Biologics are a type of medication that targets parts of your immune system that are involved in psoriasis and psoriatic arthritis. The Food and Drug Administration (FDA) has approved both Taltz and Humira to treat moderate to severe plaque psoriasis. There arent any herbs or supplements that have been specifically reported to interact with Taltz. RA is a disease in which your immune system attacks your joints, making them swollen, stiff, and painful. If you have symptoms of other infections, such as a fever, or if you get infections that keep coming back, tell your doctor. Plaque psoriasis is the most common form of psoriasis. Can Salmon Last 3 Days in the Fridge? Know that you can keep Taltz at room temperature up to 86F (30C) for up to 5 days. For more information on these conditions, see the Taltz uses section above. Taking Taltz with warfarin might make your warfarin less effective. Medicines that interact with Taltz may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Taltz. Note: For more information about the conditions mentioned here, see the Taltz uses section above. Last updated on March 31, 2023. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. Taltz can weaken your immune system. The following lists contain some of the key side effects that may occur while taking Taltz. (2020). Taltz is available in one strength: 80 milligrams per milliliter (mg/mL). This can lead to different problems, depending on the type of vaccine. Because of this, its best to get any vaccines you may need, live or inactive, before you start treatment with Taltz. This helps prevent others, including children and pets, from taking the drug by accident. The actual price youll pay depends on your insurance plan, your location, and the pharmacy you use. You will receive Taltz and Skyrizi as injections under the skin. Using more than this can lead to serious side effects. Taltz works on a part of the immune system thats known to cause some of this joint inflammation (swelling). Turn the lock ring to the unlock position, and when ready, activate the injection by pressing the green injection button. If somebody else is giving you your injection they can also administer it into the outer area of your upper arm. They can give you tips on how to deal with any side effects that may be bothersome. One clinical study looked at both Taltz and Humira in people with active psoriatic arthritis. For most people who are starting treatment for active psoriatic arthritis, the 2018 guidelines recommend using TNF-alpha blockers (such as Humira) over interleukin-17 blockers (such as Taltz). Taltz treats certain forms of psoriasis and arthritis by affecting part of your immune system. Note: To learn more about psoriatic arthritis, see the Taltz uses section below. Examples of other drugs that may be used to treat non-radiographic axial spondyloarthritis (nr-axSpA) include: Note: To learn more about nr-axSpA, see the Taltz uses section above. Questions you might want to ask your doctor about Taltz include: To learn more about Taltz, see these articles: Here are a few other Healthline articles you might find helpful: To get information on different conditions and tips for improving your health, subscribe to any of Healthlines newsletters. Shining UV light on the skin can suppress inflammation and may help clear plaques. However, itll probably take a few weeks for you to notice any changes. With psoriasis, your immune system attacks your skin, causing inflamed, scaly, itchy patches. The 2019 guidelines state that Humira may also be better than Taltz for plaque psoriasis that affects the scalp and for erythrodermic psoriasis (a very rare type of psoriasis). Other interactions can increase side effects or make them more severe. In addition to Cosentyx (above), Humira is another drug that has some uses similar to those of Taltz. You may have a skin reaction in the area where you inject doses of Taltz. What are some frequently asked questions about Taltz? Even when fully cooked, bad salmon still poses a high risk of food poisoning.. People with these forms of psoriasis and arthritis often have high levels of this protein in their bodies. Do not put Taltz back in the fridge once its been kept at room temperature. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Your doctor will recommend the dosage thats right for you. These infections may need to be treated before you can start treatment with Taltz. Humira contains adalimumab, which is a tumor necrosis factor-alpha blocker. But call 911 or your local emergency number if your symptoms feel life threatening or if you think youre having a medical emergency. Taltz is a prescription medication used to treat adults: with moderate to severe plaque psoriasis and who may benefit from taking injections or pills (systemic therapy) or phototherapy (treatment using ultraviolet or UV light) with active psoriatic arthritis (can be used alone or with the medicine methotrexate) Taltz is a monoclonal antibody that reduces inflammation and may be used to treat conditions such as psoriasis, psoriatic arthritis, or ankylosing spondylitis. Serious side effects of Taltz that have been reported include: Learn more about some of the side effects Taltz may cause. They may adjust your dosage of warfarin if needed. Both Taltz and Humira are also FDA-approved to treat active psoriatic arthritis in adults. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. In people who received Taltz treatment for 60 weeks, 57% got an infection compared to 32% who received a placebo. Often, nearby joints are also affected, especially the two joints that connect your lower spine to your pelvis (sacropelvic joints). If you have psoriasis, your doctor may want to monitor your liver function closely. Humira contains adalimumab, which is a type of drug called a tumor necrosis factor-alpha (TNF-) blocker. Letting the medication warm up can help with injection discomfort. And about half the people with psoriatic arthritis who took Taltz had less severe symptoms and better physical function by 12 weeks after the start of treatment. Scientists use genetic rewiring to increase lifespan of cells, Beyond amyloid and tau: New targets in developing dementia treatments, Napping longer than 30 minutes linked to higher risk of obesity and high blood pressure, Activity 'snacks' could lower blood sugar, complication risk in type 1 diabetes, In Conversation: Investigating the power of music for dementia. Taltz is approved to treat these two forms of, In addition, both Taltz and Cosentyx are approved for treating non-radiographic axial, https://www.psoriasis.org/about-psoriasis, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=77c4b13e-7df3-42d4-81db-3d0cddb7f67a, https://onlinelibrary.wiley.com/doi/full/10.1002/art.40753, https://www.fda.gov/Drugs/ResourcesForYou/Consumers/BuyingUsingMedicineSafely/EnsuringSafeUseofMedicine/SafeDisposalofMedicines/ucm186187.htm, https://www.fda.gov/drugs/resourcesforyou/specialfeatures/ucm481139.htm, https://www.jaad.org/article/S0190-9622(18)33002-0/fulltext, https://www.fda.gov/drugs/questions-and-answers-fdas-adverse-event-reporting-system-faers/fda-adverse-event-reporting-system-faers-public-dashboard, https://www.karger.com/Article/FullText/479163, https://www.psoriasis.org/advance/how-cigarettes-and-alcohol-affect-psoriasis, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=608d4f0d-b19f-46d3-749a-7159aa5f933d, https://link.springer.com/article/10.1007/s00296-016-3480-9, https://www.jaad.org/article/S0190-9622(18)33001-9/fulltext, https://ascpt.onlinelibrary.wiley.com/doi/abs/10.1038/clpt.2008.302, https://www.aad.org/public/diseases/scaly-skin/psoriasis/diagnosis-and-treatment-of-psoriasis/biologics, https://www.niams.nih.gov/health-topics/psoriatic-arthritis, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3908707/, https://journals.sagepub.com/doi/10.1177/2475530318812244, https://clinicaltrials.gov/ct2/show/NCT03151551, https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ac96658a-d7dc-4c7c-8928-2adcdf4318b2, https://www.tandfonline.com/doi/full/10.1080/14712598.2019.1605352, https://onlinelibrary.wiley.com/doi/full/10.1111/bjd.16140, New clues to slow aging? Its not known if Taltz passes into human breast milk or if it affects how your body makes breast milk. You should store Taltz in the refrigerator. In clinical studies, Crohns disease occurred in 0.1% of people who received Taltz. You should be able to see the gray plunger at the top of the clear base. But if your doctor thinks you are experiencing depression, you might need treatment for it. Half this group then took Taltz for another 48 weeks. With this type of SA, joint damage can be seen on X-rays. These allergic reactions included angioedema and urticaria (an itchy skin rash also known as hives). . When you get Taltz from the pharmacy, the pharmacist will add an expiration date to the label on the bottle. Taltz and Cosentyx are both brand-name drugs. For plaque psoriasis, Taltz is approved for use in adults and children ages 6 years and older. We link primary sources including studies, scientific references, and statistics within each article and also list them in the resources section at the bottom of our articles. Its suitable for people whose psoriasis may benefit from systemic treatment (therapy that affects your whole body) or phototherapy (light treatment). You can self-inject them after your doctor shows you how to do so. Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Psoriatic arthritis. Symptoms of minor infections may include: Its very important to see your doctor if the infection doesnt clear up. But in some cases, you may still have some psoriasis plaques (thick, red, scaly patches on your skin). They can also talk with you about other treatment options for your condition. a single-use vial thats given as an injection by your healthcare provider, increased risk of infections that may be serious, such as, psoriatic arthritis thats active (currently causing symptoms), you have plaque psoriasis and light therapy or treatments applied to your skin havent worked, you have psoriatic arthritis and anti-inflammatory treatments (which help reduce swelling) such as pain relievers or steroids havent worked, injection site reactions, such as redness and soreness around the injection area, blood problems, such as reduced numbers of, reduce the formation of plaques on your skin in, reduce inflammation (swelling) of your joints in psoriatic arthritis, non-radiographic axial spondyloarthritis, and active ankylosing spondylitis. But be sure to check with your pharmacist before using any. There are currently no generic forms of either drug. Examples of other drugs that may be used to treat ankylosing spondylitis (AS) include: Note: To learn more about AS, see the Taltz uses section above. This isn't surprising given that mayonnaise, often a main ingredient in pimiento cheese, doesn't freeze that well . Your doctor may prescribe Taltz for plaque psoriasis that could benefit from phototherapy or systemic therapy. So osteoarthritis wouldnt be helped by drugs, such as Taltz, that affect your immune system. Symptoms of a mild allergic reaction can include: A more severe allergic reaction is rare but possible. They can tell you about other medications that may work well for you. You will need to use Taltz more often than Skyrizi. Change your injection site each month so that you are not injecting into the same spot each time. Before your appointment, write down questions such as: How will Taltz affect my body, mood, or lifestyle? Note: To learn more about psoriatic arthritis and plaque psoriasis, see the Taltz uses section below. If youre sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while youre using Taltz. Systemic therapy is a treatment that affects your whole body and is taken by mouth or as an injection.) (2019). If you feel down, depressed, or anxious, be sure to talk to your doctor about it. See the section just above for information on this. Sometimes there's an underlying condition like psoriasis at play. Taltz contains ixekizumab, which is a type of drug called a humanized monoclonal antibody. Hold the clear base flat and firmly against your skin at the chosen injection site. Taltz can cause mild or serious side effects. It stops it from telling your immune system to attack cells in your skin and joints. Some of these infections can become serious. But they also have some different side effects. In comparison, 28% of people who took Humira had their symptoms improve by at least 50%. For plaque psoriasis, your first Taltz dose will be two 80-mg injections (for a total of 160 mg) on the same day. These can include: Weight gain or weight loss (not a side effect). Then youll be able to give following injections to yourself. After 52 weeks of treatment, 30% of people using Taltz had their symptoms reduced by 40% more. Reply Share React LiveLongAndProsper Jul 30, 2017 9:42 AM Watch TV or something while you're injecting. The condition develops in about 30% of people who have psoriasis. (An autoinjector is a device that injects a dose of medication when you press a button.). (An autoinjector is a device that injects a dose of medication when you press a button.) Symptoms of serious infection can include: Before starting Taltz treatment, your doctor will likely test you for TB. This can come in the form of psychological therapy or medication. Here, learn more about this type of psoriasis and, Psoriasis is a skin condition that causes itchy, inflamed, and scaly patches. If you have certain types of psoriasis or arthritis, your doctor may prescribe Taltz. TALTZ should be discarded if not used within this 5-day period. Note that this list is not all-inclusive and includes only common medications that may interact with Taltz. These two drugs are both called monoclonal antibodies. To learn about other mild side effects, talk with your doctor or pharmacist, or visit Taltzs medication guide. Make sure to tell your doctor if youre pregnant or are planning a pregnancy before you start treatment. Off-label use is when a drug thats approved to treat one condition is used to treat a different condition. They can discuss the potential risks and benefits of the drug with you. They can also talk with you about other treatment options for your condition. Symptoms of this condition include back and hip pain and stiffness. Humira can also be used for several other conditions, including rheumatoid arthritis and inflammatory bowel disease. Currently, the only medication approved to treat acne inversa is Humira (adalimumab). Serious side effects from Taltz arent common, but they can occur. Psoriasis and rheumatoid arthritis are autoimmune-related conditions. Heres some detail on some of the side effects this drug may or may not cause. weeks 2, 4, 6, 8, 10, and 12: 80 mg (one injection every 2 weeks) You . (A generic drug is an exact copy of the active drug in a brand-name medication.). And they want you to get the best care possible. Make sure theyre out of the reach of children. For Taltz to work well, its important to take it as your doctor prescribes. After your loading dose (at "week 0"), you'll get . Before you start Taltz, all your vaccinations should be up to date. And these conditions are both possible side effects of Taltz. If you have both psoriatic arthritis and plaque psoriasis, youll use the Taltz dosage and dosing schedule for moderate to severe plaque psoriasis. These symptoms include: Avoiding infections during Taltz treatment. Your dosing schedule for Taltz depends on the condition being treated. Its common to get mild infections from time to time while youre using Taltz. Maybe. But if you think youre having a medical emergency, call 911 or your local emergency number. Only inject into clear, healthy skin. Find answers to some commonly asked questions about Taltz. But if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room. For more details about the dosage of Taltz, refer to this article. Besides food, you can also help improve your immune system by adopting certain habits. Eli Lilly and Company. There is a lack of scientific studies to support its effectiveness. Taltz is not recommended during pregnancy unless the benefits outweigh the risks but tell your doctor immediately if you become pregnant while being administered Taltz. Taltz has a number of possible side effects, and some of them can be serious. If youre pregnant, breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor. Do not shake Taltz. For people with psoriatic arthritis, 57% of participants achieved an ACR20 (20% improvement in tender and swollen joint counts) by week 12, and 58% achieved an ACR20 by week 24. If you need financial support to pay for Taltz, or if you need help understanding your insurance coverage, help is available. IL-17 inhibition in axialspondyloarthritis: Current and future perspectives [Abstract]. For example, hair loss can result from psoriasis of the scalp. You may have questions about Taltz and your treatment plan. Check that the lock ring is in the lock position and then twist off the base cap in the direction of the arrows. You should refer to the prescribing information for Taltz for a complete list of interactions. Theres currently no cure for plaque psoriasis or psoriatic arthritis. Always keep Taltz in the original carton to protect it from light. Some peoples symptoms cleared up completely or became minor after 12 weeks. This study looked at treatment with Taltz compared with that of a placebo (treatment with no active drug). Before starting Taltz, your doctor will ask you if you have been exposed to tuberculosis (TB) in the past. a bad cough that lasts for 3 weeks or longer, you have plaques (thick, red, scaly patches) on more than 3% of your body, your psoriasis greatly affects your quality of life, treatments that are topical (applied to your skin) havent brought your psoriasis under control, non-radiographic axial spondyloarthritis (nr-axSpA), active ankylosing spondylitis (AS) or radiographic axial spondyloarthritis (r-axSpA). Tearing off leaves or stems and especially hulling the strawberries will expose the mold-prone juicy flesh to air and bacteria, speeding up the rotting process. 30% of people using Taltz had their symptoms reduced by 40% or more. 34% of participants achieved an ACR50 (50% improvement in tender and swollen joint counts) by week 12 and 40% achieved an ACR50 by week 24. To help reduce your risk for infection with Taltz: If you get any symptoms of infection while youre using Taltz, contact your doctor. Follow the instructions in the carton on how to take care of your medicine properly. These include: Note: For more information about the potential negative effects of Taltz, see the Taltz side effects section above. For more information, videos, and images of injection instructions, see the manufacturers website. If you dont understand something related to your condition or treatment, ask your doctor to explain it to you. They may adjust your dosage of cyclosporine if needed. However, weight loss can be a symptom of tuberculosis (TB) or inflammatory bowel disease (IBD). As an exception to this, the following side effects occurred more often in children than in adults: In the same study, Crohns disease occurred 0.9% more often in children taking Taltz than it occurred in children taking a placebo. For details about this use, see the section above called Taltz for moderate to severe plaque psoriasis.. A biologic is made from parts of living organisms. They can look into whats causing it. If you have any concerns about weight gain or weight loss, talk with your doctor. Ulcerative colitis and Crohns disease are forms of IBD. Taking Taltz with cyclosporine might make your cyclosporine less effective. If youd like to know more about how Taltz and Cosentyx compare, see this article. Examples of mild infections include: Symptoms of infection can vary depending on the type of infection you have. Its found in high levels in people with certain forms of psoriasis and arthritis. But they may include: Although rare, its possible to get serious infections such as pneumonia or tuberculosis (TB) while youre using Taltz. The Food and Drug Administration (FDA) has approved Taltz to treat: Taltz contains ixekizumab, which is a humanized IgG monoclonal antibody. These factors include what your insurance plan covers and which pharmacy you use. Taltz can weaken the activity of your immune system, so it can affect how your body responds to vaccines. Taltz's loading dose schedule for plaque psoriasis in adults is: week 0: 160 milligrams (mg), which is two 80-mg injections. Taltz may be used to reduce symptoms of moderate to severe plaque psoriasis in adults and children over the age of 6, active psoriatic arthritis in adults, and ankylosing spondylitis in adults. Because Taltz stops IL-17A from interacting with the IL-17 receptor, this could normalize the formation of CYP450 enzymes. As with all medications, the cost of Taltz can vary. Its approved to treat the following conditions: For plaque psoriasis, Taltz can be prescribed for adults and children ages 6 years and older. For more information on the possible side effects of Taltz, talk with your doctor or pharmacist. Taltz has few side effects, although it may increase the risk of infection. You can learn more about how we ensure our content is accurate and current by reading our. One specific process has to do with a protein called interleukin-17A. This is because the formation of CYP450 enzymes can be altered by increased levels of certain cytokines (such as IL-1, IL-6, IL-10, and IL-17) during chronic inflammation. Psoriatic arthritis is a form of arthritis in which one or more joints become swollen, painful, and stiff. If you have new or worsening symptoms of IBD, see your doctor. Symptoms of a mild allergic reaction can include: A more severe allergic reaction is rare but possible. However, your doctor may prescribe the drug off-label if other approved treatments havent worked for you. After that, your maintenance dosage will be one 80-mg injection once every 4 weeks for as long as your doctor recommends. Before taking Taltz, talk with your doctor about your health history. Report any symptoms such as diarrhea, abdominal pain, fever, blood in the stool, or weight loss to your doctor. But only Taltz is approved for treating non-radiographic axial spondyloarthritis in adults. (2015). If you have been shown how to self-inject Taltz, administer a dose once every month, preferably on the same day of the month, otherwise see your healthcare provider for a dose every month. Keep TALTZ where young children cannot reach it. Don't focus on the injection or the pain, just do it. Also, talk with your doctor about which drug is better for you. Taltz can interact with some other medications. Brand-name medications usually cost more than generics. Taltz isnt expected to interact with other drugs or supplements. For more information about taking Taltz during pregnancy, see the Taltz and pregnancy section above. Symptoms of a severe allergic reaction can include: In clinical studies, allergic reactions occurred in 0.1% or less of people who received Taltz. If theyre more severe or dont go away, talk with your doctor or pharmacist. If the prefilled autoinjector has been frozen, do not use it. If you have questions about treatment options for osteoarthritis, talk with your doctor. Your doctor will explain how you should use Taltz. Talk with your doctor about your health history before you use Taltz. Other infections included conjunctivitis (pink eye) and fungal infections, such as. Only 7% of the placebo group had no or minor symptoms. If you dont use a syringe or pen within 5 days, youll need to safely dispose of it. FDA adverse event reporting system (FAERS) public dashboard. benzodiazepines, such as alprazolam or clonazepam, chemotherapy agents, such as cyclophosphamide, methotrexate, or bleomycin, corticosteroids (such as prednisone or dexamethasone), heart medications such as amiodarone or flecainide, hormones such as levonorgestrel or norgestrel, immunosuppressants (such as azathioprine, cyclosporine, or tacrolimus), live vaccines and some other vaccines, such as BCG, cholera, measles, or hepatitis b vaccines, other biologics, such as adalimumab, golimumab, or infliximab, statins, such as atorvastatin or simvastatin. You could try to: For tips on maintaining a healthy immune system, read more here. But if you get one of these vaccines while youre using Taltz, the vaccine could be less effective than usual. If you have any symptoms of TB during your treatment, its important to call your doctor right away. Taltz stops IL-17A from interacting with the IL-17 receptor, which prevents inflammation. Below are commonly used dosages, but always use the dosage that your doctor prescribes. Infections are more likely to occur with Taltz because it affects the immune system, reducing its ability to respond to pathogens. Taltz contains ixekizumab, which is a type of drug called a monoclonal antibody. But you should follow your doctors instructions regarding this. Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. For more information and to find out if youre eligible for assistance, call 844-825-8966 or visit the program website. Is the ketogenic diet right for autoimmune conditions? Read more about the physical and mental health changes that may increase flare-ups, plus how. Taltz at room temperature reduces the risk of stinging. It must be stored in the refrigerator before use. Researchers found that about 40% of people who received Taltz for 12 weeks recovered from their depression symptoms. Examples of inactivated vaccines that your doctor might recommend you get before you start Taltz include: Taltz may not be right for you if you have certain medical conditions or other factors that affect your health. You should not get live vaccines while youre using Taltz. It can be more challenging to diagnose on black skin. If bacon has been sitting out for more than 2 hours . It helps clear up skin plaques in psoriasis. People prescribed Taltz can be taught how to self administer it by a healthcare professional. (See Taltz and live vaccines in the Taltz interactions section below to learn more.). Taltz contains ixekizumab, while Cosentyx contains secukinumab. Taltz starts working within a week with noticeable improvements usually seen after 4 weeks. You can self-inject them after your doctor shows you how to do so. When your immune system isnt strong enough to fight off germs, you may be more likely to get an infection. moderate to severe plaque psoriasis that is suitable for systemic therapy or phototherapy; for this use, the drug can be prescribed for adults and children ages 6 years and older, non-radiographic axial spondyloarthritis (nr-axSpA) in adults, active ankylosing spondylitis (AS), which is also called radiographic axial spondyloarthritis (r-axSpA); for this use, the drug can be prescribed for adults. Interleukin-17 causes your immune system to attack cells in your skin and joints. The drug may also make it easier for you to move about and do daily tasks, such as dressing, washing, eating, and walking. Taltz comes as a liquid solution inside prefilled syringes and autoinjectors. As with most drugs, some people can have an allergic reaction after taking Taltz. Food with antioxidants can help boost the activity of your immune system by decreasing the amount of free radicals your body creates. And these reactions may cause symptoms such as redness or pain. *, Also, its recommended that you get any vaccinations you need prior to Taltz treatment. During a power outage, frozen food will last longer than refrigerated foods. If you have TB, theyll treat it before you start using Taltz. 3 Below is a list of medications that can interact with Taltz. IBD is a group of conditions that cause inflammation in your digestive tract. For information about Taltzs effectiveness in treating the conditions listed above, see the Taltz uses section below. This will be 160 mg given as two 80-mg injections. Taltz comes as a liquid solution inside prefilled syringes and autoinjectors. In clinical studies, Crohns disease occurred in 0.1% of people with plaque psoriasis who received Taltz. They block the activity of a protein in your immune system called interleukin-17. You can also use the back of your upper arms, but you may need someone else to give you the injection. On rare occasions, using Taltz can cause you to develop inflammatory bowel disease (IBD). These vaccines cant cause an infection in people who get them. IL-17A mediates innate immunity (natural immunity) to infecting substances and it can also contribute to the development of chronic diseases characterized by inflammation, such as psoriasis and rheumatoid arthritis. But long-term treatment with Taltz may help control the symptoms of these conditions. Once stored at room temperature, it should not be put back in refrigerator. After 24 weeks, Taltz improved these symptoms by: Taltz is FDA-approved to treat moderate to severe plaque psoriasis in adults and children ages 6 years and older.
Senator Mark Warner Staff, Ochoa Brothers Sister, Articles H