What is a Levemir FlexTouch Insulin Pen?

It is a pre-filled insulin pen filled with Insulin Detemir, which is a long-acting human insulin analog. Insulin analogs are man-made versions of naturally occurring insulin that have been slightly modified to change some of its characteristics. Insulin Detemir is nearly identical to naturally occurring insulin, with a minor modification that allows it to be quickly absorbed in your body then slowly released for a long duration of action. It is a basal, or background insulin that provides blood sugar control evenly for the entire day. Levemir has been associated with having a lower risk of causing weight gain than other insulin analogs.

The Levemir FlexTouch Pen is a convenient option to administer your insulin. It comes pre-filled with Insulin Detemir and an adjustable dose setting dial for accurate dosing from 1 to 80 units with a large and clear dose display. It also has a low force push button and a lower injection force than other insulin pens. Once opened Levemir can last up to 42 days without refrigeration once in use. The Levemir FlexTouch Pen is available in the 100 unit/mL 5×3 mL pen.

What is it used for?

Levemir (insulin detemir) is used to help improve blood sugar level regulation in adults and children with diabetes mellitus.

It is specifically is used for the treatment of:

• Type 1 diabetes in adults, adolescents and children who are 2 years old and over
• Type 2 diabetes in adults when insulin is required for the control of high blood sugar
• Type 2 diabetes in combination with other oral antidiabetic drugs in adults
• Type 2 diabetes in combination with liraglutide and metformin

It is recommended for use in combination with a rapid-acting mealtime insulin to help control blood sugar levels all day and night, as well as between and during meals. It is not used for the treatment of diabetic ketoacidosis (DKA). An intravenous short- or rapid-acting insulin is the choice treatment type for DKA.

How does it work?

Levemir, or Insulin Detemir works just like naturally occurring insulin does, only longer. It is a long-acting human insulin analog used for maintaining your basal level of insulin. It is taken as a subcutaneous (under the skin) injection under the skin and lasts up to 24 hours with a flat and predictable mode of action.

Like naturally occurring insulin, which is a naturally occurring hormone produced in the pancreas, Levemir works by regulating the breakdown of food such as sugars, fats and proteins. It stimulates the absorption of sugar from the blood into fat, liver and skeletal muscle cells. It also blocks the liver’s ability to produce and release sugar into the blood. Once the sugar is out of your blood, your blood sugar levels decrease and when the sugar is inside your cells, it gives you more energy. Clinical trials with people who have type 2 diabetes have shown that those who took Levemir gained less weight than those taking other insulin analogs.

Side effects

Common negative effects may include:

• Hypoglycemia
• Allergic reactions
• Injection site reactions, including lipodystrophy
• Rash
• Pruritus (itching)
• Diarrhea (if taken with a GLP-1 receptor agonist)

Hypoglycemia is a condition of low blood sugar, and is the most common side effect of Levemir. Make sure to closely monitor your blood sugar level, especially if you have to change your insulin dose, use other diabetic medications, change you meal pattern or diet, exercise more or less frequently, and particularly if you have any liver or kidney problems. Severe hypoglycemia may be a life-threatening condition that may cause seizures or even death. It can impair your ability to concentrate and can slow your reaction time down, which can effect your ability to drive or operate machinery.

Possible reactions in and around the injection site can include localized lipodystrophy, or lipoatrophy which the localized loss of fat around the injection site, and lipohypertrophy which is the accumulation of fat at and around the injection site. Other localized skin reactions may include itching, redness and swelling at the injection site.

How to take this medication

Levemir is taken as a subcutaneous (under the skin) injection in the abdomen, thigh or upper arm. As with all insulin, its absorption, onset and duration of action, can be affected by exercise, stress, sickness, or changes in medications or meal patterns. If you use Levemir once a day you should administer your dose with your evening meal or at bed time. If you require twice a day dosing you can administer your evening dose with your evening meal, at bed time, or 12 hours following your morning dose. As with all insulin, your injection sites should be rotated within the same region (abdomen, thigh, or shoulder) from one injection to the next to help reduce your risk for lipodystrophy.

Do not dilute or mix with any other insulin or solution and never inject Levemir into a vein or muscle.

Dosage

Your dose of Levemir must be personalized based on your body’s blood sugar response. Carefully monitoring your blood sugar level is essential for all patients who are on insulin therapy. If you are adjusting your timing or amount of dose, you should only do so with your doctor’s consent and with careful blood sugar monitoring. Levemir must be used together with rapid- or short-acting insulin if you have type 1 diabetes.

If you have type 1 diabetes the recommended initial dose of should be about 1/3 of your total daily insulin needs. A short-acting or rapid-acting, mealtime insulin should be added used to meet the rest of your daily insulin needs.

If you have type 2 diabetes which hasn’t been controlled by oral antidiabetic medications, your recommended starting dose is 10 Units (or 0.1 to 0.2 Units/kg) taken once a day in the evening or split up into two times a day.

If you are switching from insulin glargine your change may be made on a unit to unit basis. If you are switching from NPH insulin, your change may also be made on a unit to unit basis. Although sometimes people with type 2 diabetes can need more Levemir insulin than NPH insulin.

Warnings and Precautions

Before taking Levemir, tell your doctor about all your medical conditions including if you are:

• taking new prescription or over -the-counter medicines, including supplements
• pregnant, or are planning to become pregnant
• breastfeeding.

Never share your Levemir FlexTouch with anyone, even if the needle is changed. Sharing poses a significant risk for the transmission of infections.

Careful blood sugar monitoring and dose adjustments may be necessary if you have kidney or liver troubles. Some drugs may change your insulin requirements and subsequently increase the risk for hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar).

Fluid retention (edema) and heart failure can occur if you use drugs called thiazolidinediones (TZDs) along with insulin, including Levemir. You should be be observed for signs and symptoms of heart failure. If you do get any signs of heart failure, you may have to reduce your dose, or stop taking TZDs altogether.

Do not drink alcohol or take medicines that contain alcohol, and do not drive or operate heavy machinery, until you know how it affects you.

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