Exubera
® (
inhaled insulin) is a prescription medication licensed to treat both type 1 and
type 2 diabetes in adults. Unlike other forms of insulin that need to be injected, Exubera is inhaled into the lungs through the mouth. It is a short-acting, or rapid-acting, insulin that is used before meals. Exubera will not replace long-acting insulin.
Note: In October 2007, Pfizer announced it will stop making Exubera. This decision was voluntary and was not based on any safety concern; Pfizer states that Exubera has not met its expectations in terms of sales. Starting in October 2007, Exubera will be available for an additional three months, which will give people enough time to change from Exubera to another type of insulin or other diabetes medication.
Exubera is made by Pfizer.
Exubera contains a manufactured version of insulin that is exactly like the insulin produced by the human body.
All people with
type 1 diabetes and some people with type 2
diabetes do not make enough (or do not make any) insulin. Insulin is necessary to help remove sugar (glucose) from the blood to produce energy. Without enough insulin, glucose cannot be removed from the blood, which causes high blood sugar.
Exubera provides insulin for the body, which helps to lower blood sugar. It works quickly to help the body remove glucose from the blood after meals. People with type 1 diabetes will need to take a longer-acting insulin in addition to Exubera to help control blood sugar in between meals. People with type 2 diabetes can use Exubera alone or in combination with oral
diabetes drugs or longer-acting insulins.
Several studies have looked at the effects of Exubera for type 1 and
type 2 diabetes, particularly its effects on hemoglobin A1c and fasting blood glucose.
Exubera and Hemoglobin A1c
Hemoglobin A1c (HbA1c) is a test used to measure long-term blood sugar control. For people without
diabetes, HbA1c results are usually less than 6 percent, while people with diabetes usually have higher levels. People who have better control over blood sugar have lower HbA1c levels. In one study of people with type 2 diabetes taking Exubera, HbA1c levels dropped by 4 percent, while people taking oral medications for diabetes decreased their HbA1c levels by only 0.2 percent. In studies of Exubera for
type 1 diabetes, people taking the drug and people taking regular injectable insulin showed similar decreases in HbA1c levels.
Exubera and Fasting Blood Glucose
Fasting blood glucose (blood sugar levels before a meal) are another good way to evaluate
diabetes medications. Exubera has been shown to lower fasting blood glucose more than oral diabetes medications (in people with type 2 diabetes) or regular injectable insulin (in people with type 1 diabetes).
When and How to Take Exubera
General considerations for when and how to take Exubera include the following:
- Exubera comes in blister packets that contain a powder. These packets must be used in the inhaler.
- Several steps are involved in using the Exubera inhaler. Your inhaler will come with detailed instructions. Make sure that your healthcare provider shows you exactly how to use the inhaler.
- You will inhale the Exubera powder into your lungs by breathing it in with a normal breath and then holding your breath for five seconds.
- Exubera works quickly; you should inhale it within 10 minutes before a meal. Using the drug more than 10 minutes before a meal could increase your chance of low blood sugar (hypoglycemia). If you skip a meal, you should also skip that Exubera dose.
- You may need to use more than one blister packet in order to get the right dose. However, three 1-mg blisters do not equal one 3-mg blister (in studies, people who used three 1-mg blisters absorbed more insulin than people who used one 3-mg blister). Unfortunately, Exubera comes in packages with both 1-mg and 3-mg blisters (you cannot buy them separately at this time), and you may have extra blisters that you cannot use.
- For Exubera to work properly, it must be used as prescribed. The medication will not work if you stop taking it.
Dosing Information for Exubera
The dose of Exubera that your healthcare provider recommends will vary, depending on a number of factors, including:
- Whether you have type 1 or type 2 diabetes
- Other medical conditions you may have
- Other medications you are currently taking.
As is always the case, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, side effects are possible with Exubera. However, not everyone who takes the drug will experience side effects. In fact, most people tolerate the medication quite well. If side effects do occur, in most cases, they are minor and either require no treatment or can be easily treated by you or your healthcare provider. Serious side effects are less common.
The most common side effects of Exubera include:
- Low blood sugar (see Exubera and Blood Sugar)
- Respiratory tract infections, such as the common cold
- Coughing
- Runny or irritated nose
- Difficulty breathing or shortness of breath.
(Click Exubera Side Effects to learn more, including potentially serious side effects to look out for.)
Drug Interactions With Exubera
Exubera: What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider prior to taking Exubera if you have:
Also let your healthcare provider know if you are:
Tell your healthcare provider about all of the medicines you take, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose of Exubera?
People who take too much Exubera may have overdose symptoms that could include:
- Low blood sugar
- Fainting
- Shakiness
- Fast heartbeat (tachycardia)
- Confusion
- Sweating.
If you happen to overdose on Exubera, seek immediate medical attention.
How Should Exubera Be Stored?
Unlike many other types of insulin, Exubera should not be refrigerated. Keep Exubera at room temperature, away from moisture. Once you open a pack of blisters, they must be thrown away after three months. The inhaler can be used for up to one year. After that, a new inhaler can be purchased. Do not use any blisters that have been refrigerated or frozen.
Keep Exubera and all medications out of the reach of children.
What Should I Do If I Miss a Dose of Exubera?
You and your healthcare provider will need to form a plan for your use of Exubera, including what you should do if you miss a dose. This will depend on factors such as how much you have eaten, your blood sugar level, and other medications you have taken.
Exubera comes in blister packets containing 1 mg Exubera or 3 mg Exubera. These blisters come together in the following packages (they cannot be purchased separately at this time):
- Exubera Combination Pack 12, containing 90 blisters of 1 mg Exubera and 90 blisters of 3 mg Exubera
- Exubera Combination Pack 15, containing 180 blisters of 1 mg Exubera and 90 blisters of 3 mg Exubera
- Exubera Kit, containing 180 blisters of 1 mg Exubera, 90 blisters of 3 mg Exubera, an Exubera inhaler, and a replacement chamber.
All of these packages also contain two Exubera release units. The release unit is a part of the inhaler that must be replaced every two weeks. Exubera inhalers, chambers (part of the inhaler), and release units can also be purchased separately.
Depending on your dose, you may have extra Exubera blisters that you cannot use. Unfortunately, as mentioned, three 1-mg blisters cannot be used in place of one 3-mg blister.
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