Discontinuation of I-neb nebulisers and Promixin

Promixin is an antibiotic used to treat lung infections caused by the bacteria Pseudomonas aeruginosa. Promixin is used with a nebuliser called an I-neb. It is dissolved in sterile salt water and breathed (inhaled) into the lungs.

The I-neb is a small battery powered nebuliser device. It provides fast delivery of medication. It comes with online software called I-adhere which helps support with adherence. You may be using this device or may have already been moved onto a different nebuliser.

• Philips were the manufacturer of the I-neb nebuliser, before it was discontinued. I-nebs and their consumables have been available for purchase directly from Philips. 
• Zambon manufactures Promixin. Previously, Zambon offered a package service in which they supplied Promixin along with an I-neb, the associated consumables (discs and chambers), ongoing maintenance of the I-neb, access to the I-adhere online adherence software and enrolment into the I-nhale Patient Support Programme.
• Since October 2024, Zambon has not been able to provide new I-nebs to patients starting on Promixin, but continued to supply Promixin and consumables to those with an I-neb. 
• Provision of both Promixin and consumables will terminate by May 2025. 

Since October 2024, Zambon UK has not been able to supply I-nebs for new patients prescribed Promixin, or replace I-nebs that become faulty for people already using I-nebs. It has been able to continue providing consumables.

Zambon is discontinuing Promixin, and thinks that stocks will run out by  May 2025. I-neb consumables are also due to become unavailable by May 2025, which  is earlier than the previous timeline of October 2025. This means Zambon will no longer be able to support existing I-neb patients with: 

• Promixin and consumables for Promixin such as replacement discs and chambers
• consumables for co-medications  (chambers)

The I-nhale Patient Support Programme, including access to the I-nhale Portal, I-adhere online adherence software will continue until December 2025.

People who are prescribed Promixin will need to be switched onto an alternative brand of colistimethate along with a suitable alternative nebuliser. People who use an I-neb for alternative treatments will also need to  transfer to a suitable alternative device under the guidance of your CF team. Your CF team are aware of this issue and that it can be difficult to change the way you take medicine. They will help you to:

• change to a suitable alternative nebuliser device;
• adjust your prescription as necessary; 
• provide any support you need to make the transition as smooth as possible.

The prescription of Promixin taken via an I-neb is different from the prescription of Promixin required via an alternative device. You should not switch devices without speaking with your CF specialist first.

No, the I-neb is permanently discontinued.

26 May 2024

• Company: Philips
• Action: I-neb discontinued - last day to order I-neb devices and consumables

October 2024

• Company: Zambon
• Action: Zambon will no longer provide I-nebs for new patients or replace faulty I-neb devices

May 2025

• Company: Zambon
• Action: Zambon will not be able to supply Promixin or replace consumables for Promixin or consumables for co-medications. 

• If you are worried about anything to do with the transition away from using your I-neb device, speak with your CF team.
• If you have immediate questions, you can contact our Helpline. Our friendly team is available to anyone looking for information or support with any aspect of cystic fibrosis, a listening ear, or just to talk things through.