Cayston
Cayston (aztreonam) is an inhaled antibiotic given through a nebulizer. It's used to treat a lung infection caused by bacteria called Pseudomonas aeruginosa in people with cystic fibrosis. Cayston (aztreonam) is taken three times per day for 28 days, and then you go off of the medication for 28 days. It's currently only available as a brand medication, so it can be expensive.
What is Cayston (aztreonam)?
What is Cayston (aztreonam) used for?
- Improve breathing symptoms in people with cystic fibrosis (CF) with Pseudomonas aeruginosa in the lungs
How Cayston (aztreonam) works
Cayston (aztreonam) is a monobactam antibiotic that works by preventing bacteria from being able to make a cell wall around them. This causes the bacteria to die.
Drug facts
Side effects of Cayston (aztreonam)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Cough (54%)
- Stuffy nose (16%)
- Wheezing (16%)
- Throat pain (12%)
- Fever (13%)
- Chest discomfort (8%)
- Stomach pain (7%)
- Vomiting (6%)
Less Common Side Effects
- Bronchospasm (narrowing of your airways)
- Rash
Cayston (aztreonam) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reactions: hives, itching, swelling of face or tongue, difficulty breathing
- Bronchospasm (narrowing of your airways): difficulty breathing, wheezing, chest pain or tightness, fatigue, cough
The following Cayston (aztreonam) side effects have also been reported
Along with its needed effects, a medicine 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:
Less common
Noisy breathing
shortness of breath
tightness in the chest
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Rash
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Cayston (aztreonam)
Pros
- Taken for 28 days followed by 28 days off
- Can be used in children as young as 7 years old
- Can be stored at room temperature for up to 28 days
- Can be taken with or without food
Cons
- Available as a brand-name medication only, which can be expensive
- Needs to be taken 3 times per day with a dose of a bronchodilator before doses
- If you're taking multiple breathing medications, there needs to be specific order in which you take Cayston (aztreonam).
- Needs to be used with a specific nebulizer
Pharmacist tips for Cayston (aztreonam)
- You should receive training from your provider or pharmacist on how to give yourself Cayston (aztreonam). Make sure you know how to give yourself Cayston (aztreonam) correctly and safely so you have the best chance at improving your breathing symptoms. Carefully read the instructions for use, and contact your provider or pharmacist if you have any questions on how to use this medication.
- Make sure to use Cayston (aztreonam) 3 times per day for the full 28 days, even if you feel better. If you miss a dose, you should still try to take all 3 of the doses per day as long as the doses are at least 4 hours apart.
- Keep Cayston (aztreonam) in the carton to protect it from light and place it in the refrigerator. If you're traveling and don't have access to a refrigerator, Cayston (aztreonam) can be kept at room temperature for up to 28 days. Don't use Cayston (aztreonam) if it has been at room temperature for longer than 28 days.
- Only prepare a dose of Cayston (aztreonam) when you're ready to use it because it needs to be used right away after mixing the medication with the diluent provided. If you mixed the medication but aren't ready to use it, throw the dose away and mix again when you're ready. Never mix Cayston (aztreonam) with other medications in your nebulizer.
- You need to use a specific type of inhaler called a bronchodilator before taking your dose of Cayston (aztreonam). Bronchodilators will relax and open up your airways and lower your chance of trouble breathing after using Cayston (aztreonam). Depending on the type of bronchodilator you're prescribed, you'll need to use it between 15 minutes and 12 hours before your dose of Cayston (aztreonam). Medications such as albuterol (ProAir, Ventolin) or levalbuterol (Xopenex) should be taken 15 minutes to 4 hours before each dose of Cayston (aztreonam). Medications such as Serevent (salmeterol) or arformoterol (Brovana) should be taken 30 minutes to 12 hours before your dose of Cayston (aztreonam). Contact your pharmacist or provider if you have any questions about when you should use your inhaler before taking Cayston (aztreonam).
- If you use other inhaled medications for your CF, the recommended order is: 1) bronchodilators, 2) mucolytics, 3) Cayston (aztreonam). Ask your provider or pharmacist if you're not sure what order to take your medications.
- Each treatment will last about 2 to 3 minutes. When your treatment is complete, throw the empty vial, stopper, and saline ampule (the diluent provided) in the household garbage.
Common questions about Cayston (aztreonam)
Cystic fibrosis (CF) is a genetic condition that causes your mucus to be more thick and sticky. This makes it hard for your lungs to clear out mucus, which can lead to bacteria growing in your lungs, blockage of your airways, and digestion problems. These bacteria can cause lung infections, lung swelling (inflammation), breathing problems, and lung damage. In your digestive tract, this mucus can prevent proteins needed for digestion from getting into your intestine, which affects your body's ability to absorb nutrients. Some symptoms of CF include salty-tasting skin, a cough that doesn't go away, frequent lung infections, shortness of breath, and poor growth or weight gain. Treatment for CF typically focuses on thinning the mucus, preventing or treating infections, and improving breathing and digestion problems.
No, Cayston (aztreonam) is only used for people with CF who are growing a specific bacteria called Pseudomonas aeruginosa in their lungs. This bacteria is known to be resistant to many antibiotics, which can lead to severe and even deadly infections if not treated properly. Using Cayston (aztreonam) will help prevent this by stopping Pseudomonas aeruginosa from growing further in your lungs and causing severe infections.
You'll need to mix the medication with the provided diluent, put it in the nebulizer, and inhale the medication through the mouthpiece of the nebulizer. This helps the medication get directly into your lungs to treat the bacteria and improve your breathing.
Although your breathing symptoms can start to improve quickly after starting Cayston (aztreonam), it's important that you complete the entire course of therapy as prescribed by your provider. Skipping doses or stopping the medication earlier than prescribed can make the bacteria in your lungs harder to treat or make them develop resistance to the medication, which is when the bacteria escape the medications designed to treat them. If the bacteria develop resistance, there's a chance it can't be cleared by Cayston (aztreonam) or other antibiotics. This raises your risk for severe and life-threatening symptoms.
There haven't been any studies on how Cayston (aztreonam) specifically affects pregnant women so it's not known if the medication can harm your unborn baby. However, aztreonam, which is the main ingredient in Cayston (aztreonam), is also available as an IV injection and studies have shown no harm to unborn babies when the IV form was given to pregnant women. Additionally, since Cayston (aztreonam) is inhaled, it's unlikely for any of the drug to be absorbed into your body and cause harm to your unborn baby. If you're pregnant or thinking of getting pregnant, talk to your provider to see if Cayston (aztreonam) is right for you.
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Risks and warnings for Cayston (aztreonam)
Cayston (aztreonam) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic reactions
- Risk factor: Allergy to beta-lactam antibiotics (e.g., penicillins, cephalosporins, carbapenems)
Severe allergic reactions to Cayston (aztreonam) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using Cayston (aztreonam), get medical attention right away.
Bronchospasm (narrowing of your airways)
Inhaled medications, including Cayston (aztreonam), can cause bronchospasm, which is a muscle spasm in your lungs. This can cause difficulty breathing, wheezing, cough, and chest discomfort. To help prevent this, you should take a bronchodilator before your dose of Cayston (aztreonam). If you become short of breath after using Cayston (aztreonam), get medical attention right away.
Cayston (aztreonam) dosage
Typical dosage for Cayston (aztreonam)
The typical dose is 1 vial (75 mg) inhaled three times per day for a 28-day course, followed by 28 days off of Cayston (aztreonam). Cayston (aztreonam) should be inhaled using an Altera® Nebulizer System.
Interactions between Cayston (aztreonam) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
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