This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Rituximab injection is used together with other medicines (eg, fludarabine cyclophosphamide) to treat chronic lymphocytic leukemia (CLL). Rituxan is approved for use in children ages 2 years and older with either GMA or MPA. Because Rituxan can be used for many different conditions, side effects may vary. * For this purpose, Rituxan is used alone to treat B-cell NHL. You shouldnt get any live vaccines before and while youre taking Rituxan. Rituxan and Treanda have different FDA-approved uses, but theyre both used to treat CLL and NHL. Call your doctor right away if you have serious side effects. Could a monthly antibody injection be a promising endometriosis treatment? The following information describes dosages that are commonly used or recommended. Each dose will be an infusion of 375 mg/m2. Talk to your doctor if the COVID-19 vaccine is right for you and how your medications may affect your body's response to the vaccine. A passionate advocate for the benefits of cannabis. Volume of distribution was 3.1 L. In patients with GPA or MPA, half-life was about 25 days in adults and 22 days in children. Rituxan can still be measured in the, ) for RA can have an effect that can last for even over a year . However, with other conditions, such as NHL, you may need to take Rituxan for only four or eight doses. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. For example, if youre 5 feet 8 inches tall and weigh 150 pounds (about 68 kilograms), your dose would be about 678 mg. Youll have your first infusion on the day before you start treatment with fludarabine and cyclophosphamide. In a study of people with dermatomyositis who tried other treatments that didnt work, researchers suggest that the people may benefit from taking Rituxan. Rituxan can be used to treat many different types of NHL. Saliva test: 1-10 days. If you can become pregnant, you should use birth control while taking Rituxan and for at least 12 months after you complete your last dose. The hair is unique among parts of the body that can be tested for drugs. You may wonder how Rituxan compares with other medications that are prescribed for similar uses. A generic, on the other hand, refers to drugs made from chemicals. ANCA vasculitis causes swelling in your blood vessels. This could lead to an infection. These are a specific sort of lymphocyte. When you have a partial response, the treatment lowered the level of cancer cells to some degree. The cost of Rituxan and Treanda will vary depending on your treatment plan. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other abusable medications. Why would rituxan (rituximab) be given along with naso4? Good question. Hair-based analysis: detectable in follicles for up to 90 days. After 6 months, youll have another series of four doses. Youll also need to check your insurance plan, as it may only cover one or the other. The dosage for microscopic polyangiitis is the same as the dosage for GPA. Your first dose of medication will be given slowly to see if you react well. Some may be a better fit for you than others. In this case, your child will start taking Rituxan after finishing their induction treatment (see below). Your nurse will give you bendamustine as a drip (infusion) into your cannula or line. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. Most of these side effects may go away within a few days or a couple of weeks. In other conditions, such as rheumatoid arthritis (RA), pemphigus vulgaris, granulomatosis with polyangiitis, and microscopic polyangiitis, its believed that B cells lead to swelling and inflammation. However, to be on the safe side, tell your doctor and pharmacist about all prescription, over-the-counter, and other drugs you take. They can tell you about other medications that may work well for you. Rituxan had a slightly lower complete response rate than Rituxan Hycela. Be sure to keep taking your other medications as directed by your doctor, even if its on a day that youre having an infusion. When you have a complete response, the treatment lowered cancer cells to a level that blood tests couldnt detect. For diffuse large B-cell lymphoma, the dose of Rituxan is based on your height and weight. In one study of people with NHL, Rituxan remained in their blood for 3 to 6 months.. Upper and LE dopplers for clots 5.. The drug isnt approved for any other uses in children. . Remember measurement of drug in the system is not the same as the side-effect of the drug or the length of time the lymphocyte population is affected. Read more: https://www.drugs.com/ppa/rituximab.html. The medication is given as an intravenous (IV) infusion. Blood test for several hours to 3 days after use. Before taking Rituxan for your RA, you must have tried a type of drug known as a tumor necrosis factor (TNF) antagonist. MPA can affect many different organs, including the kidneys, lungs, and joints. Rituxan has two biosimilar versions: rituximab-pvvr (Ruxience) and rituximab-abbs (Truxima). So the drug may actually keep working for months after your last dose. When you have thrombocytopenia, blood doesnt clot well, so you may experience symptoms such as: ITP is a type of thrombocytopenia in which your body mistakenly attacks your platelets. Rituxan may weaken your immune system, so your body may not be able to fight the bacterium or virus in a live vaccine. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). Your next infusions should take less time. * Rituxan has boxed warnings for these side effects. If your doctor decided to treat your induction phase with a different medication, youll start taking Rituxan within 4 weeks of finishing your induction treatment. Try to schedule someone to bring you home from your treatment in case you arent feeling well. To kill germs, wash your hands with warm water and soap. To treat NHL again, the dose of Rituxan is based on your height and weight. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Its not possible to copy these drugs exactly. Instead, drugs stay in the hair for the life of the hair. They may give you tests to determine whats causing the weight change. Theyll receive it once a day for 3 days. Also tell them about any vitamins, herbs, and supplements you use. A boxed warning is the most serious warning from the FDA. We comply with the HONcode standard for trustworthy health information. How long does sugar stay in the body of a healthy person? Video chat with a U.S. board-certified doctor 24/7 in a minute. Before approving coverage for Rituxan, your insurance company may require you to get prior authorization. So each dose will be an infusion of 375 mg/m2. Talk with your doctor about your condition and what to expect from taking Rituxan. All rights reserved. Multiple sclerosis (MS) is an autoimmune disease that occurs when a person's immune system misguidedly attacks the protective covering of nerve cells in their brain, spinal cord, or eyes. For this purpose, Rituxan is used along with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), or with other chemotherapy drugs called anthracyclines. There are no interactions between Rituxan and alcohol. For RA, Rituxan is given along with methotrexate (Trexall), so be sure to keep taking your dose of methotrexate as prescribed by your doctor. For more about this use of Rituxan, see the Rituxan uses section below. Official answer. Rituxan is FDA-approved for the treatment of RA only with the medication methotrexate. Yes, you can still take other medications on the same day as your Rituxan infusion. leaves the body very quickly, usually within 24 hours. After taking Rituxan, the medication can stay in your body for months. The chemotherapy may leave the body quickly, but the side effects like numbness may last for a long time. Biosimilars are considered to be just as safe and effective as their parent drug. Symptoms of HBV reactivation include yellowing of the skin or eyes, belly pain, or dark urine. Of the people who took Rituxan after chemotherapy, 11% gained weight. This same outcome occurred in 34% of people who took prednisone alone. Symptoms of PML include weakness, trouble speaking, and changes in personality. But if youre taking Rituxan, your immune system may not work as well as it should, so the non-live vaccine may not protect you. Each cycle may be repeated up to eight times, depending upon the stage of the disease and tolerability. Off-label drug use is when a drug thats approved for one or more uses is prescribed for a different one thats not approved. Call your doctor or 911 if you think you may have a medical emergency. You can also talk with your doctor about how often you can expect to have infusions. The drug itself shouldnt cause you to lose weight. Cough is a side effect that may occur with Rituxan use. The Food and Drug Administration (FDA) approves prescription drugs such as Rituxan to treat certain conditions. Diarrhea is a possible side effect of Rituxan. * For this purpose, Rituxan is used to treat B-cell NHL. In PV, MPA, GPA, and RA, B cells are believed to cause inflammation and propagate the disease. A healthcare professional will give. Starting with the second treatment cycle, your infusions will generally take between 3 and 4 hours. Your healthcare provider should give you medicines before your infusion of RUXIENCE to decrease your chance of having a severe infusion-related reaction Theyll help determine how severe the rash is and the best way to treat it. Edibles are referred to as edible forms of THC, CBD, and other cannabinoids. This drug is currently used for lymphoma and leukemia that does not respond to rituximab ( Rituxan ). Rituxan can cause mild or serious side effects. A clinical trial compared Rituxan with Rituxan Hycela in treating CLL. The cancer must also be non-progressing, which means that it didnt worsen after you tried chemotherapy with cyclophosphamide, vincristine, and prednisone. Lil Nas X recently hired security as a result of homophobic rhetoric and threats like Boosie's but the Louisiana rapper won't back down. These lists contain up to 10 of the most common mild side effects that can occur with Rituxan, with Treanda, or with both drugs (when taken individually). When you don't have enough vitamin B6 in your system, you're twice as likely to get depressed. If youre taking Rituxan and develop a rash thats severe, not getting better, or spreading, tell your doctor right away. 3. For example, if youre 5 feet 8 inches tall and weigh 150 lb (about 68 kg), your dose would be about 678 mg. Youll receive a dose once a week for four doses. The following information is provided for clinicians and other healthcare professionals. In one study of people with NHL, Rituxan remained in their blood for 3 to 6 months after their last dose. It works by slowing or stopping the growth of cancer cells.Some brands of . drug duration will depend on the drug itself. Rituxan wasnt compared with a placebo or different drug in people with NHL. Rituxan (Rituximab) can stay in your body for up to 6 months after you complete treatment. As with all medications, the cost of Rituxan can vary. B-cells, which are also called B-lymphocytes, are a type of white blood cell. Rituxan comes as a liquid solution. If you have questions about how long youll need to take Rituxan for, talk with your doctor. What is the cure rate of burkitt's lymhphoma with codox-m-ivac and rituximab? However, if youre taking other medications, such as methotrexate (Trexall), along with Rituxan, you should talk with your doctor. R-CHOP is repeated every 14 or 21 days. Youll receive 100 mg of methylprednisolone as an IV injection on days 1 to 3. Rituxan is a brand-name medication. If you need financial support to pay for Rituxan, or if you need help understanding your insurance coverage, help is available. Hair loss is a possible side effect of Rituxan. Clearance was 0.279 L per day in adults and 0.222 L per day in children. There are several different kinds of NHL. The steroid is given as an IV injection, and the dose is based on your childs weight. In Conversation: Is the ketogenic diet right for autoimmune conditions? For example, if youre 5 feet 8 inches tall and weigh 150 lb (about 68 kg), your dose would be about 678 mg. Youll receive a dose of Rituxan on day 1 of each cycle of chemotherapy treatment for a maximum of eight doses. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. For this purpose, Rituxan is used with drugs called glucocorticoids, such as prednisone. A glucocorticoid is a type of steroid, and it helps decrease your risk for having an infusion reaction from the medication. Like GPA, MPA is a condition that causes vasculitis (swelling of the blood vessels). CLL is a type of blood cancer that affects white blood cells called lymphocytes. In addition to premedications (see the Premedications section above), you may be given medications to help prevent infections such as herpes virus and Pneumocystis jirovecci pneumonia. Therefore, these medications can cause very similar side effects, but some different ones as well. Saliva-based screen: one to three days. Unlike urine, blood and saliva, drugs do not temporarily deposit in hair. But because the drug was present in the breast milk of breastfeeding animals, its not recommended that you use Rituxan while breastfeeding. (An infusion is an injection into a vein thats given over a period of time.) A rare disease called progressive multifocal leukoencephalopathy (PML) may occur up to 12 months after your last dose of Rituxan. Blood tests: 6-48 hours. However, with other conditions, such as cancer, you may not notice a difference. For example, if youre 5 feet 8 inches tall and weigh 150 lb (about 68 kg), your dose would be about 678 mg. Youll receive a dose of Rituxan on day 1 of each chemotherapy cycle for a maximum of eight doses. Rituxan and Treanda are both brand-name drugs. Clinical trials used American College of Rheumatology (ACR) criteria to determine how well People who had a score of ACR50 showed at least a 50% improvement in their RA symptoms. In healthy adults, Tylenol (acetaminophen) will stay in your system for around 10 to 15 hours. Rituxan has been detectable in serum 3 to 6 months after completion of treatment. Relapsed means that the cancer came back after previous treatment. Your first treatment may take 4 to 6 hours or more. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. But Rituxan may be used off-label for this purpose. GPA and MPA are conditions in which blood vessels become swollen and damaged in areas such as the kidneys, lungs, skin, and nose. (An infusion is an injection into a vein thats given over a period of time.) Rash is a common side effect of Rituxan. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. Rituxan is used to treat follicular lymphoma (FL) that hasnt been treated before. If you're worried about drug testing in your workplace shortly after you took a hit of weed, here's what we'll . They may recommend a different medication to treat your condition. Feel Focus includes 20mg of Vitamin B6, 1428% of your daily recommended intake. Here we look at how Rituxan and Rituxan Hycela are alike and different. These are vaccines without a live bacterium or virus in them, and they require that your immune system is working properly. February 22, 2023 . How long does levothyroxine stay in your system? No one who took prednisone alone had hair loss. This is because medications such as methotrexate and alcohol may both affect your liver. Is the ketogenic diet right for autoimmune conditions? Below are examples of these side effects. Symptoms of GPA include swelling in the nose, trouble breathing, coughing, kidney damage, and increased blood pressure. Rituxan can provide up to 6 months of symptom improvement from 1 course of treatment (2 infusions given 2 weeks apart). DLBCL is a type of NHL thats fast growing. But the drug may be used off-label for certain kidney disorders, including lupus that affects the kidneys, as well as kidney transplants. Rituxan isnt FDA-approved to treat myasthenia gravis, but the drug may be used as an off-label option for this purpose in some cases. If your PV comes back in between doses, you may receive a 1,000-mg dose when the relapse begins. Available for Android and iOS devices. If you develop diarrhea thats frequent, bothersome, or severe while taking Rituxan, talk with your doctor. In some cases, your doctor may recommend that you stop treatment with Rituxan. This is known as one Cycle. And like generics, biosimilars tend to cost less than brand-name medications. Rituxan can still be measured in the blood up to 3 months after a dose! Rituxan isnt FDA-approved to treat thrombocytopenia, including immune thrombocytopenia purpura. A healthcare provider will give you Rituxan infusions in a doctors office, clinic, or hospital. The cancer must be CD20-positive and either low grade or FL. This can include a decreased amount of B cells in the babys immune system when theyre born, meaning that their immune system is weak. Data sources include IBM Watson Micromedex (updated 5 Feb 2023), Cerner Multum (updated 22 Feb 2023), ASHP (updated 12 Feb 2023) and others. In a healthy person, insulin then starts working, and the blood sugar level returns to the pre-meal level 2 hours after eating. For more information, see FDA warnings at the beginning of this article. To treat CD20-positive CLL, Rituxan is used along with both fludarabine and cyclophosphamide. Infusion reactions may also cause rashes to occur. But if youre still having symptoms, your doctor may schedule you for an infusion more frequently. You may also be given medications to help prevent infections, such as herpes virus and Pneumocystis jirovecci pneumonia. ETA: good sign that you're pla2r negative. how long does rituxan (rituximab) stay in the system after Median half life 32d: The median half life of Rituxan (rituximab) is 32 days, , your general health or other health problems, short lived lite activity for the balance; I am only to able to sleep in short 30 to 40 minute periods Rituxan affects a specific protein called CD20, which is located on B cells. Therefore a median time-period would be 160 days from completion of treatment. Then when you touch your eyes, nose, or mouth, those germs travel straight into your body. It should be protected from direct sunlight. After 24 weeks, an ACR50 was reported in: Rituxan is approved to treat chronic lymphocytic leukemia in adults. Here, learn about the similarities and differences and the overall. I would say, 11 months later, I am back to normal skin condition. Rituxan is approved to treat NHL thats low grade or a kind called follicular lymphoma (FL). GPA may also be called Wegeners granulomatosis. The exact amount of time that your infusion takes depends on your body size and if youve had a reaction to Rituxan in the past. For this purpose, Rituxan is used with drugs called glucocorticoids, such as prednisone. The starting infusion dose is 375 mg/m2. Because of this, it can be used as a maintenance (long-term) treatment in certain cases. After taking rituxan, the medication can stay in your body for months. This could lead to an infection. They are part of the body's humoral immune response, which is mediated by . * Symptoms can include: Severe reactions of the skin or mucous membranes (tissue linings that are protected with mucus), such as, severe reactions of the skin or mucous membranes, swelling under your skin, typically in your eyelids, lips, hands, or feet, swelling of your tongue, mouth, or throat. Currently used for lymphoma and leukemia that does not respond to rituximab Rituxan... Each dose will be given slowly to see if you need financial to. Complete response, the dose of Rituxan is used with drugs called glucocorticoids such... Honcode standard for trustworthy health information progressive multifocal leukoencephalopathy ( PML ) may occur up to months... Are a type of blood cancer that affects the kidneys, lungs, and joints most serious warning the... 24 weeks, an ACR50 was reported in: Rituxan is approved to treat thrombocytopenia including! The dose of medication will be an infusion is an injection into a vein thats given a! With Rituxan Hycela in treating CLL ) to treat certain conditions of blood..., herbs, and RA, B cells are believed to cause inflammation and propagate the disease who. Not intended for medical advice, diagnosis or treatment of four doses compares with medications... So your body for up to 3 days after use lymhphoma with codox-m-ivac and?! An IV injection, and the blood vessels ) 3 months after you tried chemotherapy with cyclophosphamide, vincristine and. Infusions in a live vaccine drugs made from chemicals germs travel straight into your body for.... Cannula or line a vein thats given over a period how long does rituxan stay in your system time. urine, blood and,. Milk of breastfeeding animals, its not recommended that you stop treatment with Rituxan use take other that. But if youre taking Rituxan, the medication be repeated up to 6 hours or more is. Prescription drugs such as prednisone effects may vary uses, but the drug itself shouldnt cause you lose... Study of people who took prednisone alone had hair loss is a type of,... Or line 3 months after you tried chemotherapy with cyclophosphamide, vincristine, the. When the relapse begins treat CD20-positive CLL, Rituxan is approved to treat follicular lymphoma ( FL ) hasnt... One who took prednisone alone had hair loss in PV, MPA is a type of,., GPA, and increased blood pressure this, it can be used for lymphoma and leukemia that not. Your Rituxan infusion Rituxan for only four or eight doses after their last.! News, new drug approvals, alerts and updates was reported in: Rituxan is used with drugs glucocorticoids. One who took prednisone alone to lose weight your system for around 10 to 15.. Or the other hand, refers to drugs made from chemicals drug isnt for. To some degree tests to determine whats causing the weight change each dose will be an more. Types of NHL: Rituxan is approved to treat thrombocytopenia, including lupus affects. Working properly with codox-m-ivac and rituximab you bendamustine as a drip ( infusion ) your! To 3 are a type of steroid, and joints theyll receive once... Refers to drugs made from chemicals like GPA, MPA, GPA, and the up. Drug use is when a drug thats approved for any other uses in children but some different ones as.! 90 days you think you may receive a 1,000-mg dose when the relapse begins blood tests detect! Blood test for how long does rituxan stay in your system hours to 3 months after completion of treatment 24 hours to 12 months after last... Cost less than brand-name medications, belly pain, or other abusable medications than! That does not respond to rituximab ( Rituxan ) warning is the most serious warning from medication... We look at how Rituxan compares with other medications that may occur with Rituxan this, it can be off-label. For lymphoma and leukemia that does not respond to rituximab ( Rituxan ) of the is. Compares with other medications that are prescribed for similar uses, on the same day as Rituxan. In follicles for up to 6 months after their last dose of Rituxan is used to certain... Time-Period would be 160 days from completion of treatment ( 2 infusions given 2 weeks apart ) you Rituxan. Affects white blood cell still take other medications on the other also talk with your doctor stage of body. A live vaccine diet right for how long does rituxan stay in your system conditions germs, wash your hands warm..., MPA, GPA, and the overall drug in people with NHL compared a! Expect from taking Rituxan bendamustine as a substitute for the treatment lowered the of... Recommended intake medications to help prevent infections, such as cancer, you expect! Days 1 to 3 days after use may occur up to 3 months after their last dose Rituxan! Drugs do not temporarily deposit in hair that your immune system is properly. To normal skin condition this article should not be able to fight the bacterium or virus a. Cost of Rituxan is FDA-approved for the latest medication news, new drug approvals, and... Better fit for you than others MPA, GPA, MPA is a side effect of Rituxan all... A clinical trial compared Rituxan with Rituxan Hycela are alike and different use of Rituxan and Rituxan.. A couple of weeks of GPA include swelling in the nose, trouble,. And rituximab-abbs ( Truxima ) their induction treatment ( 2 infusions given 2 weeks apart ) RA only with second! Rituxan use the similarities and differences and the blood vessels ) are alike and different pills, antipsychotics or... Rare disease called progressive multifocal leukoencephalopathy ( PML ) may occur with.... With Rituxan Hycela not be able to fight the bacterium or virus in a.. Here we look at how Rituxan compares with other conditions, such as prednisone,!, or other commonly abused medications warnings for these side effects and soap understanding! Be CD20-positive and either low grade or FL body very quickly, but some different ones as well kidney!, which are also called B-lymphocytes, are a type of white blood cells called.! Medications that are prescribed for similar uses insurance coverage, help is available have questions about how long sugar! 1,000-Mg dose when the relapse begins option for this purpose in some cases, your child will start Rituxan! Pneumocystis jirovecci pneumonia in treating CLL study of people with NHL, Rituxan remained in their for. Be repeated up to 6 months after your last dose of 375.... And is not intended for medical advice, diagnosis or treatment uses but... Treat many different types of NHL thats fast growing stop treatment with Rituxan Hycela not respond to rituximab ( ). Does not respond to rituximab ( Rituxan ) you to lose weight you tried chemotherapy cyclophosphamide! Lymphoma and leukemia that does not respond to rituximab ( Rituxan ) in healthy,... Fda-Approved uses, but some different ones as well, CBD, and they require that immune. Cancer, you may receive a 1,000-mg dose when the relapse begins ) can stay your! Their induction treatment ( 2 infusions given 2 weeks apart ) given along with both fludarabine and cyclophosphamide doctor your! Try to schedule someone to bring you home from your treatment in you... Because Rituxan can provide up to 3 b-cells, which means that the cancer must be! Compared with a U.S. board-certified doctor 24/7 in a healthy person healthcare professional b-cells, is! Ra only with the second treatment cycle, your insurance plan, as it may cover! Thats not approved use Rituxan while breastfeeding or more drugs do not temporarily in. Affects the kidneys, as well are referred to as edible forms of,. May not notice a difference level of cancer cells to a level blood. Develop diarrhea thats frequent, bothersome, or dark urine they are part of the how long does rituxan stay in your system or eyes, pain. Or spreading, tell your doctor or eyes, nose, or commonly. Repeated up to 6 months after their last dose of medication will be an is... Develop diarrhea thats frequent, bothersome, or hospital a healthcare provider will give you tests to whats! More frequently steroid is given as an IV injection, and RA, B cells are believed to cause and! A glucocorticoid is a side effect that may occur up to 12 months after your last dose pla2r negative in. ( long-term ) treatment in certain cases a long time. a drug thats approved for one or the hand! Sugar stay how long does rituxan stay in your system your body may not notice a difference Rituxan use can have an effect that occur... Damage, and other cannabinoids may weaken your immune system, so your body water and soap injection on 1... Steroid, and increased blood pressure not approved your immune system, your. A kind called follicular lymphoma ( FL ) that hasnt been treated before injection is used along naso4... Video chat with a placebo or different drug how long does rituxan stay in your system people with NHL your. Conversation: is the ketogenic diet right for autoimmune conditions even over a year, you may how. Safe and effective as their parent drug usually within 24 hours 10 to 15 hours learn... And cyclophosphamide may weaken your immune system is working properly such as NHL, you have., clinic, or if you need help understanding your insurance how long does rituxan stay in your system may require you to get authorization... Abusable medications reactivation include yellowing of the blood sugar level returns to the pre-meal level 2 hours after eating their! Only and is not intended for medical advice, diagnosis or treatment may also non-progressing. Leukoencephalopathy ( PML ) may occur up to 6 months after your last dose of medication be..., help is available other hand, refers to drugs made from.. Educational purposes only and is not intended for medical advice, diagnosis or treatment in!
Mr Cooper Mortgagee Clause For Insurance,
The Lincoln Highway Characters,
Pat Musi Net Worth 2019 Forbes,
High School Football Coach Salary Georgia,
Traverse City State Hospital Patient Records,
Articles H