Afrezza in the real world!

1. NEWLY APPROVED INSULIN
INHALERS
PRESENTED BY
NIJEESH.CH
PHARM.D 5TH YEAR
NETPC, RAICHUR

2. INTRODUCTION
 inhalable insulin is a powdered form of insulin,
delivered with a nebulizer into the lungs where it is
absorbed. A 2007 systematic review concluded that
inhaled insulin "appears to be as effective, but no better
than injected short-acting insulin. The additional cost is
so much more that it is unlikely to be cost-effective.
 Exubera, developed by Pfizer, became the first
inhaled insulin product to be marketed in 2006, but
poor sales led Pfizer to withdraw it in 2007. Afrezza,
developed by Mannkind, was approved by the FDA in
2014

3. WHAT IS AFREZZA ?
• Afrezza (insulin inhalation) is a rapid-acting form of
human insulin that is inhaled through the mouth.
• Afrezza is used to treat type 1 (insulin dependent) or
type 2 (non-insulin dependent) diabetes in adults.
• In type 1 diabetes, patient need to use a long-acting
injectable insulin.
• In type 2 diabetes, Afrezza may be the only medicine
to control blood sugar.

4. LIMITATIONS OF USE
 Do not use Afrezza® in place of long-acting insulin;
Afrezza® must be used with a long-acting insulin in
patients with type 1 diabetes.
 Do not use Afrezza® to treat diabetic ketoacidosis.
 It is not known if Afrezza® is safe and effective for
use in people who smoke. Afrezza® is not for use in
patients who smoke or who have recently stopped
smoking (less than 6 months).
 It is not known if Afrezza® is safe and effective in
children under 18 years of age.

5. WARNING
 Risk of Sudden lung problems (acute bronchospasm)
have been seen in patients with asthma and COPD
(chronic obstructive pulmonary disease) using Afrezza®.
 Afrezza® is not to be used in patients with long-term lung
disease such as asthma or COPD.

6. Starting Mealtime Dose:
 Insulin Naïve Individuals: Start on 4 units of Afrezza at each
meal.
 Individuals Using Subcutaneous Mealtime (Prandial)
Insulin: Determine the appropriate Afrezza dose for each
meal by converting from the injected dose using Figure 1.
 Individuals Using Subcutaneous Pre-mixed Insulin: Estimate
the mealtime injected dose by dividing half of the total
daily injected pre-mixed insulin dose equally among the
three meals of the day. Convert each estimated injected
mealtime dose to an appropriate Afrezza dose using Figure
1. Administer half of the total daily injected pre-mixed dose
as an injected basal insulin dose.

9. CONTRAINDICATIONS
Afrezza is contraindicated in patients with the
following:
 During episodes of hypoglycemia
 Chronic lung disease, such as asthma or chronic
obstructive pulmonary disease (COPD), because of
the risk of acute bronchospasm .
 Hypersensitivity to regular human insulin or any of
the Afrezza excipients