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Initial investigation

Conduct an initial investigation of
patients with chronic cough (>8 weeks) to assess patient history, which includes any red flags (shown below), occupational and environmental issues, travel exposures, physical exam, and chest radiograph. Always consider
smoking history, medications known to cause cough, and whether the cause of cough suggests a life-threatening condition.9

Underlying conditions

In patients whose initial assessment
does not reveal factors that may
contribute to cough, further
investigation into common underlying conditions (eg, asthma, GERD, UACS [postnasal drip], NAEB) is needed.9


Other investigations may be considered including swallow evaluations, sinus imaging, cardiac workup, and occupation assessments9

GERD, gastroesophageal reflux disease; UACS, upper airway cough syndrome; NAEB, nonasthmatic eosinophilic bronchitis

If cough persists

If cough persists despite appropriate investigation and treatment for underlying conditions, consider referral to a cough clinic for investigation of refractory chronic cough or unexplained chronic cough.9

What is DIFICID® (fidaxomicin)?

DIFICID is an antibiotic medicine used to treat an infection called Clostridioides difficile-associated diarrhea (CDAD) in adults and children 6 months of age and older.

  • DIFICID is not to be used to treat other types of infections in the body.
  • Sometimes infections are caused by viruses rather than bacteria. Antibiotic medicines including DIFICID do not kill viruses.
  • It is not known if DIFICID is safe and effective in children under 6 months old.

Important Safety Information

  • Do not take DIFICID if you are allergic to fidaxomicin, or any other ingredient in DIFICID.
  • Tell your doctor before you take DIFICID if you are pregnant or plan to become pregnant, are breastfeeding or plan to breastfeed. It is not known if DIFICID will harm your baby while you are pregnant or if DIFICID passes into breast milk. You and your doctor should decide together if you will take DIFICID if you are pregnant or breastfeeding.
  • Know the medicines you take. Keep a list of your medicines to show your doctor and pharmacist when you get a new medicine.
  • DIFICID can cause serious side effects, including allergic reaction. If you get a severe allergic reaction while taking DIFICID, including problems breathing or shortness of breath, rash, itching or hives, or swelling of the mouth, throat, or face, stop taking DIFICID and get emergency help right away.
  • The most common side effects of DIFICID in adults include nausea, vomiting, stomach pain, bleeding in the stomach or intestines, low red blood cell count (anemia), and low white blood cell count (neutropenia).
  • The most common side effects of DIFICID in children include fever, vomiting, diarrhea, stomach pain, constipation, rash, and high levels of enzymes called aminotransferases in the blood which may indicate liver damage.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please read the accompanying Patient Information for DIFICID® and discuss it with your health care professional. The physician Prescribing Information also is available.

Having trouble paying for your Merck medicine? Merck may be able to help. Visit merckhelps.com.

What is DIFICID® (fidaxomicin)?

DIFICID is an antibiotic medicine used to treat an infection called Clostridioides difficile-associated diarrhea (CDAD) in adults and children 6 months of age and older.

  • DIFICID is not to be used to treat other types of infections in the body.
  • Sometimes infections are caused by viruses rather than bacteria. Antibiotic medicines including DIFICID do not kill viruses.
  • It is not known if DIFICID is safe and effective in children under 6 months old.

DIFICID is an antibiotic medicine used to treat an infection called Clostridioides difficile-associated diarrhea (CDAD) in adults and children 6 months of age and older.DIFICID is an antibiotic medicine used to treat an infection called Clostridioides difficile-associated diarrhea.

DIFICID is an antibiotic medicine used to treat an infection called Clostridioides difficile-associated diarrhea (CDAD) in adults and children 6 months of age and older.DIFICID is an antibiotic medicine used to treat an infection called Clostridioides difficile-associated diarrhea (CDAD) in adults and children 6 months of age and older.

Important Safety Information

  • Do not take DIFICID if you are allergic to fidaxomicin, or any other ingredient in DIFICID.
  • Tell your doctor before you take DIFICID if you are pregnant or plan to become pregnant, are breastfeeding or plan to breastfeed. It is not known if DIFICID will harm your baby while you are pregnant or if DIFICID passes into breast milk. You and your doctor should decide together if you will take DIFICID if you are pregnant or breastfeeding.
  • Know the medicines you take. Keep a list of your medicines to show your doctor and pharmacist when you get a new medicine.
  • DIFICID can cause serious side effects, including allergic reaction. If you get a severe allergic reaction while taking DIFICID, including problems breathing or shortness of breath, rash, itching or hives, or swelling of the mouth, throat, or face, stop taking DIFICID and get emergency help right away.
  • The most common side effects of DIFICID in adults include nausea, vomiting, stomach pain, bleeding in the stomach or intestines, low red blood cell count (anemia), and low white blood cell count (neutropenia).
  • The most common side effects of DIFICID in children include fever, vomiting, diarrhea, stomach pain, constipation, rash, and high levels of enzymes called aminotransferases in the blood which may indicate liver damage.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

Please read the accompanying Patient Information for DIFICID® and discuss it with your health care professional. The physician Prescribing Information also is available.

Having trouble paying for your Merck medicine? Merck may be able to help. Visit merckhelps.com.

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Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua. Rutrum tellus pellentesque eu tincidunt. Bibendum enim facilisis gravida neque. Velit scelerisque in dictum non consectetur a erat.