). If a physician determines you’re not a good candidate for telemedicine, you’ll get a full refund for your online visit.

Is Roman covered by insurance?

Our services are not covered by insurance, but the $15 online visit is less than most co-pays.

How much does the medication cost?

If prescribed, the cost of treatment depends on the type of medication and the number of doses you receive. Check out the current Roman Pharmacy Network prices. Prices at your local pharmacy may vary and are often twice the cost of the Roman Pharmacy Network.

When am I charged for this medication?

You’re only charged for the medication after a physician has approved a personalized treatment plan. If you’re unsuitable for telemedicine, you’ll be refunded for your online visit ($15).

Testosterone support

What is testosterone?

Testosterone is a steroid hormone that is present in the bodies of both men and women, although men have higher concentrations of it. Testosterone is made in the testes, ovaries, and adrenal glands and is derived from cholesterol. It is primarily responsible for the development of the male reproductive system and also plays a role in body hair growth, muscle mass, fat distribution, voice depth, and libido. In the body, some testosterone is converted into dihydrotestosterone, which plays a role in prostate enlargement and baldness, and estradiol, which is a type of estrogen.

What causes low testosterone?

It is normal for testosterone levels to decrease with age. This can be a result of declining testicular function as well as modifiable lifestyle factors, like how much you are exercising. However, some men have low testosterone independent of this age-related decline. And while there are many possible causes for low testosterone (alcohol abuse, diabetes, genetic disorders, metabolic disorders, medications, trauma, etc.), some men may never discover what is causing it in them. Low testosterone is a medical condition that should be treated with the guidance of a healthcare professional. 

What are the symptoms of low testosterone?

There are a variety of symptoms you may be experiencing that could indicate you have low testosterone. Having little interest in sex or having difficulty getting or maintaining an erection are two of the sexual symptoms related to low testosterone. However, there are also more nonspecific symptoms such as low energy, depression, decreased muscle mass, increased fat mass, and decreased body hair. If you have any of these symptoms, you should talk to your healthcare provider about whether you may be suffering from low testosterone

How do I know if I have low testosterone?

If you think you may have low testosterone, you should talk to a healthcare provider. Your healthcare provider will likely ask many questions to find out more about your medical history, your risk factors, and your symptoms. A blood test can then diagnose whether or not you have low testosterone. Your testosterone levels change throughout the day and are generally highest in the morning, so it is likely that your healthcare provider will ask you to do the blood test between 8:00am and 10:00am, and that they will do this twice to confirm the diagnosis. Once you have the results, your healthcare provider will be able to counsel you on the next best steps for you. If you do have low testosterone, your healthcare provider may try to figure out the cause or may suggest treating you with testosterone replacement therapy or other therapies to increase testosterone levels.

Why did Roman choose the ingredients in Roman’s Testosterone Support supplement?

Roman’s Testosterone Support supplement is a mix of five individual ingredients, including ashwagandha, maca, magnesium, vitamin D, and zinc. Roman chose these ingredients because each has individually been shown to have beneficial effects in some studies. These include improving sexual functioning, increasing libido, improving semen quality, and raising testosterone levels. In some cases, the evidence is limited because studies have only been done in vitro, in animals, or in small human clinical trials. And in other cases, these effects were only noted in men who had specific vitamin deficiencies. All five ingredients are generally well tolerated and some are important for overall health as well. And in some cases, like with vitamin D, evidence suggests that a significant portion of the society is deficient and could benefit from supplementation. One older study also found that hospitalized patients have a high rate of magnesium deficiency. Roman’s Testosterone Support supplement isn’t intended to treat low testosterone and isn’t a substitute for prescription treatments prescribed by your healthcare provider.

How does ashwagandha impact testosterone?

One study in older, overweight males demonstrated that 8 weeks of supplementation with ashwagandha extract increased levels of DHEA-S (a steroid hormone that helps make testosterone) and testosterone. Other limited studies have shown that supplementation is associated with improved muscle strength, increased muscle size, decreased body fat percentage, and improved semen quality. However, ashwagandha has not been evaluated by the FDA and further studies need to be done to better understand its effects and optimal dosing.

How does maca impact testosterone?

Maca has not been found to play a role in testosterone levels. However, limited studies have found that maca is associated with improved sexual performance scores, libido, and semen quality. However, maca has not been evaluated by the FDA and further studies need to be done to better understand the effects and optimal dosing of maca.

How does magnesium impact testosterone?

Magnesium is necessary for the normal functioning of several bodily processes. One study that looked at the effects of magnesium supplementation in both sedentary and athletic individuals found that testosterone levels increased after 4 weeks. Another study found that magnesium levels in men ages 65 and older are closely associated with testosterone levels. However, magnesium has not been evaluated by the FDA as a treatment for low testosterone and further studies need to be done to better understand the effects and optimal dosing of magnesium.

How does vitamin D impact testosterone?

Vitamin D is necessary for the normal functioning of several bodily processes. One study on overweight men who had a vitamin D deficiency found that after a year of supplementation with vitamin D, testosterone levels increased. Another small study found that supplementation with vitamin D was associated with increased testosterone levels and improved erectile function. However, vitamin D has not been evaluated by the FDA as a treatment for low testosterone and further studies need to be done to better understand the effects and optimal dosing of vitamin D.

How does zinc impact testosterone?

Zinc is necessary for the normal functioning of several bodily processes. One study found that restriction of zinc led to a decline in testosterone levels, while supplementation in those who were zinc-deficient led to increased testosterone levels. Another very limited study has shown that zinc supplementation is associated with improved semen quality and a study in rats indicated that zinc supplementation may be associated with improved sexual competence. However, zinc has not been evaluated by the FDA as a treatment for low testosterone and further studies need to be done to better understand the effects and optimal dosing of zinc.

How do these supplements compare to other testosterone support supplements I can buy?

There are many different supplements on the market that advertise that they support healthy testosterone levels in men. While some individual ingredients may overlap between Roman’s Testosterone Support supplement and other brands, not all formulations are exactly the same. All five ingredients and their dosages in Roman’s supplements were individually selected and specifically chosen.

Roman’s Testosterone Support supplement was not tested against or compared to any other products. Roman makes no claims about how this pack will affect your body compared to other testosterone support supplements. While Roman believes Roman’s Testosterone Support supplement combines the best ingredients to support healthy testosterone levels, ultimately whichever supplements you end up taking are at your own discretion.

Will Roman’s Testosterone Support supplement increase my levels of testosterone?

Roman’s Testosterone Support supplement is not intended to diagnose, treat, cure, or prevent any disease. The supplements have not been tested in any clinical trials and there is no guarantee that taking the supplements will lead to an increase of testosterone in your body. Moreover, the supplements themselves are not testosterone nor are they precursors to testosterone. Rather, the supplements are made of plants, vitamins, and minerals that have been shown to naturally raise testosterone levels or otherwise impact the sexual health of men in some studies at certain doses when tested individually.

Will Roman’s Testosterone Support supplement improve my stamina and performance during sex?

Roman’s Testosterone Support supplement is not intended to diagnose, treat, cure, or prevent any disease. The supplements have not been tested in any clinical trials and there is no guarantee that taking the supplements will lead to an improvement in your sexual stamina or functioning. While some of the ingredients in Roman’s Testosterone Support supplement have individually been shown to improve libido and sexual functioning in men in some studies, these specific supplements have not been tested. That being said, some men may find that their stamina and performance during sex do improve after taking these supplements.

How should I take Roman’s Testosterone Support supplement?

Roman’s Testosterone Support supplement is intended to be taken daily. Each individual packet contains four tablets, with each containing a mixture of all five ingredients. You may take all four tablets at once, or you can take them in divided doses throughout the day. To facilitate the absorption of vitamin D, it is recommended that you take the supplements with food.

To assess tolerability, you may want to begin by taking 1-2 tablets per day. Depending on the side effects you may be experiencing (if any), you can then gradually work your way up to the full dose.

Can I take more than four tablets per day?

It is not recommended that you take more than four tablets of Roman’s Testosterone Support supplement per day. Doing so may increase your chance of experiencing side effects and may even be dangerous for your health. The Institute of Medicine publishes the Tolerable Upper Intake Levels (UL) for many nutrients. The UL indicates the “maximum daily intake unlikely to cause adverse health effects” for these nutrients. Three of the ingredients in Roman’s Testosterone Support supplement (magnesium, vitamin D, and zinc) have published ULs. Taking more than the recommended four tablets per day may therefore increase your chances of experiencing side effects. Additionally, these supplements should not be taken in combination with other supplements that contain magnesium, vitamin D, or zinc.

Why does Roman’s Testosterone Support supplement contain more magnesium than the UL? Is that dangerous?


The UL for supplemental magnesium is 350mg per day. This value refers to the maximum amount of magnesium that should be ingested daily in supplement form to avoid side effects such as diarrhea, nausea, and abdominal pain. Roman’s Testosterone Support supplement contains 400mg of magnesium, which is above the UL. However, Roman offers magnesium in the form of magnesium citrate, which is less likely than other formulations to cause side effects. Magnesium citrate is safe to ingest even at doses as high as 2.8g for a limited amount of time (five day maximum), which is sometimes given as a laxative. Note that the Recommended Dietary Allowance (RDA) of magnesium is 400mg per day for men ages 19-30 and 420mg per day for men ages >30, which is higher than the UL. Be sure to talk to your healthcare provider about any new side effects you experience while taking Roman’s Testosterone Support supplement.

What do I do if I accidentally miss a dose?

If you accidentally miss a dose, you can either take it when you remember or you can wait until the next day to resume the supplements. It does not matter what time of day you take the supplements. However, to avoid going over the Tolerable Upper Intake Levels for magnesium, vitamin D, and zinc, you should not take more than four tablets in a 24-hour period.

What are the side effects of Roman’s Testosterone Support supplement?

Roman’s Testosterone Support supplement has not been tested to establish a side effect profile. However, based on the individual ingredients in the supplements, possible side effects include altered menstrual cycles, altered mood, cramping, difficulty sleeping, drowsiness, fatigue, gastrointestinal discomfort, and loose stools. Rarer, but more serious side effects may also occur. If you are experiencing worrisome symptoms, stop taking the supplements immediately and speak to your healthcare provider.

Can women take Roman’s Testosterone Support supplement?

It is safe for women to take Roman’s Testosterone Support supplement. However, the supplements are potentially dangerous during pregnancy, so women of child-bearing age should avoid taking the supplements unless they know they are not pregnant. Additionally, many of the benefits this supplement is designed for (improved sexual function, increased libido, improved semen quality, and higher testosterone levels) have only ever been tested in men, so it is unclear what the effects of this supplement may be in women.

If I stop taking Roman’s Testosterone Support supplement, will my body still be able to make testosterone?

One concern with taking testosterone replacement therapy is that the artificially introduced testosterone can suppress the body’s drive to create its own natural testosterone. As a result, when testosterone replacement therapy is abruptly stopped, there may be a period of time that the body is producing less testosterone than it is capable of.

Roman’s Testosterone Support supplement works differently in the body than testosterone replacement therapy. Roman’s Testosterone Support supplement contains specific nutrients that are thought to naturally support testosterone production. The support pack does not contain testosterone and will not suppress the body’s production of testosterone the way that taking testosterone replacement therapy will. However, if you have an underlying magnesium, vitamin D, or zinc deficiency, you may recognize that symptoms of those deficiencies return after stopping this supplement.

How else can I support healthy testosterone levels in my body?

Roman’s Testosterone Support supplement has not been tested in clinical trials and it is unknown how quickly users who benefit from taking the supplement will see results. It is likely that individual users will begin feeling the effects of supplementation at different times from one another. Some people may not feel any differently even if the supplement is having an effect.

When the individual ingredients were tested in studies, some study participants began seeing effects in as little as 4 weeks. However, other studies followed participants for months to years before the benefits of treatment were quantified.

If you have a marked deficiency of magnesium, vitamin D, or zinc, it is possible you will start feeling the effects of supplementation even sooner than 4 weeks.

Should I take testosterone replacement therapy instead of Roman’s Testosterone Support supplement or vice versa?

Testosterone replacement therapy is a treatment for those with low testosterone and must be prescribed by a healthcare provider. Never attempt to obtain testosterone on your own and always talk to your healthcare provider about everything you are taking. While testosterone replacement therapy may be indicated in some patients, it can be dangerous in others or when used improperly.

Roman’s Testosterone Support supplement is not a treatment for low testosterone. If your healthcare provider has determined that testosterone replacement therapy would be right for you, this supplement is not an appropriate substitute.

Allergies

What is allergic rhinitis?

Allergic rhinitis is sometimes called “hay fever” or “seasonal allergies,” although it can be caused by nonseasonal substances as well. Allergic rhinitis refers to inflammation in the nose (rhinitis) that occurs when you are exposed to a substance you are allergic to. The term “allergic rhinitis” does not refer to all kinds of allergies you may have. For example, food allergies and allergies to medications do not typically cause allergic rhinitis.

What are allergies?

“Allergies” is a general term that refers to a reaction the body has to allergens. Allergens are substances that are generally not harmful to the body. However, if you have allergies, the immune system thinks allergens are dangerous and tries to fight them off like it would any other intruder, such as bacteria, viruses, and parasites. Having allergies, therefore, means the immune system is overactive. In other words, the immune system is doing something it is normally supposed to do but the reaction is exaggerated, unnecessary, and even harmful to the body. In medical terminology, this overreaction is called a type 1 hypersensitivity reaction.

There are many different kinds of allergies that differ based on the part of the body affected and the severity of symptoms. In some cases, allergies may cause a small rash or runny nose. In other cases, allergies can be life-threatening. Types of allergies include allergic rhinitis (inflammation in the nose), contact dermatitis (an allergic reaction on the skin), allergic asthma (a specific type of asthma), and anaphylaxis (a life-threatening condition that involves swelling of the airways).

What are the most common allergens?


There are many different allergens that affect the body. These include foods, plants, animals, metals, chemicals, medications, and more. Some allergens are known as airborne allergens because they are present in the air. The most common airborne allergens include tree pollens, grass pollens, weed pollens, pet dander, and molds. Dust mites and cockroach allergens are also common and may be airborne, however they settle more quickly than the other airborne allergens.

Roman only offers treatment for allergic rhinitis, which is caused by airborne allergens. However, there are many other common allergens you may have. The most common food allergens are fish, shellfish, peanuts, tree nuts, eggs, wheat, soy, and milk. These allergens always need to be labeled on food if they are present. Other allergens you may have heard of include:

  1. Insect venom (e.g. getting stung by a bee)
  2. Nickel (e.g. getting a rash after wearing certain jewelry)
  3. Latex (e.g. getting a rash when coming into contact with latex)
  4. Medications (e.g. getting hives after taking penicillin)

What causes allergic rhinitis?

Allergic rhinitis is typically caused by allergens that are airborne. These are roughly divided into outdoor airborne allergens and indoor airborne allergens. Common airborne allergens found outdoors include tree pollens, grass pollens, and weed pollens. Common airborne allergens found indoors include animal dander, dust mites, and mold.

Outdoor allergens are usually seasonal because plants release pollen at certain times of the year. Spring allergies are commonly due to tree pollens. Late spring and summer allergies are commonly due to grass pollens. Late summer and autumn allergies are commonly due to weed pollens, such as ragweed pollen. In fact, ragweed pollen is one of the primary causes of allergic rhinitis and 75% of people with pollen allergies are allergic to ragweed.

Indoor allergens may be present throughout the year. However, certain situations can make indoor allergies worse. For example, animal dander allergies may be worse in the winter because pets may spend more time indoors and there is less circulating fresh air. And mold allergies may be worse if there is a very rainy spring season.

What causes allergies?

Researchers aren’t sure why some people develop allergies and others do not. What we do know is that the tendency to develop allergies is genetic. This means if your family members have allergies, you are more likely to have them as well. Additionally, certain allergic conditions commonly occur together. Known as the “atopic triad,” these conditions are allergic rhinitis, eczema (also called atopic dermatitis), and allergic asthma.

What is immunoglobulin E (IgE)?

Immunoglobulin E (IgE) is a type of antibody. Antibodies are proteins that the body forms to help fight invaders, known as pathogens. There are several kinds of antibodies that the body can make. IgA antibodies are typically found in mucous membranes, such as the mouth and the intestinal linings. IgA is also found in breastmilk and can transfer from mother to baby. IgD antibodies are less understood and signal certain immune cells to activate. IgM antibodies are the first antibodies the body makes when exposed to a pathogen. And IgG antibodies take longer to make but are the antibodies we typically think of that are associated with immunity to diseases.

IgE antibodies are normally beneficial because they help protect against parasites. However, IgE antibodies are also responsible for allergic reactions. When the body encounters an allergen for the first time, it develops IgE antibodies that are targeted against that allergen. The IgE antibodies then attach to the surface of immune cells called mast cells and basophils. The next time the body is exposed to the same allergen, the allergen links up with the IgE antibodies, beginning a series of events that result in allergy symptoms.

What is histamine?

Histamine is an inflammatory chemical that is released by immune cells during an allergic reaction. The release of histamine is normally helpful because it can help fight pathogens that are affecting the body. However, during an allergic reaction, histamine is released when it shouldn’t be. Histamine is responsible for symptoms like watery eyes, runny nose, sneezing, and itchy skin.

What are leukotrienes?

Leukotrienes are inflammatory chemicals that are released by immune cells during an allergic reaction. The release of leukotrienes is normally helpful because they can help fight pathogens that are affecting the body. However, during an allergic reaction, leukotrienes are released when they shouldn’t be. Leukotrienes are responsible for inflammation and the production of a large amount of mucus.

What are the steps of an allergic reaction?

Vitamin D is necessary for the normal functioning of several bodily processes. One study on overweight men who had a vitamin D deficiency found that after a year of supplementation with vitamin D, testosterone levels increased. Another small study found that supplementation with vitamin D was associated with increased testosterone levels and improved erectile function. However, vitamin D has not been evaluated by the FDA as a treatment for low testosterone and further studies need to be done to better understand the effects and optimal dosing of vitamin D.

  1. The first time the body is exposed to an allergen, it responds by creating antibodies known as immunoglobulin E (IgE).
  2. IgE antibodies attach to the surface of immune cells called mast cells and basophils.
  3. The next time the body is exposed to the same allergen, the allergen links up with the IgE antibodies. This prompts the mast cells and basophils to release inflammatory chemicals, including histamine and leukotrienes.
  4. The release of histamine and leukotrienes causes the symptoms that are typically associated with allergies. Histamine is responsible for watery eyes, runny nose, sneezing, and itchy skin. Leukotrienes are responsible for inflammation and the production of a large amount of mucus.

How does azelastine help treat allergic rhinitis?

Azelastine works by blocking the H1 receptors on cells, which are receptors that are normally activated by the chemical histamine. When the body is exposed to an allergen, immune cells (called mast cells and basophils) release histamine. Since azelastine blocks histamine from activating the H1 receptors, the symptoms that are typically caused by histamine are lessened. Azelastine also has anti-inflammatory effects and reduces congestion.

How does fluticasone propionate help treat allergic rhinitis?

Researchers are not entirely sure how fluticasone propionate works but it is known to have a wide range of effects on different immune cells and chemicals that cause inflammation, including mast cells, histamine, and leukotrienes.

How does levocetirizine help treat allergic rhinitis?

Levocetirizine works by blocking the H1 receptors on cells, which are receptors that are normally activated by the chemical histamine. When the body is exposed to an allergen, immune cells (called mast cells and basophils) release histamine. Since levocetirizine blocks histamine from activating the H1 receptors, the symptoms that are typically caused by histamine are lessened.

How does montelukast help treat allergic rhinitis?

Montelukast works by blocking cysteinyl leukotriene receptors, which can be activated by the chemical leukotriene D4. When the body is exposed to an allergen, immune cells (including mast cells and basophils) release leukotriene D4. Since montelukast blocks leukotriene D4 from activating the cysteinyl leukotriene receptors, the symptoms that are typically caused by leukotriene D4 are lessened.

Does azelastine make you drowsy?

Yes, azelastine may make you drowsy. Azelastine is a type of medication known as an antihistamine. One of the common side effects of antihistamines is drowsiness. As such, azelastine may make users drowsy after use. Users should exercise caution when taking azelastine and should be aware that mental alertness may be decreased. This can impact the ability to drive or operate machinery.

Does fluticasone propionate make you drowsy?

No, fluticasone propionate should not make you drowsy. Antihistamines are a group of medications that are commonly used to treat allergies and one of the side effects of antihistamines is drowsiness. However, fluticasone propionate is not an antihistamine. It is a type of medication known as a glucocorticoid. Therefore, fluticasone propionate does not typically cause drowsiness as other allergy medications do. That being said, the Prescriber’s Digital Reference (PDR) for fluticasone propionate does list fatigue as one of the many possible side effects of taking the medication.

Does levocetirizine make you drowsy?


It is possible levocetirizine will make users drowsy but the exact answer is unclear. Levocetirizine is a type of medication that is sometimes referred to as a third-generation antihistamine. It is derived from cetirizine (brand name Zyrtec), which is a second-generation antihistamine. The third-generation antihistamines are a new type of drug class that is believed to cause less drowsiness than the second-generation antihistamines. However, the exact extent of this difference is unclear. As such, while it is possible that levocetirizine is less sedating than cetirizine, it still may cause drowsiness. Users should exercise caution when taking levocetirizine and should be aware that mental alertness may be decreased. This can impact the ability to drive or operate machinery.

Does montelukast make you drowsy?

No, montelukast should not make you drowsy. Antihistamines are a group of medications that are commonly used to treat allergies and one of the side effects of antihistamines is drowsiness. However, montelukast is not an antihistamine. It is a type of medication known as a leukotriene receptor antagonist. Therefore, montelukast does not typically cause drowsiness as other allergy medications do. That being said, the Prescriber’s Digital Reference (PDR) for montelukast does list fatigue as one of the many possible side effects of taking the medication.

What should you do if you’re experiencing a severe allergic reaction?

A severe allergic reaction is known as anaphylaxis. Roman does not offer treatment for anaphylaxis. If you are experiencing a severe allergic reaction (or even if you just think you might be in trouble), call 9-1-1 immediately and seek medical help. The symptoms of a severe allergic reaction include itching of the mouth and lips, swelling of the airway, tongue, and lips, flushing, hives, decreased blood pressure, difficulty breathing, confusion, and loss of consciousness. These symptoms may occur rapidly and are life-threatening, requiring emergent treatment. 

If you have a history of anaphylaxis or are at risk of developing anaphylaxis, your healthcare provider may have prescribed you a medication called epinephrine. You should carry this medication with you at all times and should give it to yourself (or have somebody else give it to you) in the event of a severe allergic reaction without delay.

Do I need a prescription for azelastine?

Yes, you need a prescription from a healthcare provider to obtain azelastine nasal spray. The medication comes in several doses and is normally available as the generic or as the brand name, Astelin. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Do I need a prescription for fluticasone propionate?

No, you do not need a prescription from a healthcare provider to obtain fluticasone propionate nasal spray. This means you can get the medication either with a prescription or over-the-counter. The medication is normally available as the generic or as the brand name, Flonase. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Do I need a prescription for levocetirizine?

No, you do not need a prescription from a healthcare provider to obtain levocetirizine. This means you can get the medication either with a prescription or over-the-counter. The medication is normally available as the generic or as the brand name, Xyzal. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Do I need a prescription for montelukast?

Yes, you need a prescription from a healthcare provider to obtain montelukast. The medication comes in several doses and is normally available as the generic or as the brand name, Singulair. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Can I take azelastine as-needed?

Yes, you can take azelastine as-needed for symptom relief. Azelastine is rapid-acting and typically starts working within 15 minutes. Taking azelastine as-needed will lead to a temporary improvement in sneezing and itchy and runny nose. However, the effects of the medication will wear off after 12 hours, so if you need continuous symptom relief it is recommended you take the medication twice daily. Using azelastine twice daily may also lead to an improvement in overall congestion.

Can I take fluticasone propionate as-needed?

Yes, you can take fluticasone propionate as-needed. However, if you do so, you may not experience the medication’s maximal effectiveness. Fluticasone propionate normally starts working after 12 hours but it may take 10 to 14 days of continuous, daily usage to see the most improvement in nasal congestion.

Can I take levocetirizine as-needed?

Yes, you can take levocetirizine as-needed for symptom relief. Levocetirizine is fast-acting and typically starts working after 1 hour. Taking levocetirizine as-needed will lead to a temporary improvement in sneezing, runny nose, and itchy eyes. However, the effects of the medication will wear off after 24 hours, so if you need continuous symptom relief it is recommended you take the medication daily.

Can I take montelukast as-needed?

No, it is not recommended that you take montelukast as-needed. Montelukast may start working after the first dose in some users. However, to experience maximal improvement in nasal congestion, it should be continued for several days.

Is fluticasone propionate bad for me because it’s a steroid?

Fluticasone propionate is a type of medication known as a glucocorticoid. Glucocorticoids are corticosteroid hormones that are effective at reducing inflammation. Corticosteroid hormones are not the same thing as anabolic steroids, which are the steroids commonly associated with athletic enhancement.

Using fluticasone propionate as prescribed for the treatment of allergic rhinitis is generally not considered dangerous. However, chronic overuse may cause specific signs and symptoms. Using greater than what is recommended by your physician can lead to trauma and irritation of the lining of the inside of the nose, which can lead to nosebleeds. Long-term use of high levels of corticosteroid hormones can cause other symptoms such as thinning skin, changes in body fat distribution, blood sugar problems, bone loss, and increased acne or facial hair. If you are experiencing worrisome symptoms, contact a healthcare provider.

What else can I do to treat my allergic rhinitis?

Besides medication, there are many other things you can be doing to treat your allergic rhinitis. One of the most important things is called allergen avoidance. This involves successfully staying away from the things you are allergic to. Some tips for how to avoid allergens include:

  • If you have pollen allergies, you may benefit from staying indoors during certain times of the year or avoiding freshly cut grass. You can also keep your windows closed at home and in your car to avoid airborne exposure.
  • If you have animal dander allergies, you may not want to own a pet or visit the homes of friends who have pets.
  • If you have dust mite allergies, you may want to purchase a hypoallergenic mattress cover and pillow covers for your bed. Weekly washing of your bed linens will also help decrease the level of dust mite exposure.
  • If you have mold allergies, you may benefit from staying out of places where mold commonly grows, such as basements. Molds thrive in warm, damp areas, which also includes showers and bathrooms. Keeping your bathroom well ventilated or dry (with a dehumidifier) can help keep mold levels to a minimum.

Purchasing a High Efficiency Particulate Air (HEPA) filter can also help protect against airborne allergens.

Another way to improve nasal symptoms is to perform nasal saline irrigation.

What is nasal saline irrigation?

Nasal saline irrigation is a practice that involves flushing the nasal passages with a large volume of a saline solution. It is highly recommended that everybody with airborne allergies irrigates their nose at least once a day (but ideally twice) per day. If you have airborne allergies, irrigating once before going outside and once when you come home is extremely helpful to clear the nose of the allergen particles that are causing your symptoms. Numerous companies sell devices that can be used for nasal saline irrigation, such as the neti pot or the Neil Med irrigation bottle.

Nasal saline irrigation can cause an unusual sensation that might be uncomfortable at first. It should always be performed with a warmed solution that is intended for nasal irrigation and not with fresh water. If you are mixing your own solution, it is extremely important that you do NOT use tap water, as this could be contaminated with organisms. Instead, make sure you only use water that has been distilled, sterilized, or boiled. If you use boiled water, do not mix the solution or use the water until it has cooled down to room temperature.

Can I take over-the-counter medications along with my treatment?

There are many other oral and nasal medications that can be taken for allergic rhinitis. There are also eye drops that can be used to treat itchy eyes. Some of these other medications include other antihistamines, other corticosteroids, decongestants, cromolyn sodium, and ipratropium bromide.

While it is safe to combine some allergy medications, certain combinations may be dangerous or may cause excessive drowsiness. Therefore, it is always important to talk to your healthcare provider about what you are taking, including over-the-counter medications. Do not start any new medications in addition to the treatment you have been prescribed here without first talking to a healthcare provider.

Will my allergies ever go away?

It is hard to say whether your allergies will ever go away. Certain allergies tend to be more common in children and many patients may find that their allergy symptoms improve with age. However, it is also possible to develop new allergies as an adult. You may also become more aware of certain allergies if you change your surroundings, such as if you move to a new city and are exposed to new pollens.

What are allergy shots?

Allergy shots, also called immunotherapy, are a type of long-term treatment for allergies. Allergy shots are given on a weekly basis for several months. It may take up to a year to see any improvement in symptoms. Allergy shots can then be given every few weeks for approximately 3 to 5 years. 

Prior to beginning allergy shots, an individual is tested to determine his or her specific allergens. The individual is then injected with small and increasing amounts of those allergens. By injecting the individual with allergens, his or her immune system is slowly retrained, becoming desensitized to those allergens. This means that when the individual is exposed to the allergens in the real world, he or she mounts less of a reaction to them. Allergy shots can potentially trigger anaphylaxis, so they must always be given in a healthcare provider’s office under supervision.

What are allergy drops?

Allergy drops are also known as sublingual immunotherapy. The idea behind allergy drops is the same as allergy shots and involves gradual desensitization to certain allergens. Allergy drops are placed under the tongue daily and do not require administration in a healthcare provider’s office. However, there are not many allergens that are currently FDA-approved for allergy drops. Additionally, since allergy drops are newer, their long-term efficacy is unknown.

Does alternative medicine work for allergies?

Remedies that have shown some efficacy in treating allergic rhinitis include the following:

  • Acupuncture and acupressure
  • Ayurvedic medicine, including a mixture of seven Indian herbs (Albizia lebbeck, Terminalia chebula, T. bellerica, Phyllanthus emblica, Piper nigrum, P. longum, and Zingiber officinale)
  • Herbal therapies, including butterbur, Tinospora cordifolia, a mixture of cinnamon bark, Spanish needle, and acerola, Benifuuki green tea, Yupingfeng granules, ginseng, and Tonggyu-tang
  • Topical treatments, including capsaicin, cellulose powder, and a petrolatum-based allergen-absorbing ointment

Remedies with less strong evidence include the following:

  • Herbal therapies, including quercetin, stinging nettle, Perilla frutescens, steamed eucalyptus, menthol, Ginkgo biloba, milk thistle, and grape seed extract
  • Laser therapy

Allergies

What is allergic rhinitis?

Allergic rhinitis is sometimes called “hay fever” or “seasonal allergies,” although it can be caused by nonseasonal substances as well. Allergic rhinitis refers to inflammation in the nose (rhinitis) that occurs when you are exposed to a substance you are allergic to. The term “allergic rhinitis” does not refer to all kinds of allergies you may have. For example, food allergies and allergies to medications do not typically cause allergic rhinitis.

What are allergies?

“Allergies” is a general term that refers to a reaction the body has to allergens. Allergens are substances that are generally not harmful to the body. However, if you have allergies, the immune system thinks allergens are dangerous and tries to fight them off like it would any other intruder, such as bacteria, viruses, and parasites. Having allergies, therefore, means the immune system is overactive. In other words, the immune system is doing something it is normally supposed to do but the reaction is exaggerated, unnecessary, and even harmful to the body. In medical terminology, this overreaction is called a type 1 hypersensitivity reaction.

There are many different kinds of allergies that differ based on the part of the body affected and the severity of symptoms. In some cases, allergies may cause a small rash or runny nose. In other cases, allergies can be life-threatening. Types of allergies include allergic rhinitis (inflammation in the nose), contact dermatitis (an allergic reaction on the skin), allergic asthma (a specific type of asthma), and anaphylaxis (a life-threatening condition that involves swelling of the airways).

What are the most common allergens?


There are many different allergens that affect the body. These include foods, plants, animals, metals, chemicals, medications, and more. Some allergens are known as airborne allergens because they are present in the air. The most common airborne allergens include tree pollens, grass pollens, weed pollens, pet dander, and molds. Dust mites and cockroach allergens are also common and may be airborne, however they settle more quickly than the other airborne allergens.

Roman only offers treatment for allergic rhinitis, which is caused by airborne allergens. However, there are many other common allergens you may have. The most common food allergens are fish, shellfish, peanuts, tree nuts, eggs, wheat, soy, and milk. These allergens always need to be labeled on food if they are present. Other allergens you may have heard of include:

  1. Insect venom (e.g. getting stung by a bee)
  2. Nickel (e.g. getting a rash after wearing certain jewelry)
  3. Latex (e.g. getting a rash when coming into contact with latex)
  4. Medications (e.g. getting hives after taking penicillin)

What causes allergic rhinitis?

Allergic rhinitis is typically caused by allergens that are airborne. These are roughly divided into outdoor airborne allergens and indoor airborne allergens. Common airborne allergens found outdoors include tree pollens, grass pollens, and weed pollens. Common airborne allergens found indoors include animal dander, dust mites, and mold.

Outdoor allergens are usually seasonal because plants release pollen at certain times of the year. Spring allergies are commonly due to tree pollens. Late spring and summer allergies are commonly due to grass pollens. Late summer and autumn allergies are commonly due to weed pollens, such as ragweed pollen. In fact, ragweed pollen is one of the primary causes of allergic rhinitis and 75% of people with pollen allergies are allergic to ragweed.

Indoor allergens may be present throughout the year. However, certain situations can make indoor allergies worse. For example, animal dander allergies may be worse in the winter because pets may spend more time indoors and there is less circulating fresh air. And mold allergies may be worse if there is a very rainy spring season.

What causes allergies?

Researchers aren’t sure why some people develop allergies and others do not. What we do know is that the tendency to develop allergies is genetic. This means if your family members have allergies, you are more likely to have them as well. Additionally, certain allergic conditions commonly occur together. Known as the “atopic triad,” these conditions are allergic rhinitis, eczema (also called atopic dermatitis), and allergic asthma.

What is immunoglobulin E (IgE)?

Immunoglobulin E (IgE) is a type of antibody. Antibodies are proteins that the body forms to help fight invaders, known as pathogens. There are several kinds of antibodies that the body can make. IgA antibodies are typically found in mucous membranes, such as the mouth and the intestinal linings. IgA is also found in breastmilk and can transfer from mother to baby. IgD antibodies are less understood and signal certain immune cells to activate. IgM antibodies are the first antibodies the body makes when exposed to a pathogen. And IgG antibodies take longer to make but are the antibodies we typically think of that are associated with immunity to diseases.

IgE antibodies are normally beneficial because they help protect against parasites. However, IgE antibodies are also responsible for allergic reactions. When the body encounters an allergen for the first time, it develops IgE antibodies that are targeted against that allergen. The IgE antibodies then attach to the surface of immune cells called mast cells and basophils. The next time the body is exposed to the same allergen, the allergen links up with the IgE antibodies, beginning a series of events that result in allergy symptoms.

What is histamine?

Histamine is an inflammatory chemical that is released by immune cells during an allergic reaction. The release of histamine is normally helpful because it can help fight pathogens that are affecting the body. However, during an allergic reaction, histamine is released when it shouldn’t be. Histamine is responsible for symptoms like watery eyes, runny nose, sneezing, and itchy skin.

What are leukotrienes?

Leukotrienes are inflammatory chemicals that are released by immune cells during an allergic reaction. The release of leukotrienes is normally helpful because they can help fight pathogens that are affecting the body. However, during an allergic reaction, leukotrienes are released when they shouldn’t be. Leukotrienes are responsible for inflammation and the production of a large amount of mucus.

What are the steps of an allergic reaction?

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  1. The first time the body is exposed to an allergen, it responds by creating antibodies known as immunoglobulin E (IgE).
  2. IgE antibodies attach to the surface of immune cells called mast cells and basophils.
  3. The next time the body is exposed to the same allergen, the allergen links up with the IgE antibodies. This prompts the mast cells and basophils to release inflammatory chemicals, including histamine and leukotrienes.
  4. The release of histamine and leukotrienes causes the symptoms that are typically associated with allergies. Histamine is responsible for watery eyes, runny nose, sneezing, and itchy skin. Leukotrienes are responsible for inflammation and the production of a large amount of mucus.

How does azelastine help treat allergic rhinitis?

Azelastine works by blocking the H1 receptors on cells, which are receptors that are normally activated by the chemical histamine. When the body is exposed to an allergen, immune cells (called mast cells and basophils) release histamine. Since azelastine blocks histamine from activating the H1 receptors, the symptoms that are typically caused by histamine are lessened. Azelastine also has anti-inflammatory effects and reduces congestion.

How does fluticasone propionate help treat allergic rhinitis?

Researchers are not entirely sure how fluticasone propionate works but it is known to have a wide range of effects on different immune cells and chemicals that cause inflammation, including mast cells, histamine, and leukotrienes.

How does levocetirizine help treat allergic rhinitis?

Levocetirizine works by blocking the H1 receptors on cells, which are receptors that are normally activated by the chemical histamine. When the body is exposed to an allergen, immune cells (called mast cells and basophils) release histamine. Since levocetirizine blocks histamine from activating the H1 receptors, the symptoms that are typically caused by histamine are lessened.

How does montelukast help treat allergic rhinitis?

Montelukast works by blocking cysteinyl leukotriene receptors, which can be activated by the chemical leukotriene D4. When the body is exposed to an allergen, immune cells (including mast cells and basophils) release leukotriene D4. Since montelukast blocks leukotriene D4 from activating the cysteinyl leukotriene receptors, the symptoms that are typically caused by leukotriene D4 are lessened.

Does azelastine make you drowsy?

Yes, azelastine may make you drowsy. Azelastine is a type of medication known as an antihistamine. One of the common side effects of antihistamines is drowsiness. As such, azelastine may make users drowsy after use. Users should exercise caution when taking azelastine and should be aware that mental alertness may be decreased. This can impact the ability to drive or operate machinery.

Does fluticasone propionate make you drowsy?

No, fluticasone propionate should not make you drowsy. Antihistamines are a group of medications that are commonly used to treat allergies and one of the side effects of antihistamines is drowsiness. However, fluticasone propionate is not an antihistamine. It is a type of medication known as a glucocorticoid. Therefore, fluticasone propionate does not typically cause drowsiness as other allergy medications do. That being said, the Prescriber’s Digital Reference (PDR) for fluticasone propionate does list fatigue as one of the many possible side effects of taking the medication.

Does levocetirizine make you drowsy?


It is possible levocetirizine will make users drowsy but the exact answer is unclear. Levocetirizine is a type of medication that is sometimes referred to as a third-generation antihistamine. It is derived from cetirizine (brand name Zyrtec), which is a second-generation antihistamine. The third-generation antihistamines are a new type of drug class that is believed to cause less drowsiness than the second-generation antihistamines. However, the exact extent of this difference is unclear. As such, while it is possible that levocetirizine is less sedating than cetirizine, it still may cause drowsiness. Users should exercise caution when taking levocetirizine and should be aware that mental alertness may be decreased. This can impact the ability to drive or operate machinery.

Does montelukast make you drowsy?

No, montelukast should not make you drowsy. Antihistamines are a group of medications that are commonly used to treat allergies and one of the side effects of antihistamines is drowsiness. However, montelukast is not an antihistamine. It is a type of medication known as a leukotriene receptor antagonist. Therefore, montelukast does not typically cause drowsiness as other allergy medications do. That being said, the Prescriber’s Digital Reference (PDR) for montelukast does list fatigue as one of the many possible side effects of taking the medication.

What should you do if you’re experiencing a severe allergic reaction?

A severe allergic reaction is known as anaphylaxis. Roman does not offer treatment for anaphylaxis. If you are experiencing a severe allergic reaction (or even if you just think you might be in trouble), call 9-1-1 immediately and seek medical help. The symptoms of a severe allergic reaction include itching of the mouth and lips, swelling of the airway, tongue, and lips, flushing, hives, decreased blood pressure, difficulty breathing, confusion, and loss of consciousness. These symptoms may occur rapidly and are life-threatening, requiring emergent treatment. 

If you have a history of anaphylaxis or are at risk of developing anaphylaxis, your healthcare provider may have prescribed you a medication called epinephrine. You should carry this medication with you at all times and should give it to yourself (or have somebody else give it to you) in the event of a severe allergic reaction without delay.

Do I need a prescription for azelastine?

Yes, you need a prescription from a healthcare provider to obtain azelastine nasal spray. The medication comes in several doses and is normally available as the generic or as the brand name, Astelin. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Do I need a prescription for fluticasone propionate?

No, you do not need a prescription from a healthcare provider to obtain fluticasone propionate nasal spray. This means you can get the medication either with a prescription or over-the-counter. The medication is normally available as the generic or as the brand name, Flonase. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Do I need a prescription for levocetirizine?

No, you do not need a prescription from a healthcare provider to obtain levocetirizine. This means you can get the medication either with a prescription or over-the-counter. The medication is normally available as the generic or as the brand name, Xyzal. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Do I need a prescription for montelukast?

Yes, you need a prescription from a healthcare provider to obtain montelukast. The medication comes in several doses and is normally available as the generic or as the brand name, Singulair. Ro only offers the generic form, which will be prescribed to you if your Ro-affiliated physician believes it is appropriate for the treatment of your allergic rhinitis.

Can I take azelastine as-needed?

Yes, you can take azelastine as-needed for symptom relief. Azelastine is rapid-acting and typically starts working within 15 minutes. Taking azelastine as-needed will lead to a temporary improvement in sneezing and itchy and runny nose. However, the effects of the medication will wear off after 12 hours, so if you need continuous symptom relief it is recommended you take the medication twice daily. Using azelastine twice daily may also lead to an improvement in overall congestion.

Can I take fluticasone propionate as-needed?

Yes, you can take fluticasone propionate as-needed. However, if you do so, you may not experience the medication’s maximal effectiveness. Fluticasone propionate normally starts working after 12 hours but it may take 10 to 14 days of continuous, daily usage to see the most improvement in nasal congestion.

Can I take levocetirizine as-needed?

Yes, you can take levocetirizine as-needed for symptom relief. Levocetirizine is fast-acting and typically starts working after 1 hour. Taking levocetirizine as-needed will lead to a temporary improvement in sneezing, runny nose, and itchy eyes. However, the effects of the medication will wear off after 24 hours, so if you need continuous symptom relief it is recommended you take the medication daily.

Can I take montelukast as-needed?

No, it is not recommended that you take montelukast as-needed. Montelukast may start working after the first dose in some users. However, to experience maximal improvement in nasal congestion, it should be continued for several days.

Is fluticasone propionate bad for me because it’s a steroid?

Fluticasone propionate is a type of medication known as a glucocorticoid. Glucocorticoids are corticosteroid hormones that are effective at reducing inflammation. Corticosteroid hormones are not the same thing as anabolic steroids, which are the steroids commonly associated with athletic enhancement.

Using fluticasone propionate as prescribed for the treatment of allergic rhinitis is generally not considered dangerous. However, chronic overuse may cause specific signs and symptoms. Using greater than what is recommended by your physician can lead to trauma and irritation of the lining of the inside of the nose, which can lead to nosebleeds. Long-term use of high levels of corticosteroid hormones can cause other symptoms such as thinning skin, changes in body fat distribution, blood sugar problems, bone loss, and increased acne or facial hair. If you are experiencing worrisome symptoms, contact a healthcare provider.

What else can I do to treat my allergic rhinitis?

Besides medication, there are many other things you can be doing to treat your allergic rhinitis. One of the most important things is called allergen avoidance. This involves successfully staying away from the things you are allergic to. Some tips for how to avoid allergens include:

  • If you have pollen allergies, you may benefit from staying indoors during certain times of the year or avoiding freshly cut grass. You can also keep your windows closed at home and in your car to avoid airborne exposure.
  • If you have animal dander allergies, you may not want to own a pet or visit the homes of friends who have pets.
  • If you have dust mite allergies, you may want to purchase a hypoallergenic mattress cover and pillow covers for your bed. Weekly washing of your bed linens will also help decrease the level of dust mite exposure.
  • If you have mold allergies, you may benefit from staying out of places where mold commonly grows, such as basements. Molds thrive in warm, damp areas, which also includes showers and bathrooms. Keeping your bathroom well ventilated or dry (with a dehumidifier) can help keep mold levels to a minimum.

Purchasing a High Efficiency Particulate Air (HEPA) filter can also help protect against airborne allergens.

Another way to improve nasal symptoms is to perform nasal saline irrigation.

What is nasal saline irrigation?

Nasal saline irrigation is a practice that involves flushing the nasal passages with a large volume of a saline solution. It is highly recommended that everybody with airborne allergies irrigates their nose at least once a day (but ideally twice) per day. If you have airborne allergies, irrigating once before going outside and once when you come home is extremely helpful to clear the nose of the allergen particles that are causing your symptoms. Numerous companies sell devices that can be used for nasal saline irrigation, such as the neti pot or the Neil Med irrigation bottle.

Nasal saline irrigation can cause an unusual sensation that might be uncomfortable at first. It should always be performed with a warmed solution that is intended for nasal irrigation and not with fresh water. If you are mixing your own solution, it is extremely important that you do NOT use tap water, as this could be contaminated with organisms. Instead, make sure you only use water that has been distilled, sterilized, or boiled. If you use boiled water, do not mix the solution or use the water until it has cooled down to room temperature.

Can I take over-the-counter medications along with my treatment?

There are many other oral and nasal medications that can be taken for allergic rhinitis. There are also eye drops that can be used to treat itchy eyes. Some of these other medications include other antihistamines, other corticosteroids, decongestants, cromolyn sodium, and ipratropium bromide.

While it is safe to combine some allergy medications, certain combinations may be dangerous or may cause excessive drowsiness. Therefore, it is always important to talk to your healthcare provider about what you are taking, including over-the-counter medications. Do not start any new medications in addition to the treatment you have been prescribed here without first talking to a healthcare provider.

Will my allergies ever go away?

It is hard to say whether your allergies will ever go away. Certain allergies tend to be more common in children and many patients may find that their allergy symptoms improve with age. However, it is also possible to develop new allergies as an adult. You may also become more aware of certain allergies if you change your surroundings, such as if you move to a new city and are exposed to new pollens.

What are allergy shots?

Allergy shots, also called immunotherapy, are a type of long-term treatment for allergies. Allergy shots are given on a weekly basis for several months. It may take up to a year to see any improvement in symptoms. Allergy shots can then be given every few weeks for approximately 3 to 5 years. 

Prior to beginning allergy shots, an individual is tested to determine his or her specific allergens. The individual is then injected with small and increasing amounts of those allergens. By injecting the individual with allergens, his or her immune system is slowly retrained, becoming desensitized to those allergens. This means that when the individual is exposed to the allergens in the real world, he or she mounts less of a reaction to them. Allergy shots can potentially trigger anaphylaxis, so they must always be given in a healthcare provider’s office under supervision.

What are allergy drops?

Allergy drops are also known as sublingual immunotherapy. The idea behind allergy drops is the same as allergy shots and involves gradual desensitization to certain allergens. Allergy drops are placed under the tongue daily and do not require administration in a healthcare provider’s office. However, there are not many allergens that are currently FDA-approved for allergy drops. Additionally, since allergy drops are newer, their long-term efficacy is unknown.

Does alternative medicine work for allergies?

Remedies that have shown some efficacy in treating allergic rhinitis include the following:

  • Acupuncture and acupressure
  • Ayurvedic medicine, including a mixture of seven Indian herbs (Albizia lebbeck, Terminalia chebula, T. bellerica, Phyllanthus emblica, Piper nigrum, P. longum, and Zingiber officinale)
  • Herbal therapies, including butterbur, Tinospora cordifolia, a mixture of cinnamon bark, Spanish needle, and acerola, Benifuuki green tea, Yupingfeng granules, ginseng, and Tonggyu-tang
  • Topical treatments, including capsaicin, cellulose powder, and a petrolatum-based allergen-absorbing ointment

Remedies with less strong evidence include the following:

  • Herbal therapies, including quercetin, stinging nettle, Perilla frutescens, steamed eucalyptus, menthol, Ginkgo biloba, milk thistle, and grape seed extract
  • Laser therapy

Nightly Defense skincare

How does skincare treatment with Ro work?

We use telemedicine technology to connect you with a U.S. licensed doctor to provide nightly defense for skincare conveniently and affordably.

It starts with your online doctor visit. Your doctor needs to know about your general health and your skincare concerns.

They also need an unedited photo of you and your ID (that shows your picture and birthdate) so they know who they will be helping. A photo of your face is also helpful to evaluate your skin. They review everything, determine if you’re a candidate for telemedicine and whether treatment is right for you, and if so, they will send you a personalized treatment plan.

Their treatment plan will include a great deal of information about skincare. It is important that you take the time to read it all to be informed and better prepared to take care of your skin.

If you qualify, your doctor will prescribe the right course of treatment to help you take control of your skincare.

What do you prescribe for skincare on Ro?

If appropriate, a Ro-affiliated physician will prescribe a nightly defense prescription cream with active ingredients hand selected to address your skin concerns. These ingredients may include tretinoin, niacinamide, ceramides, vitamin E (acetate), azelaic acid, MAP, and tranexamic acid. If prescribed, you will receive information on ingredients and use in your personalized treatment plan.

What’s in the prescription skincare treatment?

Prescription skincare treatment recommendations can be made with ingredients hand selected by Ro’s board-certified dermatologist. Examples include tretinoin, niacinamide, ceramides, vitamin E (acetate), azelaic acid, magnesium ascorbyl phosphate (MAP, a type of vitamin C), and tranexamic acid. There will not be any parabens, butylated hydroxyanisole (BHA), or formaldehyde in your prescription skincare.

Can I use prescription skincare products with my other skincare products?

The prescription skincare treatment recommended for you may be incorporated into your usual skincare regimen. If you are using other topical prescription medications, make sure to tell your doctor.

When will I start to see improvement with my skin?

The timing of the effects of your treatment will be dependent on many factors, including your specific skincare goals (e.g. reducing the appearance of fine lines and wrinkles, helping prevent wrinkles, reducing redness, etc.), how severe your symptoms are, how well you tolerate the treatment, and others. It is also important to understand that for certain treatments, your skin may get worse before it gets better. Depending on the treatment you are prescribed, you will receive detailed information on the formulation and what to expect.

Eczema

How does eczema treatment with Ro work?

We use telemedicine technology to connect you with a  U.S. licensed doctor who can provide eczema treatment conveniently and inexpensively.

It starts with your online doctor visit. Your doctor needs to know about your general health and how eczema affects you.
They also need an unedited photo of you and of your ID (that shows your face and birthdate) so they know who they will be helping, as well as a photo of the affected area(s) to confirm the diagnosis. They review everything, determine if you’re a candidate for telemedicine and whether treatment is right for you, and if so , they will send you a personalized treatment plan.

The treatment plan will include a great deal of information about eczema. It is important that you take the time to read it all to be informed and better prepared to manage your condition.

What medication do you prescribe for eczema?

If a prescription is appropriate, Ro-affiliated physicians may prescribe triamcinolone (0.1%) cream, a medium potency steroid cream. Steroid cream is effective for treating flare-ups and in certain cases may also be used to help prevent flare-ups, and is the recommended first-line treatment for eczema by the American Academy of Dermatology. Triamcinolone (0.1%) cream may not be appropriate for everyone. To learn more about side effects and contraindications, see “What are the side effects of eczema treatment” below and read Important Safety Information for triamcinolone cream.

Can I get treatment if I haven’t been diagnosed with eczema by a doctor before?

At this time, we are only offering treatment for eczema if you have previously been diagnosed with eczema by a doctor or other healthcare provider.

Can a doctor diagnose eczema remotely?

Skin conditions may sometimes be difficult to definitively diagnose by telemedicine. At this time, we are only offering treatment for eczema if you have previously been diagnosed with eczema by a doctor or other healthcare provider.

Can I use the eczema treatment even if I’m not having a flare-up right now?

Yes, triamcinolone cream may be used for prevention of flare-ups, if directed by your doctor. Long term steroid use may be associated with side effects, so it’s important to keep your doctor in the loop about the severity of your flare-ups so they can recommend the best treatment for you.

Is eczema treatment effective?

Steroid creams, including triamcinolone, are considered effective for both treatment of active eczema as well as prevention of flare-ups, and are recommended by the American Academy of Dermatology as first-line treatment based on large volumes of high quality studies*. Triamcinolone (0.1%) cream may not be appropriate for everyone. To learn more about side effects and contraindications, see “What are the side effects of eczema treatment” below and read Important Safety Information for triamcinolone cream.


*Eichenfield LF, Tom WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116-32.

Can I use the eczema treatment in place of my regular moisturizer?

Triamcinolone cream doesn’t contain a significant amount of moisturizer, so you should use a regular moisturizer in addition to triamcinolone cream. In general, it is important to moisturize your skin, especially in areas prone to flare-ups, as dry skin can make your eczema symptoms worse.

What are the side effects of eczema treatment?

Triamcinolone cream can cause redness, dryness, itching, and/or irritation at the sites where it’s applied. These effects are usually mild, and can be helped by making sure the skin is properly moisturized. More serious side effects that can happen with prolonged use or if large amounts are used over large surface areas include thinning skin, stretch marks, or impaired wound healing. These can be avoided by only using the smallest amount of cream necessary for the shortest duration of time necessary (usually two weeks) to reduce your symptoms. If you have concerns about side effects or think you might be having side effects from your eczema treatment, you can reach out to your Ro-affiliated doctor at any time.

Read Important Safety Information for triamcinolone cream.

Will the steroids thin my skin or cause permanent stretch marks?

Steroid creams may cause skin thinning or permanent stretch marks if used in large amounts, over large surface areas, and/or for a long time continuously. The general principle for using steroid creams is that you should only use as much as is needed to improve your symptoms and only for as long as is necessary.

What should I do if the eczema treatment isn’t working?

Most people experience relief of symptoms within a few days, and some even sooner. If you don’t feel that the eczema treatment is significantly improving your symptoms, reach out to your doctor anytime to talk about other options for treatment.

Dandruff

How does dandruff treatment with Ro work?

We use telemedicine technology to connect you with a U.S. licensed doctor to provide dandruff treatment conveniently and affordably.

It starts with your online doctor visit. Your doctor needs to know about your general health and how dandruff affects you.
They also need an unedited photo of you and your ID (that shows your picture and birthdate) so they know who they will be helping. A photo is also helpful to confirm the diagnosis. They review everything, determine if you’re a candidate for telemedicine and if treatment is right for you, and if so, they will send you a personalized treatment plan.

Their treatment plan will include information about dandruff. It is important that you take the time to read it all to be informed and better prepared to manage your condition.
If you qualify, your doctor will prescribe the right course of treatment to help you take control of your dandruff.

What do you prescribe for dandruff on Ro?

If appropriate, a Ro-affiliated physician will prescribe a blended shampoo containing ciclopirox as its main active ingredient. Ciclopirox is an antifungal agent and one of the most effective ingredients for clearing dandruff, according to high quality scientific evidence*.

* Okokon EO, Verbeek JH, Ruotsalainen JH, Ojo OA, Bakhoya VN. Topical antifungals for seborrhoeic dermatitis. Cochrane Database Syst Rev. 2015;(5):CD008138.

What is in the prescription dandruff treatment?

The prescription dandruff shampoo that may be prescribed to you can be made with ingredients hand selected by our board-certified dermatologist. These ingredients may include ciclopirox, zinc pyrithione, salicylic acid, tea tree and peppermint oil, glycerin, calcium pantothenate (vitamin B5), and a shampoo base. There will not be any parabens, sulfates, phosphates, or dyes in your shampoo.

When will I start to see improvement in my dandruff?

When used as directed, many people start seeing improvement in symptoms (dandruff flakes and itching) after just a few uses (1-2 weeks) with ciclopirox shampoos, and others might see improvement within 2-4 weeks. If you don’t think the treatment is working, you can reach out to your Ro-affiliated doctor at any time to talk about your treatment plan.

What should I do if the dandruff treatment isn’t working?

Sometimes scalp flakes are caused by an underlying skin condition other than simple dandruff, so if you don’t think the treatment is adequately treating your symptoms, contact your Ro-affiliated doctor at any time to discuss your treatment plan.

Excessive sweating (hyperhidrosis)

How does hyperhidrosis treatment with Ro work?

We use telemedicine technology to connect you with a U.S. licensed doctor to provide hyperhidrosis treatment conveniently and affordably.

It starts with your online doctor visit. Your doctor needs to know about your general health and how excessive sweating affects you.

They also need an unedited photo of you and your ID (that shows your picture and birthdate) so they know who they will be helping, as well as a photo of the affected area(s) to confirm the diagnosis. They review everything, determine if you’re a candidate for telemedicine and whether treatment is right for you, and if so, they will send you a personalized treatment plan.
Their treatment plan will include a great deal of information about hyperhidrosis. It is important that you take the time to read it all to be informed and better prepared to manage your condition.

If you qualify, your doctor will prescribe the right course of treatment to help you take control of your hyperhidrosis.

What causes hyperhidrosis?

Sweating is controlled by the central nervous system, which sends signals to sweat glands on the skin. Sweating is normal when it happens in response to physical exertion, or if your body senses a threat and goes into “fight or flight” mode. However, the kind of excessive sweating seen in hyperhidrosis is much more than usual, and can be very disruptive to everyday life. The sweat glands are normal in hyperhidrosis, but the signalling from the central nervous system is abnormal. There may be some influence from genetics which is not very well understood.

What medication do you prescribe for hyperhidrosis?

If a prescription is appropriate, Ro-affiliated physicians may prescribe 20% aluminum chloride hexahydrate (Drysol), a prescription antiperspirant that works by blocking the sweat glands. Aluminum-containing antiperspirants are recommended for hyperhidrosis by the American Academy of Dermatology.

Not everyone should use Drysol. To learn more about side effects and contraindications, see “What are the side effects of hyperhidrosis treatment” below and read Important Safety Information for aluminum antiperspirant.

Can I get treatment if I haven’t been diagnosed with hyperhidrosis by a doctor before?


Many people don’t realize that hyperhidrosis is a treatable condition, so it’s okay if you haven’t previously seen a doctor or healthcare provider for your excessive sweating before. Your Ro-affiliated doctor will collect information about your medical history and your excessive sweating symptoms via telemedicine. If hyperhidrosis is diagnosed and treatment is appropriate for you, your doctor will make a recommendation and prescribe the treatment.

Is hyperhidrosis treatment effective?

Aluminum antiperspirant is considered the standard prescription treatment for hyperhidrosis for people who have tried over-the-counter antiperspirants. If you’ve been using prescription antiperspirant as directed and aren’t satisfied with the results, you can reach out to your Ro-affiliated doctor at any time to discuss.

Not everyone should use Drysol. To learn more about side effects and contraindications, see “What are the side effects of hyperhidrosis treatment” below and read Important Safety Information for aluminum chloride hexahydrate.

What’s the difference between antiperspirant and deodorant?

Although the term “deodorant” is often used interchangeably with “antiperspirant” when talking about products applied to the armpits, antiperspirants are intended for directly stopping or reducing sweating, whereas deodorants are intended for reducing the odor associated with sweating. It’s important to understand that you can use your regular deodorant with the prescription antiperspirant (use antiperspirant at night as directed, and your regular deodorant in the morning).

When will I start to see improvement in my excessive sweating?

Most people see an improvement in sweating within a week or so of using the antiperspirant as directed. If you feel your sweating isn’t getting better, or isn’t improving as much as you’d expect, contact your Ro-affiliated doctor at any time, who can advise on potential changes to your treatment plan.

What are the side effects of hyperhidrosis treatment?

Aluminum antiperspirant commonly causes itching and burning at sites where it is applied. There are a number of ways to help lessen the severity of these effects, including applying the antiperspirant less frequently, avoiding applying to recently shaved areas, and avoiding applying to areas with broken skin. You can also try applying over-the-counter hydrocortisone cream to help relieve the symptoms. And, you can always reach out to your doctor at any time to report side effects and discuss potentially changing or stopping your treatment plan.

Does antiperspirant/deodorant cause cancer?

There is no definitive link between aluminum-containing antiperspirants and cancer. An internet rumor from the late 1990s claimed a possible link between antiperspirants and breast cancer, because of a theoretical idea that toxins from antiperspirants could be absorbed and cause cancerous mutations. This has not been conclusively supported by evidence and is not considered a concern in the medical and scientific community.

  1. Jones J. Can rumors cause cancer?. J Natl Cancer Inst. 2000;92(18):1469-71.
  2. https://www.cancer.org/cancer/cancer-causes/antiperspirants-and-breast-cancer-risk.html
  3. https://www.cancer.gov/about-cancer/causes-prevention/risk/myths/antiperspirants-fact-sheet

What should I do if the hyperhidrosis treatment isn’t working?

If you feel your sweating is not significantly improving, reach out to your Ro-affiliated physician at any time to talk about potential changes to your treatment plan.