rm, tannedbuns stickingup invitingly.
Mark didn'tneed anyencouragement.
Heclimbed upbehind hismother andpushed hiscock upinto herass, andnot gentlyeither, butsavagely, brutallylike theman haddone tohis sister.
Ahhhhhaaaaaaaaaaaaaa!" Lindawailed, asMark drovethe HersheyHighway.
MeanwhileBecky continuedto suckher father'sdick whilethe bigman reamedout herass.
Theman whohad helpedMark gotup andapproached hisbrother.
Lemmeget someof that..."
Theteenager gruntednastily andpulled hermouth offof herfather's cock,looking backover hershoulder justin timeto seethe menchange places.
Oh godno..." shegroaned, buta momentlater thesecond man'scock hadslid painfullyup intoher butt.
Oh daddy,help me..."the youngsterpleaded betweengrunts andgasps.
They'retakin' turns...They'retakin' turnsin myheinie!!!"
The minutesclicked slowlyby.
Thefirst brotherto fuckBecky's assreplaced theone holdingthe gun,and hetoo tookhis turnin thelittle girl'sbutt.
Shestill thrashedand moanedfrom thepain, sobbingand suckingaway ather father'scock.
Lindaon theother handhad quieteddown.
Howis that,boy?" oneof themen asked.
It's tight..."Mark hissedthrough clenchedteeth.
Rockheard hiswife moanand sawher reachback tograb theboys hands,pulling themforward, liftingthe frontof herbody offthe floormomentarily, sothe boycould gethold ofher giganticjugs.
Squeezethem whileyou cornholeme..."
Linda begged,surprising Rockwith herlanguage.
Comeon. Makeit hurt!"
Markbegan tosavage hismother, poundinghis dickup herass.
Lindawailed andshivered, andsaid somethingRock wouldnever forget.
You canfuck mybutt anytimeyou want,baby...
Youjust saythe wordand I'llbend overfor you.
I'll evenbend overfor yourfriends, too!
Would youlike that,baby?
Wouldyou likeme tolet allyour friendsdo ittoo?"
The threebrothers brokeinto pealsof laughter.
The minutesturned intoten, andthen twenty.
The threebrothers hadswitched againand again,each ofthem havingfive orsix turnsapiece uplittle Becky'sass.
ToRock's absolutehorror, thetiny, 85pound schoolgirlbegin tomew nastily,and hesaw herback archand herass beginto quiver.
At thesame timeshe beganto suckhim feverishly,her lipssucking andsmacking athis cockin away thatwas impossibleto ignore.
Rock felthis cockbegin toharden inhis littlegirl's mouth.
Oh it'sgood nowdaddy..."
Becky cooed,"Let memake youfeel goodtoo..."
She wentback tosucking herfather's cockhungrily, whilearound herthe threebrother's laugheduproariously.
Markhad beenwatching hissister thewhole time.
Hearing hernow wasjust toomuch forhim.
Ohgod yeahmom squeezeit!"
The mansodomizing Beckypulled hiscock fromher assand threwher tothe floorbeside hermother andbrother.
Makethe littletramp cleanyour dickoff inher mouth!"
Hetold Mark.As Becky'solder brothergrinned andpulled hisslimy prickout ofhis mother'sass, thelittle girlrolled overonto herback, hermouth openand inviting.
I've alwayswanted todo this,Becky..."
Mark said,as heslid hisdirty dickinto hissister's mouth.
He tookboth ofthe youngster'stits inhand andsqueezed them,letting hissister doall thework.
Beckymoaned andtook hertime suckinghim clean,obviously enjoyingthe terribleact.
Then,to thethree brother'simmense enjoyment,Mark hadan ideaof hisown.
Lickit up..."Mark said,pushing littleBecky's facebetween thegreasy cheeksof hermother's ass.
Clean outher asswith yourtongue!"
Ohhhhhhhhhhhhh..." Beckygroaned, herface coveredwith theslime fromher mother'sass.
Shewas soexcited, shecursed forthe veryfirst time.
The mengathered round,encouraging theboy toream hissister harder,laughing ashe slammedhis dickup intoher.
Withevery strokethe littlegirl movedcloser toher veryfirst orgasm.
Uhhhhgod Markie..."she groaned,"Don't stop...
I... I...uhhhhhhhhhhhhhhh!!!"
Eeeeeiiiieeeeeeeeeeeeeeeeee!!!"
Becky shriekedas shecame again,harder thistime...
Ahhhghhhh!!"the mangrunted, andunleashed atorrent ofhot jismup intoBecky's rectum.
He turnedhis headto lookat Rock.
I justbusted mynut upyour littlegirl's butt..."
Myturn." saidthe secondbrother.
Heclimbed upbehind Beckyand insertedhis fatprick inher butt.
Almost immediately,the littlegirl beganworking towardsanother orgasm.
Rock. "Yeah..."he said,"This won'ttake long..."
Ashe strokedthe youngster,his brotherforced thelittle girlto lickhis cockclean, whichshe did,cumming againhalfway throughthe project...
In lessthan aminute, hetoo pumpeda largeload upinto thelittle girl'sbowels.
God,this trampshole isgettin' nasty!"
Becky'sass. Hemoved aroundin frontof thegirl andgrinned asshe lickedit likea lollypop.
It wasthe thirdone's turnafter that.
When theyhad finished,they madethe littlegirl squatover hermother's face,forcing theolder womanto catchthe jismon hertongue andswallow it,as itoozed outof herdaughter's ass.
Little Beckysquatted overher mother'sface, leaningforward onher hands.
Every timeher mother'stongue flickedacross herburning anusshe twitchedand spasmed.
She couldfeel agreat gobof cumstill upin herass...
Witha nastyfarting sound,the cumdribbled outof her,slowly atfirst andthen ploppingout ina goeyglob rightinto hermother's openmouth.
Uhhhhhhh!!!"little Beckygroaned, cumming.
Linda slurpedand gulpeddown thenasty mess,digging inher cuntwith bothhands.
Stillnot satisfied,the menhad thetwo females69 next...
The manwith thegun motionedRock over.
Lemme seeyou bustyour littlegirl's butt."
Rockdropped tohis kneesbehind Becky,his cockin hishand.
Hedidn't haveany choice.
Don't worry,daddy..." shesighed, "Ilike itnow..."
Rock closedhis eyesand strokedher, easyat first,but harderand harderas themen urgedhim on.
Soon hewas reallyplowing her...
Becky wasgroaning andtossing herhead, obviouslyenjoying itimmensely.
Ohgod daddy...it feelsso good....
I'm gonnalet allthe boysat schoolput theirthings upthere...
AsRock listenedto hisdaughter babbleon, hefelt hisprick beganto swellin hertight littleass.
Hepushed herface intohis wife'scunt, listenedto herslurp atthe sloppy,greasy gash.
He grabbedher firmlittle tittiesand strokedher...
Youdo that,Becky..." Rockgrunted, "Youhear?
Iwant youto askevery boyat schoolto puthis cockin yourass..."
Yes, daddy."Becky moaned,"I swearI will..."
You'rea littlewhore, Becky...
Rock gruntedand ajet ofcum burstup intoBecky's butt.
He quicklypulled hiscock fromher tightlittle shitterand pushedit rightinto hermouth.
Swallowdaddy's cum,you littleslut...
Swallowit likeyou're gonnaswallow allthose loadsat school!"
Beckygroaned anddrank herfather's jism.
When shefinished, thethree menthrew themtheir clothes,and thenpushed themout ontothe porch,slamming thedoor.
Thefamily lookedat eachother fora momentand thendressed, beforestarting backtowards thecar.
Theywalked fora mileor so,dense treeslining bothsides ofthe road.
Rock andLinda werewalking behindtheir twokids, andRock's eyesfell tothe dampspot onhis daughter'sshorts...
Helooked tohis rightand sawLinda staringtoo.
Areyou thinkingwhat I'mthinking?"
Rock grinned."Sure am..."
Hetook littleBecky's handand ledher intothe woods.
Come on,honey..." Lindasaid, leadingher sonby thehand.
Mommaneeds herbutt fucked..."
Ittook acouple yearsbecause ofthe researchwe hadto do.
A couplemonths ago,research wascomplete andCindi, Holly'shelp, startedwriting.
Whenshe finished,Holly didthe editing.
I'm taskedto submitit.
Imust admitthough, itwas abit awkwardenduring thestares wegot whenwe didthe research,especially byour parents.
In theend, itturned outok andwe're verysatisfied withour work.
But readersseem toappreciate frankadvice.
TwasI whofound thescholarly citationsand persuadedCindi toinclude themat theend.
Ialso slippedher theThurber quotation,which shethought waspretty good.
She hadthe WoodyAllen andSimpsons quotes,as youmight guess.
This piecehas theplot ofa telephonedirectory andthe characterdevelopment ofzip codes.
There area coupledozen TOPICS,related, ofcourse.
Mostcontain fourparts.
Thefirst coupleof topicslean towardthe serious,but thenCindi loosensup.
Colon.Girls needmoms.
Letme knowyour edits,suggestions andirritations.
Thus,according tomy friendCindi...
MYLITTLE PONIESRemember MyLittle Ponies,those cutesypastel equinefigurines thatcluttered ourdressers?
Today'saction figuresinvolve mutilation,but girlhoodwasn't alwaysso modern.
Being littlethen, theevent itselfsticks withme.
Mom,Kyle andI wereat ayard sale.
Reclamation ofcloset spacewas.
Whatmakes thetoy industryrun is,of coursethe "yearbefore".
Thismust havebeen justafter thefad peaked.
Mom wasalways goodfor aquarter.
MyLittle Pony"Blossom", purplewith purplehair andwhite flowers,was thebest, theonly oneworth having.
I shouldn'thave announcedit, though,because revealingmy preferenceinvited siblingchallenge.
Kyledidn't evenwant onebecause he'sa boy,but then,of course,he hadto haveBlossom.
Brothers!I doknow weended updistraught andMom saidthat Kylegot firstchoice forsome stupidreason.
Kylesmirked andI endedup withCotton Candy,which Ihated assoon aswe droveoff.
Whenwe gothome, Kylemade ananimal aparade withBlossom asleader.
Heinvited dumbCotton Candyto marchas wellbecause heknew I'dsay no.
To sealhis victoryhe announcedthat theparade wouldbe freeto thepublic.
Thatnight aftersupper, Kyleinterrupted myLego tower.
Each rowof brickswas justone color.
Cindi, Blossomfeels sadand wantsa friendto livewith.
IfI givehim toyou, canhe beCotton Candy'sbest friend?"
Ididn't evenknow howto answer.
Kyle didn'teven knowthat Blossomwas agirl, butthat wasn'twhy.
OK,if youhelp memake thema littlebarn," asI startedto disassemblemy tower.
Or shouldwe makeit afort againstthe badwolves?"
If myBlossom wasto bea boy,he'd bemore interestedin battlements.
It didn'tmatter thatwe lackedthe Legosto givethe castlea watchtowerbecause wemade thema secretescape door.
Psychiatrist: "Freudspeaks ofrepressed memories."
Sister:"But doctor,I hadsex withmy brotherjust yesterdayafternoon.
Iremember everything."
Sister:"We're prettysure thatshe doesit withDad already."
Ghostwriter'sdisclaimer: Cindiinsisted onthese jokes.
Everything. Whydo youthink Istarted offabout MyLittle Poniesinstead ofan orgasmictrue fantasyof feigningslumber whilebrother ravagedmy nubilebody?
Ghostwriter'snote: Cindisaid, "Fuckedme," butI foundthat verboverly simplistic.
Making lovewith Kyle,when ithappened, hadeverything todo withMy LittlePonies.
Solet's bevery clear.
My thoughtsdeal withmutual affectionbetween caringsiblings.
Youprobably loveyour fathertoo, butthat's notthe same.
You andhe aren'tequal indeciding.
Ifyou're sexuallyactive athome, oddsare thatit's withyour fatheror otherolder male.
I said,RAPING YOU.Find asafer placeto live.
If youhave ayounger sister,go toyour schoolcounselor orthe police.
Tell Mom.Nothing thatfollows appliesto bullying.
If we'rejust horny,there aremillions ofstuds.
AsWoody Allenobserved, "Sexwithout loveis anempty experience,but asempty experiencesgo, it'sa prettygood one."
Sogo toa singlesbar.
Putan adin thepaper, "Enjoysunsets, classicrock, Californiawine andintercourse."
If the"Women seekingMen", listingsdon't likethat lastword, then,"Ford trucks".
You probablydon't wantto lookfor yourguy ata contradance.
Ghostwriter'slament: WhenI phonedthe onewho responded,I saidI justlove thecommercial wherethe guysdrive theirSilverado tofight theforest fire.
He lostinterest. Cindi'sjust beingsnotty aboutcontra dancers.
If youbed yourbrother thefirst timeyou getitchy, maybeyou're anatural rabbit.
That's toobad, becauseyou'll endup eatinglettuce.
Ifit takesa whileto shareintimacy, letit.
Thatcan bejust asexciting asproving it.
Ever triedthe IndonesianHelicopter?
Mywhole theory,actually, isthat themechanics usuallywork outjust fine.
My thoughtsapply tothose ofus whowere willingfirst timeand remainso today.
Enough romanticschmaltz.
Sister:"Maybe so.We getreal noisywhen we'rehome alone."
YourIQ exceedshis penislength.
Trythis littlesurvey onyour girlfriends.
Describe yourfirst intercourse.
Describe theforeplay thatgot youthere.
You'llbe luckyto getmore thana fewclinical sentencesfor (1).
Mostly anexercise incleaning upafter him.
When didhe firsttouch hernipple?
Howwere theypressing whenshe realizedwhat itwas?
You'llhear howher underwearcame off,how shegot thecourage toreach intohis pants.
See whatthis says?Sex isa journey,a continuumof delights,not justa penetration.
Psychiatrist: "Thisjourney thememight besignificant.
Perhapsyou feelabandoned inthis world,longing forthe securityof home."
Sister:"I'm sureI putmy addresson theinsurance form.
HESITATION Ofcourse you'vegot trepidation.
And ofcourse yourbrother hashis doubtstoo.
You'dnever ask,"Shall wehave sex?
Yes orNo?" Butyou mighttry, "Apart ofus wantsto finishtogether, buta partof usis usedto howit wasbefore, asI seeit.
We'renot tryingto proveanything; we'rejust showinghow wefeel, right?
Just alittle bit."Or, "Thereare somany thingsto thinkabout, right?
But youknow? Knowingthat wewant todo putsthe restof itin perspective.
We canfigure thingsout whenwe needto, right?
Or even,"Part ofyou wantsto loveme likea woman,like Iwant tolove youas aman, butpart ofyou knowshow I'ma girltoo.
Didyou catchhow toelicit positiveprogressive responses?
Psychology? Youbet! Ispsychology ascience?
Ghostwriter'ssuggestion: Thoseof usboth hesitantand unpsychologicalcan justslip achemical intothe cocoa.
You'll dealwith itover andover, buteach timehesitate aboutsomething abit closerto whereyou wantto endup.
Itwould dependon howshe grewup, ifshe hada brotherherself, maybe.
A hintthat Mommight knowsomething: Shepoints youto theprogressive possibilities.
The thingis thatyou kidshave alot ofyears ahead,much lessa longride tonight.
Why notgive eachother footrubs?
Sister:"Actually, that'swhere Ilike itbest."
See?" VIRGINITYWhen youand yourbrother firsthave sex,there arebut fourpossibilities.
Eversee BlueLagoon? BrookShields wasjust 15when sheplayed therole inthe nude!
But then,she posednaked whenshe was10, somaybe 15'sno bigdeal.
WhenI was15, Ilooked about10, soshe beatme forthe part.
Anyway, seeingthe moviewill makeyou andyour brotherwant tolose yourinnocence together.
You saythat you'vealready beenprofessionally reamedby astudly cockthat droveyou totwenty minutesof unabashedecstasy?
Yourbrother hasto startsomewhere andyou shouldbe honored.
Don't instruct.A novicewon't knowabout yourclitoris (andeven ifhe's riddena fewmares, soto speak,he mightnot knowmuch).
Putyour otherrelationships onhold fora while.
He'll becavalier aboutyou aswell.
Ohyes, you'reKyle's sister,"you'll hearfrom someleering drunktrying tolook downyour neckline.
But ifyou findcomfort inhis care,give himyou love.
Dating closerto home,so tospeak, entersthe menu.
Sexual prowessmakes gameplaying lessnecessary.
Theadult thingwould beto discussintercourse frominformed vantagepoints andthen executethe agreement.
Leave roomfor someseduction, somevacillation, somenovelty.
Sister:"Well, Iguess Iwas sorefor acouple ofdays."
In "Brothersjust goto Bordersand readit wherethey sellcoffee.
Onesuggests thatit mightbe 2percent priorto age14.
Anotherestimates 17percent priorto age13.
Anothersuggests 15percent.
Andanother, that12 percentof ourhousehold partnersare brothers.
The lastfigure doesn'teven approximatelyfit, butit's published.
I liketo studythings, butlet's notargue numbershere.
Iteach scienceand liketo illustratehow numbersfit together.
As 2to 17percent stillisn't muchcompared to56 percent,those ofus who'veslept withbrother areway inthe minority.
So takea momentto decidewhere youfit whenyou firstmade lovetogether (orwill fitwhen youdo).
VirginsBoth (2)Virgin Brother(3) VirginSister (4)Virgins NeitherHow doesour sororitydivide intothese fourgroups?
We'llstart byassuming thatour brother'sbehavior isnot relatedto ours(we callthis "statisticalindependence").
Seeif youcan figureout howI gotthose numbers.
It surelyvaries byage.
Mymath showsthe VirginBrother groupcount tobe 16,15, and14 whenbrother isyounger, thesame age,and older.
There arefewer oldervirgin brothersfor youngerexperienced sisters.
Makes senseto me.Actually, nomatter theage difference,our VirginBrother groupisn't thatlarge.
Ifmy brotherwasn't sexuallyactive, maybeit's tiedto ourfamily valuesand I'mmore likelyto bea virgintoo.
Solet's pushthat toits limit.
Q: Whyare therenow nobrothers loosingtheir virginityto experiencedsisters?
Theremaining 17experienced brothersget thevirgins.
Poorfellows! Reallife fallssomewhere betweenpure statisticalindependence andperfect correlation.
Do youreally care?OK, no,if you'rejust intoprose.
Onthe otherhand, it'skind offun tosee whereyou fallinto thespectrum.
Ghostwriter'sdisclaimer: Ihave noidea whatshe said.
Psychiatrist: "Whyare youso numericabout siblingsex?"
Sister: "Iam not!I justhave onebrother."
Sister: "Gee,doctor. Iguess itdid justpick upspeed."
That lastsection washeavy.
Youjust likeeach otherand youthink thoughtsthat comewith age.
So whatmakes somethinghappen?
It'sour breaststhat winthem over.
Brothers mayinitially shyaway fromsex withhis sister,but nonewill missthe opportunityto checkher out.
So westart bymaking ourbreasts available.
Imagine askingyour brotherwhat colorof blouseyou woreyesterday?
Orangemaybe." Youdon't evenown orangebecause you'rea Winter.
Then askwhat colorof bra?
Black, Iguess." It'sno guess;he remembersexactly: lacetrim, showsa littlenipple, strapsthat slip.
Cups driveboys wildand itusually onlytakes abutton.
Ifyou're small,hunch yourshoulders enoughtogether sothe cupsfall awayto showthe realdeals.
Iloosen mystrap forit towork well.
Upstairs, casuallywalk aroundwithout yourblouse.
Hisimagination startswith whatyou reveal.
Leave hisimagination roomto travel.
He'll notice,but won'tcomment.
Orthe timeyou, sheand UncleRob werein thekitchen andshe pulledoff hersweater andput ona sweatshirt.
Or whenshe andher brotherwent toshop fora lawnmower.
She wastrussed, though,before Dadcame upfrom thebasement..
Psychiatrist:"Perhaps ifwe unhookedyour strap,you couldlay backmore comfortably."
Psychiatrist:"It's foreye exams.
Can youread mylicense?"
Psychiatrist: "Picturea quietpond, littlenipples washingupon thesandy shore.
FEELINGS Fuckingcan bequite rapid.
Lovemaking, onthe otherhand, takestime.
Itsounds silly,but somethinglike teachingyourselves todance canbe asweet wayto start.
Everybody seeingmakes itbetter.
Peoplethink thatbecause you'rerelated, neitherof youis payingany attention.
Girls likeme, however,are designedto pushstraight on.
Give hima brushthat drawshis armup youroutside anddown yourinside.
Braor nobra worksthe same.
Let himcatch younoticing, butbutton yourlips.
Ifhe seemsanxious tolet yourub it,he'll figureout away.
You'llbe amazedhow muchsmarter hegotten, nowthat he'solder.
We'llget tothe fondlingpart ina bit.
This isjust aboutintroductions.
Whenshe tangoswith Kyle,she holdshim thereal way.
Chest forward,neck back.
You surecan, anyway,when shehands himover.
Youeven madehim comeone timewhen Momwas talkingyou throughthe quebrada,where youhang onhim.
Fortunatelyshe hadto gocheck thestove beforeyou separated.
Psychiatrist: "Onceyou understandyour earliestfeelings, we'llmake someprogress."
Sister: "OK.The firstone, hewas reachingacross mefor thesyrup whileMom waswatching thewaffle iron.
We couldtell howlong wehad bythe littlered light."
Brothersdon't expectexotics; theyknow weprefer cotton.
A littlecontrast ofcolor doeswonders, though.
A darktriangle behindpink briefslooks betterthan justthe trianglesometimes.
Thedetail isfor later.
If yournightgown ridesup whilewatching TVor whatever,him seeingyour pantiesdoesn't matterbecause you'rein yourown house,tell him.
And sometimesleave yourdoor alittle open.
Hey, Kyle,when youcome backfrom thebathroom, bringmy hairbrush?
A hintthat Mommight knowsomething: Whileyou werecombing yourhair andtelling Kylethat hehad tobicycle ifhe wantedto stayfor AstronomyClub, Momcame inand helpedwith yourpart.
Sheagreed aboutbicycling.
Likeyou, shewas inher bra.
Unlike you,though, notin herpanties, sinceKyle wasthere.
Psychiatrist:"So whydo yousay heslipped offyour 'petitculottes'?"
Sister: "Becausewe werepracticing vocabularyfor aFrench test."
Why?"Psychiatrist: "Thesemust beso inhibiting."
CONFIDANTBecome hisconfidant, competitorand comforter.
These threeC's arewhat thesesections areabout.
Ifwe catchthem insome transgression,we sympathize,not threaten.
He maybe mortified,but he'llknow thathis secretwill bekept.
Coercionmight getyou afuck, butyou'll loosea lover.
Think aboutthis transaction.
Get out!"He'll behorrified.
OK.I didn'tsee anything."
You'llbe asembarrassed asis he.
You reallywill. Buthe'll knowyou saw.
You wouldn'tdeny seeingwhat youdidn't.
Soconfess, "It'snatural.
Everybodydoes it."Then causallyadd, "It'sjust differentfor girls."
Thekey isto putyourself therewith him,as ifyou'd beencaught sideby side.
Or someday whenyou're haulinglaundry, "Kyle,there's thisproblem, Ithink," likesometimes youdon't wantto knowstuff.
Whatproblem?" "Yourpajamas andbottom sheetsort of,well, showstuff."
Like?" "Well,you know.
Oh," ashe won'tknow whatelse tosay.
Couldyou usea towelor something?"
Leaveit atthat, justa problemto besolved.
It'spretty easyto implicatehim electronically.
This oneany good?"He'll askwhat you'retalking about.
Ignore thequestion andgive anopinion.
It'stoo posed.You gottabe madeto thinka little."
He'llstill pretendnot tounderstand, sojust goback towhatever youwere doing.
Pretty soonhe'll return;it's toodangerous toleave open.
Are yougoing totell?"
Shoot, no."Don't inferthat heowes youone.
Abook?" "Abook aboutdoing it.
How peopledo itdifferent ways,"to expandthe subject.
That evening,put "TheJoy ofSex" underhis coversand tellhim toput itback underyours thenext night.
It's tooearly toexchange itpersonally.
Leavingit ineach other'sbed issort ofpersonal, anyway.
Use bookmarksto showwhere you'rereading.
Don'tdiscus thecontents, though,until afteryou havesex.
Ifyou changedthe book'shiding place,she'd knowshe wascaught, soyou justused asecond bookmark,sometimes justtrailing behindhers.
WhenKyle wasat camp,the bookmarkled youto thesection onfemale masturbation.
Psychiatrist: "It'sgood forhis mentalhealth toshare hisdarkest secretswith someonehe cantrust."
Sister: "Ifyou sayso, doctor,but Idon't understandDoonesbury either."
Psychiatrist:"No, Iwas thinkingthat maybeyou shouldtell mehow youand yourbrother masturbateeach other."
Thepictures helpeda lot."
Psychiatrist:"You canshare yourinnermost fantasieswith me,like howyou imaginewhat Isleep in.
I canthink ofnothing moreintimate thanorgasm betweenkids whoonce foughtover the64 Crayolaset Momsaid toshare.
Inventlittle privategames.
Kyleused totease abouthow flatI was.
He wasn'ttrying tobe mean,but Ididn't likeit.
Hetold methat hehad growthlotion thatwas onehundred percentguaranteed.
WhenI pretendedto believeit, heput somecold creamin agreen jarand hadme takeoff myshirt.
Imust havehad tentreatments.
Heknew thatI wasn'tthat dumb.
We werejust havingfun.
Afterthen, Iwasn't asshy abouthim lookingdown mytop ormaybe doinga littlesomething ifwe werehorsing around.
A fewyears laterI offeredto applysome guaranteedgrowth lotionon himand welaughed athis trickery.
One timeat apicnic Iwas mindingmy ownbusiness andKyle squeezeda wetwatermelon seedbetween hisfingers andshot meright inthe tit.
So Itook aseed andwhen hestood up,popped himright inhis crotch.
Nobody sawthat either.
No greatsex storythere, justtwo kidsshooting watermelonseeds.
Wrestle.If hetouches yourbreast inthe match,raise yourarm beforetrying toescape.
Ifhe touchesyour butt,giggle thathe betternot spankyou.
He'llbrush betweenyour legswhen he'spinning you,but notlong enoughto doanything.
Histouches aren'tall accidental,you know.
If abutton comesloose anda boobpops out,claim itdoesn't matterbecause youused totake bathstogether anyway.
Say heundid iton purposeand makehim buttonyou backin.
He'lldeny andcomply.
Workyour legbetween his,or maybeyour armwill getthere.
Likewith yourchest, ifit seemsaccidental he'llgo along.
Watch hisbreathing tosee what'sworking.
Ifhe comesanyway, playit beear.
Thosetypes ofgames needothers watching.
Whatever contestsyou twomight devise,think ofthem asgames, notforeplay.
Youand yourbrother havecompeted forabout everythingover theyears.
Sokeep itup. You'llwin eachother.
Ahint thatMom mightknow something:She showedKyle aScientific Americanarticle claimingthat femalesare strongerthan males,pound forpound excludingfatty tissue.
Psychiatrist: "Don'tfeel alone.
For somany sisters,victimization isby powerand dominance."
Sister:"Oh, butI tryto lethim winhalf thetime."
COMFORTER There'scomfort inproximity.
Theysay thatmore siblingrelationships startin sleepingbags thanon beds.
The folkswill haveput yourtent awayfrom theirs,as freshair andchange ofvenue invigorateMom andDad too.
It willbe darkenough toget intoyour PJ'swithout seeing,no problem.
The twoof youcan whisperwhoppers afterlights out.
He's justmaking hisstory op.
He'll lookbehind him,but itwill begone.
Butthe dangerwill betoo quiet.
Good idea.Just askme ifyou wantme toshine theflashlight anywhere."
Witha brotherwe haveyears tolearn aboutholding eachother, whisperingstories, giggling.
Proving ourlove thushas allthat tobuild upon.
When thetwo ofyou figuredout howto zipperyour bagsas one,she notedthat itmakes agood cushionfor whenyou readafter lunch.
She neverasked ifyou separatethem forsleeping.
Yourtent willbe justa bitsmaller inrelation tothe bothof you.
Scoot yourpad rightagainst hisbecause youneed roomon theoutside foryour duffel.
You probablybrought toomany clothes.
After marshmallowsand atrip tothe smellyrestroom andyou've zippedthe flapshut, remindyour brotherabout thepsychos.
Rememberhow weheard onelast year?
Well, wehave tostick togetheris all."
Whenhe finallydrifts off,poke himawake, "HeyKyle, doyou needto gopee?"
No." "WellI do,but I'mnot goingout therealone."
Why not?""Weirdoes. Youcome too."
Topee?" "Justto theplace."
Go yourself.""I'm scared,"which, ofcourse youaren't.
Justgo." "ThenI'll peein thetent," asbest youcan pout.
You betternot!" "Weshould peetogether."
No, Imean doit inthe woods.
Well, Ido. Comeon!" Soyou sneakover inthe trees.
You squatand hestands whereeach canhear theother.
Youwant himto thinkabout pajamasbeing down.
Can Iaim you?"ask inyour mostnatural voice.
I'll holdit reallycarefully," tellhim.
Himin yourhand isthe ideayou're fostering.
No, Isaid!" "Whenyou're finished,can Ipractice aim?"
Don'teven botherto justifywhy.
Youbetter not!""You haveto letme.
Youcan touchmine," nota concessionyou'll mindgiving, actually.
Your what?""You know.
Where Ipee?" "Forhow long?"
We'lltake turns,the same."
Youwon't tell?"So backto yourtent youcreep.
Lethim gofirst becauseyou wokehim up.
Put hishand onyour chestand undosome buttons.
Your titswill behard andpointy.
Aftera minuteor two,put hishand onyour stomachand pushit tothe elastic.
Then guidehim towhat makesus girls.
Let himtouch whileyou freehis underpants.
You didn't,per chance,urinate oneach other,did you?
Just asmall amount,even.
Sometimesyou forgetsuch incidentsuntil alicensed professionallike mereminds you.
You mighthave evenbeen talkingabout somethingelse andhardly noticed.
Think so?"Sister: "Ipee inthe swimmingpool, Iguess."
Wear yourbra. Justhop intohis lapin themiddle ofthe movieand gethim towrap hisarms underyour boobs.
Snuggle deeperso hiserection fitsagainst yourcrack.
He'llget one.To getmore comfy,move hisarms up.
If hecups youthrough yournightie, hewon't actintentional.
Hecan bumpyour nip,but shouldn'tsqueeze, ifyou getthe difference.
Tug yourneckline outenough forhim lookover hershoulder.
He'sseen yourbra amillion times,but notwhen you'relaying backinto him.
Let himsee thatyou're lookingtoo.
Maybeyou'll havesex rightaway, butprobably not.
Enjoy yourlittle moviewatching routinefor themovie too.
In X,they reallyhave sex.
In R,they justact likethey are.
Wasn't itfun towatch howTom Hanksplayed ForrestGump?
Jenny:"Have youever beenwith agirl, Forrest?"
Forrest:"I seethem inmy HomeEconomics classall thetime."
Would youhave ratherwatched atruly handicappedfellow?
Ofcourse not.We enjoythe artof drama.
Sort oflike youtwo, right?
Am Istuck onsome sortof themehere?
Yourbrother needsideas isall.
Jennygave Forrestenough ofan ideafor himto starther baby.
Ghostwriter's review:But TomHanks wasreally goodin theway hefell inlove withMeg Ryanin "You'veGot Mail."
Youand Kylewatched itTuesday andyou returnedit onThursday.
Wednesdaywhen youwere atschool waswhen UncleRob deliveredall thoseapples thatyou kidshad topeel.
Psychiatrist:"I have'Cheerleader Countercharge'right hereon mymachine.
You'regoing togo tocollege, right?
I'd liketo participatorallyobserve howyou react.
Let mecancel mynext appointment."
Sister:"We sawit. Mybrother thoughttheirs werereal, even.
You cantell wherethey ranout ofmoney andhad tosplice inanother filmfor thealien impregnationpart."
DRIVING Sexcan getgoing inthe strangestplaces, sayin theback ofyour car,dozing ona longtrip.
He'sup againstyou, hisarm justa littletoo muchacross yourfront.
It'snervy atfirst andyou'll bothbe cautious,but aftera bityou'll bothfigure thatthe other'sasleep andyou'll getcloser.
Whenyour nipplesget hard,he'll realizeyou're lettinghim.
It'squiet, exceptfor thecar radio.
Dad willbe calculatingthe lastpossible placeto getgas.
Probablyyou shouldpull acoat orsomething overyour laps.
Your brotherwill becautious becausehe's stillnot reallysure.
Undoa buttonto tellhim where.
It's amagic momentwhen heslips upinside yourcamisole.
Hisgiveaway iswhen herolls towardyou, kneesapart.
Brusha fingerbeside hiszipper; hewants youto know.
Don't stop,even ifhe shakeshis head.
It takeslonger onthe outside,but he'lllove youfor it.
His pulseis agood wayto tellwhat's coming.
Did Isay that?Naughty me!
Help himhide hiswet spotwhen youget outof thecar.
Youmade himdo it,right?
Ahint thatMom mightknow something:When caughtglancing back,she toldDad somethinglike, "They'recuddled upjust likewhen we'dput themin thestroller together.
Remember?" Psychiatrist:"We knowthat theautomobile isthe modernworld's phallicsymbol, justlike obeliskin Egypt."
Sister:"Well Dadalways buysAmerican cars,so wedo endup witha littleextra roomin theback."
Sister: "Shoot,doctor.
Mybrother wastiny whenwe started,but welearned whereto rubit."
AT THEMOTEL I'llstick withthe familytrip venue,since Ican envisionit prettywell.
Butbasically I'mmoving usfrom touchingto theact itself.
My mainpoint isthat it'sseamless.
It'swhere thejourney leads,not somestarting orstopping point.
Nighttime changesthings.
It'sreally riskydoing itin thesame room,but kidsare alittle stupidsometimes.
Dadsleeps likea logafter allthat driving;Mom's yourchallenge.
Ghostwriter'swarning: Describingrisky behaviorgives itsome legitimacy,I fear.
They saythat forevery sound,there isa frequencythat willcancel it.
Claim thebed awayfrom thewindow, sincelight fromthe parkinglot cansilhouette youif youget twodeep, soto speak.
Quietest isyou onyour back,one kneeup, histhighs underit andscissored aroundyour other.
Your headsare wayapart.
You'rein goodpositions tocoordinate.
Plusit doesn'thurt yourback.
Bythe thirdnight you'llhave itto ascience.
TVoff afterthe weather.
Thirty minutestill Mom'sout ofit.
Underpantsdown. Themain thingisn't thatyou screw;anybody cando that.
It's thatyou pullit offtogether.
Whatevergets thebedding wetdoesn't matterbecause themotel peopledeal withstains allthe time.
The maidnever knowswho waswhere.
Asif shedoesn't changeother kids'beds afterwards!
If you'renot onthe pill,you shouldbe usinga rubber.
Just leaveit inthe sheetsfor themaid totoss.
She'llhardly speakEnglish, anyway.
If youthrew itin thewastebasket, Momwould seeit rightoff.
Dad,if heever lookedin thetrash, wouldprobably fillout thatlittle "How'dwe do?"
Ghostwriter'sapology: Hospitalitystaff areoften undocumentedbecause Americancitizens preferhigher pay.
Cindi isbeing somewhatcondescending regardinglinguistic ability.
Psychiatrist: "Youknow?
There'sa Motel6 notfar fromhere.
Sister:"Kinda likebeing ina tent?"
Psychiatrist:"It mightgive youa senseof malesecurity torest yourhand righthere."
Sister: "Isee whatyou meantabout thesize thing.
My brotheris hardlystarting hisgrowth spurtand alreadyhe's..."
Psychiatrist: "Sotell mea dreamor something."
ONTHE BEDWherever youstarted, you'llend upon yourbed orhis.
Siblinglove isabout beingat home.
Know whywe knowall theJohn Denversongs?
Becausethey're abouthome.
Haveany ofus actuallylived inWest Virginia?
I startedoff with"What's lovego todo withit?"
Well, let'smake that,"What's homegot todo withit."
Same answer.Everything.
Asister andbrother cansleep togethera bunchif theirfolks' bedroomis downstairs.
Avoid creakyfloorboards.
Whosebed isthe quietist?
If needbe, doyou havea thickrug?
Setan alarmto getback, especiallyif Dadgets upearly toread thepaper.
Momdoes thesheets, soput somethingdown likea darktowel.
Onetime, turnaround soyour headsare atthe footof thebed.
Anestablished bedroomroutine ensues.
Codeword itsomething like,"Upstairs."
Did youuse mytowel upstairs?"
I'llbet Ileft thatNewsweek upstairs,"casually atthe dinnertable suffices.
At theodd useof "upstairs"in yourtable talk,she smilesand hernipples show.
Visualize thatthis ishis handholding yourlovely breast."
Sister:"OK, doctor.Kyle, justbecause youdidn't helprake theleaves doesn'tmean thatI haveto bagthem allby myself.
And don'tpinch somuch!"
THE UPSAND THEDOWNS OFIT Didyou catch"Top Tips"in thetitle ofthis document?
Take turnswho getsto beon top.
Being theguy doesn'tmake himalways theboss.
Hemay beable tokowtow agirlfriend, butnot hissister.
Weowe thetop thingto thebra burners.
A guycan shootwhile ridinga bicycle.
For us,it's thelittle changesin pressure,the modulation,the eyecontact, howyou gotthere, whatyou'll doafterwards.
Lookingdown, yousee thesynergy.
Siblingsdon't needto explainstuff oract coolwith eachother.
He'llsteady yourboobs even,not becausesqueezing issuch abig dealby thispoint, butso you'llnot getsore bouncingaround.
Minedon't bouncemuch becauseof theirsize problem,so I'mjust talkinggenerally.
Plus,a guyalways becomesa betterfucker whenhe realizesit's notjust amale thing.
Did youever seeLeaving LasVegas?
I'dsaid tosee BlueLagoon withyour brother,but ifyou wantto seean adultside oflove, thisone's sadderand better.
A hintthat Mommight knowsomething: Shesuggested thatyou doyour bookreport onLilith.
Thepatriarchal scribesreplaced Lilithwith Evein Genesis,she revealed,but madeyou readthe bookto seewhy.
Psychiatrist:"Being thesuperior isa commonfeminine fantasy.
Do youthink ina previouslife youmight havebeen aNative Americanprincess?"
Sister: "Nah,my jobwas totorture captivebraves, butit doesn'tfit inour school'smulticultural curriculum.
Anyway, whatI'd dowas getthis flaminghot tomahawkand dancenaked infront ofhim untilhe got,you know,and thenchop offabout aninch andthen doit allover again.
If hewas reallybrave, I'dlet himdo mewith hislast inchand thatwould makeour nextChief.
ThenI'd take...."Psychiatrist: "That'ssurely enough.
So showme howfast youlike togo byraising yourhips.
Thatwas avery goodreflex youjust showed."
Sister:"My otherjob wasto haveceremonial sexwith buffaloes."
ThisI promise:it willget betterand betterand better.
I'm talkingabout forsix years.
Better andbetter. Basicallyaim forabout halfspeed.
Thebest thingabout withyour brotheris thatcaution forcesyou tofind thequiet ways.
At homethere's maybesomeone who'dwonder aboutthumping sounds.
You can'tbe vibratingyour bedaround theroom.
Assiblings aregenetically thesame, younaturally climaxright atthe sameminute evenwhile you'relearning.
DNAis thereason. Wehave adouble helixmodel inmy classroomthat wemade withfoam ballsand wires.
Visuals arevery importantfor theirlearning experience.
Genes explainwhy twinscan sometimestell whenthe otherone isin trouble.
Ghostwriter's disbelief:I don'tcare ifCindi doesteach science.
Our hormonesmake usdo it,not ourDNA.
Hisorgasm isabout sixsquirts worth,so gettingthere wasmost ofhis fun.
A brotherwill stickwith youall theway upand allthe waydown.
Psychiatrist:"It mustbe difficultfor you."
Sister:"Well, notso muchafter wegot topuberty."
Psychiatrist: "Imean thatit's notnormal."
Sister: "Werealized that,trying 'Lizardson theCeiling', sowe stickwith positions1, 2and 4."
Psychiatrist:"So tellme aboutyour brother'spenis.
Howlong, howthick, howhe likesit held,that sortof thing.
Sometimes it'sgood topsychoanalyze bothpartners, Ifind.
Icould fithim inTuesdays andThursdays untilwe setup somethingregular."
Sister: "Doyou havean itchdown there,or something?"
It'smore specialwhere youcan seeall yourgirly thingslike RaggedyAnne.
SqueakCity! (3)If youtry newstuff, now'sthe time.
Untested ideassometimes turnout tobreak itemslike lawnchairs.
It'sbath time.You didit togetherwhen yourwere little.
Put towelsaround thetub becauseyou'll slosh.
Turn offthe lightsand burna candleso itdoesn't lookso muchlike abathroom.
It'sromantic, evenif heis yourrelative.
There'llbe bubblebath inthe cupboardfrom whenyou wereten.
Andif youspill yourwine inthe tub,who cares?
Get himreally soapy.It's hardto usea rubber,though, sobathe togetherat theright timeof themonth.
Ahint thatMom mightknow something:She madea bigracket atthe frontdoor whenthey camehome earlierthan expected.
Psychiatrist: "Onyour parents'bed makesit Oedipal."
Sister:"I thinkit stilltastes yucky."
Hi,this isCindi. ...
Not much.... Hey,our folksare outthis eveningand Kyleand mewere wonderingif youand Andrewwanted tocome overand watcha movie?
Blue Lagoon,I wasthinking.
Iagree. Brotherscan beso unromanticsometimes, butas theysay, they'reconvenient.
No,I readit somewhere.
OK, butjust fourcans.
Iwas thinkingmaybe togetheron thesofa, rightwith themovie.
Youwearing yourblack one?
We shouldbe thesame.
Hello,www. You'llfind thegraphical stuffnear thegrandmother+dog selection.
Talk aboutbullshit! Dothey looklike siblings?
Why wouldsiblings wantto getfilmed?
Sick.Worse thingis thatpeople payto seeit.
Wow,man! Here'sa jpegwhere thebrother isshoving hisbig blackdick rightup thewazoo ofhis gorgeousblond sister!
Sex storysites havecaptured themarket forunlikely similesand metaphors.
In sciencewe justsay whathappens.
Therotifer eatsthe bacteria,"not, "Theslathering voraciousrotifer pullsthe weakenedand tremblingbacteria intoits consumingjaws."
They likethat laststyle forsex stories.
Pretty stupid,if youask me.
So stripout allthe pathologicparagraphs aboutbig cocksand hungryholes.
What'sleft inbrother+sister storiesis thatwatching adirty movie,or whatever,somehow makesbrother startscrewing sisterand shediscovers thatshe lovesit.
Onlyone outof 50even tries.
I didcome acrossa questionnairefrom theearly webdays, discussiongroup style,about siblings'personal history.
There werefrank responsesfor awhile andthen theperverts startedsending fantasyfiction.
Fromthis close,the aromais makingmy headspin intototal euphoria.
I moveeven closerand lickgently upand down.
Those youngEarnest Hemingwayskilled thesurvey.
Conclusion(1) surelybiases (3).
Let's wonderabout (2)because mostother studiessuggest thatthe girlis usuallythe younger.
Ghostwriter's concern:Cindi surfswhen thestudents areworking attheir desks.
Things cantravel electronically.
This somebodyhas adistribution list.
You discoveryourself onthe Internet.
She hadthis littlelog cabinon herass becausethey werefrom Illinois.
Maybe theWebmaster thoughtit wasa dacha.
I'm notsure howmy boyfriendknew shehad it,though.
Theweb haslots ofsites dealingwith abuse.
A hintthat Mommight knowsomething: Thesibling sexsite cookieson yourcomputer keepbeing modifiedwhen youand Kyleare atschool.
Psychiatrist:"I suspectyou mayhave beeninfluenced bySister: "Didn'tfool meone bit.
A realsister wouldundress beforeher brotherdid it."
CHURCHI ama goodCatholic, andnot justbecause Iwent toa parochialschool (whichI did)and goto Massevery week(which Ido).
TheChurch hassome verygood valuesand basictruths.
Wherewould civilizationbe withoutthem?
Beinga goodCatholic includesbeing (orat leasttrying tobe) agood person.
So howto dealwith sex?
Two points:(1) Godcreated it.
Do itin love.So why'swhat abrother andsister doa religiousissue?
Tworeasons: (1)Biblical mention.
But wait!Almost allthe Biblicalprohibitions dealwith girlsand fathers,boys andmothers.
Thereare justa fewreferences tosiblings, towit, "Thenakedness ofthy sister,the daughterof thyfather, ordaughter ofthy mother,whether shebe bornat home,or bornabroad, eventheir nakednessthou shaltnot uncover."
Adamand Evebegat Cainand Ableand theyhad tohave begotsome daughterstoo, whenyou considerthat therewas anext generation.
So sexwith sisteris aBiblical fact.
Figured itout inSunday school.
After theFlood, eightpeople populatedthe worldagain, butcousins couldhave donethat.
Donot havesex withthe authorities."
ThePope regulatessex toenhance hisown authority.
He's notGod, justHis spokesperson.
Have yourbrother useanother confessor,just incase bothof youlet slipsomething like,"We we'rejust pickingplumbs and..."
Likewe're goingto getout ofbed withour brother,rob abank, filea fraudulent1040 andpark inthe disabledzone?
Everybody'sDNA ispretty muchthe sameanyway.
Didyou knowthat humansand chimpanzeesare 99.4percent identical?
When Isay soin myclass, someparent alwayscomplains tothe Boardthat I'madvocating sexwith animals.
Ridiculous! That'swhy we'vegot eachother.
Brotherssubconsciously wantto getus pregnant;it's naturalinstinct toexpand theclan.
Iheard aboutthis guywho wouldgive hissister asleeping pillso shewouldn't knowwho'd knockedher up.
She'd havean orgasm,though, evenasleep.
Ghostwriter'scorrection: Theaccount Iheard saidthat shewas simultaneouslypulling thesame stunton him.
It's apain tohave todig underyour sweatersevery time,though.
Lookfor someplacemore convenient.
Big girlsstill puttheir dollon theirbed andI hadmy favoriteRaggedy Anne.
I usedher drawersand putthe foiland theused onesback inthe sameplace.
Itwas easierthan havingto getrid ofthe stuffevery time.
She suggestedusing thepill justto makeyour periodsmore predictable.
When Igot onthe pill,planning gotsimpler.
Likesomething youmight havebrought inyour purse?"
Sister:"We always,always lockthe door."
Psychiatrist:"What aboutyour genes?"
Sister:"We alwaystake themoff."
Psychiatrist: "Well,I thinkyou havea psychosis."
Sister:"No way,because wepractice safesex."
LOVE ANDMARRIAGE Gotogether likea horseand carriage.
In apoem, anyway.You canstill datearound becauseof courseyou'll nevermarry eachother.
JamesThurber wrotea greatline, "Shesaid heproposed somethingon theirwedding nightthat evenher ownbrother wouldn'thave suggested."
Ifsex withyour brotheris stillmore funthan sexwith yourhusband, we'retalking siblingaddition.
Itbeing an"addiction" mayqualify youfor somesort ofmental healthbenefit.
Getcreative withhubby.
Sayyour brotherties theknot.
Wecan tellour brothersto getreal withtheir fantasies.
Women aresmarter aboutreality.
Yourbrother justwon't beyour "hotdate" anymore.
He'llbe thesomeone youcan fallback tofor somethinga bitmore relaxed.
Sister: "Positions1, 2,3, and4.
Whatare youdoing now?"
Psychiatrist:"This iswhat wecall theMarmoreal FulfillmentTest tosee ifyou haveanxiety about(how canI phrasethis?) breastfeeding.
INCEST ISFOREVER Sothey say.
We're goingto keepseeing thesebrothers ofours fora longtime; it'snot likea relationshipwe candump.
You'llbe entwinedon theguest bed,going niceand slowly,giggling aboutthat earlytime onthe sofawhen thefolks camehome early.
He didn'thave timeto puthis underpantsback on,so youstuffed hisdrawers intoyour joggingpants.
Ifsomeone passingthe bedroomdoor hearspanting, they'llassume thatthe twoor youare rearrangingthe furnitureor something.
They callour affection"a hiddenlove".
Well,it's notbecause wehide itthat well.
It's becausethey hidefrom knowing.
So takecare ofthe guyand lethim takecare ofyou.
Ahint thatMom mightknow something:The moreyou listened,it suredidn't soundlike sheand UncleRob werediscussing UncleRudy.
Sowhen Dadappeared atthe endof thehall, yousent himback tolook foran extensioncord.
Herbrother waspart ofher essencetoo, ayouthful partthat neededto bepreserved.
Psychiatrist:"So youdon't wanthelp stopping?
I needto completemy file,is all."
Sister:"Seven inchesmaybe.
Psychiatrist:"Just hangyour skirton thechair.
Mebeing inpsychiatry, Ican eliminatethe psychosomaticones."
FINAL THOUGHTSSo there,you knowwhat Ithink.
Ghostwriter'sclarification: Thanksto mythematic organization,word choice,paring ofredundancies, eliminationof objectionableallusions, sourceconfirmations, dialogcompression, etc.
To wit:Mom didn'twant togo tothe Elk'sconvention inDenver, soDad flewahead andyou threedrove topick himup forcamping afterwards.
So thefirst nighton theInterstate, youand Kyleclaimed oppositesides ofyour queensize, glaringdistance.
Momtook thenear sideof thebed bythe window.
Since Momwatched Cheersin herbra andchanged afterwardsinto hernightgown, sodid you.
Emerging fromthe bathroom,her breastsswayed withinthe summercotton, hernipples wideon theirorbs.
Yourswere erectas well,but highand close.
When Momleaned acrosstheir bedto kissRob goodnight,you watchedhow shepressed againsthim asthey drewup theircovers.
TVoff afterthe weather.
Thirty minutes.Underpants down.
But beforeyou embracedKyle, aheadlight illuminatedthe motelwindow.
Asyou watchedthem makelove, herevery fiberseemed toresonate withhis everymuscle.
Youremembered hearingMom breathethat waybefore, atthat timesuspecting thesexual.
Butlying inthe sameroom, youknew thatintercourse wasbut afacet oftheir union.
You signaledKyle togo aheadand getunder yourknee.
Yourown chinwas tremblingtoo.
Dotwin muffledmelodies makea secretsymphony?
Inthe morning,all fourvolunteered howquickly youfell asleep.
The maidfound evidenceto thecontrary, however.
Something forhim tolook forwardto, youfigured.
Youcould havemade Denverfor supper,but by2:00 itwas hot,so youpulled intoa HolidayInn.
Momand UncleRob werepretty tiredso youkids wentto thepool foran hour.
You said,"an hour."They werebathed andrested onyou return,so theywent toswim fortheir hour.
Mom alsoannounced, "anhour."
That evening,you andMom werein panties.
It feltweird havingUncle Robsee you,but thenMom probablyfelt thesame havingKyle there.
Watching Cheers,you tauntedKyle underyour sheet,denying thefinish ofwhat wasuncompleted inthe car.
His reflexivebegging onlymade youtease himmore.
Undertheir sheet,Rob wascurled behindMom likea halfshell abouta walnut,her backwardwiggles confirmingtheir conformity.
Kyle atfirst resisted,it beingso obvious,but yougave himlittle choice.
You knowMom witnessedbecause onlyafter youthroes subsideddid shetake Robwith equalferocity.
Nextmorning whileUncle Robwas shaving,Mom wentin thebathroom andshut thedoor.
Prettysoon youcould hearthe showerand aftera whilethe two,Rob themore sheepish,came outwith wethair.
Next,"suggested Mom.You hadKyle giveyou ashampoo.
Travelingaffords intimacybeyond theerotic.
Sincecheckout wasn'ttill 11:00,you postedthe "DoNot Disturb",pulled thedrapes, hoppedback underthe sheetsand turnedup DiscoveryChannel.
Thiswould betheir lasttime togetherbefore youall gotback home.
You werebeing astinker, remotingthe TVvolume downwhen Mom'sbreathing pickedup, butshe afterwardsgiggled thatshe hadthe sameidea foryou.
You'dnever discussedyour bookreport, butyou knew.
In theTV illumination,you andshe grinnedand wavedat oneanother beforeattending toyour loversbelow.
Inthe car,the fourof youmade plansfor thetango conventionnext year.
Sister: "Youreally thinkthis therapyworks betternaked, doctor?"
Psychiatrist:"The standardprocedure forclitoral confirmationis digital,but Iprefer visualverification.
Anoverlooked clitoridectomymight explainyour dissatisfactionwith yourbrother."
Psychiatrist: "Yourweeping innerego.
Psychiatrist:"Is yourbrother's hairreally thiscolor?"
Psychiatrist: "No,no, thedesire ofan oldermale toengage insex withboys.
Butwhat doI know?I justhave onebrother.
Hereare somealleged experts.
Unlike realscience, however,behavioral scienceis flaky.
Ghostwriter's certainty:Cindi justskimmed thetitles.
Ina surveyof 796undergraduates atsix NewEngland collegesand universities,15% ofthe femalesand 10%of themales reportedsome typeof sexualexperience involvinga sibling.
Fondling andtouching ofthe genitalswere themost commonactivities inall agecategories.
Reactionsto theexperiences wereequally dividedamong thosewho consideredthem positiveand thosewho consideredthem negative.
Females weremore likelyto havebeen exploitedand feelbadly aboutit.
Fewof eithersex evertold anyone.
Females whoreport siblingsexual experiences,both positiveand negative,have substantiallyhigher levelsof currentsexual activity.
Symonds, C.L.,Mendoza, M.J.
Constantine andF.M. Martinson(eds.), Childrenand Sex,New Findings,New Perspectives,Little, Brownnarcotic painmedicine; sedativesor tranquilizers(such asValium); medicinefor depressionor anxiety;medicine formental illness(such asbipolar disorder,schizophrenia); orstreet drugs.
Seizures haveoccurred insome peopletaking tramadol.
Your riskof aseizure maybe higherif youhave anyof theseconditions: ahistory ofdrug oralcohol addiction;a historyof epilepsyor otherseizure disorder;a historyof headinjury; ora metabolicdisorder.
Talkwith yourdoctor aboutyour individualrisk ofhaving aseizure fromthis medicine.
Before takingtramadol, tellyour doctorif youare allergicto anydrugs, orif youhave: kidneydisease; liverdisease; astomach disorder;or ahistory ofdepression, mentalillness, orsuicide attempt.
If youhave anyof theseconditions, youmay notbe ableto usetramadol, oryou mayneed adosage adjustmentor specialtests duringtreatment.
Taketramadol exactlyas itwas prescribedfor you.
Do nottake itin largerdoses orfor longerthan recommendedby yourdoctor.
Followthe directionson yourprescription label.
Do nottake morethan 300milligrams oftramadol inone day.
Tramadol canbe takenwith orwithout food,but takeit thesame wayeach time.
This isnormal anddoes notmean thatyou arenot receivingenough ofthe medicine.
Do notstop usingthis medicationsuddenly withouttalking toyour doctor.
You mayneed togradually reducethe dose.
Withdrawal symptomsmay occurwhen youstop usingtramadol.
Withdrawalsymptoms includeanxiety, sweating,nausea, diarrhea,tremors, chills,hallucinations, troublesleeping, orbreathing problems.
Call yourdoctor atonce ifyou haveany ofthese withdrawalsymptoms afteryou stopusing tramadol.
Take themissed doseas soonas youremember.
Ifit isalmost timefor yournext dose,skip themissed doseand takethe medicineat thenext regularlyscheduled time.
Do nottake extramedicine tomake upthe misseddose.
Avoidusing drugsthat makeyou sleepy(such ascold medicine,other painmedications, musclerelaxants, andmedicine forseizures, depressionor anxiety).
These drugsmay slowyour breathingor increasedrowsiness whenused togetherwith tramadol.
Continue takingtramadol andtalk toyour doctorif youhave anyof theseless seriousside effects:dizziness, drowsiness,weakness; nausea,vomiting, constipation,loss ofappetite; blurredvision; flushing(redness, warmth,or tinglyfeeling); orsleep problems(insomnia).
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Youmay bemore likelyto havea seizure(convulsions) ifyou taketramadol whileyou areusing certainother medicines.
Do nottake tramadolwithout tellingyour doctorif youalso useany ofthe following:an MAOinhibitor suchas isocarboxazid(Marplan), tranylcypromine(Parnate), phenelzine(Nardil), orselegiline (Eldepryl,Emsam); oran antidepressantsuch asamitriptyline (Elavil),citalopram (Celexa),clomipramine (Anafranil),desipramine (Norpramin),escitalopram (Lexapro),fluoxetine (Prozac,Sarafem), fluvoxamine(Luvox), imipramine(Tofranil), nortriptyline(Pamelor); paroxetine(Paxil), orsertraline (Zoloft).
John's wort;quinidine (Quinaglute,Quinadex, Cardioquin,Quinora); ordrugs thatmake yousleepy (suchas coldmedicine, otherpain medications,muscle relaxants,and medicinefor seizures,depression oranxiety).
Ifyou areusing anyof thesedrugs, youmay notbe ableto usetramadol oryou mayneed dosageadjustments orspecial testsduring treatment.
There maybe otherdrugs notlisted thatcan affecttramadol.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Tramadol isavailable witha prescriptionunder thebrand namesUltram andUltram ER.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
Version: 9.03.Revision date:8/11/06 9:17:45AM.
Codeineis usedto treatmild tomoderate pain.
Codeine mayalso beused forpurposes otherthan thoselisted inthis medicationguide.
Beforeusing codeine,tell yourdoctor ifyou areallergic toany drugs,or ifyou have:asthma, COPD,sleep apnea,or otherbreathing disorders;underactive thyroid;curvature ofthe spine;a historyof headinjury orbrain tumor;epilepsy orother seizuredisorder; lowblood pressure;gallbladder disease;Addison's diseaseor otheradrenal glanddisorders; enlargedprostate, urinationproblems; mentalillness; ora historyof drugor alcoholaddiction.
Olderadults maybe moresensitive tothe effectsof thismedicine.
Takethis medicationexactly asit wasprescribed foryou.
Nevertake codeinein largeramounts, oruse itfor longerthan recommendedby yourdoctor.
Followthe directionson yourprescription label.
Tell yourdoctor ifthe medicineseems tostop workingas wellin relievingyour pain.
Keep trackof howmany pillshave beenused fromeach newbottle ofthis medicine.
Codeine isa drugof abuseand youshould beaware ifany personin thehousehold isusing thismedicine improperlyor withouta prescription.
Since codeineis takenas needed,you maynot beon adosing schedule.
If youare takingthe medicationregularly, takethe misseddose assoon asyou remember.
If itis almosttime forthe nextdose, skipthe misseddose andwait untilyour nextregularly scheduleddose.
Donot useextra medicineto makeup themissed dose.
Overdose symptomsmay includeextreme drowsiness,pinpoint pupils,confusion, coldand clammyskin, weakpulse, shallowbreathing, fainting,or breathingthat stops.
Less seriousside effectsinclude: feelingdizzy ordrowsy; nausea,vomiting, constipation;sweating; headache;trouble sleeping(insomnia); lossof interestin sex;dry mouth;blurred vision;or mildskin rash.
This listis notcomplete andother sideeffects mayoccur.
Tellyour doctorabout anyunusual orbothersome sideeffect.
Theremay beother drugsthat caninteract withcodeine.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Tell yourdoctor ifthe medicationdoes notseem towork aswell intreating yourcondition.
Itworks byslowing downimpulses inthe brainthat causeseizures.
Lyricaalso affectschemicals inthe brainthat sendpain signalsacross thenervous system.
Lyrica isused tocontrol seizuresand totreat fibromyalgia.
Lyrica mayalso beused forpurposes otherthan thoselisted inthis medicationguide.
Beforeusing Lyrica,tell yourdoctor ifyou areallergic toany drugs,or ifyou have:congestive heartfailure; diabetes;or kidneydisease.
Ifyou haveany ofthese conditions,you maynot beable touse Lyrica,or youmay needa dosageadjustment orspecial testsduring treatment.
If aman fathersa childwhile usingthis medication,the babymay havebirth defects.
Use acondom toprevent pregnancyduring yourtreatment.
Takethis medicationexactly asit wasprescribed foryou.
Donot takethe medicationin largeramounts, ortake itfor longerthan recommendedby yourdoctor.
Followthe directionson yourprescription label.
Do notchange yourdose ofLyrica withoutyour doctorsadvice.
Tellyour doctorif themedication doesnot seemto workas wellin treatingyour condition.
Take themissed doseas soonas youremember.
Ifit isalmost timefor yournext dose,skip themissed doseand takethe medicineat yournext regularlyscheduled time.
Do nottake extramedicine tomake upthe misseddose.
Symptomsof aLyrica overdoseare notknown.
Lessserious sideeffects maybe morelikely tooccur, suchas: dizzinessor drowsiness,anxiety; blurredvision; lossof balanceor coordination;problems withmemory orconcentration; drymouth; skinrash oritching; constipation,stomach pain;increased appetite;or jointor musclepain.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Theremay beother drugsnot listedthat canaffect Lyrica.
This includesvitamins, minerals,herbal products,and drugsprescribed byother doctors.
Do notstart usinga newmedication withouttelling yourdoctor.
Pregabalinis availablewith aprescription underthe brandname Lyrica.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
The manufacturerof Bextrahas announcedthe voluntarywithdrawal ofthe drugfrom theU.S.
Bextrawas withdrawnfrom theU.S.
Bextraworks byreducing substancesin thebody thatcause inflammation,pain, andfever.
Bextrais usedto reducepain, inflammation,and stiffnesscaused byosteoarthritis andadult rheumatoidarthritis.
Bextrais alsoused totreat painfulmenstruation.
Bextramay alsobe usedfor purposesother thanthose listedin thismedication guide.
The manufacturerof Bextrahas announcedthe voluntarywithdrawal ofthe drugfrom theU.S.
Bextrashould notbe usedfor thetreatment ofpain aftercoronary arterybypass surgery(CABG).
Theuse ofBextra insuch patientshas ledto anincreased incidenceof cardiovascularevents, deepsurgical infectionsand woundcomplications.
Talkto yourdoctor beforetaking Bextraif youare beingtreated forpain associatedwith CABG.
Before takingBextra, tellyour doctorif yousmoke; drinkalcohol; havean ulceror bleedingin thestomach; haveasthma; havecongestive heartfailure; havefluid retention;have heartdisease; havehigh bloodpressure; havea coagulation(bleeding) disorderor aretaking ananticoagulant (bloodthinner) suchas warfarin(Coumadin); orare takinga steroidmedicine suchas prednisone(Deltasone andothers), methylprednisolone(Medrol andothers), prednisolone(Prelone, Pediapred,and others),and others.
You maynot beable totake Bextra,or youmay requirea dosageadjustment orspecial monitoringduring treatmentif youhave anyof theconditions, orare takingany ofthe medicines,listed above.
Take Bextraexactly asdirected byyour doctor.
If youdo notunderstand theseinstructions, askyour pharmacist,nurse, ordoctor toexplain themto you.
Bextra canbe takenwith orwithout foodor milk.
Follow yourdoctor's instructions.
Take themissed doseas soonas youremember.
Ifit isalmost timefor thenext dose,skip thedose youmissed andtake onlythe nextregularly scheduleddose asdirected.
Donot takea doubledose ofthis medicationunless otherwisedirected byyour doctor.
Symptoms ofa Bextraoverdose includedrowsiness, nausea,vomiting, andstomach pain.
There areno restrictionson food,beverages, oractivity whiletaking Bextraunless otherwisedirected byyour doctor.
Other, lessserious sideeffects maybe morelikely tooccur.
Continueto takeBextra andtalk toyour doctorif youexperience diarrhea;nausea orupset stomach;or headache.
Side effectsother thanthose listedhere mayalso occur.
Talk toyour doctorabout anyside effectthat seemsunusual orthat isespecially bothersome.
You maynot beable totake Bextra,or youmay requirea dosageadjustment orspecial monitoringduring treatmentif youare takingany ofthe medicineslisted above.
Drugs otherthan thoselisted heremay alsointeract withBextra.
Bextrawas withdrawnfrom theU.S.
Tylenolis usedto treatmany conditionssuch asheadache, muscleaches, arthritis,backache, toothaches,colds, andfevers.
Tylenolmay alsobe usedfor purposesother thanthose listedin thismedication guide.
Use Tylenolfor upto 3days forfever orup to10 daysfor pain(or upto 5days totreat achild's pain).
If thesymptoms donot improve,or ifthey getworse, stopusing Tylenoland seea doctor.
Care shouldbe takento avoidtaking morethan therecommended amountof acetaminophenper doseor perday.
TakeTylenol exactlyas directedby yourdoctor orfollow theinstructions onthe package.
If youdo notunderstand theseinstructions, askyour pharmacist,nurse, ordoctor toexplain themto you.
Tylenol canbe takenwith orwithout food.
Use Tylenolfor upto 3days forfever orup to10 daysfor pain(or upto 5days totreat achild's pain).
If thesymptoms donot improve,or ifthey getworse, stopusing Tylenoland seea doctor.
If youare takingTylenol ona regularschedule, takethe misseddose assoon asyou remember.
Wait theprescribed amountof timeor asdirected inthe packagelabeling beforetaking anotherdose.
Donot takea doubledose.
Takethe doseas soonas youremember, anddo nottake anotherdose forthe amountof timeprescribed oras directedin thepackage labeling.
Symptoms ofan Tylenoloverdose includenausea, vomiting,diarrhea, abdominalpain, sweating,seizures, confusion,and anirregular heartbeat.
Care shouldbe takento avoidtaking morethan therecommended amountof acetaminophenper doseor perday.
Other,less seriousside effectsare notknown tooccur.
Sideeffects otherthan thoselisted heremay occur.
Talk toyour doctorabout anyside effectthat seemsunusual orthat isespecially bothersome.
Care shouldbe takento avoidtaking morethan therecommended amountof acetaminophenper doseor perday.
Tylenolmay causefalse urineglucose testresults.
Talkto yourdoctor ifyou havediabetes andyou noticechanges inyour glucoselevels whiletaking Tylenol.
Other medicationsmay interactwith Tylenol.
Many formulationsof acetaminophenare availablealone andin combinationproducts.
Askyour pharmacistany questionsyou haveabout Tylenol,especially ifit isnew toyou.
Pleaserefer tothe Drugs.comTerms ofUse.
Theappearance ofany medicationmay besubject tochange andmay varyfrom countryto country.
To confirmthe identityof anymedication youmust consultyour doctoror pharmacist.
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CytogenCorporation DanielsPharmaceuticals DeyLaboratories DuPontPharma ElanCorporation, plcEndo PharmaceuticalsFischer PharmaceuticalLaboratories ForestPharmaceuticals, Inc.
Genentech, Inc.Geron Corp.
GlaxoSmithKline HelixBiopharma Corp.
ICN Pharmaceuticals,Inc.
TheImmune ResponseCorp.
IncytePharmaceuticals, Inc.
IntraBiotics Pharmaceuticals,Inc.
IntrogenTherapeutics, Inc.
Isis Pharmaceuticals,Inc.
IVPPharmaceutical Care,Inc.
JanssenPharmaceutica Products,L.P JohnsonJohnson KeyPharmaceuticals, Inc.
Lilly andCompany, Eli3M PharmaceuticalsMartek BiosciencesCorp.
Merckand Company,Inc.
MylanLaboratories Inc.
Nagase PharmaceuticalsNexstar Pharmaceuticals,Inc.
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ProteinDesign Labs,Inc.
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RobertsPharmaceutical CorporationSirna TherapeuticsSolvay Pharmaceuticals,Inc.
SonusPharmaceuticals SuperGenTanox Biosystems,Inc.
TaroPharmaceuticals USA,Inc.
UCBPharmaceuticals, Inc.
Valeant PharmaceuticalsVertex Pharmaceuticals,Inc.
Version:3.02. RevisionDate: 1/23/04.
Xanax affectschemicals inthe brainthat maybecome unbalancedand causeanxiety.
Xanaxis usedto treatanxiety disorders,panic disorders,and anxietycaused bydepression.
Xanaxmay alsobe usedfor purposesother thanthose listedin thismedication guide.
Before takingXanax, tellyour doctorif youhave anybreathing problems,glaucoma, kidneyor liverdisease, ora historyof depression,suicidal thoughts,or addictionto drugsor alcohol.
Avoid usingother medicinesthat makeyou sleepy.
They canadd tosleepiness causedby Xanax.
It isdangerous totry andpurchase Xanaxon theInternet orfrom vendorsoutside ofthe UnitedStates.
Medicationsdistributed fromInternet salesmay containdangerous ingredients,or maynot bedistributed bya licensedpharmacy.
Samplesof Xanaxpurchased onthe Internethave beenfound tocontain haloperidol(Haldol), apotent antipsychoticdrug withdangerous sideeffects.
Formore information,contact theU.S.
Foodand DrugAdministration (FDA)or visitwww.fda.gov/buyonlineguide.
Itis dangerousto tryand purchaseXanax onthe Internetor fromvendors outsideof theUnited States.
Medications distributedfrom Internetsales maycontain dangerousingredients, ormay notbe distributedby alicensed pharmacy.
Samples ofXanax purchasedon theInternet havebeen foundto containhaloperidol (Haldol),a potentantipsychotic drugwith dangerousside effects.
For moreinformation, contactthe U.S.
Food andDrug Administration(FDA) orvisit www.fda.gov/buyonlineguide.
Sporanox) orketoconazole (Nizoral);or ifyou areallergic toalprazolam orto otherbenzodiazepines, suchas chlordiazepoxide(Librium), clorazepate(Tranxene), diazepam(Valium), lorazepam(Ativan), oroxazepam (Serax).
Before takingXanax, tellyour doctorif youare allergicto anydrugs, orif youhave: asthma,emphysema, bronchitis,chronic obstructivepulmonary disorder(COPD), orother breathingproblems; glaucoma;kidney orliver disease(especially alcoholicliver disease);a historyof depressionor suicidalthoughts orbehavior; ora historyof drugor alcoholaddiction.
Ifyou haveany ofthese conditions,you maynot beable touse Xanax,or youmay needa dosageadjustment orspecial testsduring treatment.
Take thismedication exactlyas itwas prescribedfor you.
Do nottake themedication inlarger amounts,or takeit forlonger thanrecommended byyour doctor.
Follow thedirections onyour prescriptionlabel.
Yourdoctor mayoccasionally changeyour doseto makesure youget thebest resultsfrom thismedication.
Totake alprazolamorally disintegratingtablets (Niravam):Using dryhands, removea tabletfrom thebottle andplace thetablet onyour tongue.
It willbegin todissolve rightaway.
Donot swallowthe tabletwhole.
Allowit todissolve inyour mouthwithout chewing.
Swallow severaltimes asthe tabletdissolves.
Ifdesired, youmay drinkliquid afterthe tablethas completelydissolved.
Yoursymptoms mayreturn whenyou stopusing Xanaxafter usingit overa longperiod oftime.
Youmay alsohave seizuresor withdrawalsymptoms whenyou stopusing Xanax.
Withdrawal symptomsmay includeblurred vision,trouble concentrating,loss ofappetite, diarrhea,muscle twitching,numbness ortingling, orincreased sensations.
To besure thismedication ishelping yourcondition, yourdoctor willneed tocheck yourprogress ona regularbasis.
Donot missany scheduledvisits toyour doctor.
Keep trackof howmany pillshave beenused fromeach newbottle ofthis medicine.
Benzodiazepines aredrugs ofabuse andyou shouldbe awareif anyperson inthe householdis usingthis medicineimproperly orwithout aprescription.
Takethe misseddose assoon asyou remember.
If itis almosttime foryour nextdose, skipthe misseddose andtake themedicine atyour nextregularly scheduledtime.
Donot takeextra medicineto makeup themissed dose.
Avoid usingother medicinesthat makeyou sleepy(such ascold medicine,pain medication,muscle relaxers,and medicinefor seizures,depression oranxiety).
Theycan increasesome ofthe sideeffects ofXanax.
Grapefruitand grapefruitjuice mayinteract withXanax andlead topotentially dangerouseffects.
Discussthe useof grapefruitproducts withyour doctor.
Do notincrease ordecrease theamount ofgrapefruit productsin yourdiet withoutfirst talkingto yourdoctor.
Lessserious sideeffects aremore likelyto occur,such as:drowsiness, dizziness,feeling irritable;amnesia orforgetfulness, troubleconcentrating; sleepproblems (insomnia);muscle weakness,lack ofbalance orcoordination, slurredspeech; blurredvision; nausea,vomiting, constipation,appetite orweight changes;dry orwatery mouth,increased sweating;or lossof interestin sex.
Side effectsother thanthose listedhere mayalso occur.
Talk toyour doctorabout anyside effectthat seemsunusual orthat isespecially bothersome.
Before takingXanax, tellyour doctorif youare usingany ofthe followingdrugs: birthcontrol pills;cimetidine (Tagamet);diltiazem (Tiazac,Cartia, Cardizem);isoniazid (Nydrazid,Rifamate); propoxyphene(Darvon, Darvocet);seizure medication;antibiotics suchas fluconazole(Diflucan), itraconazole(Sporanox) orketoconazole (Nizoral);or antidepressantssuch asfluvoxamine (Luvox),desipramine (Norpramin),or imipramine(Janimine, Tofranil).
If youare usingany ofthese drugs,you maynot beable touse Xanax,or youmay needdosage adjustmentsor specialtests duringtreatment.
Theremay beother drugsnot listedthat canaffect Xanax.
This includesvitamins, minerals,herbal products,and drugsprescribed byother doctors.
Do notstart usinga newmedication withouttelling yourdoctor.
Alprazolamis availablewith aprescription underthe brandnames Xanaxand Niravam.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
It fightsbacteria inyour body.
Metronidazole isused totreat bacterialinfections ofthe vagina,stomach, skin,joints, andrespiratory tract.
This medicationwill nottreat avaginal yeastinfection.
Metronidazolemay alsobe usedfor purposesother thanthose listedin thismedication guide.
Before takingmetronidazole, tellyour doctorif youare allergicto anydrugs, orif youhave: astomach orintestinal diseasesuch asCrohns disease;a bloodcell disordersuch asanemia (lackof redblood cells)or leukopenia(lack ofwhite bloodcells); epilepsyor otherseizure disorder;or nervedisorders.
Ifyou haveany ofthese conditions,you maynot beable touse metronidazole,or youmay needa dosageadjustment orspecial testsduring treatment.
Take thismedication exactlyas itwas prescribedfor you.
Do nottake themedication inlarger amounts,or takeit forlonger thanrecommended byyour doctor.
Follow thedirections onyour prescriptionlabel.
Tobe surethis medicationis notcausing harmfuleffects, yourblood willneed tobe testedon aregular basis.
Your liverfunction mayalso needto betested.
Donot missany scheduledvisits toyour doctor.
This medicationcan causeyou tohave unusualresults withcertain medicaltests.
Tellany doctorwho treatsyou thatyou areusing metronidazole.
Take themissed doseas soonas youremember.
Ifit isalmost timefor yournext dose,skip themissed doseand takethe medicineat yournext regularlyscheduled time.
Do nottake extramedicine tomake upthe misseddose.
Symptomsof ametronidazole overdosemay includenausea, vomiting,dizziness, lossof balanceor coordination,numbness andtingling, orseizures (convulsions).
Check thelabels ofany medicinesor foodproducts youuse tomake surethey donot containalcohol.
Antibioticmedicines cancause diarrhea,which maybe asign ofa newinfection.
Ifyou havediarrhea thatis wateryor hasblood init, callyour doctor.
Do notuse anymedicine tostop thediarrhea unlessyour doctorhas toldyou to.
Keep takingmetronidazole andtalk withyour doctorif youhave anyof theseless seriousside effects:nausea, stomachpain, diarrhea;headache, dizziness,loss ofbalance; vaginalitching ordischarge; drymouth orunpleasant metallictaste; cough,sneezing, runnyor stuffynose; orswollen orsore tongue.
Side effectsother thanthose listedhere mayalso occur.
Talk toyour doctorabout anyside effectthat seemsunusual orthat isespecially bothersome.
Before takingthis medication,tell yourdoctor ifyou aretaking anyof thefollowing medicines:cimetidine (Tagamet);seizure medicationsuch asphenytoin (Dilantin)or phenobarbital(Luminal, Solfoton);a bloodthinner suchas warfarin(Coumadin); lithium(Lithobid, Eskalith,others); ordisulfiram (Antabuse).
If youare usingany ofthese drugs,you maynot beable touse metronidazoleor youmay needdosage adjustmentsor specialtests duringtreatment.
Theremay beother drugsnot listedthat canaffect metronidazole.
This includesvitamins, minerals,herbal products,and drugsprescribed byother doctors.
Do notstart usinga newmedication withouttelling yourdoctor.
Metronidazoleis availablewith aprescription underthe brandnames Flagyland Protostat.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
The drugidentification picturesare sourcedfrom Micromedex,a leadingprovider ofhealth andmedical information.
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Not sureabout someof thoseleftover pillsstill inthe bathroomcabinet?
There'sa goodchance thatour pillidentifier canhelp youmatch size,shape, colour...
Our picturesof prescriptiondrugs canhelp toidentify anyunlabeled drugsin yourmedicine cabinet.
Basic drugsafety meansyou shouldnever takea pillif youare not100% surewhat itis youare taking!
When youare readyto identifyyour pillswith thePill IdentificationWizard, haveyour pill(s)ready tocompare withthe drugpictures inthe imagedatabase, andclick here.
The safestbet isto keepall medicationsin theiroriginal bottlesor packets,with pertinentlabeling andinstructions attached,to avoidconfusion andmistakes.
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Youshould notuse fentanyltopical ifyou havehad anallergic reactionor severeside effectswhen usingany narcoticpain medicine.
Avoid drinkingalcohol, orusing othermedicines thatmake yousleepy (suchas coldmedicine, otherpain medication,muscle relaxers,and medicinefor seizures,depression oranxiety).
Theycan addto sleepinesscaused byfentanyl andmay causeextreme drowsinessor breathingproblems.
Fentanylis anarcotic (opioid)pain medicine.
The Duragesicfentanyl skinpatch isused totreat moderateto severechronic pain.
The Ionsysfentanyl transdermaldevice isused onlyin ahospital totreat acutepain aftersurgery.
Fentanyltopical mayalso beused forpurposes otherthan thoselisted inthis medicationguide.
COPD);a historyof headinjury orbrain tumor;a heartrhythm disorder;liver disease;or kidneydisease.
Ifyou haveany ofthese conditions,you maynot beable touse fentanyltopical, oryou mayneed adosage adjustmentor specialtests duringtreatment.
Usethis medicationexactly asit wasprescribed foryou.
Donot usethe medicationin largeror smalleramounts, oruse itfor longerthan recommendedby yourdoctor.
Usingtoo muchfentanyl canbe veryharmful orfatal.
Duragesicskin patchesmay beused athome.
Readall patientinstructions carefullybefore usingthe patches.
Ask yourdoctor orpharmacist ifyou havequestions.
Ifthe skinmust bewashed beforefentanyl topicalis applied,use clearwater only.
Allow theskin todry completelybefore applyingthe medicine.
Apply theskin patchto aflat, dry,hairless areaof thechest, back,side, orouter sideof yourupper arm.
To removeany hairfrom theseareas, clipthe hairshort butdo notshave it.
Press thepatch firmlywith thepalm ofyour handfor 30seconds.
Makesure thepatch issticking firmly,especially aroundthe edges.
You maywear thepatch forup to72 hours.
Do notwear morethan 1patch ata time.
After removinga skinpatch foldit inhalf, stickyside in,and flushthe patchdown thetoilet.
Applya newpatch toa differentskin areaon thechest, back,side, orupper arm.
Do notuse thesame skinarea twicein arow.
Thetransdermal devicewill beapplied whereyou canreach it,such asyour chestor theouter sideof yourupper arm.
The deviceis wornfor 24hours oruntil thedevice hasdelivered 80doses offentanyl.
Torelease themedicine fromthe transdermaldevice, pressthe dosingbutton twice.
The devicewill sounda beepwhen thedose starts,and ared lightwill comeon for10 minuteswhile thedose isdelivered.
Thelight willalso flashbetween dosesto letyour caregiversknow howmany dosesare leftin thedevice.
Tellyour careprovider ifthe patchcomes looseor fallsoff.
Keepeach skinpatch inits foilpouch untilyou areready touse it.
If thepouch sealis alreadybroken, donot usethe patch.
After removinga patchfrom thefoil pouch,apply thepatch toyour skinright away.
Do notuse afentanyl topicalskin patchor deviceif thepatch ordevice hasbeen cutor damaged.
Keep trackof howmany skinpatches havebeen usedfrom eachnew packageof thismedicine.
Fentanylis adrug ofabuse andyou shouldbe awareif anyperson inthe householdis usingthis medicineimproperly orwithout aprescription.
Sincefentanyl topicalis usedas needed,you maynot beon adosing schedule.
If youare usingthe skinpatches regularly,apply themissed patchas soonas youremember.
Continuewearing thepatch forup to72 hoursand thenapply anew oneif neededfor pain.
Do notwear extrapatches tomake upa misseddose.
Avoidusing othermedicines thatmake yousleepy (suchas coldmedicine, otherpain medication,muscle relaxers,and medicinefor seizures,depression oranxiety).
Theycan addto sleepinesscaused byfentanyl topical.
Avoid exposinga fentanyltopical skinpatch toheat whileyou arewearing it.
This includesa hottub, heatingpad, sauna,or heatedwater bed.
Heat canincrease theamount ofdrug youabsorb throughyour skinand maycause harmfuleffects.
Continueusing fentanyltopical andtalk withyour doctorif youhave anyof theseless seriousside effects:nausea, vomiting,stomach pain,constipation, gas;dizziness, drowsiness,anxiety, sleepproblems (insomnia);muscle stiffness,back pain;itching, blistering,redness, orswelling wherethe patchor devicewas worn;or increasedsweating, urinatingless thanusual.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Beforeusing thismedication, tellyour doctorif youare usingany ofthe followingdrugs: carbamazepine(Tegretol, Carbatrol);phenytoin (Dilantin);St.
Theremay beother drugsnot listedthat canaffect fentanyltopical.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Fentanyl topicalis availablewith aprescription underthe brandnames Duragesicand Ionsys.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
Version: 4.02.Revision date:7/27/06 10:13:01AM.
Methadonealso reduceswithdrawal symptomsin peopleaddicted toheroin orother narcoticdrugs withoutcausing the"high" associatedwith thedrug addiction.
Methadone isused asa painreliever andas partof drugaddiction detoxificationand maintenanceprograms.
Methadonemay alsobe usedfor purposesother thanthose listedin thismedication guide.
Death mayoccur ifbreathing becomestoo weak.
Never usemore methadonethan yourdoctor hasprescribed.
Callyour doctorif youthink themedicine isnot working.
Before takingmethadone, talkto yourdoctor ifyou have:a personalor familyhistory of"Long QTsyndrome"; asthma,COPD, sleepapnea, orother breathingdisorders; underactivethyroid; curvatureof thespine; ahistory ofhead injuryor braintumor; epilepsyor otherseizure disorder;low bloodpressure; gallbladderdisease; Addison'sdisease orother adrenalgland disorders;enlarged prostate,urination problems;mental illness;or ahistory ofdrug oralcohol addiction.
Older adultsand peoplewith debilitatingconditions maybe moresensitive tothe effectsof thismedication.
Usemethadone exactlyas itwas prescribedfor you.
Do notuse themedication inlarger amountsor forlonger thanrecommended byyour doctor.
Follow thedirections onyour prescriptionlabel.
Deathmay occurif breathingbecomes tooweak.
Neveruse moremethadone thanyour doctorhas prescribed.
Call yourdoctor ifyou thinkthe medicineis notworking.
Whenmethadone isused aspart ofa treatmentprogram fordrug addictionor detoxification,you willreceive themedication througha clinicor specialpharmacy.
Yourdoctor mayrecommend thatmethadone begiven toyou bya familymember orother caregiver.
This isto makesure youare usingthe medicineas itwas prescribedas partof yourtreatment.
Additionalforms ofcounseling and/ormonitoring maybe recommendedduring treatmentwith methadone.
Methadone isavailable intablets, dispersibletablets, oralsolution (liquid)and asan injection.
The pilland oralliquid formsof methadonemust neverbe usedto makea methadoneinjection.
Themethadone dispersibletablet (Diskets)is madeto bedissolved inwater.
Donot chew,crush, orswallow thetablet whole.
The tabletwill notdissolve completely.
Drink thismixture rightaway.
Tomake sureyou getthe entiredose, adda littlemore liquidto thesame glass,swirl gentlyand drinkright away.
Keep trackof howmuch ofthis medicinehas beenused.
Methadoneis adrug ofabuse andyou shouldbe awareif anyperson inthe householdis usingthis medicineimproperly orwithout aprescription.
Usethe medicationas soonas youremember.
Ifit isalmost timefor thenext dose,skip themissed doseand waituntil yournext regularlyscheduled dose.
Do notuse extramedicine tomake upthe misseddose.
Seekemergency medicalattention ifyou thinkyou haveused toomuch ofthis medicine.Anoverdose ofmethadone canbe fatal,especially ifyou takeit withalcohol orother narcoticmedications.
Overdosesymptoms mayinclude extremedrowsiness, pinpointpupils, confusion,cold andclammy skin,weak pulse,shallow breathing,fainting, orbreathing thatstops.
Other,less seriousside effectsmay bemore likelyto occur,such as:feeling anxious,nervous, orrestless; sleepproblems (insomnia);dizziness, drowsiness,or weakness;dry mouth,nausea, vomiting,diarrhea, constipation,loss ofappetite; ordecreased sexdrive, impotence,or difficultyhaving anorgasm.
Thislist isnot completeand otherside effectsmay occur.
Tell yourdoctor aboutany unusualor bothersomeside effect.
This listis notcomplete andthere aremany othermedicines thatmay causeserious medicalproblems ifyou takethem togetherwith methadone.
This includesvitamins, minerals,herbal products,and drugsprescribed byother doctors.
Do notstart usinga newmedication withouttelling yourdoctor.
Keepa listwith youof allthe medicinesyou useand showthis listto anydoctor orother healthcareprovider whotreats you.
Methadone isavailable witha prescriptionunder thebrand namesDolophine andMethadose.
Otherbrand orgeneric formulationsmay alsobe available.
Ask yourpharmacist anyquestions youhave aboutthis medication,especially ifit isnew toyou.
Version:4.03. Revisiondate: 7/18/03.
Talk toyour doctorif youhave anysigns ofhyperglycemia suchas increasedthirst orurination, excessivehunger, orweakness.
Ifyou arediabetic, checkyour bloodsugar levelson aregular basiswhile youare takingZyprexa.
Dizzinessmay bemore likelyto occurwhen yourise froma sittingor lyingposition.
Riseslowly toprevent dizzinessand apossible fall.
Avoid usingother medicinesthat makeyou sleepy(such ascold medicine,pain medication,muscle relaxers,and medicinefor seizures,depression oranxiety).
Theycan addto sleepinesscaused byZyprexa.
Zyprexais anantipsychotic medication.
It worksby changingthe actionsof chemicalsin thebrain.
Zyprexais usedto treatthe symptomsof psychoticconditions suchas schizophreniaand bipolardisorder (manicdepression).
Zyprexamay alsobe usedfor purposesother thanthose listedin thismedication guide.
Before takingZyprexa, tellyour doctorif youhave: kidneydisease; heartdisease, highblood pressure,heart rhythmproblems; ahistory ofheart attackor stroke;a historyof breastcancer; seizuresor epilepsy;a personalor familyhistory ofdiabetes; anenlarged prostateor difficultyurinating; glaucoma;or troubleswallowing.
Ifyou haveany ofthese conditions,you maynot beable touse Zyprexa,or youmay needa dosageadjustment orspecial testsduring treatment.
Zyprexa maycause youto havehigh bloodsugar (hyperglycemia).
Talk toyour doctorif youhave anysigns ofhyperglycemia suchas increasedthirst orurination, excessivehunger, orweakness.
Ifyou arediabetic, checkyour bloodsugar levelson aregular basiswhile youare takingZyprexa.
Theolanzapine orallydisintegrating tablet(Zyprexa Zydis)may containphenylalanine.
Talkto yourdoctor beforeusing thisform ofZyprexa ifyou havephenylketonuria (PKU).
Take thismedication exactlyas itwas prescribedfor you.
Do nottake themedication inlarger amounts,or takeit forlonger thanrecommended byyour doctor.
Follow thedirections onyour prescriptionlabel.
Zyprexacan betaken withor withoutfood.
Zyprexais usuallytaken oncea day.
Follow yourdoctor's instructions.
To takeolanzapine orallydisintegrating tablets(Zyprexa Zydis):Keep thetablet inits blisterpack untilyou areready totake themedicine.
Openthe packageand peelback thefoil fromthe tabletblister.
Donot pusha tabletthrough thefoil oryou maydamage thetablet.
Usingdry hands,remove thetablet andplace itin yourmouth.
Itwill beginto dissolveright away.
Do notswallow thetablet whole.
Allow itto dissolvein yourmouth withoutchewing.
Swallowseveral timesas thetablet dissolves.
If desired,you maydrink liquidto helpswallow thedissolved tablet.
To besure thismedication ishelping yourcondition, yourdoctor willneed tocheck yourprogress ona regularbasis.
Itis importantthat younot missany scheduledvisits toyour doctor.
Take themissed doseas soonas youremember.
Ifit isalmost timefor yournext dose,skip themissed doseand takethe medicineat thenext regularlyscheduled time.
Do nottake extramedicine tomake upthe misseddose.
Dizzinessmay bemore likelyto occurwhen yourise froma sittingor lyingposition.
Riseslowly toprevent dizzinessand apossible fall.
Avoid usingother medicinesthat makeyou sleepy(such ascold medicine,pain medication,muscle relaxers,and medicinefor seizures,depression oranxiety).
Theycan addto sleepinesscaused byZyprexa.
Continuetaking Zyprexaand talkto yourdoctor ifyou haveany ofthese lessserious sideeffects: dizziness,drowsiness, orweakness; constipation;dry mouth;swelling inyour handsor feet;back pain;weight gain,increased appetite;or upsetstomach.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Beforetaking Zyprexa,tell yourdoctor ifyou aretaking anyof thefollowing medicines:a medicationto treathigh bloodpressure ora heartcondition; carbamazepine(Tegretol); fluvoxamine(Luvox); ora medicationto treatParkinson's diseaseincluding levodopa(Sinemet, Larodopa,Atamet), selegiline(Eldepryl, Emsam),pramipexole (Mirapex),ropinirole (Requip),and others.
If youare usingany ofthese drugs,you maynot beable touse Zyprexa,or youmay needdosage adjustmentsor specialtests duringtreatment.
Theremay beother drugsnot listedthat canaffect Zyprexa.
This includesvitamins, minerals,herbal products,and drugsprescribed byother doctors.
Do notstart usinga newmedication withouttelling yourdoctor.
Olanzapineis availablewith aprescription underthe brandname Zyprexa.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
Facts andComparisons hasbeen akey sourceof druginformation forpharmacists formore thanfifty years.
Also knownas MedispanIMM.
Multumleaflets providebasic consumerdrug information,such asdrug descriptionsand interactions,details ofpossible sideeffects andthe effectsof misseddoses andoverdosing, aswell asinstructions foruse.
Theleaflets areavailable inEnglish andSpanish.
ThePhysician's DeskReference (PDR)Consumer DrugInformation databasecontains informationon drugindications, recommendeddosages foradults andchildren, sideeffects, possiblefood anddrug interactions,and detailedinstructions foruse (includingin pregnancyor whilebreastfeeding).
ThomsonMicromedex AdvancedConsumer Informationprovides comprehensiveconsumer informationpertaining toa widevariety ofdrugs, suchas alist ofcommonly usedbrand names,drug descriptions,warnings andprecautions, anddetailed informationon theproper useof eachdrug.
TheProfessional DrugInformation databaseis arepository ofdrug informationsourced directlyfrom theFDA.
Itincludes detailednotes onthe clinicalpharmacology ofa widevariety ofdrugs.
WoltersKluwer Healthis aleading providerof informationfor professionalsand studentsin medicine,nursing, alliedhealth, pharmacyand thepharmaceutical industry.
Wolters KluwerHealth druginformation product,Facts asthma,emphysema, bronchitis,chronic obstructivepulmonary disorder(COPD), orother breathingproblems; kidneyor liverdisease; ahistory ofdepression orsuicidal thoughtsor behavior;or ahistory ofdrug oralcohol addiction.
If youhave anyof theseconditions, youmay notbe ableto uselorazepam, oryou mayneed adosage adjustmentor specialtests duringtreatment.
Takethis medicationexactly asit wasprescribed foryou.
Donot takethe medicationin largeramounts, ortake itfor longerthan recommendedby yourdoctor.
Followthe directionson yourprescription label.
Your doctormay occasionallychange yourdose tomake sureyou getthe bestresults fromthis medication.
Your symptomsmay returnwhen youstop usinglorazepam afterusing itover along periodof time.
You mayalso haveseizures orwithdrawal symptomswhen youstop usinglorazepam.
Withdrawalsymptoms mayinclude tremor,sweating, musclecramps, stomachpain, vomiting,unusual thoughtsor behavior,and seizure(convulsions).
Tobe surethis medicationis notcausing harmfuleffects, yourdoctor mayneed tocheck yourprogress ona regularbasis.
Donot missany scheduledvisits toyour doctor.
Keep trackof howmany pillshave beenused fromeach newbottle ofthis medicine.
Benzodiazepines aredrugs ofabuse andyou shouldbe awareif anyperson inthe householdis usingthis medicineimproperly orwithout aprescription.
Takethe misseddose assoon asyou remember.
If itis almosttime foryour nextdose, skipthe misseddose andtake themedicine atyour nextregularly scheduledtime.
Donot takeextra medicineto makeup themissed dose.
Symptoms ofa lorazepamoverdose mayinclude extremedrowsiness, confusion,muscle weakness,fainting, orcoma.
Avoidusing othermedicines thatmake yousleepy (suchas coldmedicine, painmedication, musclerelaxers, andmedicine forseizures, depressionor anxiety).
They canincrease someof theside effectsof lorazepam.
Less seriousside effectsare morelikely tooccur, suchas: drowsiness,dizziness, tiredness;blurred vision;sleep problems(insomnia); muscleweakness, lackof balanceor coordination;amnesia orforgetfulness, troubleconcentrating; nausea,vomiting, constipation;appetite changes;or skinrash.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Ifyou areusing anyof thesedrugs, youmay notbe ableto uselorazepam, oryou mayneed dosageadjustments orspecial testsduring treatment.
There maybe otherdrugs notlisted thatcan affectlorazepam.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Lorazepam isavailable witha prescriptionunder thebrand nameAtivan.
Otherbrand orgeneric formulationsmay alsobe available.
Ask yourpharmacist anyquestions youhave aboutthis medication,especially ifit isnew toyou.
Itaffects chemicalsin thebrain andnerves thatcontribute tohyperactivity andimpulse control.
Ritalin isused totreat attentiondeficit disorder(ADD), attentiondeficit hyperactivitydisorder (ADHD),and narcolepsy.
Ritalin mayalso beused forpurposes otherthan thoselisted inthis medicationguide.
Donot usethis medicationif youare allergicto Ritalinor ifyou have:glaucoma; apersonal orfamily historyof tics(muscle twitches)or Tourette'ssyndrome; orsevere anxiety,tension, oragitation (Ritalincan makethese symptomsworse).
Beforeusing Ritalin,tell yourdoctor ifyou areallergic toany drugs,or ifyou have:a congenitalheart defect;high bloodpressure; heartfailure, heartrhythm disorder,or recentheart attack;a personalor familyhistory ofmental illness,psychotic disorder,bipolar illness,depression, orsuicide attempt;epilepsy orother seizuredisorder; ora historyof drugor alcoholaddiction.
Ifyou haveany ofthese conditions,you maynot beable touse Ritalin,or youmay needa dosageadjustment orspecial testsduring treatment.
Tell yourdoctor ifthe childusing thismedication isnot growingor gainingweight properly.
Take thismedication exactlyas itwas prescribedfor you.
Do nottake themedication inlarger amounts,or takeit forlonger thanrecommended byyour doctor.
Follow thedirections onyour prescriptionlabel.
Swallowthis mixtureright awaywithout chewing.
Do notsave themixture forlater use.
Discard theempty capsule.
To preventsleep problems,take thismedication earlyin theday, nolater than6:00 pm.
Take themissed doseas soonas youremember.
Ifit isalmost timefor yournext dose,skip themissed doseand takethe medicineat yournext regularlyscheduled time.
Do nottake extramedicine tomake upthe misseddose.
Symptomsof aRitalin overdosemay includevomiting, agitation,tremors, muscletwitching, seizure(convulsions), confusion,hallucinations, sweating,fast orpounding heartbeat,blurred vision,dry mouthand nose,and fainting.
Continue takingRitalin andtalk withyour doctorif youhave anyof theseless seriousside effects:vision problems;mild skinrash; dizziness;nervous feeling,sleep problems(insomnia); nausea,vomiting, lossof appetite;or weightloss.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Beforetaking Ritalin,tell yourdoctor ifyou areusing anyof thefollowing drugs:blood pressuremedications; ablood thinnersuch aswarfarin (Coumadin);clonidine (Catapres);seizure medicinesuch asphenytoin (Dilantin),phenobarbital (Luminal),primidone (Mysoline);or antidepressantssuch asamitriptyline (Elavil,Etrafon), amoxapine(Ascendin), citalopram(Celexa), escitalopram(Lexapro), clomipramine(Anafranil), desipramine(Norpramin), doxepin(Sinequan),fluoxetine (Prozac,Sarafem), fluvoxamine(Luvox), imipramine(Janimine, Tofranil),nortriptyline (Pamelor),paroxetine (Paxil),protriptyline (Vivactil),sertraline (Zoloft),or trimipramine(Surmontil).
Ifyou areusing anyof thesedrugs, youmay notbe ableto useRitalin, oryou mayneed dosageadjustments orspecial testsduring treatment.
There maybe otherdrugs notlisted thatcan affectRitalin.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Methylphenidate isavailable witha prescriptionunder manybrand namessuch asRitalin, Methylin,Methylin ER,Metadate ER,Metadate CD,and Concerta.
Generic formulationsmay alsobe available.
Ask yourpharmacist anyquestions youhave aboutthis medication,especially ifit isnew toyou.
Donot usethis medicinejust beforeor afterhaving heartbypass surgery(also calledcoronary arterybypass graft,or CABG).
Seek emergencymedical helpif youhave symptomsof heartor circulationproblems, suchas chestpain, weakness,shortness ofbreath, slurredspeech, orproblems withvision orbalance.
Thismedicine canalso increaseyour riskof seriouseffects onthe stomachor intestines,including bleedingor perforation(forming ofa hole).
These conditionscan befatal andgastrointestinal effectscan occurwithout warningat anytime whileyou aretaking Mobic.
Older adultsmay havean evengreater riskof theseserious gastrointestinalside effects.
Call yourdoctor atonce ifyou havesymptoms ofbleeding inyour stomachor intestines.
This includesblack, bloody,or tarrystools, orcoughing upblood orvomit thatlooks likecoffee grounds.
Mobic worksby reducinghormones thatcause inflammationand painin thebody.
Mobicis usedto treatpain orinflammation causedby arthritis.
Mobic mayalso beused forpurposes otherthan thoselisted inthis medicationguide.
Thisrisk willincrease thelonger youuse anNSAID.
Donot usethis medicinejust beforeor afterhaving heartbypass surgery(also calledcoronary arterybypass graft,or CABG).
NSAIDs canalso increaseyour riskof seriouseffects onthe stomachor intestines,including bleedingor perforation(forming ofa hole).
These conditionscan befatal andgastrointestinal effectscan occurwithout warningat anytime whileyou aretaking anNSAID.
Olderadults mayhave aneven greaterrisk ofthese seriousgastrointestinal sideeffects.
Beforetaking Mobic,tell yourdoctor ifyou areallergic toany drugs,or ifyou have:a historyof heartattack, stroke,or bloodclot; heartdisease, congestiveheart failure,high bloodpressure; ahistory ofstomach ulcersor bleeding,bowel problems,diverticulosis; asthma;polyps inyour nose;or ifyou smoke.
If youhave anyof theseconditions, youmay notbe ableto useMobic, oryou mayneed adosage adjustmentor specialtests duringtreatment.
Takethis medicationexactly asit wasprescribed foryou.
Donot takethe medicationin largeramounts, ortake itfor longerthan recommendedby yourdoctor.
Followthe directionson yourprescription label.
The maximumamount ofMobic foradults is15 milligrams(mg) perday.
Knowthe amountof meloxicamin thespecific productyou aretaking.
Ifyou takeMobic fora longperiod oftime, yourdoctor maywant tocheck youon aregular basisto makesure thismedication isnot causingharmful effects.
Do notmiss anyscheduled visitsto yourdoctor.
Thismedication cancause youto haveunusual resultswith certainmedical tests.
Tell anydoctor whotreats youthat youare usingMobic.
Takethe misseddose assoon asyou remember.
If itis almosttime foryour nextdose, skipthe misseddose andtake themedicine atyour nextregularly scheduledtime.
Donot takeextra medicineto makeup themissed dose.
Keep takingMobic andtalk toyour doctorif youhave anyof theseless seriousside effects:upset stomach,mild heartburnor stomachpain, diarrhea,constipation; bloating,gas; dizziness,headache, nervousness;skin itchingor rash;dry mouth;increased sweating,runny nose;blurred vision;or ringingin yourears.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Ifyou areusing anyof thesedrugs, youmay notbe ableto useMobic oryou mayneed dosageadjustments orspecial testsduring treatment.
There maybe otherdrugs notlisted thatcan affectMobic.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Meloxicam isavailable witha prescriptionunder thebrand nameMobic.
Otherbrand orgeneric formulationsmay alsobe available.
Ask yourpharmacist anyquestions youhave aboutthis medication,especially ifit isnew toyou.
Thismedicine isavailable onlywith yourdoctor's prescription,in thefollowing dosageform(s): Indeciding touse amedicine, therisks ofusing themedicine mustbe weighedagainst thegood itwill do.
This isa decisionyou andyour doctorwill make.
For amifostine,the followingshould beconsidered: AllergiesTell yourdoctor ifyou haveever hadany unusualor allergicreaction toamifostine.
PregnancyAmifostine hasnot beenstudied inpregnant women.
However, inanimal studies,large dosescaused toxicor harmfuleffects inthe fetus.
Before receivingthis treatment,make sureyour doctorknows ifyou arepregnant orif youmay becomepregnant.
Becauseamifostine maycause birthdefects orother harmfuleffects inthe fetus,it isusually recommendedthat womenbeing treatedfor canceruse birthcontrol.
ChildrenAlthough thismedicine hasbeen givento alimited numberof children,there isno specificinformation comparinguse ofamifostine inchildren withuse inother agegroups.
Olderadults Manymedicines havenot beenstudied specificallyin olderpeople.
Therefore,it maynot beknown whetherthey workexactly thesame waythey doin youngeradults orif theycause differentside effectsor problemsin olderpeople.
Althoughamifostine hasbeen givento alimited numberof elderlypeople, thereis nospecific informationcomparing useof amifostinein theelderly withuse inother agegroups.
Othermedicines Althoughcertain medicinesshould notbe usedtogether atall, inother casestwo differentmedicines maybe usedtogether evenif aninteraction mightoccur.
Inthese cases,your doctormay wantto changethe dose,or otherprecautions maybe necessary.
When youare receivingamifostine, itis especiallyimportant thatyour healthcare professionalknow ifyou aretaking anyof thefollowing: Othermedical problemsThe presenceof othermedical problemsmay affectthe useof amifostine.
Make sureyou tellyour doctorif youhave anyother medicalproblems, especially:Dosing Thedose ofamifostine willbe differentfor differentpatients.
Itdepends onthe patient'ssize.
Themedicine willbe givenby, orunder theimmediate supervisionof, thedoctor treatingyou forcancer.
Alongwith itsneeded effects,a medicinemay causesome unwantedeffects.
Althoughnot allof theseside effectsmay occur,if theydo occurthey mayneed medicalattention.
Tellthe doctoror theperson givingyou theinjection rightaway ifyou feeldizzy orfaint whilethe injectionis beinggiven.
Also,check withyour doctoras soonas possibleif anyof thefollowing sideeffects occurlater on:More commonBlurred vision;confusion; dizziness,faintness, orlightheadedness whengetting upfrom alying orsitting positionsuddenly; faintingor lossof consciousness;fast orirregular breathing;itching; nauseaand vomiting;red, scaly,swollen, orpeeling areasof skin;swelling ofeyes oreyelids; troublein breathing;tightness inchest; wheezing;skin rash;sweating; unusualtiredness orweakness RareBurning ortingling sensation;convulsions; fast,slow orirregular heartbeator pulse;loss ofbladder control;muscle cramps;muscle spasmor jerkingof allextremities; palpitationsOther sideeffects mayoccur thatusually donot needmedical attention.
These sideeffects maygo awayduring treatmentas yourbody adjuststo themedicine.
However,check withyour doctorif anyof thefollowing sideeffects continueor arebothersome: Lesscommon orrare fever;headache; nervousness;pounding inthe ears;sleepiness (severe)Other sideeffects thatsometimes occurare harmlessand willgo awaywithout treatment.
These are:Less commonor rareFeeling unusuallywarm orcold; flushingor rednessof faceor neck;hiccups Otherside effectsnot listedabove mayalso occurin somepatients.
Ifyou noticeany othereffects, checkwith yourdoctor.
Oncea medicinehas beenapproved formarketing fora certainuse, experiencemay showthat itis alsouseful forother medicalproblems.
Althoughthis useis notincluded inthe productlabeling, amifostineis usedin certainpatients withthe followingmedical conditions:Other thanthe aboveinformation, thereis noadditional informationrelating toproper use,precautions, orside effectsfor thisuse.
Developed:06/29/1998 Revised:11/28/2005 Theinformation containedin theThomson Healthcare(Micromedex) productsas deliveredby Drugs.comis intendedas aneducational aidonly.
Itis notintended asmedical advicefor individualconditions ortreatment.
Itis nota substitutefor amedical exam,nor doesit replacethe needfor servicesprovided bymedical professionals.
Talk toyour doctor,nurse orpharmacist beforetaking anyprescription orover thecounter drugs(including anyherbal medicinesor supplements)or followingany treatmentor regimen.
Only yourdoctor, nurse,or pharmacistcan provideyou withadvice onwhat issafe andeffective foryou.
Theuse ofthe ThomsonHealthcare productsis atyour solerisk.
Theseproducts areprovided "ASIS" and"as available"for use,without warrantiesof anykind, eitherexpress orimplied.
ThomsonHealthcare andDrugs.com makeno representationor warrantyas tothe accuracy,reliability, timeliness,usefulness orcompleteness ofany ofthe informationcontained inthe products.
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ThomsonHealthcare doesnot assumeany responsibilityor riskfor youruse ofthe ThomsonHealthcare products.
Megace ESutilizes theNanoCrystal Technologydelivery systemto improvethe rateof dissolutionand bioavailabilityof theoriginal megestrolacetate oralsuspension.
Recentdata haveshown thatthe bioavailabilityof theoriginal formulationis reducedsubstantially whentaken onan emptystomach.
WithMegace ES,this reductionin bioavailabilityis minimizedin thefasted state,resulting inimproved bioavailabilityin patientswho havenot eaten.
Megace ES625 mg/5mL andmegestrol acetateoral suspension800 mg/20mL arebioequivalent ina fedstate.
Previously,patients hadto drinkone 20mL cup(800 mg/20mL) ofmegestrol acetateoral suspensiondaily toreceive thedrug's fullbenefit.
MegaceES alsois 16times lessviscous (10cP versus163 cP)than theoriginal formulation.
Efficacy ofMegace ESThe FDAapproval ofMegace ESwas basedon pharmacokineticstudies demonstratingbioequivalence between625 mgof MegaceES and800 mgof megestrolacetate oralsuspension whendosed ina fedstate.
Theclinical benefitsof megestrolacetate oralsuspension intreating patientswith anorexia,cachexia, oran unexplained,significant weightloss havebeen clearlydemonstrated inpatients withAIDS.
Patientsalso reportedan improvedsense ofwell being.
Moreover, abioavailability studydirectly comparingthe rateand extentof absorptionof MegaceES andmegestrol acetateoral suspensionrevealed thatthe Cmaxlevel withthe originalformulation was1,364 ng/mLin fedpatients and187 ng/mLin unfedpatients.
Incontrast, theCmax levelwith MegaceES was1,517 ng/mLin fedpatients and1,041 ng/mLin unfedpatients.
Further,in unfedpatients MegaceES achieved5 timesgreater peakplasma levelsthan megestrolacetate oralsuspension.
Additionally,the studydemonstrated thata lowervolume ofMegace ESachieved maximumblood concentrationmore rapidlythan thecurrently availableoral suspensionproducts.
AboutUnintended WeightLoss Anorexia(a persistentlack ofappetite), unintendedweight loss,and cachexia(significant weightloss thatinvolves depletionof bothfat andlean bodymass) representa seriousrisk inpatients withAIDS.
Significantweight lossand cachexiaare associatedwith worseningillness, physicalimpairment, decreasedtolerance ofsome therapeuticagents, andincreased susceptibilityto infection.
Important SafetyInformation AboutMegace ESMegace ESand megestrolacetate oralsuspension arecontraindicated inpatients witha historyof hypersensitivityto megestrolacetate orany componentof theformulation, orpatients withknown orsuspected pregnancy.
Evidence ofadrenal suppressionhas beenobserved inpatients receivingmegestrol acetateoral suspension.
The glucocorticoidactivity ofmegestrol acetateoral suspensionhas notbeen fullyevaluated.
Themost commonadverse events(less thanor equalto 1%and thanplacebo) associatedwith MegaceES 625mg/5 mLand megestrolacetate oralsuspension 800mg/20 mLare impotence,flatulence, rash,hypertension, insomnia,fever, decreasedlibido, dyspepsiaand hyperglycemia.
For moreinformation onMegace ES,or forcomplete prescribinginformation, pleasevisit theMegaceES website.
Source: ParPharmaceutical Companies,Inc.
Thistype ofvision lossis causedby decreasedblood flowto theoptic nerveof theeye.
Itis notclear whetherCialis isthe actualcause ofsuch visionloss.
Cialisrelaxes musclesand increasesblood flowto particularareas ofthe body.
Cialis isused totreat erectiledysfunction (impotence).
Cialis mayalso beused forpurposes otherthan thoselisted inthis medicationguide.
Asmall numberof patientshave hada suddenloss ofeyesight aftertaking Cialis.
This typeof visionloss iscaused bydecreased bloodflow tothe opticnerve ofthe eye.
It isnot clearwhether Cialisis theactual causeof suchvision loss.
Before takingCialis, tellyour doctorif youhave: heartdisease orheart rhythmproblems; arecent historya heartattack (withinthe past90 days);a recenthistory ofstroke orcongestive heartfailure (withinthe past6 months);angina (chestpain); highor lowblood pressure;liver disease;kidney disease(or ifyou areon dialysis);a bloodcell disordersuch assickle cellanemia, multiplemyeloma, orleukemia; ableeding disordersuch ashemophilia; astomach ulcer;retinitis pigmentosa(an inheritedcondition ofthe eye);a physicaldeformity ofthe penis(such asPeyronie's disease);or ifyou havebeen toldyou shouldnot havesexual intercoursefor healthreasons.
Ifyou haveany ofthese conditions,you maynot beable touse Cialisor youmay needa dosageadjustment orspecial testsduring treatment.
Take Cialisexactly asit wasprescribed foryou.
Donot takeit inlarger dosesor forlonger thanrecommended byyour doctor.
Cialis canbe takenwith orwithout food.
Cialis isusually takenonly whenneeded, justbefore sexualactivity.
Themedication canhelp achievean erectionwhen sexualstimulation occurs.
An erectionwill notoccur justby takinga pill.
Follow yourdoctor's instructions.
Since Cialisis usedas needed,you arenot likelyto beon adosing schedule.
Grapefruit andgrapefruit juicemay interactwith Cialis.
Discuss theuse ofgrapefruit productswith yourdoctor.
Donot increaseor decreasethe amountof grapefruitproducts inyour dietwithout firsttalking toyour doctor.
Side effectsother thanthose listedhere mayalso occur.
Talk toyour doctorabout anyside effectthat seemsunusual orthat isespecially bothersome.
If youare usingany ofthese drugs,you maynot beable totake Cialis,or youmay needdosage adjustmentsor specialtests duringtreatment.
Theremay beother drugsnot listedthat canaffect Cialis.
This includesvitamins, minerals,herbal products,and drugsprescribed byother doctors.
Do notstart usinga newmedication withouttelling yourdoctor.
Tadalafilis availablewith aprescription underthe brandname Cialis.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
Version: 2.02.Revision date:7/10/06 3:37:10PM.
Thistype ofvision lossis causedby decreasedblood flowto theoptic nerveof theeye.
Itis notclear whetherViagra isthe actualcause ofsuch visionloss.
Viagrarelaxes musclesand increasesblood flowto particularareas ofthe body.
Sildenafil underthe nameViagra isused totreat erectiledysfunction (impotence)in men.
Another brandof sildenafilis Revatio,which isused totreat pulmonaryarterial hypertensionand improveexercise capacityin menand women.
Sildenafil mayalso beused forpurposes otherthan thoselisted here.
A smallnumber ofpatients havehad asudden lossof eyesightafter takingViagra.
Thistype ofvision lossis causedby decreasedblood flowto theoptic nerveof theeye.
Itis notclear whetherViagra isthe actualcause ofsuch visionloss.
Beforetaking Viagra,tell yourdoctor ifyou have:heart diseaseor heartrhythm problems;a recenthistory (inthe past6 months)of aheart attack,stroke, orheart rhythmdisorder; congestiveheart failure;high orlow bloodpressure; coronaryartery disease;liver disease;kidney disease;a bloodcell disordersuch assickle cellanemia, multiplemyeloma, orleukemia; ableeding disordersuch ashemophilia; astomach ulcer;retinitis pigmentosa(an inheritedcondition ofthe eye);a physicaldeformity ofthe penis(such asPeyronies disease);or ifyou havebeen toldyou shouldnot havesexual intercoursefor healthreasons.
Ifyou haveany ofthese conditions,you maynot beable touse Viagraor youmay needa dosageadjustment orspecial testsduring treatment.
Take Viagraexactly asit wasprescribed foryou.
Donot takeit inlarger dosesor forlonger thanrecommended byyour doctor.
Revatio isusually takenthree timeseach day,about 4to 6hours apart.
Viagra isusually takenonly whenneeded, 30minutes to1 hourbefore sexualactivity.
Youmay takeit upto 4hours beforesexual activity.
Do nottake Viagramore thanonce perday.
Viagracan helpyou havean erectionwhen sexualstimulation occurs.
An erectionwill notoccur justby takinga pill.
Follow yourdoctors instructions.
If youbecome dizzyor nauseated,or havepain, numbness,or tinglingin yourchest, arms,neck, orjaw duringsexual activity,stop andcall yourdoctor rightaway.
Youcould behaving aserious sideeffect ofViagra.
Viagrais usedas needed,so youare notlikely tomiss adose.
Ifyou missa doseof Revatio,take themissed doseas soonas youremember.
Ifit isalmost timefor yournext dose,skip themissed doseand takethe medicineat thenext regularlyscheduled time.
Do nottake extramedicine tomake upthe misseddose.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Ifyou areusing anyof thesedrugs, youmay notbe ableto takeViagra, oryou mayneed dosageadjustments orspecial testsduring treatment.
There maybe otherdrugs notlisted thatcan affectViagra.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Sildenafil isavailable witha prescriptionunder thebrand namesViagra andRevatio.
Otherbrand orgeneric formulationsmay alsobe available.
Ask yourpharmacist anyquestions youhave aboutthis medication,especially ifit isnew toyou.
Yourdaily intakeof fat,protein, andcarbohydrates shouldbe evenlydivided overall ofyour dailymeals.
Followyour diet,medication, andexercise routinesvery closely.
Read thelabel ofall fooditems youconsume, payingspecial attentionto thenumber ofservings percontainer.
Yourdoctor, nutritioncounselor, ordietitian canhelp youdevelop ahealthy eatingplan.
Yourdoctor mayrecommend youtake vitaminand mineralsupplements whileyou aretaking alli.
Take thesupplement atleast 2hours beforeor afteryou takealli.
Ifyou haveany ofthese conditions,you maynot beable touse alli,or youmay needa dosageadjustment orspecial testsduring treatment.
Take alliexactly asdirected onthe label,or asit wasprescribed foryou.
Donot takethe medicationin largeramounts, ortake itfor longerthan recommendedby yourdoctor.
Followthe directionson yourprescription label.
Follow thesedirections carefully.
Ask yourdoctor orpharmacist ifyou haveany questions.
Your dailyintake offat, protein,and carbohydratesshould beevenly dividedover allof yourdaily meals.
Follow yourdiet, medication,and exerciseroutines veryclosely.
Ifyou skipa mealor youeat ameal thatdoes notcontain anyfat, skipyour allidose forthat meal.
The fatcontent ofyour dailydiet shouldnot begreater than30% ofyour totaldaily caloricintake.
Forexample, ifyou eat1200 caloriesper day,no morethan 360of thosecalories shouldbe inthe formof fat.
Read thelabel ofall fooditems youconsume, payingspecial attentionto thenumber ofservings percontainer.
Yourdoctor, nutritioncounselor, ordietitian canhelp youdevelop ahealthy eatingplan.
Yourdoctor mayrecommend youtake vitaminand mineralsupplements whileyou aretaking alli.
Take thesupplement atleast 2hours beforeor afteryou takealli.
Keeptrack ofhow manypills havebeen usedfrom eachnew bottleof thismedicine.
Takethe misseddose assoon asyou remember,but nomore than1 hourafter eatinga meal.
If ithas beenmore thanan hoursince yourlast meal,skip themissed doseand takethe medicineat yournext regularlyscheduled time.
Do nottake extramedicine tomake upthe misseddose.
Ifyou missa meal,or ifyou havea mealwithout fat,you canskip yourdose ofalli forthat mealalso.
Symptomsof analli overdoseare notknown.
Thefollowing sideeffects occurcommonly withthe useof alli.
These sideeffects areusually temporaryand maylessen asyou continuetreatment withalli: oilyspotting inyour undergarments;oily orfatty stools;orange orbrown coloredoil inyour stool;gas withdischarge, anoily discharge;loose stools,or anurgent needto goto thebathroom, inabilityto controlbowel movements;an increasednumber ofbowel movements;or stomachpain, nausea,vomiting, diarrhea,rectal pain.
Other sideeffects thatmay occurwhile takingalli include:problems withyour teethor gums;cold orflu symptoms;headache, backpain; orskin rashor itching.
Side effectsother thanthose listedhere mayalso occur.
Talk toyour doctorabout anyside effectthat seemsunusual orthat isespecially bothersome.
Before takingalli, tellyour doctorif youare usingany ofthe followingdrugs: cyclosporine(Gengraf, Neoral,Sandimmune); digoxin(digitalis, Lanoxin,Lanoxicaps); ora bloodthinner suchas warfarin(Coumadin).
Ifyou areusing anyof thesedrugs, youmay notbe ableto usealli, oryou mayneed dosageadjustments orspecial testsduring treatment.
There maybe otherdrugs notlisted thatcan affectalli.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout alli,especially ifit isnew toyou.
Theyare relatedto testosterone,a malesex hormone.
Anabolic steroidshelp torebuild tissuesthat havebecome weakbecause ofserious injuryor illness.
A diethigh inproteins andcalories isnecessary withanabolic steroidtreatment.
Anabolicsteroids areused forseveral reasons:Anabolic steroidsmay alsobe usedfor otherconditions asdetermined byyour doctor.
Anabolic steroidsare availableonly withyour doctor'sprescription, inthe followingdosage forms:In decidingto usea medicine,the risksof takingthe medicinemust beweighed againstthe goodit willdo.
Thisis adecision youand yourdoctor willmake.
Foranabolic steroids,the followingshould beconsidered: AllergiesTell yourdoctor ifyou haveever hadany unusualor allergicreaction toanabolic steroidsor androgens(male sexhormones).
Alsotell yourhealth careprofessional ifyou areallergic toany othersubstances, suchas foods,preservatives, ordyes.
PregnancyAnabolic steroidsshould notbe usedduring pregnancy.
They maycause thedevelopment ofmale featuresin thefemale fetusand prematuregrowth anddevelopment ofmale featuresin themale fetus.
Be sureyou havediscussed thiswith yourdoctor.
ChildrenAnabolic steroidsshould beused withcaution inpediatric patients.
This medicinemay causechildren tostop growingor theirbone growthto slowdown.
Olderadults Whenelderly malepatients aretreated withanabolic steroids,they mayhave anincreased riskof enlargedprostate orcancer ofthe prostate.
Other medicinesAlthough certainmedicines shouldnot beused togetherat all,in othercases twodifferent medicinesmay beused togethereven ifan interactionmight occur.
In thesecases, yourdoctor maywant tochange thedose, orother precautionsmay benecessary.
Whenyou aretaking anabolicsteroids, itis especiallyimportant thatyour healthcare professionalknow ifyou aretaking anyof thefollowing: Othermedical problemsThe presenceof othermedical problemsmay affectthe useof anabolicsteroids.
Makesure youtell yourdoctor ifyou haveany othermedical problems,especially: Takethis medicineonly asdirected .
Do nottake moreof itand donot takeit moreoften thanyour doctorordered.
Todo somay increasethe chanceof sideeffects.
Inorder forthis medicineto workproperly, itis importantthat youfollow adiet highin proteinsand calories.
Ifyou haveany questionsabout this,check withyour healthcare professional.
Dosing Thedose ofthese medicineswill bedifferent fordifferent patients.
Follow yourdoctor's ordersor thedirections onthe label.
Thefollowing informationincludes onlythe averagedoses ofthese medicines.
If yourdose isdifferent, donot changeit unlessyour doctortells youto doso.
Thenumber oftablets thatyou takedepends onthe strengthof themedicine.
Also,the numberof dosesyou takeeach day,the timeallowed betweendoses, andthe lengthof timeyou takethe medicinedepend onthe medicalproblem forwhich youare takingthe anabolicsteroid .
Missed doseIf youmiss adose ofthis medicineand yourdosing scheduleis: Ifyou haveany questionsabout this,check withyour doctor.
Storage Tostore thismedicine: Yourdoctor shouldcheck yourprogress atregular visitsto makesure thatthis medicinedoes notcause unwantedeffects.
Anabolicsteroids mayinterfere withnormal bonegrowth.
Althoughthese effectsare rare,they canbe veryserious andmay causedeath.
Discussthese possibleeffects withyour doctor.
Along withits neededeffects, amedicine maycause someunwanted effects.
Although notall ofthese sideeffects mayoccur, ifthey dooccur theymay needmedical attention.
These sideeffects maygo awayduring treatmentas yourbody adjuststo themedicine.
However,check withyour doctorif anyof thefollowing sideeffects continueor arebothersome: Forboth femalesand malesLess commonChills; diarrhea;feeling ofabdominal orstomach fullness;muscle cramps;trouble insleeping; unusualdecrease orincrease insexual desireFor malesonly Morecommon AcneLess commonDecreased sexualability Otherside effectsnot listedabove mayalso occurin somepatients.
Ifyou noticeany othereffects, checkwith yourdoctor.
Oncea medicinehas beenapproved formarketing fora certainuse, experiencemay showthat itis alsouseful forother medicalproblems.
Althoughthese usesare notincluded inproduct labeling,anabolic steroidsmay beused incertain patientswith thefollowing medicalconditions: Otherthan theabove information,there isno additionalinformation relatingto properuse, precautions,or sideeffects forthese uses.
Revised: 10/28/2004The informationcontained inthe ThomsonHealthcare (Micromedex)products asdelivered byDrugs.com isintended asan educationalaid only.
It isnot intendedas medicaladvice forindividual conditionsor treatment.
It isnot asubstitute fora medicalexam, nordoes itreplace theneed forservices providedby medicalprofessionals.
Talkto yourdoctor, nurseor pharmacistbefore takingany prescriptionor overthe counterdrugs (includingany herbalmedicines orsupplements) orfollowing anytreatment orregimen.
Onlyyour doctor,nurse, orpharmacist canprovide youwith adviceon whatis safeand effectivefor you.
The useof theThomson Healthcareproducts isat yoursole risk.
These productsare provided"AS IS"and "asavailable" foruse, withoutwarranties ofany kind,either expressor implied.
Thomson Healthcareand Drugs.commake norepresentation orwarranty asto theaccuracy, reliability,timeliness, usefulnessor completenessof anyof theinformation containedin theproducts.
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ALL IMPLIEDWARRANTIES OFMERCHANTABILITY ANDFITNESS FORA PARTICULARPURPOSE ORUSE AREHEREBY EXCLUDED.
Thomson Healthcaredoes notassume anyresponsibility orrisk foryour useof theThomson Healthcareproducts.
Ketekis ina groupof drugscalled antibiotics.
Ketek helpsthe bodyfight infectionthat iscaused bybacteria.
Ketekis usedto treatbacterial infectionsin thelungs andsinuses.
Ketekmay alsobe usedfor purposesother thanthose listedin thismedication guide.
If youhave anyof theconditions listedabove, youmay notbe ableto useKetek oryou mayneed adosage adjustmentor specialtests duringtreatment.
TakeKetek exactlyas yourdoctor hasprescribed itfor you.
Do notuse moreof themedication thanrecommended.
Donot takeKetek forlonger thanyour doctorhas prescribed.
Follow thedirections onyour prescriptionlabel.
Ketekcan betaken withor withoutfood.
Ketekis usuallytaken oncea day.
Try totake Ketekat aboutthe sametime eachday.
Followyour doctor'sinstructions.
Takethe misseddose assoon asyou remember.
If itis almosttime foryour nextdose, skipthe misseddose andtake themedicine atthe nextregularly scheduledtime.
Donot takeextra medicineto makeup themissed dose.
Antibiotic medicinescan causediarrhea, whichmay bea signof anew infection.
If youhave diarrheathat iswatery orhas bloodin it,call yourdoctor.
Donot useany medicineto stopthe diarrheaunless yourdoctor hastold youto.
Otherless seriousside effectsare morelikely tooccur.
Talkwith yourdoctor ifyou haveany ofthese sideeffects: mildnausea, vomiting;vaginal itchingor discharge;headache; ordizziness.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Valium),midazolam (Versed),alprazolam (Xanax),chlordiazepoxide (Librium),temazepam (Restoril);itraconazole (Sporanox)or ketoconazole(Nizoral); heartrhythm medicationsuch asamiodarone (Cordarone,Pacerone), sotalol(Betapace, BetapaceAF, Sorine),quinidine (Cardioquin,Quinaglute), disopyramide(Norpace), procainamide(Pronestyl, Procanbid),dofetilide (Tikosyn);rifampin (Rifadin,Rimactane); seizuremedication suchas phenytoin(Dilantin), carbamazepine(Tegretol), phenobarbital(Luminal); metoprolol(Lopressor, ToprolXL); tacrolimus(Prograf) orsirolimus (Rapamune);cyclosporine (Sandimmune,Neoral); ordigoxin (Lanoxin,Lanoxicaps).
Ifyou areusing anyof thesedrugs, youmay notbe ableto takeKetek, oryou mayneed dosageadjustments orspecial testsduring treatment.
There maybe otherdrugs notlisted thatcan affectKetek.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Telithromycin isavailable witha prescriptionunder thebrand nameKetek.
Otherbrand orgeneric formulationsmay alsobe available.
Ask yourpharmacist anyquestions youhave aboutthis medication,especially ifit isnew toyou.
Cymbaltaaffects chemicalsin thebrain thatmay becomeunbalanced andcause depression.
Cymbalta isused totreat majordepressive disorderand generalanxiety disorder.
It isalso usedto treatpain causedby nervedamage inpeople withdiabetes (diabeticneuropathy).
Cymbaltamay alsobe usedfor purposesother thanthose listedin thismedication guide.
You mayhave thoughtsabout suicidewhen youfirst starttaking anantidepressant, especiallyif youare youngerthan 24years old.
Your doctorwill needto checkyou atregular visitsfor atleast thefirst 12weeks oftreatment.
Avoidusing othermedicines thatmake yousleepy (suchas coldmedicine, painmedication, musclerelaxers, medicinefor seizures,other medicationfor depressionor anxiety).
They canadd tosleepiness causedby Cymbalta.
Before takingCymbalta, tellyour doctorif youare allergicto anydrugs, orif youhave: seizuresor epilepsy;bipolar disorder(manic depression);or ahistory ofdrug abuseor suicidalthoughts.
Ifyou haveany ofthese conditions,you maynot beable touse Cymbalta,or youmay needa dosageadjustment orspecial testsduring treatment.
You mayhave thoughtsabout suicidewhen youfirst starttaking anantidepressant, especiallyif youare youngerthan 24years old.
Tell yourdoctor ifyou haveworsening symptomsof depressionor suicidalthoughts duringthe firstseveral weeksof treatment,or wheneveryour doseis changed.
Your familyor othercaregivers shouldalso bealert tochanges inyour moodor symptoms.
Your doctorwill needto checkyou atregular visitsfor atleast thefirst 12weeks oftreatment.
Olderadults maybe moresensitive tothe sideeffects ofthis medication.
Take thismedication exactlyas itwas prescribedfor you.
Do nottake themedication inlarger amounts,or takeit forlonger thanrecommended byyour doctor.
Your doctormay occasionallychange yourdose tomake sureyou getthe bestresults fromthe medication.
Try totake themedicine atthe sametime eachday.
Followthe directionson yourprescription label.
Take themissed doseas soonas youremember.
However,if itis almosttime forthe nextregularly scheduleddose, skipthe misseddose andtake thenext oneas directed.
Do nottake extramedicine tomake upthe misseddose.
Avoidusing othermedicines thatmake yousleepy (suchas coldmedicine, painmedication, musclerelaxers, medicinefor seizures,other medicationfor depressionor anxiety).
They canadd tosleepiness causedby Cymbalta.
Call yourdoctor atonce ifyou haveany newor worseningsymptoms suchas: moodor behaviorchanges, anxiety,panic attacks,trouble sleeping,or ifyou feelimpulsive, irritable,agitated, hostile,aggressive, restless,hyperactive (mentallyor physically),more depressed,or havethoughts aboutsuicide orhurting yourself.
Other lessserious sideeffects aremore likelyto occur,such as:constipation; drowsiness,dizziness, headache;sleep problems(insomnia); weightchanges; feelinganxious ornervous, increasedsweating; sorethroat; ordecreased sexdrive, impotence,or difficultyhaving anorgasm.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Beforetaking Cymbalta,tell yourdoctor ifyou areusing anyof thefollowing medicines:cimetidine (Tagamet);linezolid (Zyvox);lithium (Lithobid,Eskalith); St.
If youare usingany ofthese drugs,you maynot beable touse Cymbalta,or youmay needdosage adjustmentsor specialtests duringtreatment.
Theremay beother drugsnot listedthat canaffect Cymbalta.
This includesvitamins, minerals,herbal products,and drugsprescribed byother doctors.
Do notstart usinga newmedication withouttelling yourdoctor.
Duloxetineis availablewith aprescription genericallyand underthe brandname Cymbalta.
Other brandor genericformulations mayalso beavailable.
Askyour pharmacistany questionsyou haveabout thismedication, especiallyif itis newto you.
Version: 3.01.Revision date:9/8/04.
Takeone pillevery dayat thesame time,no morethan 24hours afterthe lastdose.
Tryto takethe pillsat atime thatyou willremember everydayfor examplejust beforebed, witha meal,or firstthing inthe morning.
Follow yourdoctors instructionsabout usinga secondform ofbirth controlwhen youfirst starttaking Seasonique,when youare takingantibiotics orother medications,or ifyou missa pill.
If youare unsurewhat todo inany ofthese cases,talk toyour pharmacist,nurse, ordoctor abouthow toensure thatyou willnot becomepregnant.
Ethinylestradiol andlevonorgestrel arehormones thataffect theovulatory andmenstrual cycleof women.
Seasonique preventsovulation (therelease ofan eggfrom anovary), thereforepreventing thepossibility ofpregnancy.
Seasoniquemay alsoinhibit pregnancyby causingthe cervicalmucous tothicken, whichmakes itharder forsperm tomove towardthe uterus,and reducingthe likelihoodof attachmentof afertilized eggto theuterus.
Seasoniqueis usedto preventpregnancy.
Seasoniquemay alsobe usedfor purposesother thanthose listedin thismedication guide.
Other medicalconditions mayalso affecttreatment withSeasonique.
TakeSeasonique exactlyas directedby yourdoctor.
Ifyou donot understandthese directions,ask yourpharmacist, nurse,or doctorto explainthem toyou.
Duringthe firstcycle ofpills, about1 in3 womenmay have20 ormore daysof unplannedbleeding orspotting.
Thistends todecrease duringlater cycles.
Treatment withSeasonique shouldnot bestopped dueto spottingor bleeding.
If thespotting continuesfor morethan 7consecutive daysor ifthe bleedingis heavy,contact yourhealthcare provider.
Take thefirst pillin apackage onthe firstSunday afteryour periodbegins, evenif youare stillbleeding.
Ifyour periodstarts onSunday, takethe firstpill thatday.
Useanother formof birthcontrol anytimeyou havesex forthe first7 daysyou takethe pills.
Take onepill everyday atthe sametime, nomore than24 hoursafter thelast dose.
Try totake thepills ata timethat youwill rememberevery dayforexample justbefore bed,with ameal, orfirst thingin themorning.
Takingthe pillat nightmay helpto reducenausea orheadache, whichmay beside effects.
Your periodshould occurduring the7 daysyou aretaking thewhite pills(these pillsare inactiveand donot containhormones).
Ifit doesnt,have apregnancy testbefore beginninga newpackage ofpills.
Aftertaking thelast whitepill froma pack,start anew packthe verynext day.
Do notskip anydays. Followyour doctorsinstructions aboutusing asecond formof birthcontrol whenyou firststart takingSeasonique, whenyou aretaking antibioticsor othermedications, orif youmiss apill.
Ifyou areunsure whatto doin anyof thesecases, talkto yourpharmacist, nurse,or doctorabout howto ensurethat youwill notbecome pregnant.
Missing apill increasesthe chanceof becomingpregnant.
Followthe exactdirections onthe packageinformation insertconcerning misseddoses.
Ifyou donot havea packageinformation insert,call yourpharmacist, doctor,or nurseto findout whatto do.
In general:If youmiss onedose, takeit assoon asyou rememberor taketwo pillsat thetime ofyour nextregularly scheduleddose.
Thereis littlelikelihood thatovulation willoccur.
Ifyou misstwo tabletsin arow, taketwo tabletseach forthe nexttwo regularlyscheduled doses(one missedtablet plusone regularlyscheduled tabletfor 2days ina row).
There isan increasedchance ofovulation andunintended pregnancy.
Use anadditional formof birthcontrol untilyou havetaken apill for7 daysin arow.
Ifyou missthree tabletsin arow, donot removethe missedtablets fromthe package,they willnot betaken.
Takethe nextpill inthe packagefor thecurrent day.
Continue totake onepill perday untilthe cycleis completed.
There isan increasedchance ofovulation andunintended pregnancy.
Use anadditional formof birthcontrol untilyou havetaken apill for7 daysin arow.You mayexperience menstrualbleeding duringthe weekfollowing themissed pills.
If youmiss anyof the7 whiteinactive pills,they canbe thrownaway.
Keeptaking thescheduled pillsuntil thepack isfinished.
Deathor seriousharm isnot likelyto occurfrom anoverdose ofSeasonique.
Consulta doctor,an emergencyroom, ora poisoncontrol centerfor advice.
Symptoms ofan overdosemay includenausea, vomiting,and menstrualbleeding.
Seasoniquedoes notprovide protectionfrom sexuallytransmitted diseasesincludingHIV andAIDS.
Other,less seriousside effectsmay alsooccur.
Continueto takeSeasonique andtalk toyour doctorif youexperience breakthroughbleeding orspotting; headache;nausea orvomiting; breasttenderness; depression;changes inweight orappetite; changesin skincolor; orchanges infit ofcontact lenses.
Side effectsother thanthose listedhere mayalso occur.
Talk toyour doctorabout anyside effectthat seemsunusual orthat isespecially bothersome.
Many otherdrugs mayinteract withSeasonique.
Someinteractions (e.g.
Version: 2.03.Revision date:06/28/06 12:10:38PM.
Wellbutrinis usedto treatmajor depressivedisorder andseasonal affectivedisorder.
Atleast onebrand ofbupropion (Zyban)is usedto helppeople stopsmoking byreducing cravingsand otherwithdrawal effects.
Wellbutrin mayalso beused forpurposes otherthan thoselisted inthis medicationguide.
Youmay havethoughts aboutsuicide whenyou firststart takingan antidepressant,especially ifyou areyounger than24 yearsold.
Yourdoctor willneed tocheck youat regularvisits forat leastthe first12 weeksof treatment.
Avoid usingWellbutrin totreat morethan onecondition ata time.
If youtake Wellbutrinfor depression,do notalso takeZyban toquit smoking.
Too muchof thismedicine canincrease yourrisk ofa seizure.
Valium). Wellbutrinmay causeseizures, especiallyin peoplewith certainmedical conditionsor whenusing certaindrugs.
Tellyour doctorabout allof yourmedical conditionsand thedrugs youuse.
Ifyou haveany ofthese conditions,you maynot beable touse Wellbutrin,or youmay needa dosageadjustment orspecial testsduring treatment.
You mayhave thoughtsabout suicidewhen youfirst starttaking anantidepressant, especiallyif youare youngerthan 24years old.
Tell yourdoctor ifyou haveworsening symptomsof depressionor suicidalthoughts duringthe firstseveral weeksof treatment,or wheneveryour doseis changed.
Your familyor othercaregivers shouldalso bealert tochanges inyour moodor symptoms.
Your doctorwill needto checkyou atregular visitsfor atleast thefirst 12weeks oftreatment.
TakeWellbutrin exactlyas itwas prescribedfor you.
Do nottake itin largerdoses orfor longerthan recommendedby yourdoctor.
Followthe directionson yourprescription label.
Wellbutrin canbe takenwith orwithout food.
If youtake Zybanto helpyou stopsmoking, youmay continueto smokefor about1 weekafter youstart themedicine.
Seta dateto quitsmoking duringthe secondweek ofZyban treatment.
By thattime youwill haveenough ofthe medicinein yourblood streamto helpyou quitsmoking.
Talkto yourdoctor ifyou arehaving troublequitting afteryou haveused Zybanfor atleast 7weeks.
Yourdoctor mayprescribe nicotinepatches orgum tohelp supportyour smokingcessation treatment.
Be sureyou readall directionsand safetyinformation forthe nicotineproduct.
Usingnicotine withZyban mayraise yourblood pressureand yourdoctor maywant tocheck yourblood pressureregularly.
Donot smokeat anytime ifyou areusing anicotine productalong withZyban.
Toomuch nicotinecan causeserious sideeffects.
Thisis normaland doesnot meanthat youare notreceiving enoughof themedicine.
Takethe misseddose assoon asyou remember.
If itis almosttime foryour nextdose, skipthe misseddose andtake themedicine atthe nextregularly scheduledtime.
Donot takeextra medicineto makeup themissed dose.
Avoid usingbupropion totreat morethan onecondition ata time.
If youtake Wellbutrinfor depression,do notalso takeZyban toquit smoking.
Too muchof thismedicine canincrease yourrisk ofa seizure.
Call yourdoctor atonce ifyou haveany newor worseningsymptoms suchas: moodor behaviorchanges, anxiety,panic attacks,trouble sleeping,or ifyou feelimpulsive, irritable,agitated, hostile,aggressive, restless,hyperactive (mentallyor physically),more depressed,or havethoughts aboutsuicide orhurting yourself.
Less seriousside effectsmay bemore likelyto occur,such as:headache ormigraine; nausea,vomiting, constipation,dry mouth;confusion, dizziness,tremors (shaking);appetite changes,weight lossor gain;mild itchingor skinrash, increasedsweating; orloss ofinterest insex.
Sideeffects otherthan thoselisted heremay alsooccur.
Talkto yourdoctor aboutany sideeffect thatseems unusualor thatis especiallybothersome.
Donot takeWellbutrin ifyou havetaken amonoamine oxidaseinhibitor (MAOI)such asisocarboxazid (Marplan),phenelzine (Nardil),rasagiline (Azilect),selegiline (Eldepryl),or tranylcypromine(Parnate) inthe last14 days.
There aremany otherdrugs thatcan affectWellbutrin.
Thisincludes vitamins,minerals, herbalproducts, anddrugs prescribedby otherdoctors.
Donot startusing anew medicationwithout tellingyour doctor.
Bupropion isavailable witha prescriptionunder thebrand namesWellbutrin, WellbutrinSR, WellbutrinXL, andZyban.
Otherbrand orgeneric formulationsmay alsobe available.
Ask yourpharmacist anyquestions youhave aboutWellbutrin, especiallyif itis newto you.
Version: 7.05.Revision date:1/4/05.
Thisrisk willincrease thelonger youuse naproxen.
Do notuse thismedicine ju