Insulin detemir

Generic Name: insulin detemir (IN su lin DE te mir)Brand names: Levemir, Levemir FlexPen, Levemir PenFill, Levemir InnoLet

What is insulin detemir?

Insulin detemir is a man-made form of a hormone that is produced in the body. It works by lowering levels of glucose (sugar) in the blood. Insulin detemir is a long-acting form of insulin that is slightly different from other forms of insulin that are not man-made.

Insulin detemir is used to treat diabetes in adults and children.

Insulin detemir may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about insulin detemir?

Many other drugs can potentially interfere with the effects of insulin detemir. It is extremely important that you tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.

Take care to keep your blood sugar from getting too low, causing hypoglycemia. Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, or trouble concentrating. Carry a piece of non-dietetic hard candy or glucose tablets with you in case you have low blood sugar. Also be sure your family and close friends know how to help you in an emergency.

Also watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, loss of appetite, fruity breath odor, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. Check your blood sugar levels and ask your doctor how to adjust your insulin doses if needed.

Never share an injection pen or cartridge with another person. Sharing injection pens or cartridges can allow disease such as hepatitis or HIV to pass from one person to another.

Insulin detemir is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, overall proper health care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

What should I discuss with my healthcare provider before using insulin detemir?

You should not use this medication if you are allergic to insulin, or if you are having an episode of hypoglycemia (low blood sugar). Before using insulin detemir, tell your doctor if you have kidney or liver disease, or any disorder of your thyroid, adrenal, or pituitary glands.

Tell your doctor about all other medications you use, including any oral (taken by mouth) diabetes medications.

Insulin detemir is only part of a complete program of treatment that may also include diet, exercise, weight control, foot care, eye care, dental care, and testing your blood sugar. Follow your diet, medication, and exercise routines very closely. Changing any of these factors can affect your blood sugar levels.

Your doctor will need to check your progress on a regular basis. Do not miss any scheduled appointments.

FDA pregnancy category C. It is not known whether this medication is harmful to an unborn baby. Before using insulin detemir, tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether insulin detemir passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I use insulin detemir?

Use this medication exactly as it was prescribed for you. Do not use it in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.

Do not mix or dilute insulin detemir with any other insulin, or use it with an insulin pump.

Insulin detemir is given as an injection (shot) under your skin. Your doctor, nurse, or pharmacist will give you specific instructions on how and where to inject this medicine. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes.

If you use this medication once daily, use the injection at your evening meal or at bedtime. If you use the medication twice daily, use your evening dose at least 12 hours after your morning dose.

Insulin detemir should be thin, clear, and colorless. Do not use the medication if it looks cloudy, has changed colors, or has any particles in it. Call your doctor for a new prescription.

Choose a different place in your injection skin area each time you use this medication. Do not inject into the same place two times in a row.

If you use an injection pen, attach a new needle to the pen each time you use it. Throw away only the needle in a puncture-proof container. You may continue using the pen for up to 42 days.

Needles may not be included with the injection pen. Ask your doctor or pharmacist which brand and type of needle to use with the pen.

Use each disposable needle only one time. Throw away used needles in a puncture-proof container. If your medicine does not come with such a container, ask your pharmacist where you can get one. Keep this container out of the reach of children and pets. Your pharmacist can tell you how to properly dispose of the container.

Some insulin needles can be used more than once, depending on needle brand and type. But a reused needle must be properly cleaned, recapped, and inspected for bending or breakage. Reusing needles also increases your risk of infection. Ask your doctor or pharmacist whether you are able to reuse your insulin needles.

Never share an injection pen or cartridge with another person. Sharing injection pens or cartridges can allow disease such as hepatitis or HIV to pass from one person to another.

Check your blood sugar carefully during a time of stress or illness, if you travel, exercise more than usual, or skip meals. These things can affect your glucose levels and your insulin dose needs may also change.

Watch for signs of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, loss of appetite, fruity breath odor, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. Check your blood sugar levels and ask your doctor how to adjust your insulin doses if needed.

Ask your doctor how to adjust your insulin detemir dose if needed. Do not change your dose without first talking to your doctor. Carry an ID card or wear a medical alert bracelet stating that you have diabetes, in case of emergency. Any doctor, dentist, or emergency medical care provider who treats you should know that you are diabetic. Storing unopened vials, cartridges, or injection pens: Keep in the carton and store in a refrigerator, protected from light. Throw away any insulin not used before the expiration date on the medicine label. Unopened vials, cartridges, or injection pens may also be stored at room temperature for up to 42 days, away from heat and bright light. Throw away any insulin not used within 42 days. Storing after your first use: Keep the "in-use" vials, cartridges, or injection pens at room temperature and use within 42 days. Do not refrigerate.

Do not freeze insulin detemir, and throw away the medication if it has become frozen.

What happens if I miss a dose?

Follow your doctor's directions if you miss a dose of insulin.

It is important to keep insulin detemir on hand at all times. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An insulin overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, blurred vision, sweating, trouble speaking, tremors, stomach pain, confusion, seizure (convulsions), or coma.

What should I avoid while using insulin detemir?

Do not change the brand of insulin detemir or syringe you are using without first talking to your doctor or pharmacist. Avoid drinking alcohol. Your blood sugar may become dangerously low if you drink alcohol while using insulin detemir.

Insulin detemir side effects

Get emergency medical help if you have any of these signs of insulin allergy: itching skin rash over the entire body, wheezing, trouble breathing, fast heart rate, sweating, or feeling like you might pass out. Call your doctor if you have a serious side effect such as:
  • swelling in your hands or feet; or

  • low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling).

Hypoglycemia, or low blood sugar, is the most common side effect of insulin detemir. Symptoms of low blood sugar may include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, trouble concentrating, confusion, or seizure (convulsions). Watch for signs of low blood sugar. Carry a piece of non-dietetic hard candy or glucose tablets with you in case you have low blood sugar.

Tell your doctor if you have itching, swelling, redness, or thickening of the skin where you inject insulin detemir.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Insulin detemir Dosing Information

Usual Adult Dose for Diabetes Mellitus Type II:

For patients with type 1 or type 2 diabetes receiving basal and bolus insulin injections, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis. The dose of insulin detemir should then be adjusted to achieve glycemic targets.For patients currently receiving only basal insulin, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis.For insulin-naive patients with type 2 diabetes who are inadequately controlled on oral antidiabetic drugs, insulin detemir should be started at a dose of 0.1 to 0.2 units/kg subcutaneously once daily in the evening. Alternatively, patients may be started with 10 units subcutaneously once or twice daily and the adjusted to achieve glycemic goals.

Usual Adult Dose for Diabetes Mellitus Type I:

For patients with type 1 or type 2 diabetes receiving basal and bolus insulin injections, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis. The dose of insulin detemir should then be adjusted to achieve glycemic targets.For patients currently receiving only basal insulin, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis.For insulin-naive patients with type 2 diabetes who are inadequately controlled on oral antidiabetic drugs, insulin detemir should be started at a dose of 0.1 to 0.2 units/kg subcutaneously once daily in the evening. Alternatively, patients may be started with 10 units subcutaneously once or twice daily and the adjusted to achieve glycemic goals.

Usual Pediatric Dose for Diabetes Mellitus Type II:

For patients with type 1 or type 2 diabetes receiving basal and bolus insulin injections, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis. The dose of insulin detemir should then be adjusted to achieve glycemic targets.For patients currently receiving only basal insulin, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis.For insulin-naive patients with type 2 diabetes who are inadequately controlled on oral antidiabetic drugs, insulin detemir should be started at a dose of 0.1 to 0.2 units/kg subcutaneously once daily in the evening. Alternatively, patients may be started with 10 units subcutaneously once or twice daily and the adjusted to achieve glycemic goals.

Usual Pediatric Dose for Diabetes Mellitus Type I:

For patients with type 1 or type 2 diabetes receiving basal and bolus insulin injections, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis. The dose of insulin detemir should then be adjusted to achieve glycemic targets.For patients currently receiving only basal insulin, changing the basal insulin to insulin detemir can be done on a unit-to-unit basis.For insulin-naive patients with type 2 diabetes who are inadequately controlled on oral antidiabetic drugs, insulin detemir should be started at a dose of 0.1 to 0.2 units/kg subcutaneously once daily in the evening. Alternatively, patients may be started with 10 units subcutaneously once or twice daily and the adjusted to achieve glycemic goals.

What other drugs will affect insulin detemir?

Using certain medicines can make it harder for you to tell when you have low blood sugar. Tell your doctor if you use any of the following:

  • albuterol (Proventil, Ventolin);

  • clonidine (Catapres);

  • reserpine;

  • guanethidine (Ismelin); or

  • beta-blockers such as atenolol (Tenormin), bisoprolol (Zebeta), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol), nadolol (Corgard), propranolol (Inderal, InnoPran), timolol (Blocadren), and others.

There are many other medicines that can increase or decrease the effects of insulin detemir on lowering your blood sugar. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

  • Your pharmacist can provide more information about insulin detemir.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.
Copyright 1996-2006 Cerner Multum, Inc. Version: 5.01. Revision Date: 04/24/2009 10:31:32 AM.
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