levemir

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

Levemir is used to treat type 2 diabetes in adults.

Levemir is also used to treat type 1 diabetes in adults and children who are at least 2 years old.

Levemir may also be used for purposes not listed in this medication guide.

Important information

You should not use Levemir if you are allergic to insulin detemir, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with a short-acting insulin).

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

Low blood sugar (hypoglycemia) can occur if you skip a meal, exercise too long, drink alcohol, or are under stress. An insulin overdose can cause life-threatening hypoglycemia. Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating. Be sure your family and close friends know how to help you in an emergency.

Before using Levemir?

You should not use Levemir if you are allergic to insulin detemir, or if you are in a state of diabetic ketoacidosis (call your doctor for treatment with a short-acting insulin).

To make sure you can safely take Levemir, tell your doctor if you have liver or kidney disease, or if you are taking any other medications.

FDA pregnancy category B. Levemir is not expected to harm an unborn baby. 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.

See also: Pregnancy and breastfeeding warnings (in more detail)

How should I use Levemir?

Use Levemir exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label. Your blood sugar will need to be checked often, and you may need other blood tests at your doctor"s office. Visit your doctor regularly.

Levemir is injected under the skin. You may be shown how to use injections at home. 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 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 use a short-acting insulin in addition to Levemir. Always inject your insulins separately. Do not mix or dilute Levemir with any other insulin. Do not use an insulin pump.

Levemir should be thin, clear, and colorless. Do not use the medicine 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 Levemir into the same place two times in a row.

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.

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 a disposable needle only once. Throw away used needles in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Know the signs of low blood sugar (hypoglycemia) and how to recognize them: headache, hunger, weakness, sweating, tremors, irritability, or trouble concentrating.

Always keep a source of sugar available in case you have symptoms of low blood sugar. Sugar sources include orange juice, glucose gel, candy, or milk. If you have severe hypoglycemia and cannot eat or drink, use an injection of glucagon. Your doctor can give you a prescription for a glucagon emergency injection kit and tell you how to give the injection. 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, increased urination, hunger, dry mouth, fruity breath odor, drowsiness, dry skin, blurred vision, and weight loss.

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

Your doctor may want you to stop taking Levemir for a short time if you become ill, have a fever or infection, or if you have surgery or a medical emergency.

Ask your doctor how to adjust your Levemir dose if needed. Do not change your medication dose or schedule without your doctor"s advice. Storing unopened vials 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 or injection pens may also be stored at room temperature for up to 42 days, away from heat and bright light. Storing vials after your first use: Keep the "in-use" vials in a refrigerator or at room temperature.

Storing injection pens after your first use: Keep the "in-use" injection pens at room temperature. Do not refrigerate.

Throw away any Levemir kept at room temperature and not used within 42 days.

Do not freeze Levemir, 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 Levemir 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 or call the Poison Help line at 1-800-222-1222. An insulin overdose can cause life-threatening hypoglycemia.

Symptoms of severe hypoglycemia include extreme weakness, confusion, tremors, sweating, fast heart rate, trouble speaking, nausea, vomiting, rapid breathing, fainting, and seizure (convulsions).

What should I avoid?

Do not change the brand of insulin detemir or syringe you are using without first talking to your doctor or pharmacist. Avoid drinking alcohol. It can lower your blood sugar.

Levemir side effects

Get emergency medical help if you have any of these signs of insulin allergy to Levemir: itching skin rash over the entire body, wheezing, trouble breathing, fast heart rate, sweating, or feeling like you might pass out.

Call your doctor at once if you have a serious side effect such as:

• itching, swelling, or redness where you inject Levemir;

• swelling in your hands or feet; or

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

Less serious Levemir side effects may include:

• thickening of the skin where you inject Levemir;

• weight gain;

• mild headache, back pain;

• stomach pain; or

• flu symptoms, or cold symptoms such as stuffy nose, sneezing, sore throat.

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.

See also: Side effects (in more detail)

What other drugs will affect Levemir?

Tell your doctor about all other medications you use, especially other diabetes medications such as:

• exenatide (Byetta, Bydureon);

• liraglutide (Victoza); or

• any oral (taken by mouth) diabetes medications, especially metformin (Glucophage, Actoplus Met, Avandamet, Glucovance, Janumet, Jentadueto, Kombiglyze, Metaglip, or Prandimet).

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:

• asthma medication;

• cholesterol-lowering medication;

• heart or blood pressure medication, including a diuretic (water pill);

• medicine to treat depression or psychiatric disorders;

• steroid medication;

• sulfa drugs; or

• thyroid replacement medication.

This list is not complete and there are many other drugs that can increase or decrease the effects of Levemir on lowering your blood sugar. Tell your doctor about all medications you use; prescription and over the counter drugs, vitamins, minerals, or herbal products. Do not start using a new medication without telling your doctor.