Inhaled aztreonam (Cayston®)

Why is this medication prescribed?
Inhaled aztreonam (Cayston®) belongs to a class of antibiotics called monobactams. Cayston® is a special, preservative-free formulation of aztreonam for inhalation used to treat or prevent bacterial infections.  

How does this medication work?
It is given by inhalation to decrease the amount of bacteria (Pseudomonas aeruginosa) in the lungs. The main goal is to improve or maintain lung function.

What is the usual dose?
The usual dose is 75 mg  three times a day via the Altera nebulizer system.

How should this medication be taken?
Your doctor may prescribe it for one month on, one month off, or continuously.  Take inhaled aztreonam (Cayston®) at approximately the same time everyday so that it is easier to remember. Each of the doses should be taken at least 4 hours apart. 

To prepare and take inhaled aztreonam (Cayston®) please also refer to Preparing Your Treatment and Taking Your Treatment.

Cayston® is the only product that should be used with the provided Altera nebulizer system. Do not use any other other medications in the Altera nebulizer system.

To prepare your dose of inhaled aztreonam (Cayston®):

1. Have one amber vial of Cayston® and one ampoule of diluent ready. Separate diluent ampoules by gently pulling them apart.

2. Ensure all the powder in the amber vial of Cayston® settles to the bottom by gently tapping the vial. Lift the metal flap on the top of the vial, and then pull the flap across and down to remove the entire metal ring and overcap from the vial. Safetly dispose of the ring and carefully remove the rubber stopper.

3. Twist off the plastic tip of the diluent ampoule. Squeeze the contents of the ampoule into the amber vial.

4. Replace the rubber stopper onto the amber vial, and gently swirl the vial until all the powder has dissolved. The liquid should be clear. Cayston® should be used immediately as soon as it is mixed.

5. Once your Altera nebulizer system is ready, remove the rubber stopper on the amber vial, and pour all of the solution into the medication reservoir. Gently tap the vial to completely empty the vial of all its contents.

If you are taking other inhaled medication(s), please take them in this order.

Note: DO NOT dilute Cayston®or mix it with any other medications. DO NOT reconstitute more than one dose at a time.Make sure to store Cayston® in your REFRIGERATOR. DO NOT FREEZE. If absolutely necessary (i.e. during transportation),  Cayston® can be stored at room temperature for up to 28 days away from heat, moisture and light.  DO NOT use Cayston® if it is cloudy, has particles in the solution, if it is expired, or if it has been stored outside of a refrigerator for more than 28 days.

After use, rinse your nebulizer well with warm water to prevent build up that can clog your nebulizer. For further instructions, see Cleaning and Disinfecting Your Equipment.

What should I do if I miss a dose?
Do not double any dose. If you forget to take a dose, take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the next scheduled dose.

What should I expect from this medication?
You may or may not experience side effects. These side effects may disappear but let your doctor know if they are severe or if they persist for more than 2 days. These can include hoarseness, chest tightness and wheezing, but tell us if you have any other side effects as well.

Precautions
Remember to tell your doctor if you have ever had a previous reaction to aztreonam, or any beta-lactam antibiotic or any inhaled medication in the past.

As well, if you are pregnant or think you may be pregnant discuss this with your CF doctor.

Patient Assistance Program
Gilead has an assistance program called Cayston PAP. For more information,  click here.  If you have further questions, please ask your social worker, pharmacist or doctor.