What are the pharmacotechnical forms of inhaled insulin

Insulin can be inhaled in different forms, depending on how it has been prepared by various companies.

• Dry powder. This is inhaled with the Exubera system of inhalations, from Pfizer Inc. and Aventis Pharma, in collaboration with Nektar Therapeutics. This system is already evolving technologically and was very recently been approved (in January 2006) by the FDA for clinical use. It is soon expected to be available in Europe.

• Aerosol (nebulized) via the AERx inhalation system (produced by Aradigm) (in phase III studies).

• 'Artificial insulin spheres' (TechnospheresTM/Insulin from MannKind), with their main characteristic being their precise resemblance to each other. The method is in phase II clinical studies.

• Insulin connected to big porous particles, stable in room temperature, which are inhaled with special appliances, from Alkermes and Eli Lilly.

These particles have a small density (<0.1 g/cm2) and large 'geometrical' diameter (10-20 mm) but their aerodynamic diameter is small (13 mm). Also in phase II studies.

• Crystalline insulin from the KOS Company. It is administered via a simple metered dose inhalations appliance that functions mechanically (in Phase II).

• Crystalline insulin (Humulin R®) in the preparation U500 from the Eli Lilly Company, with an inhalation appliance from Aerogen (in Phase I).

There is no consensus on whether dry powder or the solution is absorbed better, or is more effective, since there are no comparative studies.

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