Starting AFREZZA®

Inhaled Insulin Dosing Information

AFREZZA is used at the beginning of the meal using the supplied oral inhaler and one or more single-use cartridges (single inhalation per cartridge). Dosage adjustment may be needed when converting from injected insulin to AFREZZA.

How to start:

  • Insulin-Naïve Individuals: Start on 4 units of AFREZZA at each meal.

  • Individuals Using Subcutaneous Mealtime Insulin: Determine the appropriate AFREZZA dose for each meal by converting from the injected dose using chart below.

  • 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 (see chart below). Administer half the total daily injected pre-mixed dose as an injected basal insulin dose.

How to convert from injected mealtime insulin:

chart_fpo

How to adjust the injected mealtime insulin dose:

Adjust the dosage of AFREZZA based on your individual metabolic needs, blood glucose monitoring results, and glycemic control goal.

 

Dosage adjustments may be needed with changes in physical activity, changes in meal patterns (i.e., macronutrient content or timing of food intake), changes in renal or hepatic function, or during acute illness.

 

Dosage adjustment may be needed when AFREZZA is co-administered with certain drugs. Please refer to the Drug Interactions section of the Prescribing Information.

 

For doses exceeding 12 units

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-unit cartridges.

 

Please see additional Important Safety Information for AFREZZA and full Prescribing Information, including Boxed WARNING.

Reimbursement Support

Contact your insurance provider to determine your coverage options for AFREZZA.

 

For additional assistance, contact MannKind CaresSM support:

Phone:

1-844-323-7399

Hours: 8:30 AM-8:00 PM EST, Monday through Friday

Helpful Resources

The following links offer additional information about AFREZZA and your overall diabetes treatment plan:

 

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.