How To Take Levemir
Use Levemir exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Insulin detemir is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don’t understand all instructions.
Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.
Your healthcare provider will show you where on your body to inject insulin detemir. Use a different place each time you give an injection. Do not inject into the same place two times in a row.
Do not inject this medicine into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.
If you use this medicine once daily, use the injection at your evening meal or at bedtime. If you use the medicine twice daily, use your evening dose at least 12 hours after your morning dose.
Your doctor may want you to also use a short-acting insulin. Always inject your insulins separately. Insulin detemir must not be given with an insulin pump, or mixed with other insulins. Do not inject into a vein or a muscle.
What Are The Main Differences Between Levemir And Lantus
Levemir and Lantus are both long-acting insulin injections. They are both available in brand name only, as a 10 ml vial or a pen injector.
Levemir contains insulin detemir and is injected once daily , or twice daily.
Lantus contains insulin glargine and is injected as one daily dose at the same time each day.
| Main differences between Levemir and Lantus |
|---|
| Levemir |
| Yes |
How To Switch Insulin Products
Switching insulins shouldalways be done with prescriber approval and close monitoring. Advise patients to closely monitor bloodglucose levels after switching insulins.If switching between human insulin brands , keep the number of units each daythe same. However, because these brandsare not AB rated pharmacists may need to contact the prescriber beforeswitching. See our chart, Comparisonof Insulins, for meal timing, onset, peak, duration of action, andother information. Also see our algorithm,Initiationand Adjustment of Insulin Regimens for Type 2 Diabetes.
Project Leader in preparation of thisclinical resource : Melanie Cupp, Pharm.D., BCPS Last modified July 2020.
References
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How Should I Use This Medication
The recommended dose of insulin depends on how much natural insulin your pancreas is producing and how well your body is able to use the insulin. Your doctor or diabetes educator will determine the appropriate dose for you according to various lifestyle factors and the blood glucose values obtained while monitoring your blood glucose.
Your dose of insulin should be injected subcutaneously exactly as instructed by your doctor or diabetes educator. Do not inject insulin detemir into the vein and do not use insulin detemir in insulin infusion pumps. Each 1 mL of insulin contains 100 units. Insulin detemir is injected under the skin once or twice daily. In addition to insulin detemir, a fast-acting insulin is usually used to control the impact of food intake on blood glucose levels during the day. There are many variations of insulin dosing.
Insulin detemir should be clear and colourless. Do not use the insulin if you notice anything unusual in the appearance of the solution, such as cloudiness, discoloration, or clumping. It is not necessary to shake or rotate the vial before use. It should not be mixed with any other insulins.
Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
How Long Does It Take To Work
Levemir begins to work almost immediately after you inject it, but it reaches its full effect about 6 to 8 hours after you inject it.
Levemir is a long-acting insulin, which means it helps maintain steady levels of insulin in your body. You shouldnt take it to quickly lower your blood sugar after a meal.
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The Size Of Your Prescribed Dose
In general, only higher doses are split because their effects dont last for as long as expected for many patients.
Small doses of Levemir are usually prescribed for patients with type 1 diabetes. This is often accompanied by other types of insulin.
So, in general, if youre taking small doses, it may not be advised to split your dose.
But if you observe that your smaller doses are not providing the expected results, then consider splitting them after consulting your doctor on this.
Is Levemir A Long
Yes, Levemir is a type of long-acting insulin. It works to help keep your blood sugar levels steady over time, including between meals and overnight.
You might also be prescribed a rapid-acting insulin that youll use with Levemir, to further help regulate your blood sugar levels as needed.
Your doctor can answer other questions you may have about long-acting insulins such as Levemir.
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Use In Specific Populations
- Pregnancy: Available data from published studies and postmarketing case reports with Levemir® use in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes.
- Clinical Considerations – Disease-Associated Maternal and/or Embryo/Fetal Risk: Poorly controlled diabetes in pregnancy increases the maternal risk for diabetic ketoacidosis, preeclampsia, spontaneous abortions, preterm delivery, and delivery complications. Poorly controlled diabetes increases the fetal risk for major birth defects, stillbirth, and macrosomia-related morbidity.
Please for Levemir® Prescribing Information.
Whats The Dosage Of Levemir For Children
The dosage of Levemir for children is calculated the same way it is for adults. Dosing for children is based on the childs total daily insulin requirement or their body weight.
The childs blood sugar level needs to be monitored to see how well Levemir is working. Their doctor will adjust the childs dosage based on their blood sugar level and goals.
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Dose Lengthening And Fading Effect
The primary reason why many split their Levemir dose is to lengthen the dose and avoid a fading out effect. This allows for peak effectiveness throughout each day.
This can bring about a more stabilized course of action than allowing the dose to fade out completely, as might be the case with a non-split dose.
Although Levemir is long-acting insulin and is marketed as a once-daily injection, it rarely covers a full 24 hours with equal concentration.
When the dose is split, by the time the effects of the first dose begin to fade, you can then take the second dose. This can kickstart the action again, showing the same effect of the insulin with the same concentration as the first dose.
This can help in the even distribution and concentration of insulin in the body, which, in turn, helps to regulate blood sugar levels regularly.
Why Is Levemir Given At Night
When NPH is added at nighttime, glargine or detemir can be taken once daily at a lower dose than if used without NPH. This minimizes the risk of having glucose levels drop between meals during the day. By adding a modest evening or bedtime dose of NPH, a nighttime/early-morning peak can be achieved.
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If Im Using Levemir Can I Switch To Using Lantus
Yes, you can switch if your doctor thinks Lantus would work well for you. Both Lantus and Levemir are long-acting insulins that work all day to lower your blood sugar levels. Talk with your doctor or pharmacist if youre interested in switching to a different insulin.
Your dosage when switching from Levemir to Lantus will depend on whether you took Levemir once or twice a day.
How Should I Use Levemir Flextouch
Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Levemir FlexTouch is injected under the skin. A healthcare provider may teach you how to properly use the medication by yourself.
Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you don’t understand all instructions.
Prepare an injection only when you are ready to give it. Do not use if the medicine looks cloudy, has changed colors, or has particles in it. Call your pharmacist for new medicine.
Your healthcare provider will show you where on your body to inject Levemir FlexTouch. Use a different place each time you give an injection. Do not inject into the same place two times in a row.
Do not inject Levemir FlexTouch into skin that is damaged, tender, bruised, pitted, thickened, scaly, or has a scar or hard lump.
If you use this medicine once daily, use the injection at your evening meal or at bedtime. If you use the medicine twice daily, use your evening dose at least 12 hours after your morning dose.
Your doctor may want you to also use a short-acting insulin. Always inject your insulins separately. Levemir FlexTouch must not be given with an insulin pump, or mixed with other insulins. Do not inject into a vein or a muscle.
Also watch for signs of high blood sugar such as increased thirst or urination.
Storing unopened Levemir FlexTouch:
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What Other Drugs Will Affect Levemir Flextouch
Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of insulin. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products.
Physiology And Relation To Case
Levemir is a long-acting insulin which delivers a constant level of insulin between meals. The long duration of action of Levemir and concurrent alcohol usage may have contributed to the persistent hypoglycaemic episodes which lasted 41 hours in this case. Alcohol is associated with increased sensitivity to insulin, possibly through an increase in adiponectin and a subsequent decrease in TNF-. Hence, alcohol usage leads to a poorer prognosis in insulin-overdose patients.
Absorption of subcutaneous insulin varies according to the type of insulin, area of body, blood flow in the region, exercise, skin fold thickness and differs between diabetics and nondiabetics. Hypoglycaemia in nondiabetic patients is more severe due to endogenous insulin secretion and insulin antibodies. The multiple sites of insulin administration in this patient may account for his varying and unpredictable blood glucose levels which were difficult to control despite continuous infusions. Surgical excision of insulin depot/subcutaneous injection sites may be effective in reducing glucose supplementation requirements after overdose. It appears to be more useful in patients with long-acting insulin overdose .
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Physical Activity Can Affect Levemir Doses
If youre physically active, which often benefits your condition, then you may not need to split your insulin because your blood sugar levels naturally reduce, and your body becomes more sensitive to insulin.
If this is the case for you, it may be best to stick to just one Levemir dose a day. Splitting your dose when you exercise regularly may cause abnormally low blood sugar levels for some individuals.
What To Do In Case Of Overdose
Call your doctor if you think youve taken too much of this drug. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. But if your symptoms are severe, call 911 or go to the nearest emergency room right away.
Its important to tell your friends and family about the symptoms of severe hypoglycemia. One of the possible side effects is loss of consciousness . Therefore, your friends and family should know what symptoms to look for and how to help.
A medication called glucagon comes as an injection that can be given in an emergency to raise your blood sugar very quickly. Teach your friends and family how to give you a glucagon injection in case you experience severe hypoglycemia.
If you take Levemir, you should also have a prescription for glucagon. Always carry glucagon with you in case your blood sugar levels get dangerously low.
The following information is provided for clinicians and other healthcare professionals.
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General Recommendations On When To Split Levemir Dose
The general recommendation on when to split Levemir dose comes from how the insulin works for you.
Its only when your Levemir cannot show a full 24-hour effect as it should that you are then recommended to split your Levemir dose.
It is important to note that splitting your Levemir dose should only be done under your doctors direction and guidance.
However, with the experience of many with diabetes that split their Levemir doses, its believed that a Levemir dose could, and perhaps should be split into 2 doses given every 12 hours.
The general recommendations regarding when to split Levemir dose falls in line with simply splitting equal units of your current full dose. The second dose should not be taken until it has been a full 12 hours since your first dose.
Side Effects Of Levemir
As with all insulin products, hypoglycemia is the most common side effect, and left untreated can lead to loss of consciousness and coma
Other serious adverse effects of Levemir can include:
- Itching rash, swelling, or redness at injection sites
- Breathing difficulties
- Light headedness or feeling faint
These are signs of insulin allergy and you should seek emergency medical help if you experience any of these.
Other side effects can include:
- Swelling in your hands or feet
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What Side Effects Are Possible With This Medication
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- numbness, weakness or pain in legs and arms
- redness, itching, or swelling at the site of the injection
Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- fluid retention causing swollen joints
- signs of an allergic reaction
- signs of low blood glucose
- signs of low potassium in the body
Stop taking the medication and seek immediate medical attention if any of the following occur:
- symptoms of a serious allergic reaction
- unconsciousness
What Other Drugs Could Interact With This Medication
There may be an interaction between insulin detemir and any of the following:
- acetylsalicylic acid
- thyroid replacement therapy
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter , and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 2022. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Levemir
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How To Use Levemir Flexpen Insulin Pen
Read the Patient Information Leaflet provided by your pharmacist before you start using this medication and each time you get a refill. If you have any questions, ask your doctor, diabetes educator, or pharmacist.
Learn all preparation and usage instructions from your health care professional and the product package.
Before using, check this product visually for particles or discoloration. If either is present, do not use the insulin. Insulin detemir should be clear and colorless.
Before injecting each dose, clean the injection site with rubbing alcohol. Change where you inject each time to lessen the risk of problems or damage under the skin . Insulin detemir may be injected in the stomach area, the thigh, or the back of the upper arm. Do not inject into a vein or muscle because very low blood sugar may occur. Do not rub the area after the injection. Do not inject into skin that is red, swollen, itchy, or damaged. Do not inject cold insulin because this can be painful. The insulin container you are currently using can be kept at room temperature . Do not shake the container.
Inject this medication under the skin as directed by your doctor, usually once or twice daily. Insulin detemir is usually injected with the evening meal or at bedtime. If you are using it twice a day, inject as directed by your doctor, usually your first dose in the morning and your second dose with the evening meal, at bedtime, or 12 hours after the morning dose.