Levemir

Levemir is a prescription drug for treating the symptoms of diabetes mellitus in adults and children. While the medication treats type 1 and type 2 diabetes, its use is not recommended in diabetic ketoacidosis. Levemir may be used as a single agent or in combination with other drugs for controlling blood glucose levels. The safety and effectiveness of Levemir in children below two are unknown.

What is Levemir and How does it Work?

Levemir (insulin detemir injection) is a synthetic, long-acting form of human insulin used to control blood sugar levels in individuals with diabetes. Human insulin is a natural substance produced by the body to keep serum glucose levels within normal range. However, with diabetes, the body does not have adequate insulin for proper glycemic control leading to high blood sugar levels. Levemir is an artificial variant of human insulin that restores insulin levels in the body and controls blood sugar.

Like natural insulin, Levemir treats high blood sugar levels by causing glucose to move from the blood into cells. By lowering the level of blood glucose, Levemir reduces diabetes symptoms and potential complications. Insulin detemir is modified to ensure it is slowly absorbed and takes longer to reach the target organs than natural insulin. Thus, Levemir will work for a longer time than human insulin.

Indications of Levemir

Levemir maintains glycemic control in adults, adolescents, and children with type 1 or type 2 diabetes mellitus. Proper management of blood glucose levels in people with diabetes is essential to prevent complications such as kidney damage, leg ulcers, vision problems, and nerve damage. Levemir may be used alone as basal insulin or in combination with anti-diabetic medications, depending on the type of diabetes and disease severity. The doctor can prescribe Levemir and:

• Short-acting insulin injections for use at mealtimes
• Diabetes medications taken by mouth, such as metformin
• Other diabetes injection drugs known as GLP-1 receptor agonists.

Note: The use of Insulin detemir in diabetic ketoacidosis is not recommended.

How to Use Levemir

Levemir is a prescription medication that should be used in strict adherence to the doctor’s instructions. Before you start taking the drug, read the Patient Information Leaflet provided by the pharmacist and consult the provider if anything is unclear.

Always check the insulin labels and inspect for any discoloration or particulate matter in the solution before injecting the drug. Only use Levemir if it is colorless and clear.

As an injection drug, Levemir can be administered subcutaneously (under the skin) in the thigh, front abdominal wall below the navel line, buttock, shoulder, or upper arm. Use an alcohol swab to clean the area before injecting each dose of Levemir. Rotate the injection sites to reduce the risk of skin damage (lipodystrophy). Swelling, reddening, itchiness, or skin hardening in an injection implies damage, and such areas should be avoided. Do not inject the drug into blood vessels or muscles as this might lead to very low blood glucose levels, which is potentially fatal (Do not administer Levemir using an insulin pump).

Injecting cold insulin can be painful; therefore, inject Levemir, which has been at room temperature for some time.

General Use Instructions

• Inject Levemir under the skin as directed by the doctor, typically once or twice daily. The drug is injected at bedtime or before the evening meal with once-daily dosing. On the other hand, with twice-daily dosing, the first dose is administered in the morning and the other at bedtime, preferably 12 hours apart.
• If receiving another insulin injection, do not mix the two or dilute the drug with any other solution.
• Do not change the brand of insulin injection unless directed by the provider.
• Avoid sharing the Levemir pen device with another person to prevent the potential spread of infections.
• Ask the healthcare provider how to discard expired or depleted Levemir pens and cartridges.
• Use the exact dose as prescribed by the doctor. Any slight change in insulin dosage might significantly affect blood glucose.
• Regularly check and record the blood sugar levels to help determine the effectiveness of Levemir in maintaining glycemic control and find the lowest effective dose

Maintain a regular schedule of injecting insulin detemir to prevent missing doses. Inform the doctor if the symptoms do not improve or worsen even with the correct drug usage.

Dosage

• Type 1 Diabetes

The recommended initial dose of Levemir is 33-50 percent of the total daily insulin requirement given once or divided into two doses. The remaining 50-67 percent of insulin requirement is administered as short-acting insulin before meals.

• Type 2 diabetes

For patients with type 2 diabetes whose sugars are not adequately controlled by oral anti-diabetic medications, the recommended starting dose is 10 units or 0.1-0.2 units/kg of body weight of Levemir given once or divided into two doses.  

The doctor should adjust the dose on a unit-to-unit basis for those switching to Levemir from other insulin medications.

Possible Levemir Side Effects

Every medication has side effects. Even if Levemir controls the blood sugar levels as desired, some unwanted effects might occur.

Common side effects associated with Levemir include:

• Low blood glucose
• Injection site reaction with pain and swelling
• Abdominal pain
• Headache
• Weight gain
• Common cold
• Fluid retention with swelling of hands and feet

If any undesired effects persist or worsen during treatment, inform the doctor promptly.

Notably, some Levemir side effects are severe and require immediate medical attention. Immediately report to the healthcare provider or the emergency department if any of the following occur:

• Severely low blood glucose (Hypoglycemia)

Symptoms of hypoglycemia include shaking, confusion, sweating, tingling sensation in the hands or feet, increased heartbeat, visual blurring, dizziness, or coma.

• Low serum potassium (hypokalemia)

Levemir moves potassium from the blood into cells and predisposes to hypokalemia. Signs of low blood potassium include muscle cramping, body weakness, and irregular heartbeat.

• Allergic reactions (hypersensitivity)

Severe, life-threatening reactions can occur with Levemir and other types of insulin. Hives, rash, difficulty breathing, and swelling of the lips or face are some symptoms of hypersensitivity. 

Other side effects besides the ones listed above can occur. Report any symptom that emerges during the use of Levemir to the doctor or FDA.

Precautions

• Before using Levemir, tell the doctor if you are allergic to the medication or other types of insulin. Do not use Levemir if allergic to it.
• Also, inform the doctor of current medications or significant medical history, including liver problems, thyroid disease, kidney issues, or adrenal/pituitary gland problems.
• Concomitant use of alcohol increases the risk of hypoglycemia. Avoid drinking alcohol when taking Levemir.
• If symptoms of hypoglycemia, such as dizziness and blurry vision, occur, avoid operating heavy machinery or driving until it is possible to do so safely.
• Other factors such as stress, infection, surgery, and pregnancy can affect glycemic control. Inform the doctor to evaluate for possible medication or dosage changes, especially when pregnant. 

Interactions and Contraindications

Many drugs can interact with Levemir to affect how it works or increase the risk of side effects. Keeping a list of all the current medications, including prescription, over-the-counter and herbal products, and presenting them to the provider is the only way of preventing potential drug interactions.

Drugs that can interact with Levemir include:

• Beta-blockers like atenolol
• Antidiabetics such as rosiglitazone
• Sympathomimetic agents like albuterol
• Corticosteroids such as prednisone

Alternatives to Levemir

• Insulin degludec (Tresiba)
• Insulin glargine (Lantus, Basaglar, Toujeo)

Buying Levemir Online

Kiwi Drug offers affordable access to all medications to people on all continents. Subject to industry regulations, Kiwi uses professional pharmacists to ensure the clients receive the best services and maintain optimum quality of life. You will need a doctor’s prescription to buy a Levemir cartridge or pen. But Kiwi’s unique online doctor service also allows you to get a prescription after a certified online doctor reviews your medical profile. Thus, purchasing Levemir from Kiwi Drug, with or without a prescription, is straightforward and quick. It involves:

• Signing up and adding the Zoladex syringe to the cart
• Clicking the “Checkout Now” button
• Answering the questions presented on the next page
• Entering payment details and waiting for your order to arrive

IMPORTANT - The Penfill does not come with an applicator pen for measuring doses - if you don't already have the Novopen device, you should order the Flexpen pack instead, as we cannot accept returns of this item if you made a mistake in ordering.