Insulin Detemir

Levemir

Levemir is an FDA-approved long-acting type of insulin that is used to manage type 1 and type 2 diabetes. It contains insulin detemir and is used as an injection under the skin (subcutaneously). It lasts up to 24 hours, depending on the dose. Your doctor or nurse will show you how to inject it safely and effectively. For best results, use this medication consistently. Do not use Levemir if you are allergic to it, its ingredients or any insulin. For more guidance on usage, dosage, storage, disposal and more, consult your doctor and discuss the potential risks and benefits of the medication. 

Product Overview

Levemir is a long-acting insulin-containing insulin detemir approved by the FDA for managing type 1 and type 2 diabetes. It is administered via subcutaneous injection and lasts up to 24 hours, depending on the dose. Levemir helps maintain a steady level of insulin in the body to control blood glucose levels and prevent complications of diabetes.

Levemir is available as a 100IU/ml Flexpen and can be used alone or with other diabetes medications. It should be used consistently and as directed by a healthcare professional. Common side effects include low blood sugar levels, injection site reactions, and weight gain. Levemir is contraindicated in individuals with allergies to insulin detemir or any insulin, and caution should be exercised in those with kidney, liver, or heart issues.

To take Levemir, follow your doctor’s instructions closely. It is crucial not to miss doses, but if you do, take it as soon as possible unless it is almost time for your next dose. Do not double dose. Store Levemir in a safe place, away from children, at 2 °C to 8°C or below 30°C. If you suspect an overdose or experience severe allergic reactions, seek medical assistance immediately. Levemir may interact with other medications, so inform your healthcare provider about all medications you are taking.

Uses

Targeted Treatment 

It is used to improve glycemic control in patients with diabetes mellitus. 

Benefits

• It regulates blood sugar levels in individuals with type 1 diabetes. 
• It is used to treat type 2 diabetes in adults, adolescents and children above the age of 2 years. 

[Note: Do not take Escitalopram without consulting your doctor. They will determine whether you need this medication based on your conditions.]

Levemir Dosage

Forms & Strengths

Form: Prefilled FlexTouch pen

Strength: 3 ml

Form: Vial 

Strength: 10 ml 

Recommended Dosages

Type 1 Diabetes 

• Initial Dose: one-third to one-half of total daily insulin dose. 
• Recommended Dose: 0.2 to 0.4 units of insulin per kilogram of body weight.

Type 2 Diabetes 

• Recommended Initial Dose: 0.1 units/kg to 0.2 units/kg or ten units. 
• To be administered once daily or twice daily. 

[Note: Remember, these recommendations may vary from person to person. Discuss it with your doctor, and they’ll customize your dosage accordingly.]

How to Take It?

• You should carefully read the patient information leaflet that comes with your prescription and follow the instructions given by your doctor. 
• Before you use insulin for the first time, your doctor will show you how to use it effectively. 
• If you have any queries regarding the medication’s usage, dosage, potential risks or benefits, ask your doctor or healthcare provider before using the medication. 
• Check the insulin for any change in appearance. Do not use it if it is discolored, cloudy or has particles. 
• Before injecting the dose properly, wash your hands and clean the injection site with rubbing alcohol, soap, and water. 
• As your doctor directs, inject this insulin subcutaneously, typically once or twice a day.  
• Rotate the injection spot each time you inject the medication to prevent lumps and pits from forming under your skin. 
• The best spots to inject the medication are the abdomen, upper arm, and front thigh.  
• Do not inject Levemir into a vein or muscle. 
• Do not inject into skin that is torn, damaged, red, swollen, itchy or has stretch marks. 
• Do not inject cold insulin, as it may be painful. 
• Do not change your type, brand or dosage of insulin without consulting your doctor.
• Do not dilute or mix Levemir with other insulin. 
• Do not use this medication in an infusion pump. 
• Do not share your syringe or pen device with anyone, as it may cause infection to spread from one person to another. 
• The insulin dosage is based on your medical condition, age, needs and how your body responds to treatment. 
• You must check your blood sugar levels regularly and share the report with your doctor to help them determine the correct dose for you.
• Let your doctor know if your condition does not improve or worsen.   

[Note: Your doctor will decide the right amount for you based on your condition, following guidelines and studies on the drug. They’ll adjust it as needed over time.]

How Does Levemir Work?

Levemir works by allowing cells throughout the body to uptake glucose so that your body can use it for energy. It is a long-acting insulin that starts working within 2 hours after injection and continues to manage your blood sugar for several hours in the day. This steady and prolonged effect helps in maintaining stable blood sugar levels and preventing complications associated with diabetes, such as eye damage, kidney damage, loss of limbs and problems related to the kidney, liver and heart. 

Important Safety Information

Side Effects

Common side effects of Levemir may include: 

• Hypoglycemia
• Injection site reaction
• Weight gain
• Itching
• Rash
• Dizziness
• Blurred vision
• swelling in your hands and feet

Serious side effects of Levemir may include:

• Severe hypoglycemia
• Severe allergic reaction
• Hypokalemia 

[Note: This list may not cover all possible side effects. Always consult with your healthcare giver for medical advice about side effects.]

Warnings 

• Do not share your syringes, needles or other injectable products with other people, even if the needle is changed, as it may cause infection to spread from one person to another.
• Do not take Thiazolidinediones alongside any insulin, including Levemir, as it may cause heart failure. 

Precautions

• Do not take Levemir if you are allergic to insulin detemir, ingredients, or insulins.
• Do not take this medication if you have severe low blood sugar. 
• Before taking this drug, let your doctor know if you have a disease related to the kidney, heart or liver.
• If you think you are pregnant, breastfeeding or planning to get pregnant, tell your doctor. They may adjust your dosage. 
• Do not drive, operate heavy machinery, or indulge in activities that require concentration because insulin may affect your vision. Do not do such things unless you determine how this medication affects you. 
• It is unsafe to consume alcohol while on treatment with Levemir as it may affect your blood sugar levels.  

Contraindications 

Levemir is contraindicated for use in patients: 

• Who have a hypersensitivity to insulin detemir or any other ingredients present in Levemir. 
• During episodes of hypoglycemia

Missed Dose

• It is crucial to take Levemir on time for safe and efficient medication use.
• If you missed a dose of Levemir, taking it as soon as possible is essential. 
• However, if it is almost time for your next dose of Levemir, you may skip the missed dose and take the next dose as per your dosing schedule. 
• Do not take two doses of the same medication to compensate for the missed dose. 

[Note: If you have missed a medication dose and are unsure when to take the next one, immediately consult your doctor or pharmacist.]

Overdose

Overdose of insulin may lead to hypoglycemia, which, if left untreated, may cause hypoglycemia and hypokalemia. If someone has taken the medication more than recommended, immediately seek medical assistance. If someone has passed out, has trouble breathing or can’t be woken up, call 911 or head to the nearest emergency room. 

[Note: If you consumed more than the recommended dose, get medical help immediately or call the Poison Help line at 1-800-222-1222.]

Storage

• You should keep all insulin, including Levemir, in a safe place, away from the sight and reach of children. 
• Unopened Levemir vial and FlexTouch pen should be kept in the refrigerator. This way, it is suitable for use until its expiration date. 
• Do not allow Levemir to freeze. Do not use it if it is frozen. 
• If it is frozen, do not use the product; discard it safely and get a new one from your pharmacist. 
• Unopened Levemir may also be kept at room temperature, but it is only suitable for 42 days when kept this way. 
• While in use, the Levemir vial and FlexTouch pen should be kept at average temperature in a dark and dry place, away from direct light, excess heat and moisture. 
• Do not keep the pen with a needle attached to it. Permanently remove the needle and replace the cap after use. 
• Do not keep medications that are outdated or no longer needed. Dispose of it safely. 

[Note: Discuss with your healthcare professional the proper disposal of unused medicine and any questions you may have regarding its storage.]

Levemir Interactions

• Antidepressants 
• Certain antidiabetic medications
• Antipsychotics
• Fluoxetine 
• MAOIs
• Sulfonamide antibiotics 
• Blood thinners
• Octreotide 
• Pasireotide 
• Lanreotide 
• Water pills 
• Oral contraceptives 
• Salicylates 
• Sulfasalazine
• Medicines used to treat high blood pressure
• Disopyramide 
• Fibrates 
• Corticosteroids 
• Estrogen 
• HIV protease inhibitors 
• Isoniazid 
• thyroid hormones

[Note: This isn’t a complete list, and there could be other drugs that interact with Levemir. Tell your doctor any prescription, over-the-counter medicines, and herbal products you’re taking.]

Levemir Alternatives 

• Lantus (insulin glargine)
• Tresiba (insulin degludec)
• Metformin (metformin hydrochloride)
• Ozempic (semaglutide)
• Rybelsus (semaglutide)
• Victoza (liraglutide)
• Januvia (sitagliptin phosphate)
• Basaglar (insulin glargine)

[Note: Your doctor will choose what’s best for you. Don’t use any of these alternative medications without consulting your healthcare provider. Taking them by yourself may cause serious side effects.] 

Frequently Asked Questions

1. Are there any precautions to be taken while taking Levemir?

Levemir should not be used if you are allergic to insulin Levemir or are in diabetic ketoacidosis (ask your doctor for short-acting insulin treatment). It is always important to avoid sharing a Levemir injection pen or syringe with any other person (even if the needle has been changed).

2. Is it necessary to take Levemir with food?

It is important to remember that when taking Levemir once daily, you should inject the insulin at bedtime or mealtime. (Levemir may be considered an intermediate-acting insulin if taken in smaller doses.) If taking Levemir twice daily, you should take the evening dose either when you eat at dinner, at bedtime, or 12 hours after taking the morning dose.

3. Do you need to refrigerate Levemir?

It is recommended that you keep your Levemir® FlexPen® in a refrigerator at a temperature of 2°C to 8°C or at a temperature below 30°C while using it or keep it at a temperature below 30°C when not in use. When refrigerating medicines, keep them away from the cooling element, do not freeze them, and never dispose of drugs in wastewater or household waste.

4. How does Levemir affect your weight?

A common side effect of Levemir is weight gain. This is generally a side effect that occurs when any insulin is taken, including Levemir. There have been studies showing that Levemir can cause small increases in weight in people with diabetes type 2 or type 1. However, this type of long-acting insulin causes less weight gain than other types of long-acting insulin.

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