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Generic Name: insulin detemir (IN soo lin DET eh meer)
Brand Names: Levemir, Levemir FlexPen, Levemir InnoLet, Levemir Penfill

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 type 1 (insulin dependent) diabetes in adults.

Insulin detemir may also be used for purposes other than those 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. Know the signs and symptoms of hypoglycemia, which 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.

You should also watch for symptoms of blood sugar that is too high (hyperglycemia). These symptoms include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth. Monitor your blood sugar levels and ask your doctor how to adjust your insulin doses if your blood sugar levels are too high.

This medication 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?

Tell your doctor about any oral (by mouth) medicine you take to treat your diabetes. Your dosage of this oral medicine may change when you start using insulin detemir.

If there are any changes in the brand, strength, or type of insulin you use, the dosage you need may change. Always check your medicine when it is refilled to make sure you have received the correct brand and type prescribed by your doctor. Ask the pharmacist if you have any questions about the medicine you receive at the pharmacy.

Take care to keep your blood sugar from getting too low, causing hypoglycemia. Know the signs and symptoms of hypoglycemia, which 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.

You should also watch for symptoms of blood sugar that is too high (hyperglycemia). These symptoms may include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, and dry mouth.

Monitor your blood sugar levels and ask your doctor how to adjust your insulin doses if your blood sugar levels are too high or too low.

It is important that you not miss any scheduled visits to your doctor, dentist, eye doctor, and other heath care providers as recommended by your doctor.

Wear some type of medical identification bracelet, necklace, or other alert tag to inform others that you have diabetes and that you require insulin in case of an emergency.

This medication 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.

How should I use insulin detemir?

Use insulin detemir exactly as it was prescribed for you. Do not use the medication in larger amounts or for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication.

Insulin detemir comes with specific instructions for injecting and storing the medicine. Read and follow these directions very carefully. Ask your doctor or pharmacist if you have any questions.

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 give yourself an injection if you do not understand these instructions. Call your doctor, nurse, or pharmacist for help with injection instructions.

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.

Use each needle and syringe only one time. Throw away used needles and syringes 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.

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.

Choose a place on your skin for each injection that is at least 1 inch away from where you injected your previous dose. If you have questions about how best to rotate the injection sites, talk with your doctor.

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.

Use the injection pen for only 42 days and then throw it away, even if it still has medicine in it. Do not use the medicine after the expiration date on the label has passed. Do not store the injection pen with the needle attached.

What happens if I miss a dose?

Follow your doctor's directions if you miss a dose of insulin. To prevent missed doses, be sure to always have enough insulin on hand, especially when you are traveling away from home.

What happens if I overdose?

Symptoms of an insulin overdose are also the symptoms of very low blood sugar levels and include headache, nausea, hunger, confusion, drowsiness, weakness, dizziness, blurred vision, fast heartbeat, sweating, tremor, trouble concentrating, confusion, seizure (convulsions), or death.

What should I avoid while using insulin detemir?

Insulin detemir side effects

Other less serious side effects are more likely to occur, such as weight gain, or pain redness, itching, swelling, or skin changes where you inject the medication:

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, seizure (convulsions), or death. 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.

Hyperglycemia, or high blood sugar, may also occur. Symptoms of hyperglycemia include increased thirst, loss of appetite, increased urination, nausea, vomiting, drowsiness, dry skin, dry mouth.

Monitor your blood sugar levels and ask your doctor how to adjust your insulin doses if your blood sugar levels are too high or too low.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect insulin detemir?

There are many other drugs that can potentially interfere with the glucose-lowering 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.

Where can I get more information?

• Your pharmacist has additional information about insulin detemir written for health professionals that you may read.

What does my medication look like?

Insulin detemir is available under the brand name Levemir. Other brand or generic forms may also be available. Ask your pharmacist any questions you have about this medication, especially if it is new to you.

• Levemir U-100-10 mL vials

• Levemir 3 mL PenFill cartridges

• Levemir 3 mL InnoLet

• Levemir 3 mL FlexPen

• 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.