LEVEMIR (Insulin Detemir)

What is this medication?

LEVEMIR (Insulin Detemir)
Long Acting Insulin

LEVEMIR (Insulin Detemir) is indicated for the treatment of diabetes mellitus types 1 and 2.

How does this medication work? 

LEVEMIR (Insulin Detemir) works on liver, muscle and adipose (fat) tissue to regulate the metabolism of carbohydrates, protein, and fats.  In the liver and muscles, it increases glycogen synthesis which is the immediate storage form of glucose.  It increases fat production by increasing fatty acid release from the liver in the form of lipoproteins which adipose tissue converts to fatty acids then to triglycerides for storage whilst also stopping the metabolism of triglycerides (fat).  Insulin also increases the cellular uptake of amino acids and some electrolytes such as potassium into the cell.  In muscle tissue protein synthesis is increased.

Normally insulin is produced by the pancreas however insulin products for pharmaceutical use have been produced via recombinant DNA technology using certain bacteria (they splice the gene for insulin production into bacterial DNA so the cell produces insulin – a gene is a portion of DNA or RNA that produces one specific protein).  Insulin detemir is different from human insulin as it has some modifications to make it last longer.  It involves the omission of threonine in position B30 and the addition of a C14 fatty acid chain to the amino acid located at position B29 (these are all names of amino acids which are the building blocks of proteins such as insulin).

How should I take this medication? 

SQ: Inject subcutaneously in one or usually two daily injections.  In type 2 diabetes someone usually starts around 10 units per day or 0.1-0.2mg/kg/day and the dosage is slowly increased until glucose control is achieved.  In type 1 diabetes 40-50% of total daily insulin is given as intermediate or long acting with the rest divided into fast acting mealtime insulin.  If converting from another insulin the number of units given may need to be lowered as a precaution.

How to Take: Follow instructions provided by physician/pharmacy label, use consistently at same times each day unless otherwise directed. Injection generally into abdomen, thighs, buttocks, or arms with absorption rates varying from site to site.  Be consistent with the part of body you inject into but rotate injection site to avoid redistribution of fat and excessive irritation to the area.  For example, if you choose abdomen which is the most common, inject in circular order at least 2 inches from navel.

You Need to Avoid: Do not use if solution seems viscous (thick) or appears cloudy, only use if clear, colorless and with no visible particles.  Avoid injecting cold insulin as it may be painful.  

What should I watch for while using this medication? 

Before starting LEVEMIR (Insulin Detemir), make sure your physician is aware of any allergies or medications you currently take, if you have had bariatric surgery, cardiovascular disease, have kidney disease, liver disease, diabetic ketoacidosis, are pregnant, or breastfeeding. 

What if I miss a dose?

If you miss a dose, take it as soon as you remember. If you remember when it’s almost time for your next dose, just skip the missed dose and take your next dose at your usual time. You should not take a double dose to make up for a missed dose. Doing so could increase your risk of side effects, such as low blood sugar.

How should I store this medication?

Unused (unopened) Levemir should be stored in the refrigerator between 2° and 8°C (36° to 46°F). Do not store in the freezer or directly adjacent to the refrigerator cooling element. Do not freeze, and do not use if it has been frozen.

If refrigeration is not possible, unused (unopened) Levemir can be kept unrefrigerated at room temperature, below 30°C (86°F) as long as it is kept as cool as possible and away from direct heat and light. Unrefrigerated Levemir should be discarded 42 days after it is first kept out of the refrigerator, even if the FlexTouch or vial still contains insulin.

What are the possible side effects of using this medication?

Headache, and hypoglycemia.

Note this is not a complete list of side effects for LEVEMIR (Insulin Detemir), only common ones.