Cayston is an antibiotic that fights severe or life-threatening infection caused by bacteria.

Cayston inhalation is used to improve breathing symptoms in people with cystic fibrosis and a lung infection caused by bacteria called Pseudomonas aeruginosa.

This medicine is for use in adults and children at least 7 years old with a 1-second forced expiratory volume (FEV1) between 25% and 75%.

Before using Cayston, tell your doctor if you are allergic to any type of antibiotic, especially a cephalosporin (Ceftin, Cefzil, Keflex, Omnicef, and others), a penicillin (Amoxil, Augmentin, Bactocill, Bicillin L-A, Dispermox, Dycill, Dynapen, Moxatag, Principen, PC Pen VK, Pen-V, Pfizerpen, Unasyn, and others), or similar antibiotics such as Invanz, Primaxin, or Merrem.

Use Cayston for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Aztreonam will not treat a viral infection such as the common cold or flu.

Cayston inhalation should be used only with an Altera brand nebulizer. Do not use any other type of nebulizer or inhaler device with this medication. Do not mix other medicines with Cayston in the nebulizer. If you use other inhaled medications, you may need to use them in a certain order while using this inhalation. Ask your doctor for specific instructions about when to use your other medications in relation to your Cayston inhalation doses.

Use Cayston exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Use this medicine only with an Altera brand nebulizer. Do not mix other medicines with Cayston in the nebulizer.

Be sure you understand how to properly mix this medicine with the liquid (diluent) before pouring it into the nebulizer. Prepare your dose only when you are ready to use the nebulizer. Call your pharmacist if the medicine looks cloudy or has particles in it.

Throw away the medicine ampule (bottle) after one use, even if there is still medicine left inside.

Cayston inhalation is usually given 3 times daily at 4-hour intervals for 28 days. Follow your doctor's dosing instructions very carefully.

You may need to use a bronchodilator medicine before each dose of Cayston. Use only the bronchodilator your doctor has prescribed and carefully follow all instructions about timing the doses in relation to your Cayston dose.

If you use a short-acting bronchodilator such as albuterol or levalbuterol (Combivent, DuoNeb, ProAir, Proventil, Respimat, Ventolin, Xoponex): Use the bronchodilator between 15 minutes and 4 hours before using Cayston.

If you use a long-acting bronchodilator such as salmeterol or formoterol (Advair, Breo, Dulera, Foradil, Serevent, Symbicort): Use the bronchodilator between 30 minutes and 12 hours before using this inhalation.

If you use a medicine to clear mucus from your lungs, use it after using a bronchodilator and before using Cayston.

Keep using Cayston for the entire 28 days, even if your symptoms quickly improve. Skipping doses could make your infection resistant to medication. Cayston will not treat a viral infection (flu or a common cold).

Store the medicine and diluent in the refrigerator. Do not freeze. Do not use past the expiration date on the label.

You may store the medicine and diluent at room temperature for up to 28 days, protected from heat and light. Do not use the medicine if it has been at room temperature for longer than 28 days.

Usual Adult Dose for Cystic Fibrosis:

Inhalation:
Initial dose: 75 mg via nebulizer over approximately 2 to 3 minutes 3 times a day for 28 days; doses should be at least 4 hours apart

Maintenance dose: Administer in alternating cycles of 28 days on and 28 days off.

Usual Pediatric Dose for Cystic Fibrosis:

Inhalation:
7 years or older:
Initial dose: 75 mg via nebulizer over approximately 2 to 3 minutes 3 times a day for 28 days; doses should be at least 4 hours apart

Maintenance dose: Administer in alternating cycles of 28 days on and 28 days off.

For patients on multiple inhaled therapies, the following order of administration is recommended: bronchodilator, mucolytics, and lastly, Cayston for inhalation.

You should not use Cayston if you are allergic to aztreonam.

Before using Cayston, tell your doctor if you are allergic to any type of antibiotic, especially:

• cephalosporins such as cefdinir (Omnicef), cefprozil (Cefzil), cefuroxime (Ceftin), cephalexin (Keflex), and others;

• penicillins such as amoxicillin (Amoxil, Augmentin, Dispermox, Moxatag), ampicillin (Principen, Unasyn), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), penicillin (Bicillin L-A, PC Pen VK, Pfizerpen), and others; or

• similar antibiotics such as ertapenem (Invanz), imipenem (Primaxin), or meropenem (Merrem).

Cayston is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Aztreonam can pass into breast milk. Do not use Cayston without telling your doctor if you are breast-feeding a baby.

Cayston should not be given to a child younger than 7 years old.

Use the medicine as soon as you can, then wait 4 hours before using your next dose. Do not use two doses at one time.

Even if you miss a dose, try and use all of your doses for the day as long as they are spaced at least 4 hours apart.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Get emergency medical help if you have signs of an allergic reaction to Cayston: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

• bronchospasm (wheezing, cough, chest tightness, trouble breathing); or

• any new or worsening breathing problems.

Common Cayston side effects may include:

• wheezing, chest discomfort;

• stomach pain, vomiting;

• fever (more common in children); or

• cough, sore throat, stuffy nose.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

If you use other inhaled medications, you may need to use them in a certain order while using Cayston inhalation. Ask your doctor for specific instructions about when to use your other medications in relation to the timing of your Cayston inhalation doses.

There may be other drugs that can interact with aztreonam. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.