Afrezza® can help you with blood sugar control without the need for mealtime injections. Before you take your first dose, make sure you understand how Afrezza® works and how to use the inhaler. It is also important to check your blood sugar frequently to track how Afrezza® is working for you. Discuss your results with your healthcare provider so you can adjust your dose if needed.

Your First Dose


Afrezza® is available in 4-, 8- and 12-unit color-coded cartridges. If needed, you can mix and match cartridges to take your prescribed dose.

For example, two 12-unit cartridges provide a dose of 24 units of Afrezza®.

Effective Dosing

Like all insulin therapy, monitor the effect Afrezza® has on you, and reach out to your doctor if you feel like you need to change your dosing.

Typical Dosing at Mealtime

In clinical trials, most patients received 12-24 Afrezza® insulin units per meal.

Switching from Injected Mealtime Insulin

Because Afrezza® is inhaled, and is in powdered form, one unit of Afrezza® may work differently than one unit of injectable, liquid insulin.

Based on clinical trials, it may take 1.5x the amount of Afrezza® to achieve the same blood sugar control as injected insulin.

This table can help provide a starting point for mealtime dose conversion, but you and your healthcare provider should decide on the appropriate starting dose for your specific needs.

How to Use Afrezza

Before you take your first dose, make sure to learn proper inhalation technique and how Afrezza® works. You can download our step-by-step guide, or watch the How to Use Afrezza® video.

What to Expect

Afrezza® works fast

  • Afrezza® is the only ultra rapid-acting inhaled insulin.
  • Afrezza® starts controlling your blood sugar in about 12 minutes and leaves the body quickly, within 1.5–3 hours, depending on your dose.

*For the 4-unit and 12-unit cartridges, respectively

Afrezza® is different than injectable insulin

  • Remember, Afrezza® is different from injectable insulin, delivering ultra-rapid control that may reduce blood sugar levels faster than you may be accustomed to, so a period of adjustment is expected.
  • Make sure to test your blood sugar levels frequently to learn how Afrezza® works for you.

Afrezza® is an inhaled dry powder

  • Since Afrezza® is an inhaled powder, you may experience a cough when you start Afrezza®.
  • As a suggestion, taking Afrezza® at room temperature and having a sip of water before and after inhalation may help.
  • If you develop a persistent or recurring cough, or have breathing difficulties while using Afrezza®, contact your healthcare provider.

How to Store
and Handle Afrezza

Package Contents

  • Each package of Afrezza® comes with two inhalers. Each inhaler may be used for up to 15 days. After 15 days of use, the inhaler must be discarded and replaced with a new inhaler.
  • Cartridges containing Afrezza®  are sealed in foil.
  • Blister cards are perforated so you can easily remove three cartridges at a time.
  • Keep new cartridges in the foil pack until you’re ready to use them.
  • Discard used cartridges right away.

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


Storing Afrezza

  • Afrezza® should be stored in the refrigerator once picked up from the pharmacy.
  • Unopened blister cards or strips can be stored at room temperature for up to 10 days.
  • After the foil is punctured, the cartridges can be stored at room temperature for up to three days.
  • You should not put Afrezza® back into the refrigerator after being stored at room temperature.

Download our Storage & Handling Guide to learn how to properly store the inhaler and cartridges.

Download →


Caring for the Inhaler

  • Use one inhaler at a time and replace it after 15 days.
  • Keep the inhaler in a clean, dry place with the mouthpiece cover on until your next dose.
  • Inhalers may be stored in the refrigerator, but they must be at room temperature before use.
  • Never leave or store unused cartridges in the inhaler.
  • Keep out of reach of children.

Use a calendar or the chart on the back of the inhaler box to help you remember to switch out your inhaler after 15 days of use.


Still have questions? Get answers to frequently asked questions about taking Afrezza®.






  1. Afrezza® (insulin human) Inhalation Powder Prescribing Information. MannKind Corporation.
  2. Data on file. MannKind Corporation.
  3. Akturk HK, Snell-Bergeon JK, Rewers A, et al. Improved postprandial glucose with inhaled Technosphere insulin compared with insulin aspart in patients with type 1 diabetes on multiple daily injections: the STAT study. Diabetes Technol Ther. 2018;20(10):639–647.
  4. Bode BW, McGill JB, Lorber DL, et al. Inhaled Technosphere insulin compared with injected prandial insulin in type 1 diabetes: a randomized 24-week trial. Diabetes Care. 2015;38(12):2266–2273.
  5. Rosenstock J, Franco D, Korpachev V, et al. Inhaled Technosphere insulin versus inhaled Technosphere placebo in insulin-naive subjects with type 2 diabetes inadequately controlled on oral antidiabetes agent. Diabetes Care. 2015;38(12):2274–2281.


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.

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