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Overview: Afrezza is an insulin powder that you breathe in to help lower blood sugar levels in people with diabetes. The most common side effects with Afrezza are low blood sugar, cough, and throat pain or irritation. Contact your healthcare provider right away if you have very low blood sugar or feel unusually weak or tired while using Afrezza.

Uses

What is Afrezza used for?

Afrezza (inhaled human insulin) is commonly used to help lower blood sugar levels in people with type 1 diabetes or type 2 diabetes.

Afrezza may also be used for other conditions as determined by your healthcare provider.

How does Afrezza work (mechanism of action)?

Afrezza helps lower your blood sugar by helping move sugar into your cells, so your body can use it for energy. The medicine also stops your liver from making sugar and helps with the creation of protein in your tissues. 

How is Afrezza supplied (dosage forms)?

Brands and other names

  • Afrezza

Dosage forms and strengths

  • 4 units single-use cartridges for use with Afrezza inhaler
  • 8 units single-use cartridges for use with Afrezza inhaler
  • 12 units single-use cartridges for use with Afrezza inhaler

See also: Insulin regular

How should I store Afrezza?

Inhaler. Store the Afrezza inhaler in a clean and dry place with the mouthpiece cover on. Avoid getting the inhaler wet. The inhaler can be stored at room temperature, between 68 F to 77 F (20 C to 25 C), or in the refrigerator, between 36 F to 46 F (2 C to 8 C). If you store the inhaler in the refrigerator, make sure it sits at room temperature for ten minutes before using it. Inhalers should only be used for 15 days. Consider using a calendar or reminder app to help you remember when to throw away a used inhaler and start using a new one. 

Cartridges. Afrezza cartridges come inside a sealed foil pouch. They can be used until the expiration date if stored in the refrigerator between 36 F to 46 F (2 C to 8 C). They must be used within ten days if stored at room temperature between 68 F to 77 F (20 C to 25 C) and can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Talk to your pharmacist about how to store and how long you can use Afrezza cartridges once they have been opened. If you store a cartridge in the refrigerator, make sure it sits at room temperature for ten minutes before using it. 

Side Effects

What are the most common side effects of Afrezza?

The most common side effects of Afrezza are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Low blood sugar (also called hypoglycemia) (see below)
  • Cough
  • Sore throat or throat irritation

There may be other side effects of Afrezza that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Afrezza?

While less common, the most serious side effects of Afrezza are described below, along with what to do if they happen.

Severe Allergic Reactions. Afrezza may cause allergic reactions, which can be serious. Stop using Afrezza and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Low Blood Sugar (Hypoglycemia). Afrezza can cause low blood sugar, which can be serious and may lead to death. You may need to check your blood sugar more often if you have changes to your diet, exercise regimen, or medicines for diabetes. Do not use Afrezza and call your healthcare provider right away if you have any of the following symptoms of hypoglycemia.

  • Headache
  • Crankiness or anxiety
  • Hunger
  • Dizziness or confusion
  • Blurry vision
  • Slurred speech
  • Sweating
  • Feeling jittery or shakiness
  • Fast heartbeat
  • Seizures

Low Potassium Levels (Hypokalemia). Afrezza can cause a low potassium level, which can be serious and may lead to death. Your healthcare provider may check your potassium levels, especially if you take certain other medicines. Keep all appointments to have your blood checked. Call your healthcare provider if you have any of the following symptoms of a low potassium level.

  • Weakness
  • Unusual tiredness
  • Muscle cramps or twitching
  • Constipation

Medication Error. If you are using multiple cartridge strengths, accidentally mixing them up and using the wrong dose can cause low blood sugar (hypoglycemia). Always check the label on your Afrezza before using them to make sure you are using the correct strength. Call your healthcare provider right away if you have any of the following symptoms of hypoglycemia [see Low Blood Sugar (Hypoglycemia) above] from Afrezza or any other insulin product that you are using.

Lung Problems. Using Afrezza for a long time may cause lung problems. Sometimes this can happen without you having any symptoms. Keep any appointments to check how well your lungs are working (even if you are not having any problems) to make sure that Afrezza is right for you. Tell your healthcare provider if you start to have any of the following symptoms of lung or breathing problems.

  • Wheezing
  • Shortness of breath
  • Trouble breathing
  • A cough that lasts a long time or keeps coming back

Warnings & Precautions

Who should not use Afrezza?

Allergies to Ingredients. People who are allergic to any of the following should not use Afrezza.

  • Regular human insulin
  • Afrezza
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Afrezza.

Low Blood Sugar (Hypoglycemia). Afrezza should not be used if you are having an episode of low blood sugar (hypoglycemia). Using Afrezza while your blood sugar is low can worsen your symptoms of low blood sugar. See the Side Effects section for more details.

Breathing Problems. Afrezza should not be used if you have breathing problems such as asthma or chronic obstructive pulmonary disease (COPD). Using Afrezza may cause the muscles around the airways to tighten (bronchospasm), which can be serious.

What should I know about Afrezza before using it?

Do not use Afrezza unless it has been prescribed to you by a healthcare provider. Use it as prescribed. Do not change your dose without talking to your healthcare provider. 

Do not share Afrezza with other people, even if they have the same condition as you. It may harm them.

Keep Afrezza out of the reach of children. Since this medicine may be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

Read and follow the Afrezza “Instructions for Use” when using it for the first time or when you haven’t used it in a while. Ask your pharmacist if you have any questions about how to use Afrezza.

Certain conditions that cause increased stress on your body, like fever, trauma (such as a car accident), infection, or surgery, can change the amount of diabetes medicines you need to use to control your diabetes. Talk to your healthcare provider if you have any of these conditions to decide if your medicine needs to be changed.

Talk to your healthcare provider about how to prevent, recognize, and manage low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and diabetes-related problems.

Afrezza can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how Afezza affects you.

What should I tell my healthcare provider before using Afrezza?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Afrezza is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Use any type of inhaler medicine
  • Skip meals or have trouble using your insulin or other diabetes medicines regularly
  • Lung cancer, history of lung cancer, or at risk for lung cancer
  • Smoke or recently stopped smoking (within the last six months)
  • Kidney or liver problems

Other Medicines and Supplements. Afrezza may interact with other medicines and supplements. Before using Afrezza, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Diet and Lifestyle Changes. Tell your healthcare provider if you have any changes in your diet, level of physical activity, or illnesses. These may affect the amount of Afrezza you need.

Pregnancy. Afrezza may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should use Afrezza while you are pregnant or trying to get pregnant. Uncontrolled diabetes can increase the risk of harm to a mother and an unborn baby. Your healthcare provider will discuss the best way to control your blood sugar. 

Breastfeeding. It is not known if Afrezza passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should use Afrezza while breastfeeding.

How can I get more information about Afrezza?

For more information about Afrezza, you can visit the manufacturer’s website at afrezza.com or call them at 844-323-7399).

Interactions

Does Afrezza interact with foods or drinks?

There are no known interactions between Afrezza and foods or drinks. Afrezza should be used at the start of each meal. 

Do not drink alcohol or use any medicines that have alcohol in them while using Afrezza. Alcohol may affect blood sugar levels in people with diabetes. 

Does Afrezza interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using Afrezza.

  • A beta-blocker, such as metoprolol (Lopressor, Toprol XL, and others), atenolol (Tenormin), or propranolol (Inderal LA, Innopran XL), which is a medicine that may be used for certain heart conditions or to reduce blood pressure
  • Clonidine (Catapres-TTS and others), which is a medicine used for high blood pressure or attention deficit hyperactivity disorder (ADHD)
  • Pioglitazone (Actos) or any other medicine for diabetes

Many other medicines can increase or decrease your blood sugar or can interfere with the effect of Afrezza. Talk to your pharmacist or healthcare provider before starting or stopping other medicines while using Afrezza. You may need to monitor your blood sugar levels more closely during these times.

This may not be a complete list of medicines that can interact with Afrezza. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Afrezza?

If you or someone else has used too much Afrezza, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Afrezza?

It is important to use your Afrezza exactly as it is prescribed. Talk to your healthcare provider, ahead of time, on what you should do if you miss a dose of Afrezza. Do not use double or extra doses.