Yaz label should be rewritten, panel says
December 8th, 2011
06:44 PM ET

Yaz label should be rewritten, panel says

In a 21 to 5 vote on Thursday, U.S. Food and Drug Administration advisers said that the labels on certain oral contraceptives do not adequately reflect the risk-benefit profile of these drugs.

The pills in question contain the hormone drospirenone. The brand names for these products include Yaz, Yasmin, Beyaz and Sayfral.

At a joint meeting of two FDA advisory committees in Adelphi, Maryland, members discussed the available evidence suggesting that drospirenone-containing oral contraceptives may be linked to a higher likelihood of venous thromboembolism (VTE), which are blood clots that can break away and move around in the circulatory system.

Some studies suggest that the risk is higher for VTE in birth control pills with drospirenone than those with another hormone called levonorgestrel, a progestin.  But the results are conflicting, and the labels for these products should communicate that uncertainty, committee members said.

The majority of the committee members (15-11) present voted that the benefits of these drugs – primarily, preventing pregnancy, but also treating certain menstrual-related problems and acne – outweigh the risks. Many said that while the relative risk of these drugs was shown to be higher in some studies of VTE, the absolute risk level is still relatively low.

Those who voted "no" noted that the alternative is not necessarily unwanted pregnancy; there are other birth control pills on the market that appear to show a lower risk of VTE.

Many voters noted that the studies on the subject, some industry-funded and some not, do not adequately take into account many factors that could contribute to the development of VTE.  Body mass index, smoking, socioeconomic status and family history are just some of the variables that could skew results.  These are also observational studies, not controlled.  Participants were not randomly assigned to take one kind of pill instead of another and followed.

Advisers called for further investigation into these confounding variables.

soundoff (79 Responses)
  1. Jena

    I personally have know 6 women who have had strokes in their early 30's. With each of them: birth control, smoking and mild obesity were factors. One is in a coma right now. She is not expected to live.

    Be smart women.

    Oral contraceptives are not healthy. There are alternatives. Use them.

    December 8, 2011 at 20:00 | Report abuse | Reply
    • Rags

      Please describe 'mild obesity'? I have yet to see anybody that has mild obesity. Most are exceptionally FAT! All they do is sit and eat, eat and sit. Either way you look at it they're just getting fatter by the minute.

      December 8, 2011 at 20:22 | Report abuse |
    • RealityChecker7

      " I have yet to see anybody that has mild obesity."

      You need to get out of your bedroom more often.

      December 8, 2011 at 21:12 | Report abuse |
    • RM

      As is widely known, smoking and OCPs are a no no, especially into ones 30s. These are unfortunate women were at high risk due to OCP use and their lifestyle choices taken together.

      December 8, 2011 at 22:06 | Report abuse |
    • VelveteenLady

      My heart goes out to those women and their families. Artificial birth control has always been a double-edged sword. It freed women from being slaves to conception happenstance, yet it came (and still comes) with a high price. As with any drug, there are always risks. One has to weigh the benefits vs. the risks in one's own life, yet, there is always the unknown about how one's body will react to any given drug. I pray that the women, about whom you wrote, all survive and get healthy.

      December 8, 2011 at 23:32 | Report abuse |
    • kate

      i'm sorry for your friends, but those who smoke should really be the ones looking for other alternatives for birth control. it's one of the most repeated phrases in BC commercials.... women who smoke are more susceptible to blood clots. plain and simple.

      December 9, 2011 at 08:13 | Report abuse |
    • Anne

      No, smoking is not healthy. If your friends were too dumb to realize that the "chances of stroke increase with smoking" warning in every single birth control commercial meant them, it's their own fault, not their birth controls'.

      December 9, 2011 at 15:28 | Report abuse |
    • MrSnow

      I originally thought this article was about the band Yaz, though in that context all of the information still applies.

      December 10, 2011 at 14:22 | Report abuse |
  2. Jami

    It was Bayer that didn't filter out women who were more susceptible to blood clots in their studies. Other independent studies did, so they are more accurate and their findings were women on Yaz and Yasmin (drospirenone-containing birth control pills) were 2-3x more likely to develop blood clots! So now Bayer will warn. BUYER BEWARE! You do NOT want to assume the risks associated with Yaz and Yasmin. There are many other birth control pills available to women that do not carry the increased risk of blood clots.

    December 8, 2011 at 20:02 | Report abuse | Reply
    • Ktiara

      Thanks for the info! I am not overweight, nor do I smoke, but I started having blood pressure problems once I went on Yaz. I stopped taking it and everything went back to normal. More studies are definitely needed about Yaz–the reason I started taking it was because my doctor told me it had FEWER risks than ordinary birth control pills.

      December 8, 2011 at 20:37 | Report abuse |
    • binky42

      Ktiara – it definitely depends on the individual. I've been on Yaz/Yasmin for 9 years, and my blood pressure has never gone up.

      December 10, 2011 at 07:50 | Report abuse |
  3. Mary McCarthy

    My sister-in-law was on yas for problems regulating her cycle. She had a pulmonary embolism which resulted in a clot in her heart. They gave her TPA the clot busting drug....this caused blood clots and bleeding in brain–severe brain damage. In ICU for over 40 days, multiple surgeries and yet servived. Went to brain rehab for weeks. Lost use of arm, limited use of leg, unable to speak, pain, emotional distress. She lived for 2.5 years in that state with constant care from my incredible brother. This was agony for him and all the folks who loved her. Yaz kills.

    December 8, 2011 at 20:02 | Report abuse | Reply
    • Donna

      My sister was on Yaz to regulate her cycle. She was in a car accident and broke her foot. A couple of weeks later she had a pulmonary embolism and died. She was a non-smoker of healthy weight. My family was too distraught to consider any legal action and still will not pursue any but it makes me wonder how many others are too traumatized to come forward.

      December 16, 2011 at 17:43 | Report abuse |
  4. Kevin O.

    Well hold on there!!! If a woman wants to abort that's her right, cuz it's her body. So if a woman wants to take a pill that gives her a blood clot and kills her, well who are we to stop the baby from going down with the ship?

    I say let the women die if that is their assumed risk desire.

    December 8, 2011 at 20:38 | Report abuse | Reply
    • Portland tony

      Hey Troll....There is no baby! No ovulation ....
      No egg to fertilize Duh!!!!!

      December 8, 2011 at 20:57 | Report abuse |
    • corpsman

      Are the rest at home as dim-witted as you?

      December 9, 2011 at 00:47 | Report abuse |
  5. CCM

    I took bc (not YAZ) for 14 years never had any problems. I followed the directions. I watched my weight, blood pressure and I did not smoke. You NEED to follow the directions, they are there for a reason. AND just listening to the commercial, WHY would you use that stuff??

    December 8, 2011 at 20:57 | Report abuse | Reply
    • Emily

      They aren't saying EVERYONE will have health problems. You didn't. Good for you. Others followed the directions and did have health problems. Many women informed of the risks should and will choose a different pill.

      December 10, 2011 at 18:16 | Report abuse |
  6. PhilG.

    I am always amazed that personal behavior that can prevent conception in the first place is not advanced and instead we get billions upon billions of dollars spent on harsh drugs that have massive side effects on previously healthy young women.

    December 8, 2011 at 22:46 | Report abuse | Reply
    • Christine

      Birth control is not the only reason for taking such medications. I would actually be interested in a poll to find out why women take those pills.
      I do so daily to avoid monthly incapacitating pain. It was only getting worse with time. I can't afford to miss work for 2, sometimes 3, days a month because I am curled up in bed or on the floor in pain and throwing up out of pain. And I can't afford to loose abnormaly huge amounts of blood every month. So I take the pill. I do not smoke (never have), eat healthy, exercise, and get checked for health problems annually. And I am single so the birth control issue is not one for me.

      December 9, 2011 at 18:43 | Report abuse |
    • Binky42

      I think it's weird that so many of these uninformed, negative comments are coming from men!

      December 10, 2011 at 15:14 | Report abuse |
    • E

      Another man who has no concept of all the different reasons women take the pill. There are many options for birth control, but there are not many treatments for hormonal imbalances and horrific pain caused by fibroids, ovarians cysts, anemia, cramps, depression, etc. etc

      December 11, 2011 at 10:01 | Report abuse |
  7. angie

    An example of mild obesity is me 5ft 5in 160lbs at least thats what my dr says. Yaz evil my result of it was a hystorectomy did i spell that right

    December 8, 2011 at 23:07 | Report abuse | Reply
    • MOLB Student

      Your BMI is 26.6, thus you are overweight, but not obese. Mild obesity is an oxymoron like slightly dead. You are either overweight or you are so overweight that you are obese. Your BMI goes over 30, you are classified as obese. You're under 30? Then you're not obese. Plain and simple.

      December 9, 2011 at 03:21 | Report abuse |
  8. mt

    This may be because of my age and gender, but when I saw the name Yaz, the only thing I could think of was Carl Yastermski.

    December 8, 2011 at 23:44 | Report abuse | Reply
    • Olsonsonsons

      My first thought when I heard "Yaz" was the Baywatch actress Yasmine Bleeth.

      December 9, 2011 at 00:13 | Report abuse |
  9. Kitty

    And this is why I am on the implant, hell my doctor suggested Yaz and I declined due to all the side effects.
    Yaz has tons of them, and very little research has been done into exactly how severe and common they are.

    December 9, 2011 at 00:17 | Report abuse | Reply
  10. EA

    I am a 21-year-old first year medical student and last year at the age of 20 I was diagnosed with multiple bilateral pulmonary emboli from taking Yaz. I was not overweight, never smoked, and in otherwise very good health. I was not taking the medication for contraception; I was taking the drug for PCOS (polycystic ovary syndrome). My health is still not the same because of the harsh side effects of Yaz. Let me be clear. I am NOT saying that women should not take birth control. Like the article said, in the vast majority of cases, the benefits greatly outweigh the risks. However, women need to be more aware of what the risks and side effects are for these oral contraceptives. I don't even know if putting more labels on boxes will even make the situation any better. I know in my personal experience, I informed my gynecologist that I was worried about going on birth control because of the adverse side effects, and I was told that I had absolutely nothing to worry about since I was in good health. When patients ask their physicians about side effects of medications, doctors should describe the symptoms they will feel if they are having a side effect, even if the risk of having a side effect is very low.

    December 9, 2011 at 00:23 | Report abuse | Reply
    • Drug Reactions

      You are in a very unique situation as a medical student who has first hand experience with drug reactions. I almost died from adverse reactions to a drug (not birth control) and my doctors were completely baffled as to what was wrong with me. Medications should be the FIRST thing doctors suspect when an otherwise healthy patient falls extremely ill, not the last.

      December 9, 2011 at 13:59 | Report abuse |
    • mw

      my wife too was very healthy, slightly overweight. doctor gave her yaz to help minimize monthly complications, she developed clots in her leg and then moved to her lungs. I thank God every day she survived. She will never be the same, constantly short of breath, can't hike any more etc. Bayer advertised this drug for things it was not aproved for, now they says ooops, we didn't really mean you could use it for that!!

      December 16, 2011 at 15:20 | Report abuse |
  11. Veronica

    I personally know someone who had a heart attack at 30 something as a result of taking Yaz. Please stay away from Yaz.

    December 9, 2011 at 00:31 | Report abuse | Reply
    • binky42

      I personally know someone who had a heart attack at 40 because he ate McDonalds everyday. Please stay away from cheeseburgers.

      December 10, 2011 at 07:46 | Report abuse |
  12. hical

    BCPs have had this risk all along ... one reason why the total dose in each was reduced over the years ... HTN and smoking and increasing age ... increase the risk further. All known since the 1980's if not before ...

    December 9, 2011 at 00:52 | Report abuse | Reply
  13. Jackie

    when they Create something that will help people suffering from pmdd that isnt yaz, maybe we can stop taking it. i for one only take it for that reason. there is nothing else that works for me and i am sure many women suffer as i do with pmdd.

    December 9, 2011 at 02:14 | Report abuse | Reply
  14. ComeOnMan9

    The pill has always had these very serious side effects. No real news. My personal experience is never feeling good when using them. Always feeling out of sync. The benefit never seemed worth it.

    December 9, 2011 at 02:46 | Report abuse | Reply
    • E

      That is your experience. My life without pills was filled with physical pain, monthly depression and anemia, plus having to have surgery for ovarian cysts.

      December 11, 2011 at 10:04 | Report abuse |
    • inReply

      I am on the same page a "E." I suffered from anemia, and my body was out of sync all the time with irregular and heavy periods. After getting on birth control (a generic version of Yasime), everything was much better. I was on it for several years with no bad effect (I am healthy weight/ non-smoker). I got off the pill to try my hand at being totally "drug-free," and it was horrible. My anemia returned, hair was falling out, and I was tired all the time. I got back on the pill again and now I feel much better.

      Everyone's body is going to react different to birth control- any drug actually. I'm fortunate that the pill has helped me and I have not (at least not yet) suffered any negative effects from it. I wish everyone would have a good reaction to it, as I did, but the realisty is that it's never going to be that way.

      December 12, 2011 at 09:32 | Report abuse |
  15. jen

    I only got really bad headaches really bad all the time

    December 9, 2011 at 03:30 | Report abuse | Reply
  16. LCD Soundsystem

    How come no one is appalled that they are using the name of a synth-pop band from the '80s? First of all I would never take a pill called Oingo Biongo. Secondly, I want to make something real.

    December 9, 2011 at 03:33 | Report abuse | Reply
  17. em

    legalize pot, its healthier than most pills ,alcohol , tobacco (all legal) .. the evil motives to keep it illegal are way old. life can be better for so many. it can come in healthier forms let alone the end of preventing people from having ok jobs or worrying about unjust law.
    oh yea...birth control, hopefully one day a formula will be perfected and it will be inexpensive so we can control our resources /population.

    December 9, 2011 at 08:16 | Report abuse | Reply
  18. Sara

    It is amazing that women take the risk in their 30's to be on birth control and still smoke. I have two friends that have been on bc for ten years plus and are smokers, it's like playing Russian roulette.

    December 9, 2011 at 08:56 | Report abuse | Reply
  19. MarCATerAlum07

    Am I really the only person here who notices that this article says NOTHING?! I am not even sure the FDA knows what they voted on here?! Someone, somewhere thinks there may be an elevated risk with this hormone compared to others, but there have been no ACTUAL studies, no RELIABLE results, no MEASURABLE increase, but these "facts" NEEDS to be labeled on the medication?!?! The fact is that ALL Oral Contraceptives have the same risk and state it clearly on all packaging. Women should be honest with themselves and their doctors about weight and overall health to help reduce the risks associated with taking this type of medication.

    December 9, 2011 at 10:57 | Report abuse | Reply
    • E

      They do not all have the same risk, because they all have different formulations. The article says it is one hormone in this one that has higher risks.

      December 11, 2011 at 10:06 | Report abuse |
    • mw

      there have been multiple studies saying the risk with yaz is almost double than any other bc.!!! why use yaz when there are other meds that do the same thing with half the risk regardless of age, weight etc!!!

      December 16, 2011 at 15:24 | Report abuse |
  20. Aaron R

    So let me get this straight. A pill that is used for infanticide may carry some health risks for the women who take it? Sounds pretty just to me. Don't think for a second that in 20 years people won't look back in horror at ab0rtion. I am not religious by the way. I am a person of science who knows very well a human begins at conception. These women should be tried for murder. And no more of this it's a woman's body junk. It is a woman's body and she is responsible for her own health. At no time should that mean she can k1ll her unborn child. Wrap up those twinkies in latex ladies. This option is bad news.

    December 9, 2011 at 14:33 | Report abuse | Reply
    • Anne

      If you were actually a scientist and not a religious nut, you would know how many fertilized eggs naturally never progress to a pregnancy and wouldn't be stupid enough to cry "murder" over a completely natural, common bodily process.

      December 9, 2011 at 15:45 | Report abuse |
    • Confused

      I'm trying to understand your thought process Aaron. So women taking birth control is murder in your eyes? Is it murder when there is spermacide in the end of a condom and a man ejaculates?

      December 9, 2011 at 16:14 | Report abuse |
    • Emperor Norton

      ...so preventing an egg from being fertilized in the first place is now infanticide? Does that make masturbation genocide?

      December 9, 2011 at 16:55 | Report abuse |
    • EA

      Thank you, Anne. You took the words right out of my mouth.

      December 9, 2011 at 17:33 | Report abuse |
    • E

      Aaron, you are a delusional nutcase. The pill prevents ovulation, preventing the egg from being fertilized. There is not baby killing because there is no zygote or embryo. It also prevents many other painful conditions in women, and many of us take it for reasons that have nothing to do with pregnancy prevention. And how about you stay out of our medical decisions and we will stay out of yours.

      December 11, 2011 at 10:11 | Report abuse |
  21. Yaz User

    I've been on both Yaz and when my insurance wouldn't cover that I went to Byaz. Took Yaz for one year and have been on Byaz for a year. Noticed no side effects. It's worked well for me. I'll be 30 in February.

    December 9, 2011 at 14:48 | Report abuse | Reply
  22. binky42

    I don't care what they put on the label, Yaz has still been a lifesaver for me. I had such awful depression and anxiety associated with PMDD, and it was ruining my life. Yaz put an end to 99% of it, and now I can function normally again. I would rather die a few years early than life my whole life in emotional agony.

    December 9, 2011 at 19:01 | Report abuse | Reply
    • Yep

      I've got PMDD too and BC works for me too. I still have a little anxiety though.

      December 10, 2011 at 09:41 | Report abuse |
    • Binky42

      I still get some anxiety during the low-dose pills, but it's not nearly as bad. I've just learned to relax more during that time of the month.

      December 10, 2011 at 15:13 | Report abuse |
  23. Charice

    My problem with Yaz is that its price keeps increasing; it seems almost every month. I have taken Yaz for about 4 years now and have had no side effects, except when I actually discontinued it. When I stopped Yaz, I got awful acne even though my face was cleared prior to starting Yaz.

    Has anybody else had this problem where Yaz's price keeps going up? I am not fortunate to always have drug coverage because I don't always work full-time. But when I first started taking Yaz, I paid about $60 for a pack, without insurance. Now I am paying about $90/pack. This is outrageous. When I ask the pharmacy why it keeps increasing, all they say is, "That's the market price." So I wonder, is it like this for everybody else?

    December 9, 2011 at 20:24 | Report abuse | Reply
    • binky42

      You should shop around. The price can vary a lot from pharmacy to pharmacy. Walgreens is usually the most expensive in my experience. I have health insurance, but I know that without it I would pay about $63 per refill at Kroger. You could also switch to Yasmin, which is an almost identical pill from the same company. It has a generic now (Ocella) which cost tons less. There is also a Bayer savings card, which might save you money. I haven't looked into it in depth, but it you qualify you could only pay $25 per refill.

      December 9, 2011 at 22:25 | Report abuse |
    • binky42

      I should add that I switched back and forth from Yaz to Yasmin generic and had no side effects, so they are very similar.

      December 9, 2011 at 22:26 | Report abuse |
    • E

      It is probably your insurance that is changing coverage, not the drug changing price. Switch to generic and call around to different pharmacies to check prices with your insurance.

      December 11, 2011 at 10:13 | Report abuse |
    • Face

      Same with me about the acne! I had very clear skin while on Yasmine, when I stopped, my face broke out like crazy.

      Also, there are cheaper generic versions as the other's who replied have said. I had the same skin-clearing effects with the generic version as the real one.

      December 12, 2011 at 09:36 | Report abuse |
  24. sukhoi

    I deal with endometriosis and the extremely painful – so bad I would vomit because of the pain, long, heavy and irregular periods that come with it. I was one step short of surgery when I finally found a birth control pill that helps me. For the first time in years my periods are only 4-5 days long, not extremely heavy, and can get through most days of my period without taking even over the counter pain relievers (I used to be on prescription painkillers for a week every month), and I down in bed for 2-3 days with pain and vomiting.

    I do not take yaz, however, I'd hate to have Yaz pulled off the market when it may be able to help some women. I bounced around from pill to pill trying to find one that relieved my symptoms. Some pills work for some women with conditions like endometriosis and pcos while others don't. What gives relief to one woman may not give relief to another, It is a matter of trial and error to find the pill that works. While I wouldn't have a problem with the FDA pulling from use as birth control, I think it should remain on the market for women who use it to treat medical conditions.

    For me it is a quality of life issue. I'm willing to except some additional risk to avoid the pain, losing days stuck in bed because I can't walk or sit up etc, issues with missing work, etc. I'm sure there are other women that feel the same way.

    December 9, 2011 at 23:39 | Report abuse | Reply
  25. Switching

    I am a Public Health Student who happens to use Yasmin for years its a great pill. But when this study came out I checked the validity of it with some professors, friends and doctors and their consesus was not to change my pill until I spoke with my OBGYN. I just saw her last week and the first thing she said to me is " We are taking you off Yasmin" I am taking all my patients off of it. I switched to LoEstrin and will be starting it when I finish this pill pack I like using the pill and am glad that I am going to be safe because of knowledge.

    December 10, 2011 at 09:27 | Report abuse | Reply
    • Binky42

      Do you know why your doctor probably switched all of her patients? It's because a Big Pharm rep probably visited her and gave her incentives to switch all her patients to a different brand. It happens ALL the time. If Yaz was actually harmful the FDA would take it off the market.

      December 10, 2011 at 15:10 | Report abuse |
  26. Allison

    I was 27 when I suffered a stroke. The only possible cause was determined to be the birth control pill. I am healthy, thin, and young. I did not smoke while on the pill. The benefit does not outweigh the risks. Use a copper IUD, condom, diaphragm...something else. If you stay on the pill, learn the signs of stroke. I was so young that the first ER misdiagnosed me!

    December 10, 2011 at 13:21 | Report abuse | Reply
    • Binky42

      I know a girl who had a stroke when she was only 23, and was otherwise healthy. However, she wasn't on the pill. So many young people are on the pill, so it become an instant scapegoat. Sometimes these things are genetic, and the doctors never bother to investigate when they can blame the most obvious thing.

      December 10, 2011 at 15:12 | Report abuse |
    • E

      I am sorry that happened to you, but many of us can only be helped by hormonal birth control since we are on the pill for our own reasons, thus we get to decide for ourselves what our choices are.

      December 11, 2011 at 10:16 | Report abuse |
  27. larry5

    In the risk analysis if they include the benefits of the profits to be made then the drug companies may not allow the FDA to force changing the labels. You have to remember that the FDA has to get the drug companies permission before making decisions that would hurt profits. The drug companies own the FDA and they keep the FDA officials on a short leash or their retirement plans get cancelled. Some executives take turns working for the FDA so that the system continues to run smoothly.

    December 10, 2011 at 14:33 | Report abuse | Reply
  28. Yaz victim

    I was put on Yaz, to lighten my excessive mentstrual bleeding, etc. (early 40s, non-smoker). After a year I ended up with 2 deep vein thrombosis (DVTs) in my leg. Went through complete internal medicine testing and 17 tubes of blood for a hematologists tests.....they couldn't find any other reason for the clotting. Months and months of coumadin, and my menstrual cycles became so bad I ruined two chairs at work (that was certainly fun). Became so bad, I had to have a hysterectomy (complicated because I was still on coumadin). I've been told my daughter should NOT take any hormones because of how they affected me. Ladies, bottomline THINK of all your options and which brands are really best for you. The absolute terror of waiting for a clot to move through your body is not worth it!

    December 11, 2011 at 23:44 | Report abuse | Reply


    December 12, 2011 at 00:02 | Report abuse | Reply
  30. carlson85

    Interestingly I was nearly hospitalized because of a different birth control and I was put on a generic of Yaz and I'm fine. I spoke with my gyno about Yaz and all the talk about it and she says it stems from several cases in which the doctors should have never prescribed it in the first place. And that the women all had other risk factors for disease. She says it's perfectly safe and she and her daughter take it. I trust her. I guess it depends on the person.

    December 12, 2011 at 05:33 | Report abuse | Reply
  31. PE Survivor

    A year ago I was in the ICU for massive blood clots that filled my lungs and a DVT in my left leg. 33, healthy weight, non-smoker, runner. My first night in the ICU my heart started to shut down b/c it was so tired of trying to push clotted blood through my lungs and I came very close to not making it, but I'm one of the lucky ones.

    I have NO clotting disorders, which can increase your likelyhood of getting a clot on Yaz or any kind of BCP. The only conclusion was that the Yaz I'd been on caused the DVT that resulted in the PEs. So I am one of those perfectly healthy people where my OB never in a million years thought I'd have problems with this pill (even after I asked her specifically about it). Now I'll be on blood thinners for the rest of my life and currently take two shots a day in my stomach.

    Do you what you want, it's your body, just educate yourself on the less riskier options available.

    December 12, 2011 at 16:06 | Report abuse | Reply
    • EA

      I am so sorry that happened to you. I can relate to your experience as the same thing happened to me. As frustrating as it is, one of the best things we can do is to educate other women about the harsh side effects that are possible with these medications.

      January 11, 2012 at 17:27 | Report abuse |
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    December 14, 2011 at 02:47 | Report abuse | Reply
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