Cayston
What is Cayston?[edit | edit source]
- Cayston (Aztreonam) is a monobactam antibacterial used to improve breathing symptoms in people with cystic fibrosis (CF).
What are the uses of this medicine?[edit | edit source]
- CAYSTON is a prescription medicine that is used to improve breathing symptoms in people with cystic fibrosis (CF) who have a lung infection caused by a bacterium called Pseudomonas aeruginosa. CAYSTON contains an antibacterial medicine called aztreonam.
How does this medicine work?[edit | edit source]
- Aztreonam (az tree' oh nam) is a monocyclic beta-lactam compound (monobactam) that was originally isolated from Chromobacterium violaceum.
- It acts by binding to penicillin binding proteins inhibiting cell wall synthesis and decreasing bacterial growth.
- Aztreonam is active mostly against gram negative organisms and more closely resembles aminoglycosides rather than penicillins.
Who Should Not Use this medicine ?[edit | edit source]
This medicine cannot be used in patients:
- with a known allergy to aztreonam.
What drug interactions can this medicine cause?[edit | edit source]
- No formal clinical studies of drug interactions with CAYSTON have been conducted.
Is this medicine FDA approved?[edit | edit source]
- Aztreonam was approved for use in the United States in 1986 and is indicated in the treatment of various moderate-to-severe systemic or skin, intra-abdominal, genitourinary, and respiratory gram-negative infections.
- Aztreonam is available in generic forms and under the brand name Azactam as a powder or a solution for injection, and under the brand name Cayston as a powder for solution to use in inhalational therapy.
How should this medicine be used?[edit | edit source]
Recommended dosage:
- The recommended dose of CAYSTON for both adults and pediatric patients 7 years of age and older is one single-use vial (75 mg of aztreonam) reconstituted with 1 mL of sterile diluent administered 3 times a day for a 28-day course (followed by 28 days off CAYSTON therapy).
- Dosage is not based on weight or adjusted for age.
- Doses should be taken at least 4 hours apart.
Administration:
- Take CAYSTON exactly as your healthcare provider tells you. Do not change your dose or stop taking CAYSTON unless your healthcare provider tells you to.
- The dose for both adults and children 7 years of age and older is:
- 1 single-use vial of CAYSTON, mixed with 1 ampule of saline (diluent) inhaled 3 times a day using a hand-held Altera Nebulizer System.
- Each dose of CAYSTON should be taken at least 4 hours apart (for example: morning, after school, and before bed).
- CAYSTON should be taken for 28 days.
- CAYSTON is taken as a breathing treatment (inhalation) with the Altera Nebulizer System. Do not use any other nebulizer for your CAYSTON treatment.
- Do not mix or dilute CAYSTON with any other medicines in your Altera Nebulizer System.
- Do not mix CAYSTON with the saline until right before you are ready to use it.
- Do not mix more than 1 dose of CAYSTON at a time.
- Each treatment should take about 2 to 3 minutes.
- If you miss a dose of CAYSTON, you can still take all 3 daily doses as long as they are at least 4 hours apart.
- You should use an inhaled bronchodilator (a type of medicine used to relax and open your airways) before taking a dose of CAYSTON. If you do not have an inhaled bronchodilator, ask your healthcare provider to prescribe one for you.
- Take short-acting bronchodilators between 15 minutes and 4 hours before you take your dose of CAYSTON
- Take long-acting bronchodilators between 30 minutes and 12 hours before you take your dose of CAYSTON
- If you are taking several medicines or treatments to treat your cystic fibrosis, you should take your medicines or other treatments in this order:
bronchodilator mucolytics (medicines to help clear mucus from your lungs) CAYSTON
- After taking CAYSTON for 28 days, you should stop taking it and wait 28 days. Complete the full 28-day course of CAYSTON even if you are feeling better. It is important that you keep to the 28-day on, 28 day off cycle.
- If you skip doses or do not finish the full 28-day course of CAYSTON, your infection may not be fully treated and CAYSTON may not work as well as a treatment for infections in the future.
What are the dosage forms and brand names of this medicine?[edit | edit source]
This medicine is available in fallowing doasage form:
- As CAYSTON (aztreonam for inhalation solution), for oral inhalation use
- Lyophilized aztreonam (75 mg/vial)
- Diluent (0.17% sodium chloride): 1 mL/ampule
This medicine is available in fallowing brand namesː
- CAYSTON
What side effects can this medication cause?[edit | edit source]
The most common side effects of this medicine include:
- cough
- nasal congestion
- wheezing
- sore throat
- fever. Fever may be more common in children than in adults.
- chest discomfort
- stomach area (abdominal) pain
- vomiting
- swelling or pain in joints
CAYSTON may cause serious side effects, including:
- Severe allergic reactions
- Trouble breathing right after treatment with CAYSTON (bronchospasm)
What special precautions should I follow?[edit | edit source]
- Allergic reaction to CAYSTON was seen in clinical trials. Stop treatment if an allergic reaction occurs. Use caution when CAYSTON is administered to patients with a known allergic reaction to beta-lactams.
- Bronchospasm has been reported with CAYSTON. Stop treatment if chest tightness develops during nebulizer use.
- Prescribing CAYSTON in the absence of known Pseudomonas aeruginosa infection in patients with CF is unlikely to provide benefit and increases the risk of development of drug-resistant bacteria.
What to do in case of emergency/overdose?[edit | edit source]
Symptoms of overdosage may include:
- drug-related respiratory adverse reactions, particularly cough.
Can this medicine be used in pregnancy?[edit | edit source]
- Available data on CAYSTON use in pregnant women is insufficient to inform a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.
Can this medicine be used in children?[edit | edit source]
- It is not known if CAYSTON is safe and effective:
- in children under 7 years of age.
What are the active and inactive ingredients in this medicine?[edit | edit source]
- Active ingredient: aztreonam
- Inactive ingredient: lysine, sodium chloride (diluent)
Who manufactures and distributes this medicine?[edit | edit source]
- Manufactured and distributed by: Gilead Sciences, Inc. Foster City, CA
CAYSTON is a registered trademark of Gilead Sciences
What should I know about storage and disposal of this medication?[edit | edit source]
- Each CAYSTON kit contains enough single-use vials of CAYSTON and ampules of saline for 28 days of treatment. There are 4 extra saline ampules in case some saline spills.
- Always keep your CAYSTON and saline together.
- Store CAYSTON and saline in the refrigerator between 36 °F to 46 °F (2 °C to 8 °C) until needed.
- When you remove CAYSTON and saline from the refrigerator, they may be stored at room temperature (up to 77 °F) for up to 28 days. Do not use any CAYSTON that has been stored at room temperature for more than 28 days.
- Keep CAYSTON away from light.
- Do not use CAYSTON after the expiration date on the vial. Do not use the saline after the expiration date on the ampule.
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Contributors: Prab R. Tumpati, MD