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Aztreonam for inhalation (Cayston®)

How does this medicine work?

Cayston® is an inhaled antibiotic used to improve respiratory symptoms in cystic fibrosis patients with a type of germ called Pseudomoas aeruginosa.

How should I give it?

  • Cayston® is inhaled using a special nebulizer, Altera nebulizer system. Cayston® should not be given with any other type of nebulizer. Do not use the Altera nebulizer to take any other of your medications.
  • Follow the instructions on how to use and assemble your Altera nebulizer included in your Cayston® You can also view the instructions at, under forms, choose videos.
  • Follow your provider’s instructions for how many times a day and for how long to take it. It is usually prescribed for 28 days, 3 times per day at least 4 hours apart, then 28 days off. The usual dose is 75 mg Aztreonam mixed with 1 mL saline solution.
  • Your child’s Cayston® will come with 28 amber colored tubes of the Cayston® powder and 28 tubes of saline (4 extra).
  • Mix the powder with the saline before each treatment. Once the Cayston® has been mixed it should be used right away. Instructions on how to do this will be in your Cayston® You can also view a “how to” video at, under forms, choose videos.
  • Your Cayston® will arrive refrigerated. Keep it in the refrigerator until you start your 28-day course. Once you start your 28-day course, Cayston® can be stored at room temp for the whole 28 days. Keep out of light.
  • While taking Cayston®, breathe normally through your mouth while keeping the handset level. When the treatment is complete the Altera nebulizer system will beep twice (usually after 2-3 minute). If your treatment is taking longer it may be time for a new handset. Call the Cayston® Access program at 1-877-7CAYSTON to order a replacement.

How do I clean and disinfect the Altera nebulizer?

To keep the Altera nebulizer working properly it is important to clean the handset as soon as possible after a treatment.

  • To clean:
    • disassemble the handset. Be careful not to touch the metal part of the aerosol generator head. When disassembled you will have 5 parts.
    • rinse each part under warm tap water for 10 seconds. Using warm soapy water (use clear dish soap) wash all parts in a basin gently swishing.
    • Rinse each part under warm running tap water.
    • Let air dry on a clean towel. Be careful not to touch the metal part of the aerosol head while cleaning.
    • Keep the seal on the handset intact, do not reassemble the handset until you are ready to use again.

Disinfecting your handset before each use is important to avoid infecting your lungs with bacteria. There are a couple of options to disinfect:

  • Boil: Bring a pot of distilled water to a boil. Place all of the cleaned handset pieces in the pot and boil for 5 minutes. Remove from the water and allow to air dry on a clean towel.
  • Dishwasher: Place cleaned handset parts in a dishwasher baby bottle or small utensil container and place in the top rack of the dishwasher. Run on your dishwasher’s “sanitize” or extra hot cycle (water temp more than158 degrees). If not completely dry after the cycle, allow to air dry on a clean towel.
  • Baby bottle steam sterilizer (ex, Wabi): Place cleaned handset parts in the sterilizer and run according to manufacturer instructions. If not completely dry when the cycle is complete, allow to air dry on a clean towel.
  • Do not reassemble the handset until you are ready to use again.
  • Store handset parts in a clean, dry container.
  • Use a disinfected handset for each treatment. After your first refill you will be given 2 more handsets so you will have the ability to clean all 3 handsets at a time. A video on cleaning and assembly can be found at, under forms, choose videos.

What should I do if a dose is missed?

If you miss a dose of Crayston® you can still take all 3 daily doses as long as they are at least 4 hours apart.

What are the side effects?

Possible side effects are:

  • Cough
  • Nasal congestion
  • Fever
  • Wheezing
  • Sore throat
  • Chest discomfort
  • Stomach pain or vomiting

When should I call the clinic?

Children with cystic fibrosis can have many symptoms. Some of these symptoms may be related to your medications. If you have new or worsening symptoms, call your provider.

What else do I need to know?

Learn the names and doses of all medications your child is taking. Share this information with anyone involved in your child’s care.

Check the label and expiration date before giving each dose. Ask your pharmacist what to do with outdated or unused medicines.

Frequent hand hygiene is the most important way to prevent the spread of germs. Always wash hands well with soap for at least 20 seconds, and/or use an alcohol hand sanitizer, such as Purell®.


This information is not specific to your child but provides general information. If you have any questions, please call your clinic.

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Minnesota Family Resource Center library, or visit

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