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Cayston

aztreonam
Used for Cystic Fibrosis
Used for Cystic Fibrosis

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.

Last reviewed on January 31, 2022
basics-icon

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.

Are you looking for information on aztreonam intravenous (IV) injection instead?

Drug Facts

Common BrandsCayston
Drug ClassAntibiotic
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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What are the 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%)

Other Side Effects

  • Bronchospasm (narrowing of your airways)
  • Rash

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

Source: DailyMed

The following 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:

More common

Chest discomfort

cough

difficulty with breathing or troubled breathing

fever

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:

More common

Abdominal or stomach pain

sore throat

stuffy nose

vomiting

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

Pros and cons of Cayston (aztreonam)

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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

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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

Pharmacist tips for Cayston (aztreonam)

pharmacist
  • 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.

                faqs

                Frequently asked questions about Cayston (aztreonam)

                What is cystic fibrosis?
                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.
                Do all CF patients need to take Cayston (aztreonam)?
                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.
                How is Cayston (aztreonam) administered?
                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.
                Can I stop using Cayston (aztreonam) once I feel better?
                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.
                Can I use Cayston (aztreonam) if I'm pregnant?
                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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                What are the 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.

                risk-warning

                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.

                  risk-warning

                  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.

                  dosage

                  Cayston (aztreonam) dosage forms

                  Typical dosing 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

                  Interactions between Cayston (aztreonam) and other drugs

                  Cayston (aztreonam) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Cayston (aztreonam). Please note that only the generic name of each medication is listed below.

                  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.

                  alternatives

                  What are alternatives to Cayston (aztreonam)?

                  There are a number of medications that your doctor can prescribe in place of Cayston (aztreonam). Compare a few possible alternatives below.
                  Cayston (aztreonam)
                  Used for:
                  • Improve breathing symptoms in people with cystic fibrosis (CF) with Pseudomonas aeruginosa in the lungs

                  Used for:
                  • Cystic fibrosis (CF) with Pseudomonas aeruginosa bacterial infection

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