Skip to Content

Insulin Inhalation, Rapid Acting Dosage

Applies to the following strength(s): 4 units ; 4 units- 8 units ; 8 units-12 units ; 1 mg and 3 mg ; 1 mg ; 3 mg

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Additional dosage information:

Usual Adult Dose for Diabetes Type 2

Insulin-naive :
Initial dose: 4 units via oral inhalation at each meal
Maintenance dose: Adjust dosage according to patient requirements

Switching from Subcutaneous Mealtime Insulin:
Dose conversion as follows:
4 units inhaled insulin replaces up to 4 units of subcutaneous mealtime insulin
8 units inhaled insulin replaces 5 to 8 units of subcutaneous mealtime insulin
12 units inhaled insulin replaces 9 to 12 units of subcutaneous mealtime insulin
16 units inhaled insulin replaces 13 to 16 units of subcutaneous mealtime insulin
20 units inhaled insulin replaces 17 to 20 units of subcutaneous mealtime insulin
24 units inhaled insulin replaces 21 to 24 units of subcutaneous mealtime insulin

Switching from Subcutaneous Pre-mixed insulin:
-Estimate mealtime injected dose by dividing the total daily injected pre-mixed insulin dose by one-half (half will be the total daily mealtime dose; half will be the daily basal dose)
-Divide the total daily mealtime dose equally among the 3 meals of the day and using the dose conversion table above, convert to the appropriate inhaled insulin dose.
-Give the appropriate basal insulin dose as calculated above.

Comments:
-Should only be administered via AFREZZA(R) inhaler.
-Administer at the beginning of a meal.
-Use a single inhalation per cartridge; doses exceeding 8 units will require multiple cartridges.
-After cartridge is inserted, keep inhaler level; if inhaler is turned upside down, shaken, or dropped after the cartridge has been inserted, replace the cartridge before use.
-Monitor blood glucose, especially in patients requiring high doses; if blood glucose control is not achieved with increasing doses, consider subcutaneous mealtime insulin.

Use: Adult patients with diabetes mellitus to improve glycemic control. Inhaled insulin is a rapid acting insulin and is not a substitute for long-acting insulin. In patients with type 1 diabetes mellitus, inhaled insulin should be used in combination with long-acting insulin.

Usual Adult Dose for Diabetes Type 1

Insulin-naive :
Initial dose: 4 units via oral inhalation at each meal
Maintenance dose: Adjust dosage according to patient requirements

Switching from Subcutaneous Mealtime Insulin:
Dose conversion as follows:
4 units inhaled insulin replaces up to 4 units of subcutaneous mealtime insulin
8 units inhaled insulin replaces 5 to 8 units of subcutaneous mealtime insulin
12 units inhaled insulin replaces 9 to 12 units of subcutaneous mealtime insulin
16 units inhaled insulin replaces 13 to 16 units of subcutaneous mealtime insulin
20 units inhaled insulin replaces 17 to 20 units of subcutaneous mealtime insulin
24 units inhaled insulin replaces 21 to 24 units of subcutaneous mealtime insulin

Switching from Subcutaneous Pre-mixed insulin:
-Estimate mealtime injected dose by dividing the total daily injected pre-mixed insulin dose by one-half (half will be the total daily mealtime dose; half will be the daily basal dose)
-Divide the total daily mealtime dose equally among the 3 meals of the day and using the dose conversion table above, convert to the appropriate inhaled insulin dose.
-Give the appropriate basal insulin dose as calculated above.

Comments:
-Should only be administered via AFREZZA(R) inhaler.
-Administer at the beginning of a meal.
-Use a single inhalation per cartridge; doses exceeding 8 units will require multiple cartridges.
-After cartridge is inserted, keep inhaler level; if inhaler is turned upside down, shaken, or dropped after the cartridge has been inserted, replace the cartridge before use.
-Monitor blood glucose, especially in patients requiring high doses; if blood glucose control is not achieved with increasing doses, consider subcutaneous mealtime insulin.

Use: Adult patients with diabetes mellitus to improve glycemic control. Inhaled insulin is a rapid acting insulin and is not a substitute for long-acting insulin. In patients with type 1 diabetes mellitus, inhaled insulin should be used in combination with long-acting insulin.

Renal Dose Adjustments

Use with caution. Frequent glucose monitoring and dose adjustment may be necessary.

Liver Dose Adjustments

Use with caution. Frequent glucose monitoring and dose adjustment may be necessary.

Precautions

US REMS: The US FDA requires a Risk Evaluation and Mitigation Strategy (REMS) for Afrezza. It includes a communication plan. For additional information: www.fda.gov/REMS

US BOXED WARNINGS:
-Acute bronchospasm has been observed in patients with asthma and COPD.
-Contraindicated in patients with chronic lung disease.
-Prior to initiating treatment, perform a detailed medical history, physical examination, and spirometry (FEV1) to identify potential underlying lung disease.

Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration Advice:
-See patient instructions for use for complete administration instructions with illustrations.
-Administer at the beginning of a meal.
-Replace inhaler every 15 days.

Storage requirements:
-Inhaler may be stored refrigerated, but should be at room temperature before use; cartridges and inhaler should be at room temperature for 10 minutes prior to use.
-Cartridges should be stored in sealed foil packages in refrigerator until ready to use; blister cards and strips should not be put back in the refrigerator after being at room temperature.
-Unopened foil package, blister card, and strips stored at room temperature should be used within 10 days.
-Opened strips should be used within 3 days.

Monitoring:
-Assess pulmonary function (FEV1) prior to initiating, at 6 months, and annually; may increase monitoring as needed.
-Routine self-monitoring of blood glucose (SMBG) and regular HbA1c testing is recommended; more frequent blood glucose monitoring is recommended during periods of stress, changes in insulin regimen, and with changes to concomitant medications.
-Monitor potassium levels in patients at risk for hypokalemia.
-Monitor for fluid retention and symptoms of heart failure in patients receiving concomitant peroxisome proliferator-activated receptor (PPAR )-agonists.

Patient Advice:
-Patients should report any respiratory difficulty to their healthcare provider.
-Patients should understand the importance of diet, exercise, and blood glucose monitoring; they should be able to recognize and treat high and low blood glucose levels.
-Patients should seek medical advice promptly during periods of stress as their insulin requirements may change.
-Patients who are pregnant or planning to become pregnant should speak with their healthcare provider.

Hide