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Inhalable Insulin Afrezza Joins Diabetes Treatment Options

Inhalable insulin Afrezza

The long wait for people with diabetes for an alternative to injectable insulin may finally be over. An inhalable insulin called Afrezza Inhalation Powder (Sanofi and MannKind Corporation) has hit the market in the United States and is available by prescription, but it is not for everyone who uses insulin.


Scientists have been working for many years to develop alternatives to insulin injections for people with type 1 diabetes and for those with type 2 diabetes who need the hormone. In addition to inhalable insulin, researchers have been exploring the efficacy and safety of insulin pills.

Afrezza, which has approval from the Food and Drug Administration (FDA), is a dry form of human insulin that is encased in small cartridges. These cartridges are placed into a portable (fits into the palm of your hand and is disposable) inhaler and administered before meals.

Once the insulin reaches the lungs, it is quickly absorbed into the bloodstream. Patients can expect to reach peak insulin levels within 12 to 15 minutes.

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While one clear advantage of Afrezza is that it does not require uncomfortable injections, it also has other advantages. It mimics the natural insulin levels during meals of people without diabetes and it also is associated with less weight gain.

What you should know about Afrezza

  • You will need to provide a complete medical history and undergo a physical examination plus spirometry (which helps identify potential lung disease) before your doctor can prescribe Afrezza.
  • The inhaler should be stored in a clean, dry location and can be used for up to 15 days before it should be discarded and a new one utilized
  • Afrezza is a rapid-action insulin and should not be used along with long-acting insulin if you have type 1 diabetes
  • Afrezza can be used along with other medications to treat diabetes to help reach desirable blood glucose levels, as recommended by your healthcare provider
  • You should not use Afrezza to treat diabetic ketoacidosis
  • Do not use Afrezza if you have any type of chronic lung disease (e.g., asthma, COPD) or if you smoke or have quit smoking recently. Acute bronchospasm can develop in people who have asthma or COPD and who use Afrezza
  • Because use of Afrezza can have a negative impact on your lung function, you will need to have your breathing checked six months after starting the inhalable insulin and yearly thereafter
  • Before using Afrezza, be sure to tell you doctor if you have lung cancer or are at risk of the disease, if you are pregnant or plan to get pregnant, or if you are breast feeding or plan to do so.
  • Low blood sugar is the most common side effect of Afrezza. Symptoms may include blurry vision, rapid heartbeat, shaking, and sweating. Other side effects that may be caused by use of Afrezza include cough, diarrhea, headache, irritated throat, nausea, pain in the throat, and tiredness
  • Concerning cost, Afrezza reportedly costs $7.54 daily, based on 12 units used per day. This is more than double the cost of an injectable also produced by Sanofi (Apidra), which costs $3.14 daily.

The introduction of Afrezza to the market offers an alternative way to take insulin for people with type 1 and type 2 diabetes. Patients and their healthcare providers will need to consider a number of factors, including contraindications, cost, and side effects, before this inhalable insulin is prescribed.

Afrezza website
Sanofi-Mannkind news release