Afrezza: Discussions and Tips on Dry Cough

Here is an Afrezza user’s comment on this:

“The suggestion of drinking water sometimes before and sometimes after inhalation has worked wonders for me. My cough is essentially gone after inhaling Afrezza. I use it for all meal and correction boluses now and have zero constrictive cough.”

Here is another Afrezza user’s comment on this:

“[T]he recommendation to drink water before and after inhaling it… has actually been very helpful to me..”

The following article contains a detailed analysis of the “dry cough” issue and author’s (Greg Johnstone (practicing consultant, pharmacologist and toxicologist)) personal experience in addressing the issue.

MannKind’s Afrezza: One Investor’s User Experience, Practical Insights And Perspective Of A Diabetic Pharmacologist

by Greg Johnstone, published on on Aug. 3, 2015  (the full article (which is both comprehensive and excellent) is published on and the following is just an excerpt (related to the dry cough issue only) from the full article. Please clink the title above or this link to access the full article).

  1. I (i.e., the author (Greg Johnstone)) had several other occasions when after inhaling the Afrezza dose, I had a brief period of mild dry non-productive cough in response to a “tickle-like” effect caused by the Afrezza powder deposited on the back of my throat (much like we get when we have a throat infection or upper respiratory cold, which can cause a coughing spasm just from normal breathing). This was less common as I improved my technique and ensured I was hydrated properly. A sip or two of water shortly after the dose cleared that up.
  2. After a number of Afrezza doses (usually the larger 8 unit or an 8 plus 4 combination), I noticed a dryness and sense of thickened mucus at the back of my throat. I attributed that sensation to the deposits of the Technosphere Insulin powder at the back of my throat during inhalation of the dose, (that would be part of the 70% which does not make it to the deep lung area). I quickly began drinking a few sips of water within minutes of the inhalation. The water seems to have washed away the residual Afrezza powder, leaving me without that sensation. Once I figured that out, it was not a problem thereafter.

Many people suffer from dehydration ……….. One of the most obvious indications of dehydration is dry mouth.  ……… if your surface tissues are dry from dehydration………, there is an increased probability of cough on contact with any agent, including the Afrezza……….There are many agents and activities that contribute to dehydration. Obvious ones are: 1. Not drinking enough water; 2. Losing too much water……….

So, in the author’s (Greg Johnstone) opinion, for most people their periodic or transient dehydration will not prevent their overall use of Afrezza or the benefits it can provide, while others may experience persistent difficulty due to the effects of chronic dehydration from their lifestyles, with inhaling any dry powder medication, including Afrezza,………. This issue needs to be understood and managed like any other factor impacting the outcome of a new delivery system. The NDA data submitted by MannKind supports the view that it will not be a material negative factor for most Afrezza users over time. The author (Greg Johnstone) is inclined to agree……….

When we think about all the people who smoke cigarettes, marijuana, inhale drugs of abuse, or other drugs for asthma and respiratory conditions, or work in environments where they inhale many things worse than Afrezza, the author (Greg Johnstone) cannot help but wonder if this issue is really a non-issue in the overall scheme of things! In spite of the adverse effects and consequences of inhalation of such agents, the users continued using them for years……….



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