Afrezza - The New Inhaled Insulin

We answer our latest question regarding the new inhaled insulin, Afrezza.

Question

Hello, I heard about a new type of inhaled insulin known as Afrezza. Can you tell me a little more about it and will is possibly be an alternative to my normal insulin injections?

Asked by John On Sep 20, 2017

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On Sep 20, 2017
Afrezza Insulin

You are correct that there is a new insulin product on the market and it is getting a lot of buzz due to the fact that patients won't have to inject it. This new insulin goes by the brand name Afreeza and it is an inhaled insulin used for diabetes.

Surprisingly enough, this is NOT the first inhaled insulin that has been approved for use by the FDA. The first inhaled insulin was known as Exubera and it was not on the market for long. There were many reasons it was discontinued but the main issues were that it was difficult to use and not very convenient in terms of size.

It was larger than the size of a tennis ball can! Hardly something that you can easily walk around with. Fortunately, Afrezza is both easier to use and much smaller.

In terms of replacing the insulin you use now, that depends. Afrezza is rapid-acting insulin... so it may be an alternative to Humalog or Novolog but it would not replace a longer acting insulin such as Lantus or Levemir. Afreeza is approved for both type 1 and type 2 diabetics so it certainly can be used for a variety of patients. As with all medications, there are pluses and minuses to consider.[1]

Afreeza Positives

  • Eliminates the need for injections of rapid-acting insulin.
  • Has a quick onset of action but a short duration of action. This tends to cause LESS hypoglycemia issues in patients.
  • Portable


Afreeza Negatives

  • Costly. It costs roughly twice as much as other rapid-acting insulin if paying out of pocket. It is unknown how insurance will cover it.
  • Studies have shown that it can slightly decrease lung function is some users. Due to this, patients need to have lung function tests before starting the medication, at 6 months and then annually after starting the medication.
  • Studies show that it decreases A1C slightly less than other rapid-acting insulin.

How To Use Afrezza

  • Remove a blister card from the foil package. Tear along the perforation to remove one strip.
  • Press the clear side of the strip to push the cartridge out.
  • To load the cartridge, hold the inhaler level in one hand with the white mouthpiece on the top and purple base on the bottom.
  • Open the inhaler by lifting the white mouthpiece to a vertical position. Prior to placing the cartridge in the inhaler, both the cartridge and the inhaler should be at room temperature for 10 minutes. Hold the cartridge with the cup facing down and line up the cartridge with the opening in the inhaler. The pointed end of the cartridge should line up with the pointed end in the inhaler. The cartridge can be placed into the inhaler.
  • Ensure that the cartridge lies flat in the inhaler. Once the cartridge is loaded, it is important that the inhaler is kept level from this point forward. In order to avoid loss of drug powder, do NOT do any of the following: turn the inhaler upside down, point the mouthpiece down, or shake or drop the inhaler. If any of these occur, throw away the cartridge and load a new one.
  • To close the inhaler, the mouthpiece should be lowered (this will open the drug cartridge). A snap will be felt when the inhaler is closed.
  • Remove the purple mouthpiece cover. Hold the inhaler away from the mouth and fully exhale. While keeping the head level, place the mouthpiece in the mouth and tilt the inhaler down towards the chin. Close lips around the mouthpiece to form a seal. Inhale deeply through the inhaler. Have the patient hold their breath for as long as comfortable and at the same time remove the inhaler from the mouth. Exhale and continue to breathe normally.
  • It is normal to see powder residue in the mouthpiece after taking the dose; this does not affect the dose.
  • Place the purple mouthpiece cover back onto the inhaler.
  • Remove the used cartridge from the inhaler. Lift up the white mouthpiece and remove the cartridge from the purple base. Discard used cartridges in the trash.[2]

Answer Summary

Afreeza is a non-injectable, inhaled insulin. 

References
  1. ^ Elsevier ClinicalKey: Afrezza Monograph
  2. ^ Afrezza Prescribing Information

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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