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What special precautions should I follow?

• tell your doctor and pharmacist if you are allergic to pantoprazole, dexlansoprazole (Dexilant), esomeprazole (Nexium, in Vimovo), lansoprazole (Prevacid), omeprazole (Prilosec, in Zegerid), rabeprazole (AcipHex), any other medications, or any of the ingredients in pantoprazole tablets or granules. Ask your pharmacist for a list of the ingredients.
• tell your doctor if you are taking rilpivirine (Edurant, in Complera, Odefsey). Your doctor will probably tell you not to take pantoprazole if you are taking this medication.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: anticoagulants (blood thinners) such as warfarin (Coumadin, Jantoven), atazanavir (Reyataz), digoxin (Lanoxin), dasatinib (Sprycel), diuretics ('water pills'), erlotinib (Tarceva), iron supplements, ketoconazole (Nizoral), methotrexate (Trexall), mycophenolate mofetil (Cellcept), nelfinavir (Viracept), nilotinib (Tasigna), and saquinavir (Invirase). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you are being treated with antibiotic medications, or if you have or have ever had a low level of magnesium in your blood, . osteoporosis (a condition in which the bones become thin and weak and break easily), or lupus (condition in which the immune system attacks many tissues and organs including the skin, joints, blood, and kidneys).
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking pantoprazole, call your doctor.

What side effects can this medication cause?
Pantoprazole may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• headache
• nausea
• vomiting
• gas
• joint pain
• diarrhea
• dizziness

Some side effects may be serious. If you experience any of the following symptoms, call your doctor immediately, or get emergency medical help:

• blistering or peeling skin
• rash; hives; itching; swelling of the eyes, face, lips, mouth, throat, or tongue; difficulty breathing or swallowing; or hoarseness
• irregular, fast, or pounding heartbeat; muscle spasms; uncontrollable shaking of a part of the body; excessive tiredness; lightheadedness; seizures
• severe diarrhea with watery stools, stomach pain, or fever
• decreased urination or blood in urine
• joint pain and rash on cheeks or arms that gets worse in the sun

What special precautions should I follow?

• tell your doctor and pharmacist if you are allergic to loratadine, any other medications, or any of the ingredients in the type of loratadine you will be taking. Check the package label for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention medications for colds and allergies.
• tell your doctor if you have or have ever had asthma or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking loratadine, call your doctor.
• if you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that some brands of the orally disintegrating tablets may contain aspartame that forms phenylalanine.

What side effects can this medication cause?Loratadine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away :

• headache
• dry mouth
• nosebleed
• sore throat
• mouth sores
• difficulty falling asleep or staying asleep
• nervousness
• weakness
• stomach pain
• diarrhea
• red or itchy eyes

Some side effects may be serious. If you experience any of the following symptoms, stop taking loratadine and call your doctor immediately :

• rash
• hives
• itching
• swelling of the eyes, face, lips, tongue, throat, hands, arms, feet, ankles, or lower legs
• hoarseness
• difficulty breathing or swallowing
• wheezing

Symptoms of overdose may include :

• fast or pounding heartbeat
• drowsiness
• headache
• unusual body movements

Warning :

• Changes in Thinking and Behavior, Depression, and Suicidal Thoughts or Actions
• Suicidal Thoughts or Actions and Antidepressant Drugs
• Antidepressants may increase the risk of suicidal thoughts or actions in some children, teenagers, or young adults within the first few months of treatment. Depression or other serious mental illnesses are the most important causes of suicidal thoughts and actions. People who have (or have a family history of) bipolar illness, or suicidal thoughts or actions may have a particularly high risk. Pay close attention to any changes, especially sudden changes in mood, behaviors, thoughts, or feelings. Call your healthcare provider right away if symptoms such as anxiety, irritability, impulsivity, trouble sleeping, aggressive behavior or suicidal thoughts are new, worse or worry you. WELLBUTRIN XL has not been evaluated for use in patients under the age of 18.

Call your healthcare provider right away if you or your family member has any of the following symptoms especially if they are new, worse, or worry you :

• thoughts about suicide or dying
• attempts to commit suicide
• new or worse depression
• new or worse anxiety
• feeling very agitated or restless
• panic attacks
• trouble sleeping (insomnia)
• new or worse irritability
• acting aggressive, being angry, or violent
• acting on dangerous impulses
• an extreme increase in activity and talking (mania)
• other unusual changes in behavior or mood

What Other Important Information Should I Know About WELLBUTRIN XL?

• Seizures - There is a chance of having a seizure (convulsion, fit) with WELLBUTRIN XL, especially in people with certain medical problems or who take certain medicines. Do not take any other medicines while you are taking WELLBUTRIN XL unless your healthcare provider has said it is okay to take them. If you have a seizure while taking WELLBUTRIN XL, stop taking the tablets and call your healthcare provider right away.
• High blood pressure (hypertension) - Some people get high blood pressure, that can be severe, while taking WELLBUTRIN XL.
• Manic episodes - Some people may have periods of mania while taking WELLBUTRIN XL.
• If you have any of the following symptoms of mania, call your healthcare provider :
  • greatly increased energy
  • severe trouble sleeping
  • racing thoughts
  • reckless behavior
  • unusually grand ideas
  • excessive happiness or irritability
  • talking more or faster than usual

• Unusual thoughts or behaviors - Some patients may have unusual thoughts or behaviors while taking WELLBUTRIN XL, including delusions (e.g. believe you are someone else), hallucinations (seeing or hearing things that are not there), paranoia (feeling that people are against you), or feeling confused. If this happens to you, call your healthcare provider.
• Visual problems - Some people are at risk of glaucoma if they take Wellbutrin. You should see an eye doctor to determine whether you are at risk prior to starting therapy.
• If you experience any of the following symptoms you should see an eye doctor:
  • eye pain
  • changes in vision
  • swelling or redness in or around the eye

• Severe allergic reactions - Some patients have severe allergic reactions to WELLBUTRIN XL. Stop taking WELLBUTRIN XL and call your healthcare provider right away if you get a rash, itching, hives, fever, swollen lymph glands, painful sores in the mouth or around the eyes, swelling of the lips or tongue, chest pain, or have trouble breathing. These could be signs of a serious allergic reaction.
• Do not take WELLBUTRIN XL if you:
• have or had a seizure disorder or epilepsy.
• have or had an eating disorder such as anorexia nervosa or bulimia. are taking any other medicines that contain bupropion, including WELLBUTRIN or WELLBUTRIN SR, APLENZIN®, ZYBAN, FORFIVO XL. Bupropion is the same active ingredient that is in WELLBUTRIN XL.
• drink a lot of alcohol and abruptly stop drinking, or use medicines called sedatives (these make you sleepy), benzodiazepines, or anti-seizure medicines, and you stop using them all of a sudden.
• take a monoamine oxidase inhibitor (MAOI). Ask your healthcare provider or pharmacist if you are not sure if you take an MAOI, including the antibiotic linezolid.
• do not take an MAOI within 2 weeks of stopping WELLBUTRIN XL unless directed to do so by your healthcare provider.
• do not start WELLBUTRIN XL if you stopped taking an MAOI in the last 2 weeks unless directed to do so by your healthcare provider.
• are allergic to the active ingredient in WELLBUTRIN XL, bupropion hydrochloride, or to any of the inactive ingredients.

Uses of Wellbutrin XL :

• It is used to treat low mood (depression).
• It is used to treat seasonal affective disorder (SAD).
• It may be given to you for other reasons. Talk with the doctor.

More Common Side Effects :

• Anxiety
• dry mouth
• hyperventilation
• irregular heartbeats
• irritability
• restlessness
• shaking
• trouble sleeping

Less serious side effects may include :

• drowsiness, dizziness;
• sleep problems (insomnia);
• mild nausea, gas, heartburn, upset stomach, constipation;
• weight changes;
• decreased sex drive, impotence, or difficulty having an orgasm; or.
• dry mouth, yawning, ringing in your ears.

What is Lexapro tablets used for?Lexapro (escitalopram) is an antidepressant in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Escitalopram affects chemicals in the brain that may be unbalanced in people with depression or anxiety. Lexapro is used to treat anxiety in adults.

Dosage :

• Adults  - The recommended dose of Lexapro is 10 mg once daily. A fixed-dose trial of Lexapro demonstrated the effectiveness of both 10 mg and 20 mg of Lexapro, but failed to demonstrate a greater benefit of 20 mg over 10 mg
• Maintenance Treatment - "It is generally agreed that acute episodes of major depressive disorder require several months or longer of sustained pharmacological therapy beyond response to the acute episode. Systematic evaluation of continuing Lexapro 10 or 20 mg/day in adults patients with major depressive disorder who responded while taking Lexapro during an 8-week, acute-treatment phase demonstrated a benefit of such maintenance treatment

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Special Precautions Before Taking Atorvastatin :

• tell Your Doctor and Pharmacist if You are Allergic to Atorvastatin, Any other Medications, or Any of the Ingredients in Atorvastatin Tablets. Ask Your Pharmacist for a List of the Ingredients.
• tell Your Doctor and Pharmacist What Prescription and Nonprescription Medications, Vitamins, Nutritional Supplements, and Herbal Products You are Taking or Plan to Take. Be Sure to Mention Any of the Following: Antifungal Medications such as Itraconazole (sporanox) and Ketoconazole (nizoral); Boceprevir (victrelis); Cimetidine (tagamet); Clarithromycin (biaxin); Cobicistat-containing Medications (stribild); Colchicine (colcrys); Digoxin (lanoxin); Efavirenz (sustiva, in Atripla); Oral Contraceptives (birth Control Pills); other Cholesterol-lowering Medications such as Fenofibrate (tricor), Gemfibrozil (lopid), and Niacin (nicotinic Acid, Niacor, Niaspan); Certain Hiv Protease Inhibitors such as Darunavir (prezista), Fosamprenavir (lexiva), Lopinavir (in Kaletra), Nelfinavir (viracept), Ritonavir (norvir, in Kaletra), Saquinavir (invirase), and Tipranavir (aptivus); Medications that Suppress the Immune System such as Cyclosporine (neoral, Sandimmune); Rifampin (rifadin, Rimactane); Spironolactone (aldactone); and Telaprevir (incivek). Your Doctor May Need to Change the Doses of Your Medications or Monitor You Carefully for Side Effects. other Medications May also Interact with Atorvastatin, So Be Sure to Tell Your Doctor About all the Medications You are Taking, Even Those that Do Not Appear On this List.
• tell Your Doctor if You have Liver Disease. Your Doctor Will Order Laboratory Tests to See How Well Your Liver is Working Even if You Do Not Think You have Liver Disease. Your Doctor Will Probably Tell You Not to Take Atorvastatin if You have or have Had Liver Disease or if the Tests Show You May Be Developing Liver Disease.
• tell Your Doctor if You Drink More Than 2 Alcoholic Beverages Daily, if You are 65 Years of Age or Older, if You have Ever Had Liver Disease, and if You have or have Ever Had Muscle Aches or Weakness; Diabetes, Seizures, Low Blood Pressure, or Thyroid or Kidney Disease.
• tell Your Doctor if You are Pregnant or Plan to Become Pregnant. You Should Not Become Pregnant While You are Taking Atorvastatin. Talk to Your Doctor About Birth Control Methods that You Can Use During Your Treatment. if You Become Pregnant While Taking Atorvastatin, Stop Taking Atorvastatin and Call Your Doctor Immediately. Atorvastatin May Harm the Fetus.
• do Not Breast-feed While You are Taking this Medication.
• if You are Having Surgery, Including Dental Surgery, Tell the Doctor or Dentist that You are Taking Atorvastatin. if You are Hospitalized Due to Serious Injury or Infection, Tell the Doctor Who Treats You that You are Taking Atorvastatin.
• ask Your Doctor About the Safe Use of Alcoholic Beverages While You are Taking Atorvastatin. Alcohol Can Increase the Risk of Serious Side Effects.

Side Effects :

• diarrhea
• heartburn
• gas
• joint Pain
• forgetfulness or Memory Loss
• confusion

Some Side Effects Can Be Serious. the Following Symptoms are Uncommon, But if You Experience Any of Them, Call Your Doctor or Get Emergency Medical Help Immediately:

• muscle Pain, Tenderness, or Weakness
• lack of Energy
• fever
• chest Pain
• nausea
• extreme Tiredness
• weakness
• unusual Bleeding or Bruising
• loss of Appetite
• pain in the Upper Right Part of the Stomach
• flu-like Symptoms
• dark Colored Urine
• yellowing of the Skin or Eyes
• rash
• hives
• itching
• difficulty Breathing or Swallowing
• swelling of the Face, Throat, Tongue, Lips, Eyes, Hands, Feet, Ankles, or Lower Legs
• hoarseness

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Special Precautions Before taking amoxicillin :

• Tell your doctor and pharmacist if you are allergic to amoxicillin; penicillin antibiotics; cephalosporin antibiotics such as cefaclor, cefadroxil, cefazolin (Ancef, Kefzol), cefepime (Maxipime), cefixime (Suprax), cefotaxime (Claforan), cefotetan, cefoxitin (Mefoxin), cefpodoxime, cefprozil, ceftaroline (Teflaro), ceftazidime (Fortaz, Tazicef, in Avycaz), ceftibuten, ceftriaxone, cefuroxime (Ceftin, Zinacef), and cephalexin (Keflex); any other medications; or any of the ingredients in amoxicillin capsules, tablets, or suspension. Ask your pharmacist for a list of the ingredients.
• Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: allopurinol (Lopurin, Zyloprim), other antibiotics, anticoagulants ('blood thinners') such as warfarin (Coumadin, Jantoven), oral contraceptives, and probenecid (Probalan, in Col-Probenecid). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• Tell your doctor if you have mononucleosis (a virus; also called 'mono') and if you have or have ever had kidney disease, allergies, asthma, hay fever, or hives.
• Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking amoxicillin, call your doctor.
• If you have phenylketonuria (PKU, an inherited condition in which a special diet must be followed to prevent mental retardation), you should know that some amoxicillin chewable tablets are sweetened with aspartame that forms phenylalanine.

What side effects can this medication cause?Amoxicillin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• Nausea
• Vomiting
• Diarrhea
• Changes in taste
• Headache

Some side effects can be serious. If you experience any of these symptoms, stop taking amoxicillin and call your doctor immediately or get emergency medical treatment :

• Rash
• Skin blisters or peeling
• Itching
• Hives
• Wheezing

Difficulty swallowing or breathingSwelling of the face, throat, tongue, lips, and eyes Severe diarrhea (watery or bloody stools) that may occur with or without fever and stomach cramps (may occur up to 2 months or more after your treatment) Amoxicillin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

Symptoms of overdose may include the following :

• Cloudy or bloody urine
• Decreased urination
• Swelling of any part of the body
• Confusion
• Nausea
• Vomiting

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What special precautions should I follow?

• tell your doctor and pharmacist if you are allergic to ibuprofen, aspirin or other NSAIDs such as ketoprofen and naproxen (Aleve, Naprosyn), any other medications, or any of the inactive ingredients in the type of ibuprofen you plan to take. Ask your pharmacist or check the label on the package for a list of the inactive ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention the medications listed in the IMPORTANT WARNING section and any of the following: angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), captopril, enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (in Zestoretic), moexipril (Univasc), perindopril (Aceon, in Prestalia), quinapril (Accupril, in Quinaretic), ramipril (Altace), and trandolapril (Mavik, in Tarka); angiotensin receptor blockers such as candesartan (Atacand, in Atacand HCT), eprosartan (Teveten), irbesartan (Avapro, in Avalide), losartan (Cozaar, in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta), and valsartan (in Exforge HCT); beta blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran); diuretics ('water pills'); lithium (Lithobid); and methotrexate (Otrexup, Rasuvo, Trexall). Your doctor may need to change the doses of your medications or monitor you more carefully for side effects.
• do not take nonprescription ibuprofen with any other medication for pain unless your doctor tells you that you should.
• tell your doctor if you have or have ever had any of the conditions mentioned in the IMPORTANT WARNING section or asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the inside of the nose); heart failure; swelling of the hands, arms, feet, ankles, or lower legs; lupus (a condition in which the body attacks many of its own tissues and organs, often including the skin, joints, blood, and kidneys); or liver or kidney disease. If you are giving ibuprofen to a child, tell the child's doctor if the child has not been drinking fluids or has lost a large amount of fluid from repeated vomiting or diarrhea.
• tell your doctor if you are pregnant, especially if you are in the last few months of your pregnancy; you plan to become pregnant; or you are breast-feeding. If you become pregnant while taking ibuprofen, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ibuprofen.
• if you have phenylketonuria (PKU, an inborn disease in which mental retardation develops if a specific diet is not followed), read the package label carefully before taking nonprescription ibuprofen. Some types of nonprescription ibuprofen may be sweetened with aspartame, a source of phenylalanine.

What side effects can this medication cause?Ibuprofen may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• constipation
• diarrhea
• gas or bloating
• dizziness
• nervousness
• ringing in the ears

Some side effects can be serious. If you experience any of the following symptoms, or those mentioned in the IMPORTANT WARNING section, call your doctor immediately. Do not take any more ibuprofen until you speak to your doctor.

• unexplained weight gain
• shortness of breath or difficulty breathing
• swelling of the abdomen, feet, ankles, or lower legs
• fever
• blisters
• rash
• itching
• hives
• swelling of the eyes, face, throat, arms, or hands
• difficulty breathing or swallowing
• hoarseness
• excessive tiredness
• pain in the upper right part of the stomach
• nausea
• loss of appetite
• yellowing of the skin or eyes
• flu-like symptoms
• pale skin
• fast heartbeat
• cloudy, discolored, or bloody urine
• back pain
• difficult or painful urination
• blurred vision, changes in color vision, or other vision problems
• red or painful eyes
• stiff neck
• headache
• confusion
• aggression

Symptoms of overdosage may include :

• dizziness
• fast eye movements that you cannot control
• slow breathing or short periods of time without breathing
• blue color around the lips, mouth, and nose

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What Special precautions Before taking clindamycin ?

• tell your doctor and pharmacist if you are allergic to clindamycin, lincomycin (Lincocin), any other medications, or any of the ingredients in clindamycin capsules or solution. Ask your pharmacist for a list of the ingredients. If you will be taking clindamycin capsules, tell your doctor if you are allergic to aspirin or tartrazine (a yellow dye found in some medications).
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention clarithromycin (Biaxin, in PrevPac), erythromycin (E.E.S, E-Mycin, Erythrocin, others), indinavir (Crixivan), itraconazole (Sporanox), ketoconazole (Nizoral), nefazodone, nelfinavir (Viracept), rifampin (Rifadin, in Rifamate, in Rifater, Rimactane), and ritonavir (Norvir, in Kaletra). Your doctor may need to change the doses of your medications or monitor you carefully for side effects. Many other medications may also interact with clindamycin, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list.
• tell your doctor if you have or have ever had asthma, allergies, eczema (sensitive skin that often becomes itchy or irritated) or kidney or liver disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking clindamycin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking clindamycin.

What side effects can this medication cause?Clindamycin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away :

• nausea
• vomiting
• unpleasant or metallic taste in the mouth
• joint pain
• pain when swallowing
• heartburn
• white patches in the mouth
• thick, white vaginal discharge
• burning, itching, and swelling of the vagina

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical treatment :

• peeling or blistering skin
• rash
• hives
• itching
• difficulty breathing or swallowing
• hoarseness
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• yellowing of the skin or eyes
• decreased urination

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Uses : for the temporary relief of minor aches and pains due to:

• Headache
• Muscular aches
• Backache
• Minor pain of arthritis
• The common cold
• Toothache
• Premenstrual and menstrual cramps
• Temporarily reduces fever.

Warnings : Liver warning

• This product contains acetaminophen. Severe liver damage may occur if adult takes more than 12 tablets in 24 hours, which is the maximum daily amount child takes more than 5 doses in 24 hours taken with other drugs containing acetaminophen adult has 3 or more alcoholic drinks every day while using this product Do not use with any other drug containing acetaminophen (prescription or nonprescription). If you are not sure whether a drug contains acetaminophen, ask a doctor or pharmacist. if you are allergic to acetaminophen or any of the inactive ingredients in this product
• Ask a doctor before use if the user has liver disease.
• Ask a doctor or pharmacist before use if the user is taking the blood thinning drug warfarin.
• Stop use and ask a doctor if Pain gets worse or lasts more than 10 days in adults and children Pain gets worse or lasts more than 5 days in children under 12 years Fever gets worse or lasts more than 3 days New symptoms occur Redness or swelling is present These could be signs of a serious condition.
• If pregnant or breast-feeding, ask a health professional before use.
• Keep out of reach of children.

Side Effects : For the Consumer
Applies to acetaminophen: capsule, capsule liquid filled, elixir, liquid, powder, powder for solution, solution, suppository, suspension, syrup, tablet, tablet chewable, tablet disintegrating, tablet effervescent, tablet extended release

Other dosage forms :

• Intravenous solution : Along with its needed effects, acetaminophen may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking acetaminophen:

Rare :

• Bloody or black, tarry stools
• bloody or cloudy urine
• fever with or without chills (not present before treatment and not caused by the condition being treated)
• pain in the lower back and/or side (severe and/or sharp)
• pinpoint red spots on the skin
• skin rash, hives, or itching
• sore throat (not present before treatment and not caused by the condition being treated)
• sores, ulcers, or white spots on the lips or in the mouth
• sudden decrease in the amount of urine
• unusual bleeding or bruising
• unusual tiredness or weakness
• yellow eyes or skin

Get emergency help immediately if any of the following symptoms of overdose occur while taking acetaminophen

Symptoms of Overdose :

• Diarrhea
• increased sweating
• loss of appetite
• nausea or vomiting
• stomach cramps or pain
• swelling, pain, or tenderness in the upper abdomen or stomach area

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