Endocrinology Book

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Inhaled InsulinAka: Insulin Inhalation Powder, Exubera

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  1. Background
    1. Off U.S. Market as of October 2007 (based on business decisions, not on recall)
    2. Listed for historical reasons
  2. Indications
    1. Diabetes Mellitus when intollerant to SQ injection
  3. Mechanism
    1. Dry powder form of rapid acting Insulin
    2. Delivery by oral inhalation
    3. Large doses needed due to inefficient absorption
      1. Most Insulin remains in lung and is inactive
  4. Dosing
    1. Powder 1 mg (in Blister pack) = Insulin 3 units
    2. Powder 3 mg (in Blister pack) = Insulin 8 units
  5. Preparations
    1. Starter: Inhaler/parts, 180 packs 1 mg, 90 packs 3 mg
    2. Refill 12: 90 packs 1 mg, 90 packs 3 mg (990 units)
    3. Refill 15: 180 packs 1 mg, 90 packs 3 mg (1260 units)
  6. Cost: Expensive (twice the cost of SQ Insulin)
    1. Starter: $190
    2. Refills: $140-180
  7. Efficacy
    1. Similar to SC Insulin
  8. Adverse Effects
    1. Hypoglycemia (esp. when used with Oral Hypoglycemics)
    2. Cough (<5%)
    3. Chest Pain (<5%)
    4. Dyspnea (<5%)
    5. Dry Mouth (<5%)
  9. Monitoring: Pulmonary Function Tests
    1. Schedule: Baseline, 6 months and annually
  10. References
    1. Borja (2007) Am Fam Physician 75:1546
    2. Cefalu (2001) Ann Intern Med 134:203
    3. Quattrin (2004) Diabetes Care 27:2622

Exubera (C1176237)

ConceptsAmino Acid, Peptide, or Protein (T116) , Pharmacologic Substance (T121) , Hormone (T125)
MSHC473734
EnglishExubera
SourcesMSH, VANDF
Derived from the NIH UMLS (Unified Medical Language System)



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