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Levemir Generic Name & Formulations
Legal Class
Rx
General Description
Insulin detemir (rDNA origin) 100 Units/mL; SC inj; contains zinc, m-cresol.
How Supplied
Vials (10mL)—1
Manufacturer
Mechanism of Action
The primary activity of insulin, including Levemir, is regulation of glucose metabolism. Insulins and its analogs lower blood glucose by stimulating peripheral glucose uptake, especially by skeletal muscle and fat, and by inhibiting hepatic glucose production. Insulin also inhibits lipolysis and proteolysis, and enhances protein synthesis.
Levemir Indications
Indications
Type 1 diabetes (in adults and children) and type 2 diabetes (in adults) when basal (long-acting) insulin is needed.
Limitations of Use
Not for treatment of diabetic ketoacidosis.
Levemir Dosage and Administration
Adults and Children
May be given once daily with evening meal or at bedtime or twice-daily (in the AM and PM). SC inj only into thigh, abdominal wall, or upper arm. <2yrs: not recommended. ≥2yrs, type 1 diabetes: starting dose should be ⅓ - ½ of total daily insulin requirements; short-acting, pre-meal insulin should be used to satisfy remainder of daily insulin requirements. Insulin-naive, type 2 diabetic adults inadequately controlled on oral antidiabetics: initially 10 Units (or 0.1–0.2 Units/kg) once daily in the evening or divided into twice daily regimen; inadequately controlled on GLP-1 receptor agonist: initially 10 Units once daily in the evening. Switching from another basal insulin: dose should be the same on a unit-to-unit basis; may need more insulin detemir when switching from NPH (see full labeling).
Levemir Contraindications
Contraindications
During episodes of hypoglycemia.
Levemir Boxed Warnings
Not Applicable
Levemir Warnings/Precautions
Warnings/Precautions
Instruct patients on diet, exercise, blood or urine testing, proper administration of insulin, change in species of origin, type or purity of insulin, and management of hypoglycemia. Do not reuse or share pens, needles, or syringes between patients, even if the needle is changed. Do not inject into areas of lipodystrophy or localized cutaneous amyloidosis. Increased risk of hyperglycemia of hypoglycemia if changes in physical activity, meal patterns, concomitant medications, renal or hepatic function, insulin regimen, administration site, and if acute illness occurs: monitor glucose more frequently and may need to adjust dose. Dosage increase may be required during infection, illness, stress, trauma, and pregnancy. Monitor potassium levels in patients at risk for hypokalemia (eg, concomitant K+-lowering or K+-sensitive drugs). Discontinue and treat if hypersensitivity reactions occur. Renal or hepatic impairment: may need dose adjustment. Pregnancy. Nursing mothers.
Levemir Pharmacokinetics
Elimination
Half-life: 5–7 hours.
Levemir Interactions
Interactions
Do not mix or dilute with other insulins. Concomitant thiazolidinediones (TZDs) may cause fluid retention and heart failure; consider dose reduction or discontinue TZDs. Potentiated by oral antidiabetic agents, ARBs, pramlintide, ACE inhibitors, disopyramide, fibrates, fluoxetine, MAOIs, salicylates, somatostatin analog, GLP-1 receptor agonists, sulfonamide antibiotics, DPP-4 inhibitors, SGLT-2 inhibitors. Antagonized by corticosteroids, isoniazid, niacin, danazol, diuretics, thiazides, phenothiazines, sympathomimetics, somatropin, thyroid hormones, estrogens, progestogens, atypical antipsychotics. Variable effects with β-blockers, clonidine, lithium salts, alcohol, pentamidine.
Levemir Adverse Reactions
Adverse Reactions
Hypoglycemia, hypokalemia, local or systemic allergy, lipodystrophy, edema.
Levemir Clinical Trials
See Literature
Levemir Note
Not Applicable
Levemir Patient Counseling
See Literature
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