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Afrezza is a rapid acting insulin that may help you keep your blood sugar in control after meals. Afrezza is available by prescription only and is for adults living with type 1 or type 2 diabetes.

Tips For Use

If you are not seeing the blood sugar results you expect, please talk to your healthcare provider.  You may need to adjust your dose.

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Please see full Prescribing Information, including boxed WARNING, Medication Guide, and Instructions for Use.

BEGINNING AFREZZA

When using Afrezza, like any insulin medication, it is important to work with your healthcare provider to find best dose and schedule for you. If you are not getting the sugar control you expect, please speak to your healthcare provider about adjusting your dose. 

NEW TO MEALTIME INSULIN:

If you have never used mealtime insulin before, your healthcare provider will start you at a dose of Afrezza at each meal to see if this works for you.

  • You may need to adjust your Afrezza dose up or down. Afrezza is supplied in 4, 8 and 12 Afrezza insulin unit cartridges to help the adjustment.
  • Your dose of Afrezza may need to change because of a change in level of physical activity or exercise, weight gain or loss, increased stress, illness, change in diet, or because of other medicines you take.

SWITCHING FROM INJECTED MEALTIME INSULIN:

If you have been taking injected mealtime insulin, you probably have settled into a routine and use a fixed number of injected insulin units per meal or snack. 

There is not a straight conversion from your injected dose of insulin to your inhaled dose of Afrezza. You and your healthcare provider can determine the appropriate dose of Afrezza that is right for you.

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REMEMBER TO MONITOR YOUR BLOOD SUGAR LEVELS

Ask your healthcare provider what your blood sugar level should be, and when you should check your blood sugar levels. It's important to test your blood sugar levels frequently- especially when starting Afrezza for the first time. Monitoring your blood sugar levels can help you and your healthcare provider determine the right dose of Afrezza your body needs for your meals. You can track your blood sugar levels using our blood sugar log template. Share your results with your healthcare provider who can help determine how well your treatment program is working for you. 

DOWNLOAD BLOOD SUGAR LOG
Dosing Users

Converting from injected mealtime insulin

Graph 3

For Afrezza doses exceeding 12 units, inhalations from multiple cartridges are necessary. To achieve the required total mealtime dose, you should use a combination of 4, 8 and 12 Afrezza unit cartridges as pictured above.

A NEW WAY TO THINK ABOUT INSULIN

Afrezza insulin units are different than injected insulin units because Afrezza is inhaled and in powder form, while other mealtime insulins are in a liquid form and injected. Your healthcare provider will start you on a dose considered best for you.

Life is constantly changing and Afrezza can be adapted to your activities and schedule. Afrezza dosing should be individualized. This table can help with initial mealtime dose when converting. As you start your new therapy, get to know how Afrezza works for you and let your healthcare provider know your progress. 

Step-by-step guide

STEP 1:  Select the cartridge for your dose

  • 4 units: If your Afrezza dose is 4 units, use 1 blue cartridge.
  • 8 units: If your Afrezza dose is 8 units, use 1 green cartridge.
  • 12 units: If your Afrezza dose is 12 units, use 1 yellow cartridge.

If your prescribed Afrezza dose is more than 12 units you will need to use more than 1 cartridge to get your right dose. Multiple inhalations will be necessary.

3 Cartridges

STEP 2:  Load a cartridge

  • HOLD INHALER: Hold the inhaler level in one hand with the white mouthpiece on the top and purple base on the bottom.
  • OPEN INHALER: Open the inhaler by lifting the white mouthpiece to a vertical position.
  • PLACE CARTRIDGE: Hold the cartridge with the cup facing down. The pointed end of the cartridge should line up with the pointed end in the inhaler. Place cartridge into the inhaler, making sure it lies flat in inhaler.
  • KEEP LEVEL: Now that the cartridge is loaded, keep the inhaler level from this point forward to avoid loss of drug powder. Do not turn it upside down, shake, or drop, as this could cause a loss of drug powder.
  • Close inhaler: Lower the mouthpiece to close the inhaler (this will open the drug cartridge). You should feel a snap when the inhaler is closed.
Insertcartridge2 Illus Fl

STEP 3:  Inhale insulin

  • Remove Cover: Remove the mouthpiece coverKeep the inhaler level.
  • Exhale: Hold the inhaler away from your mouth and exhale fully.
  • Position inhaler: Keeping your head and inhaler level, place the mouthpiece in your mouth. Close your lips around the mouthpiece to form a seal. Tilt the inhaler downward while keeping your head level as shown. 
  • Inhale deeply and hold breath: With your mouth closed around the mouthpiece, inhale deeply through the inhaler. Hold your breath for as long as comfortable and at the same time remove the inhaler from your mouth. Exhale and breathe normally.
Tilt Inhale 3Illustrations

STEP 4:  Remove cartridge and discard

  • Replace Cover: Put the mouthpiece cover back onto the inhaler.
  • Open Inhaler: Open the inhaler by lifting the white mouthpiece.
  • Remove Cartridge: Remove the cartridge from the purple base.
  • Discard: Throw away the cartridge in your regular household trash.

Repeat steps 2 through 4 for each Afrezza cartridge you need for your dose. 

Step4Illustrations

CARING FOR THE INHALER

Product

Your Afrezza Inhaler

Each package of Afrezza comes with 2 inhalers. Use 1 inhaler at a time and replace it after 15 days. 

Care instructions

Once you have taken your full dose, make sure the purple mouthpiece cover has been replaced and the inhaler is closed. 

  • The Afrezza inhaler can be used for up to 15 days from the date of first use. After 15 days of use, the inhaler must be discarded and replaced with a new inhaler.
  • Keep the inhaler in a clean, dry place with the mouthpiece cover on until your next dose.
  • May be stored refrigerated, but must be at room temperature before use.
  • Never leave or store cartridges in the inhaler.
  • Keep out of reach of children.

Tip: Keep track of 15 days from when you start using the inhaler with a calendar, or use the chart on the back of the inhaler box.

Inhaler Ifu With Labels

Afrezza insulin cartridges

Afrezza insulin comes in 4, 8 and 12 unit color-coded cartridges. Cartridges containing the fast-acting insulin are sealed in foil packages containing 2 blister cards with 15 cartridges each. Cards are perforated so you can easily remove 3 cartridges at a time.

Cartridges Chart



It's important not to mix new and used cartridges. Keep new cartridges in the foil pack until right before use. Discard used cartridges right away.

TIP: New cartridges have the cup positioned forward near the point. Used cartridges will have the cup positioned in the center.

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Storage and handling

AFREZZA® INHALERS

Table Device Opened package May be used for up to 15 days

AFREZZA® CARTRIDGES

Not in use: Refrigerated storage Refrigerated (36˚-46˚)
Table Packet Sealed (Unopened)* May be used until the expiration date
Blister card and stripsTable Packet 1 Sealed (Unopened)* Must be used within 1 month
In use: Room temperature storage Room temperature
Blister cards and stripsTable Packet 1 Sealed (Unopened) Must be used within 10 days
StripsTable Packet 2 Opened Must be used within 3 days
Do not put a blister card or strip back into the refrigerator after being stored at room temperature.
Clock Before use, cartridge and inhaler should be at room temperature for 10 minutes.

* If a foil package, blister card, or strip is not refrigerated, the content must be used within 10 days.

Inhaler In Hand 1

MannKind Cares®

MannKind is committed to helping people gain access to Afrezza.

MannKind Cares supports people with diabetes and caregivers who have questions about Afrezza. We understand the challenges people may face with the healthcare system and are here to help. MannKind Cares provides support services to help answer your questions related to insurance coverage, prescription cost, and product use.

If your doctor recommends Afrezza for you, ask your physician about enrolling you in MannKind Cares.  We will work with your insurance provider to check whether Afrezza is covered and provide support to get your prescription filled.  Please contact us if you have questions. 

Phone:

1-844-323-7399, 8:30am-8:00pm ET
Monday through Friday

Important Safety Information for Afrezza (insulin human) Inhalation Powder

Afrezza can cause serious side effects, including: Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza, your healthcare provider will give you a breathing test to check how your lungs are working.

IMPORTANT SAFETY INFORMATION

What is the most important information I should know about Afrezza?

Afrezza can cause serious side effects, including:

Sudden lung problems (bronchospasms). Do not use Afrezza if you have long-term (chronic) lung problems such as asthma or chronic obstructive pulmonary disease (COPD). Before starting Afrezza, your healthcare provider will give you a breathing test to check how your lungs are working.

  • Afrezza is a man-made insulin that is breathed-in through your lungs (inhaled) and is used to control high blood sugar in adults with diabetes mellitus. 
  • Afrezza is not for use in place of long-acting insulin. Afrezza must be used with long-acting insulin in people who have type 1 diabetes mellitus. 
  • Afrezza is not for use 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 people who smoke or 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.

Do not use Afrezza if you:

  • Have chronic lung problems such as asthma or COPD.
  • Are allergic to regular human insulin or any of the ingredients in Afrezza. See the end of this Medication Guide for a complete list of ingredients in Afrezza. 

Before using Afrezza, tell your healthcare provider about all your medical conditions, including if you:

  • Have lung problems such as asthma or COPD
  • Have or have had lung cancer
  • Are using any inhaled medications
  • Smoke or have recently stopped smoking
  • Have kidney or liver problems
  • Are pregnant, planning to become pregnant, or are breastfeeding. Afrezza may harm your unborn or breastfeeding baby.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins or herbal supplements.

Before you start using Afrezza, talk to your healthcare provider about low blood sugar and how to manage it.

  • Read the detailed Instructions for Use that comes with your Afrezza.
  • Take Afrezza exactly as your healthcare provider tells you to. Your healthcare provider should tell you how much Afrezza to use and when to use it.
  • Know the strength of Afrezza you use. Do not change the amount of Afrezza you use unless your healthcare provider tells you to.
  • Take Afrezza at the beginning of your meal.
  • Check your blood sugar levels. Ask your healthcare provider what your blood sugar should be and when you should check your blood sugar levels.
  • Keep Afrezza and all medicines out of the reach of children.
  • Change in level of physical activity or exercise, weight gain or loss, increased stress, illness, change in diet, or because of other medicines you take. 

While using Afrezza do not:

  • Drive or operate heavy machinery, until you know how Afrezza affects you.
  • Drink alcohol or use over-the-counter medicines that contain alcohol.
  • Smoke.

Afrezza may cause serious side effects that can lead to death, including:

See “What is the most important information I should know about Afrezza?” at the top of this page.

  • Low blood sugar (hypoglycemia). Signs and symptoms that may indicate low blood sugar include:
    • Dizziness or light-headedness, sweating, confusion, headache, blurred vision, slurred speech, shakiness, fast heartbeat, anxiety, irritability or mood change, hunger.
  • Decreased lung function. Your healthcare provider should check how your lungs are working before you start using Afrezza, 6 months after you start using it and yearly after that.
  • Lung cancer. In studies of Afrezza in people with diabetes, lung cancer occurred in a few more people who were taking Afrezza than in people who were taking other diabetes medications. There were too few cases to know if lung cancer was related to Afrezza. If you have lung cancer, you and your healthcare provider should decide if you should use Afrezza.
  • Diabetic ketoacidosis. Talk to your healthcare provider if you have an illness. Your Afrezza dose or how often you check your blood sugar may need to be changed.
  • Severe allergic reaction (whole body reaction). Get medical help right away if you have any of these signs or symptoms of a severe allergic reaction:
    • A rash over your whole body, trouble breathing, a fast heartbeat, or sweating.
  • Low potassium in your blood (hypokalemia).
  • Heart failure. Taking certain diabetes pills called thiazolidinediones or “TZDs” with Afrezza may cause heart failure in some people. This can happen even if you have never had heart failure or heart problems before. If you already have heart failure it may get worse while you take TZDs with Afrezza. Your healthcare provider should monitor you closely while you are taking TZDs with Afrezza. Tell your healthcare provider if you have any new or worse symptoms of heart failure including:
    • Shortness of breath, swelling of your ankles or feet, sudden weight gain.

Treatment with TZDs and Afrezza may need to be changed or stopped by your healthcare provider if you have new or worse heart failure.

Get emergency medical help if you have:

• Trouble breathing, shortness of breath, fast heartbeat, swelling of your face, tongue, or throat, sweating, extreme drowsiness, dizziness, confusion.

The most common side effects of Afrezza include:

  • Low blood sugar (hypoglycemia), cough, sore throat

These are not all the possible side effects of Afrezza. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 (1-800-332-1088).

Active ingredient: human insulin

Inactive ingredients: fumaryl diketopiperazine, polysorbate 80


General information about the safe and effective use of Afrezza.

Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. Do not use Afrezza for a condition for which it was not prescribed. Do not give Afrezza to other people, even if they have the same symptoms that you have. It may harm them.

This Medication Guide summarizes the most important information about Afrezza. If you would like more information, talk with your healthcare provider. You can ask your pharmacist or healthcare provider for information about Afrezza that is written for health professionals. For more information, go to www.afrezza.com or call MannKind Corp. 1-877-323-8505.