What are the side effects of Afrezza?
The common side effects of Afrezza are similar to other rapid-acting insulins, including hypoglycemia (low blood sugar), weight gain and hypokalemia (lower than normal amount of potassium in the blood).
Since Afrezza is inhaled, it can also cause throat pain and irritation, as well as a dry cough that usually starts within 10 minutes after inhalation.
Clinical trials showed that Afrezza can cause a reduction in lung function. One of the serious side effects is acute bronchospasm in asthma and COPD patients. Afrezza has a Black Box Warning for this reason. Bronchospasm is tightening of the muscles around the bronchioles of the lungs. Afrezza also caused wheezing, bronchoconstriction (tightening of the airways) and asthma exacerbation in asthma patients in a clinical study. Therefore patients with chronic lung disease such as asthma or COPD or those who smoke should not use Afrezza. Patients taking Afrezza for the first time will need to take a lung test before they start, after 6 months of use, and every year after that, even if they are not having lung problems.
Afrezza can also cause more formation of anti-insulin antibodies when compared to other injectable rapid insulins. Antibodies are proteins that are produced by the body’s immune system to help destroy harmful substances like bacteria or viruses. When the body makes antibodies to destroy insulin, this can lead to type 1 diabetes.
Cases of lung cancer were reported during clinical trials in 2 patients taking Afrezza who had a past history of heavy tobacco use, as well as 2 patients who were non-smokers. Therefore patients with active lung cancer, a previous history of lung cancer, or patients that have a risk of getting lung cancer should consider whether the benefits of using Afrezza outweigh the risks.
What are Afrezza drug interactions?
The following are some examples of drugs that may interact with Afrezza:
Other antidiabetic drugs including insulin and oral drugs may increase the risk of hypoglycemia when used with Afrezza because of the combined effect of lowering blood glucose.
Atypical antipsychotics (such as olanzapine) may reduce the glucose-lowering effect of Afrezza possibly by preventing beta cells from producing insulin, therefore making Afrezza less effective.
Beta-blockers (such as propranolol) may reduce or block the signs and symptoms of hypoglycemia (low blood sugar) by blocking the increase in heart rate and blood pressure that occurs during hypoglycemia. Therefore the patient may not be aware that they have low blood sugar.
Combining Afrezza with TZDs (Thiazolidinediones) such as Actos (Pioglitazone) may cause heart failure or make existing heart failure worse. This is because TZDs cause the body to retain fluid. Excess fluid in the body can put more pressure on the heart and can lead to heart failure. When Afrezza is used together with TZDs it can increase the risk of retaining body fluid and therefore the risk of heart failure.
There are other medications that can interact with Afrezza. Patients should inform their physician or pharmacist about other drugs they are taking to determine if there is a risk of interaction with Afrezza.
The dose of Afrezza may need to be adjusted when used with the medications listed above. Patients should also be informed to closely monitor their blood sugar and report any unusual signs and symptoms, episodes of hypoglycemia, or symptoms of heart failure such as shortness of breath and swelling of the ankles and feet.
Next: Warnings, Dosing