The 'Aztreonam Tablet' Misconception
Many people searching for the price of an aztreonam tablet are surprised to learn that a standard oral pill form of this medication is not commercially available. The primary reason is that aztreonam has less than 1% absorption from the gastrointestinal tract when taken orally [1.5.6]. This poor bioavailability means the drug would be broken down in the digestive system without ever reaching the bloodstream to fight an infection. To be effective, aztreonam must be administered directly into the body, which is why it is only available as an intravenous/intramuscular injection or an inhalation solution [1.5.1, 1.5.4].
What Is Aztreonam?
Aztreonam is a synthetic monobactam antibiotic, a class of drugs that is structurally different from more common beta-lactams like penicillins and cephalosporins [1.5.2]. This unique structure gives it a significant advantage: it can often be used safely in patients with allergies to penicillin (with the exception of a specific allergy to ceftazidime, which shares a similar side chain) [1.5.4]. Its mechanism of action involves inhibiting the synthesis of the bacterial cell wall, which ultimately kills the bacteria [1.5.3, 1.5.5]. Aztreonam is specifically effective against aerobic gram-negative bacteria, including notoriously difficult-to-treat organisms like Pseudomonas aeruginosa [1.5.2, 1.5.9].
Approved Uses and Formulations
Aztreonam is FDA-approved for treating a variety of serious infections caused by susceptible gram-negative microorganisms [1.5.5]. The specific formulation used depends on the site and type of infection.
- Aztreonam for Injection (Brand Name: Azactam®, also available as a generic): This form is administered intravenously or intramuscularly. It is used for systemic infections, including complicated urinary tract infections (UTIs), lower respiratory tract infections like pneumonia and bronchitis, septicemia (bloodstream infections), skin and structure infections, intra-abdominal infections, and gynecologic infections [1.5.3, 1.5.7].
- Aztreonam for Inhalation Solution (Brand Name: Cayston®): This formulation is delivered directly to the lungs using a specialized nebulizer. It is indicated to improve respiratory symptoms in cystic fibrosis (CF) patients aged 7 and older who have a Pseudomonas aeruginosa lung infection [1.3.7, 1.3.9].
Understanding the Costs of Aztreonam Formulations
Since a tablet price is not applicable, the cost of aztreonam varies dramatically depending on whether it is the injectable or inhaled version.
Price of Aztreonam for Injection
The injectable form of aztreonam is available as a generic, making it significantly less expensive than the branded inhalation solution. However, prices can still fluctuate widely. Without insurance, a course of treatment can be costly. For example, discount coupon providers list prices for generic aztreonam ranging from approximately $121 to over $490, depending on the dosage and quantity [1.4.1]. SingleCare indicates a potential price of around $124.90 for nine 1-gram vials with a coupon, against a retail price of about $164.90 or more [1.4.3]. For hospitalized patients, the cost of the drug is typically bundled into the overall cost of hospital care, making it difficult to isolate.
Price of Aztreonam for Inhalation (Cayston®)
Cayston® is a specialty drug with a much higher price point. The list price for a 28-day supply (84 single-use vials) can be over $12,000 [1.3.4]. The treatment cycle typically involves 28 days of use followed by 28 days off [1.3.7]. The actual out-of-pocket cost for patients depends heavily on their insurance coverage. The manufacturer, Gilead Sciences, offers the Cayston Access Program®, which provides co-pay assistance for eligible, privately insured patients, potentially lowering their co-pay to as little as $10 per fill [1.6.2, 1.6.5]. There are also patient assistance programs that may provide the medication at no cost for qualified uninsured or underinsured individuals [1.6.3].
Comparison of Aztreonam Formulations
| Feature | Injection (Generic/Azactam®) | Inhalation (Cayston®) |
|---|---|---|
| Administration | Intravenous (IV) or Intramuscular (IM) injection [1.5.4] | Nebulized inhalation via Altera® Nebulizer System [1.6.4] |
| Primary Use | Systemic gram-negative infections (UTIs, pneumonia, sepsis) [1.5.7] | Improve respiratory symptoms in CF patients with P. aeruginosa [1.3.9] |
| Brand/Generic | Brand (Azactam®) and generic versions available [1.4.3] | Brand name only (Cayston®) [1.3.5] |
| Typical Cost | Lower cost; varies, e.g., ~$125-$165 for multiple vials [1.4.3] | Very high list price; >$12,000 for 28-day supply [1.3.4] |
| Common Side Effects | Diarrhea, nausea, vomiting, injection site reactions [1.4.3] | Cough, wheezing, nasal congestion, sore throat [1.3.7, 1.5.4] |
Factors Influencing the Final Price
The final price a patient pays for either form of aztreonam is influenced by several factors:
- Insurance Coverage: The plan's formulary, deductible, and co-pay/co-insurance structure are the biggest determinants of out-of-pocket costs.
- Patient Assistance Programs: Manufacturer programs like the Cayston Access Program® can drastically reduce costs for eligible patients [1.6.2].
- Pharmacy & Discount Cards: For the injectable form, prices vary between pharmacies, and prescription discount cards can offer significant savings off the retail price [1.2.1].
- Healthcare Setting: The cost of injectable aztreonam administered in a hospital is part of a larger bill, while outpatient or home-infusion has a different cost structure.
Conclusion
While the search for an 'aztreonam tablet price' is common, the medication's pharmacology dictates that it cannot be administered as a pill. Instead, patients receive aztreonam through injection for systemic infections or inhalation for specific lung conditions in cystic fibrosis patients. The cost difference between the generic injectable and the brand-name inhaled solution is substantial. Patients needing injectable aztreonam can find savings through generic options and discount cards. For those prescribed Cayston®, navigating insurance and utilizing the manufacturer's assistance programs is essential to manage the high cost.
For more information on the medication itself, you can visit the FDA's drug database.
