AFREZZA® How-To Guide

How to Use AFREZZA®: A Step-by-Step Guide

Before you begin taking AFREZZA® insulin

Your healthcare professional will review your medical history, do a physical exam, and perform a breathing test (called spirometry). You should not take AFREZZA if you have chronic lung disease, such as asthma or COPD, or if you smoke or have recently stopped smoking. Once you are ready to start AFREZZA inhaled insulin, please read the instructions for use in the Full Prescribing Information.

Step 1: Select
Step 2: Load
Step 3: Inhale
Step 4: Discard
Safety Considerations

Step 1: Select the cartridge for your dose

  • If your AFREZZA dose is 4 units, use 1 blue cartridge
  • If your AFREZZA dose is 8 units, use 1 green cartridge
  • If your AFREZZA dose is 12 units, use 1 yellow cartridge
  • Multiple cartridges are required for doses exceeding 12 units

cartridge_updated

Step 2: Load a cartridge

  • Open inhalerHolding the inhaler level, lift the white mouthpiece to a vertical position
  • Load cartridgePlace cartridge into the inhaler, making sure it lies flat in inhaler
  • Keep inhaler levelDo not turn upside down, shake, or drop, as this could cause a loss of insulin
  • Close inhalerLower the mouthpiece to close the inhaler

load_updated

Step 3: Inhale insulin

  • ExhaleRemove mouthpiece cover, hold the inhaler away from your mouth and exhale fully
  • Position inhalerKeeping your head and inhaler level, place the mouthpiece in your mouth, then tilt the inhaler down toward your chin
  • Inhale deeply and hold breathWith your mouth closed around the mouthpiece, inhale deeply and hold your breath as long as is comfortable before exhaling

inhale_updated

Step 4: Remove cartridge and discard

  • Put the mouthpiece cover back onto the inhaler
  • Open the inhaler by lifting the white mouthpiece
  • Remove the cartridge from the purple base
  • Dispose of cartridge in your regular household trash

Repeat as necessary.

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.

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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 perform a detailed medical history, physical examination, and will give you a breathing test (called spirometry) to check how your lungs are working.

AFREZZA is a man-made rapid-acting inhaled insulin breathed in through your lungs and is used to control high blood sugar in adults with diabetes. AFREZZA is available by prescription only.

  • 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.
  • 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.
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 perform a detailed medical history, physical examination, and will give you a breathing test (called spirometry) to check how your lungs are working.

Who should not use AFREZZA?

Do not use AFREZZA:

  • During episodes of low blood sugar (hypoglycemia).
  • If you have chronic lung problems such as asthma or COPD.
  • If you are allergic to regular human insulin or any of the ingredients of AFREZZA as this may cause a significant and severe allergic reaction.

What should I tell my healthcare provider before using 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.

How should I use AFREZZA?

  • Read the detailed Instructions for Use that comes with your AFREZZA.
  • Take AFREZZA exactly as your healthcare provider tells you to, including 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 level should be and when you should check your blood sugar levels.
  • Keep AFREZZA and all medicines out of reach of children.

Your dose of AFREZZA may need to change because of:

  • 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.

What should I avoid while using AFREZZA?

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.

What are the possible side effects of AFREZZA?

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

  • Low blood sugar (hypoglycemia). Signs and symptoms of 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 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 (TZDs) with AFREZZA may cause heart failure in some people. This can happen even if you 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 are low blood sugar (hypoglycemia), cough, sore throat, headache, diarrhea, tiredness and nausea.

These are not all the possible side effects of AFREZZA. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of all prescription drugs to the FDA.

Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please click here for full Prescribing Information, including Boxed WARNING, Medication Guide, and Instructions for Use for AFREZZA.

*Offer is not valid for patients if their prescriptions are paid in part or in full by any state or federally funded programs, including, but not limited to, Medicare or Medicaid, Medigap, VA, DOD or TRICARE. Offer is not valid, where prohibited by law. MannKind Corporation reserves the right to rescind, revoke, or amend this offer without notice. Maximum benefit is $150 per prescription depending on your out-of-pocket costs for the duration of the program. Eligibility criteria: Only patients who reside in the United States, Puerto Rico, Guam or the U.S. Virgin Islands can participate in this program. If you have any questions about this program, please call 855-262-5296, or if you have questions about AFREZZA, talk to your healthcare professional.