Insulin Human Inhalation : Uses, Side Effects, Interactions & More

IMPORTANT WARNING:
Inhaling insulin can decrease lung function and cause bronchospasm (difficulty breathing). Tell your doctor if you have or have ever had asthma or chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways). Your doctor will tell you not to use insulin inhalation if you have asthma or COPD. Your doctor will order certain tests to check how well your lungs are working before therapy, 6 months after starting therapy, and annually while using insulin inhalation treatment. Tell your doctor if you have any of the following symptoms: wheezing or trouble breathing.

Keep all appointments with your doctor and the laboratory.

Your doctor or pharmacist will give you the manufacturer’s patient information sheet (Medication Guide) when you start insulin inhalation treatment and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the manufacturer’s website to obtain the Medication Guide.

Talk to your doctor about the risks of using insulin inhalation.

Why is this medication prescribed?
Insulin inhalation is used in combination with a long-acting insulin to treat type 1 diabetes (a condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). It is also used in combination with other medications to treat people with type 2 diabetes (a condition in which the body does not use insulin normally and therefore cannot control the amount of sugar in the blood) who need insulin to control their diabetes. Insulin inhalation is not used to treat diabetic ketoacidosis (a serious condition that can develop if high blood sugar is not treated). Insulin inhalation is a synthetic version of short-acting human insulin. Insulin inhalation works by replacing insulin that is normally produced by the body and helping move sugar from the blood to other body tissues where it is used for energy. It also prevents the liver from producing more sugar.

Over time, people with diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medicine, making lifestyle changes (for example, diet, exercise, quitting smoking), and regularly checking your blood sugar can help control your diabetes and improve your health. This therapy can also lower your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numbness, cold legs or feet; decreased sexual ability in men and women) , eye problems, including changes. or vision loss or gum disease. Your doctor and other healthcare providers will talk with you about the best way to control your diabetes.

How should this medicine be used?
Insulin inhalation comes as a powder to be inhaled by mouth with a special inhaler. It is usually used at the beginning of each meal. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any parts you don’t understand. Use insulin inhalation exactly as directed. Do not use more or less or use it more often than prescribed by your doctor.

Inhaling insulin controls diabetes, but it does not cure it. Keep using insulin inhalation even if you feel fine. Do not stop using insulin inhalation without consulting your doctor. Do not switch to another type of insulin without consulting your doctor.

Before using your oral insulin inhaler for the first time, read the written instructions that come with it. Look at the diagrams carefully and make sure you recognize all parts of the inhaler. Ask your doctor or pharmacist to show you how to use it. Practice using the inhaler in your presence.

Insulin inhalation powder comes as a single-use cartridge. Cartridges should only be used with the inhaler that came with your prescription. Do not try to open the cartridge, swallow the cartridge, or inhale the contents without the inhaler that comes with your prescription.

After inserting a cartridge into the inhaler, keep the inhaler level with the white mouthpiece at the top and the purple base at the bottom. If you turn the inhaler upside down, or if the mouthpiece is pointed down, shaken, or falls off, you may lose the medicine. If this happens, you will need to replace the cartridge with a new cartridge before using the inhaler.

Follow your doctor’s instructions on how many insulin inhalation cartridges to use each day. When you start using insulin inhalation, your doctor may need to adjust the doses of your other diabetes medications, such as long-acting insulin and oral diabetes medications. Your doctor may also need to adjust your insulin inhalation dose during your treatment. Follow these instructions carefully and consult your doctor if you have any questions. Do not change your inhalation dose of insulin or any other diabetes medicine without talking to your doctor.

Other uses for this medicine
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before using insulin inhalation,

  • Tell your doctor and pharmacist if you are allergic to insulin (Apidra, Humulin, Lantus, Levemir, Novolog, others), any other medications, or any of the inactive ingredients in insulin inhalation. Ask your pharmacist or see the Medication Guide for a list of ingredients.
  • Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: albuterol (Proair HFA, Proventil, Ventolin, others); angiotensin converting enzyme (ACE) inhibitors such as benazepril (Lotensin, in Lotrel), enalapril (Vasotec, in Vaseretic), fosinopril, lisinopril (Prinivil, Zestril, in Prinzide, in Zestoretic), quinapril (Accupril, in Quinaretic), and ramipril (Altace); angiotensin II antagonists (angiotensin receptor blockers; ARBs) such as azilsartan (Edarbi), candesartan (Atacand, in Atacand HCT), eprosartan (Teveten, in Teveten HCT), irbesartan (Avapro, in Avalide), losartan (Cozaar , in Hyzaar), olmesartan (Benicar, in Azor, in Benicar HCT, in Tribenzor), telmisartan (Micardis, in Micardis HCT, in Twynsta) and valsartan (Diovan, in Diovan HCT, in Exforge HCT, others); beta-blockers such as atenolol (Tenormin, in Tenoretic), labetalol (Trandate), metoprolol (Lopressor, Toprol XL, in Dutoprol, others), nadolol (Corgard, in Corzide), and propranolol (Hemangeol, Inderal, Innopran XL); clonidine (Catapres, Catapres-TTS, Kapvay, others); clozapine (Clozaril, Fazaclo ODT, Versacloz); danazol; disopyramide (Norpace, Norpace CR); diuretics; fenofibrate (Lipofen, TriCor, Triglide); fluoxetine (Prozac, Sarafem, Selfemra, in Symbyax); gemfibrozil (Lopid); HIV protease inhibitors, including atazanavir (Reyataz), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), ritonavir (Norvir, in Kaletra, in Viekira Pak), and saquinavir (Invirase); Hormone replacement therapy; isoniazid (Laniazid, in Rifamate, in Rifater); lithium (Lithobid); medications for asthma, colds, mental illness, and nausea; monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar); niacin; oral contraceptives (birth control pills); oral medications for diabetes such as pioglitazone (Actos, in Actoplus Met, in Duetact, in Oseni) or rosiglitazone (Avandia, in Avandamet, in Avandaryl); oral steroids such as dexamethasone, methylprednisolone (Medrol), and prednisone (Rayos); Octreotide (Sandostatin); olanzapine (Zyprexa, Zydis, in Symbyax); other inhaled medications; pentamidine (NebuPent, Pentam); pentoxifylline (Pentoxil); pramlintide (Symlin); propoxyphene; reserpine; salicylate pain relievers such as aspirin; somatropin (Genotropin, Humatrope, Nutropin, others); sulfa antibiotics; terbutaline; and thyroid medications. Your doctor may need to change the doses of your medications or monitor you closely for side effects.
  • Tell your doctor if you have symptoms of hypoglycemia (low blood sugar). Your doctor will probably tell you not to take inhaled insulin if you have this condition.
  • Tell your doctor if you have an infection or if you smoke or if you quit smoking in the past 6 months. Also, tell your doctor if you have or have ever had lung cancer, nerve damage caused by your diabetes, heart failure, or kidney or liver disease.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while using insulin inhalation, call your doctor.
  • If you are having surgery, including dental surgery, tell the doctor or dentist that you are using insulin inhalation.
  • Ask your doctor how often to check your blood sugar. Be aware that low blood sugar levels can affect your ability to perform tasks like driving, and ask your doctor if you need to check your blood sugar before driving or operating machinery.
  • Alcohol can cause changes in blood sugar. Ask your doctor about the safe use of alcoholic beverages while using insulin inhalation.
  • Ask your doctor what to do if you get sick, gain or lose weight, experience unusual stress, plan to travel across time zones, or change your exercise or activity schedule. These changes can affect your dosing schedule and the amount of insulin you will need.

What special dietary instructions should I follow?
Be sure to follow all of the diet and exercise recommendations made by your doctor or dietitian. It is important to eat a healthy diet and eat roughly the same amounts of the same types of foods at about the same times every day. Skipping or delaying meals or changing the amount or type of food you eat can cause problems with your blood sugar control.

What should I do if I forget a dose?
When you first start using insulin inhalation, ask your doctor what to do if you forget to inhale a dose at the correct time. Write down these instructions for future reference.

What side effects can this medication cause?

This medication may cause changes in your blood sugar. You should know the symptoms of low and high blood sugar and what to do if you have these symptoms.

Insulin inhalation may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

  • cough
  • sore throat or irritation
  • tiredness
  • diarrhea
  • nausea
  • headache
  • painful, burning urination
  • weight gain

Some side effects can be serious. If you experience any of these symptoms or those listed in the IMPORTANT WARNINGS section, call your doctor immediately or get emergency medical treatment:

  • rash or itching
  • hives
  • fast heartbeat
  • sweating
  • difficulty swallowing
  • shortness of breath
  • swelling of the arms, hands, feet, ankles, or lower legs
  • sudden weight gain
  • extreme drowsiness
  • confusion
  • dizziness

Inhaling insulin can increase the risk of developing lung cancer. Talk to your doctor about the risks of using insulin inhalation.

Inhaling insulin can cause other side effects. Call your doctor if you have any unusual problems while using this medicine.

If you experience a serious side effect, you or your doctor can submit a report online to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about storage and disposal of this medication?
Keep this medicine in the refrigerator, in the container it came in, tightly closed, and out of the reach of children. Before use, remove the cartridges from the refrigerator and store them at room temperature for 10 minutes. Unopened medications can be stored at room temperature for up to 10 days. Once opened, use the cartridge blister strips within 3 days when stored at room temperature. Use the inhaler for up to 15 days from the first day of use, then throw it away and replace it with a new inhaler. Never wash the inhaler; keep it dry.

Unnecessary medications must be disposed of in special ways to ensure that pets, children, and others cannot consume them. However, you should not flush this medicine down the toilet. Instead, the best way to dispose of your medications is through a drug take-back program. Talk to your pharmacist or contact your local garbage / recycling department to find out about take-back programs in your community. Check out the FDA drug safe disposal website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medicines out of the sight and reach of children, since many containers (such as those containing weekly pills and those for eye drops, creams, patches and inhalers) are not child-resistant and small children can easily open them. To protect young children from poisoning, always close the safety caps and immediately place the medicine in a safe place, one that is upright and out of their sight and reach. http://www.upandaway.org

In case of emergency/overdose
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim collapsed, had a seizure, has trouble breathing, or cannot wake up, immediately call 911 for emergency services.

Insulin inhalation overdose can occur if you take too much insulin inhalation or if you take the right amount of insulin inhalation but eat or exercise less than usual. Insulin inhalation overdose can cause hypoglycemia. If you have any of the symptoms of hypoglycemia, follow your doctor’s instructions for what you should do if you develop hypoglycemia. Other symptoms of overdose:

  • loss of consciousness
  • seizures

What other information should I know?
Your blood sugar and glycosylated hemoglobin (HbA1c) should be checked regularly to determine your response to insulin inhalation. Your doctor will also tell you how to check your insulin response by measuring your blood or urine sugar levels at home. Follow these instructions carefully.

Don’t let anyone use your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important that you keep a written list of all prescription and over-the-counter (over-the-counter) medications you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should take this list with you every time you visit a doctor or if you go into hospital. It is also important information to take with you in case of emergencies.

Brand Names

  • Afrezza®

Disclaimer: We have made every effort to ensure that all information is factually accurate, comprehensive and up-to-date. However, this article should not be used as a licensed health care professional’s choice of knowledge and expertise. You should always consult your doctor or other health care professional before taking any medication. The information given here is subject to change and it has not been used to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions or adverse effects. The lack of warning or other information for any drug does not indicate that the combination of medicine or medication is safe, effective or appropriate for all patients or all specific uses.

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