What Is Afrezza? Uses, Dosage, and What You Need to Know in 2026

What Is Afrezza?

Afrezza is an FDA-approved inhaled insulin used to improve blood sugar control in adults with type 1 diabetes and type 2 diabetes. Unlike traditional insulins that you inject with a needle or pen, Afrezza is a dry powder that you breathe into your lungs using a small, pocket-sized inhaler.

Afrezza is made by MannKind Corporation and is the only inhaled insulin currently available in the United States. It is a rapid-acting insulin, meaning it works quickly to help manage blood sugar spikes that happen after meals.

How Is Afrezza Different From Injectable Insulin?

The biggest difference is the delivery method. Instead of injecting insulin under your skin, you inhale a fine powder through a small device called the Afrezza Inhaler. This makes it an attractive option for people who:

• Dislike needles or have needle phobia
• Want a more discreet way to take mealtime insulin
• Are looking for faster-acting insulin (Afrezza starts working within 12-15 minutes)
• Experience injection site problems like pain, bruising, or lipodystrophy

However, Afrezza is not a replacement for long-acting (basal) insulin. If you have type 1 diabetes, you still need a basal insulin like Lantus, Basaglar, or Tresiba in addition to Afrezza. For type 2 diabetes, your doctor will determine whether Afrezza alone or in combination with other medications is right for you.

What Is Afrezza Used For?

Afrezza is approved to improve glycemic control in adults with:

• Type 1 diabetes mellitus — Used as mealtime insulin alongside a long-acting basal insulin
• Type 2 diabetes mellitus — Used as mealtime insulin, often in combination with oral diabetes medications or basal insulin

Afrezza is taken at the beginning of each meal. It helps your body use the sugar from the food you eat, preventing blood sugar spikes after eating.

Understanding the Afrezza 180 Titration Pack (60, 60, 60)

The Afrezza 180 Titration Pack contains a combination of single-use cartridges in different strengths (4-unit, 8-unit, and 12-unit cartridges). The "60, 60, 60" refers to the cartridge count breakdown in the pack. This titration pack is designed for patients who are starting Afrezza or adjusting their dose, allowing them to try different strengths to find the right mealtime dose.

Dosing: How Much Afrezza Should You Take?

Your doctor will determine your dose based on your individual needs. Here are the general guidelines:

• Starting dose (insulin-naive patients): 4 units at the beginning of each meal
• Dose adjustment: Your doctor will increase or decrease the dose based on your blood sugar readings
• Available cartridge strengths: 4 units, 8 units, and 12 units
• Combining cartridges: You can use more than one cartridge per meal to achieve higher doses (for example, two 12-unit cartridges for a 24-unit dose)

Each cartridge is used for a single inhalation. The inhaler device itself should be replaced every 15 days.

How to Use the Afrezza Inhaler

Using Afrezza is straightforward:

1. Open the inhaler and place a cartridge into the device
2. Close the inhaler — this punctures the cartridge
3. Exhale normally (away from the inhaler)
4. Place the mouthpiece in your mouth and inhale deeply
5. Hold your breath for a few seconds, then exhale normally
6. Dispose of the used cartridge

Take Afrezza at the beginning of your meal. Because it works fast, timing it right helps it match your blood sugar rise from eating.

For a deeper explanation of how the drug works in your body, see How Does Afrezza Work? Mechanism of Action Explained.

Important Safety Information

Boxed Warning

Afrezza has a boxed warning — the FDA's most serious type of warning — about the risk of acute bronchospasm in patients with chronic lung disease. Afrezza is contraindicated (must not be used) in patients with:

• Asthma
• COPD (chronic obstructive pulmonary disease)

A spirometry test (lung function test) is required before starting Afrezza to make sure your lungs are healthy enough for the medication.

Who Should Not Take Afrezza?

• People with asthma or COPD
• Current smokers or those who recently quit
• Anyone with a known allergy to human insulin or Afrezza's ingredients
• During episodes of hypoglycemia

Common Side Effects

The most common side effects include cough, sore throat, hypoglycemia, headache, diarrhea, and fatigue. For a complete breakdown, read our guide: Afrezza Side Effects: What to Expect and When to Call Your Doctor.

Cost and Insurance Coverage

Afrezza is a brand-name medication with no generic available. The cash price typically ranges from $550 to $650 per prescription. Many insurance plans cover Afrezza but may require prior authorization or step therapy (trying injectable insulin first).

MannKind offers a savings program through AfrezzaAssist. For more ways to reduce costs, see How to Save Money on Afrezza.

Finding Afrezza in 2026

Because Afrezza is made by a single manufacturer and is not widely stocked at retail pharmacies, it can sometimes be hard to find. If you are having trouble locating it, try these resources:

• MedFinder — Search pharmacy availability near you
• How to Find Afrezza in Stock Near You
• How to Check Pharmacy Stock Without Calling

Drug Interactions

Afrezza can interact with several other medications, including beta-blockers, ACE inhibitors, corticosteroids, and other diabetes drugs. Always tell your doctor about all medications you take. For a full list, see Afrezza Drug Interactions: What to Avoid.

Special Populations

• Pregnancy: Use only if clearly needed; discuss risks with your doctor
• Breastfeeding: May pass into breast milk; consult your doctor
• Children: Afrezza is not approved for patients under 18
• Older adults: Can be used with caution and close monitoring

Key Takeaways

• Afrezza is the only inhaled insulin available in the U.S., used for mealtime blood sugar control in adults with type 1 or type 2 diabetes.
• It works within 12-15 minutes — faster than most injectable rapid-acting insulins.
• A spirometry (lung function) test is required before starting.
• It is contraindicated in patients with asthma, COPD, or current smokers.
• The 180 Titration Pack is designed for patients starting or adjusting their dose.
• Use MedFinder to find Afrezza in stock near you.