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Generic Name:

insulin-detemir, Injectable solution

Generic Name:
Levemir,Levemir FlexTouch

insulin-detemir, Injectable solution

All Brands

  • Levemir
  • Levemir FlexTouch
SECTION 1 of 5

Highlights for insulin-detemir

Injectable solution
1

Insulin detemir is an injectable drug used to treat high blood sugar (hyperglycemia) in people with type 1 and type 2 diabetes.

2

Your starting dose of insulin detemir will depend on the type of diabetes that you have, your blood sugar levels, and what other diabetes medicines that you’ve taken. Once you’re taking insulin detemir, your dose changes will depend on your blood sugar readings.

3

The main side effect is low blood sugar (hypoglycemia). Symptoms of low blood sugar include hunger, nervousness, shakiness, sweating, chills, or clamminess, dizziness, fast heart rate, lightheadedness, sleepiness, confusion, blurred vision, headache, feeling confused or not like yourself, and irritability. If you have a low sugar reaction, you’ll need to treat it.

4

Inject insulin detemir under your skin in your upper arm, stomach, or thigh (subcutaneously). Never inject into a vein or muscle. Doing so can cause severe low blood sugar.

5

Tell your doctor if you’re sick, throwing up, or have changed your eating or exercise habits. Your insulin detemir dose may need to be adjusted.

IMPORTANT INFORMATION

Low blood sugar warning

Insulin detemir can cause very low blood sugar levels (hypoglycemia). Severe low blood sugar can be dangerous. It can harm your heart or brain, and cause unconsciousness, seizures, or even be fatal. Low blood sugar can happen very quickly and come on without symptoms. This is why it’s important to check your blood sugar as often as your doctor says to. Low blood sugar symptoms occur most frequently when your blood sugar level is less than 70 mg/dL.

Allergic reaction warning

Insulin detemir can cause a severe allergic reaction. Don’t take insulin detemir if you’ve ever had an allergic reaction to it or any ingredients in the injection. Taking it a second time after an allergic reaction could be fatal.

Diabetic ketoacidosis risk

If you have type 1 diabetes and your blood sugar levels are high, your body may try to break down fat to get energy. In this process, chemicals called ketones are produced. High levels of ketones can poison your body and cause diabetic ketoacidosis. insulin detemir shouldn’t be used to treat diabetic ketoacidosis.

What is insulin detemir?

Insulin detemir is a prescription drug. It’s available as an injectable solution and a prefilled syringe. The drug is self-injectable.

This drug may be used as part of a combination therapy. That means you may need to take it with other medicines.

Why it's used

Insulin detemir is used to decrease blood sugar levels in people who have type 1 or type 2 diabetes.

How it works

Insulin detemir belongs to a class of medicines called insulin. A class of drugs refers to medications that work similarly.

More Details

How it works

Insulin detemir belongs to a class of medicines called insulin. A class of drugs refers to medications that work similarly. They have a similar chemical structure and are often used to treat similar conditions. Insulin detemir is a long-acting insulin.

If you have type 1 diabetes, your pancreas cannot make insulin. Insulin detemir replaces part of the insulin that your body needs.

If you have type 2 diabetes, your pancreas may not make enough insulin or your body can’t use the insulin that your pancreas makes.

Insulin detemir helps the sugar in your blood go to the muscles so that they can work. It also helps to store extra sugar in muscle and fat. It also stops the liver from releasing more sugar into your blood.

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SECTION 2 of 5

insulin-detemir Side Effects

Injectable solution

Most Common Side Effects

The most common side effects that occur with insulin detemir include:

  • low blood sugar

  • injection site reactions. Change the area of your skin where you inject your insulin each day to prevent these skin changes. Symptoms may include:

    • redness
    • swelling
    • itching
  • weight gain

  • swelling (edema) in your arms, legs, feet, and ankles

If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

  • severe low blood sugar (less than 35–40 mg/dL). Symptoms may include:

    • hunger
    • nervousness
    • shakiness
    • sweating, chills, and clamminess
    • dizziness
    • fast heart rate
    • lightheadedness
    • sleepiness
    • confusion
    • vision changes
    • headache
    • mood changes
    • irritability
    • nightmares or crying out in your sleep

    If you don’t treat low blood sugar, you can have a seizure, pass out, and possibly develop brain damage. Low blood sugar can even be fatal. If you pass out because of a low sugar reaction or cannot swallow, someone will have to give an injection of glucagon to treat the low sugar reaction. You may need to go to the emergency room.

  • skin thickening (lipohypertrophy) or pits at the injection site (lipodystrophy). Change where you inject your insulin to prevent these skin changes from happening. Don’t inject insulin into this type of skin.

  • allergic reaction. Symptoms may include:

    • rash all over your body
    • itching
    • trouble breathing
    • fast heart rate
    • swelling of your tongue and throat (angioedema)
    • feeling faint
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug will decrease your blood sugar levels. Insulin detemir can cause your blood sugar level to drop too low (hypoglycemia). If you have a low blood sugar reaction, you need to treat it.

  • For hypoglycemia (55–70 mg/dL), treatment is 15–20 grams of glucose (a type of sugar). You need to eat or drink one of the following:
    • 3–4 glucose tablets
    • a tube of glucose gel
    • ½ cup of juice or regular, non-diet soda
    • 1 cup of nonfat or 1% cow’s milk
    • 1 tablespoon of sugar, honey, or corn syrup
    • 8–10 pieces of hard candy, such as lifesavers
  • Test your blood sugar 15 minutes after you treat the low sugar reaction. If your blood sugar is still low, then repeat the above treatment.

Once your blood sugar level is back in the normal range, eat a small snack if your next planned meal or snack is more than 1 hour later.

If you have type 1 diabetes and your blood sugar levels are high, your body may try to break down fat to get energy. In this process, chemicals called ketones are produced. High levels of ketones can poison your body and cause diabetic ketoacidosis. Symptoms include:

  • signs of high blood sugar levels, such as thirst or very dry mouth and frequent urination
  • nausea
  • vomiting
  • stomach pain
  • loss of appetite
  • difficulty breathing
  • fruity smelling breath
  • confusion

Seek medical help right away if you have signs of diabetic ketoacidosis. Insulin detemir shouldn’t be used to treat diabetic ketoacidosis. Rapid- or short-acting insulin is given into the vein to treat it in the hospital.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

insulin-detemir May Interact with Other Medications

Injectable solution

Insulin detemir can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Food interactions

The amount and type of food you eat can affect how much insulin detemir that you need. Talk to your healthcare provider if you change your diet. They may need to adjust your insulin detemir dose.

Alcohol interaction

Drinking alcohol while taking Insulin detemir can affect your blood sugar levels. Avoid drinking while taking this medication.

Medications that might interact with this drug

Medicines for diabetes
  • oral diabetic medications
  • pramlintide

These medications can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicines for depression
  • fluoxetine
  • monoamine oxidase inhibitors (MAOIs)

These medications can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicines to treat infections
  • sulfonamide antibiotics
  • sulfamethoxazole with or without trimethoprim

These medications can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicines for pain
  • propoxyphene
  • salicylates

These medications can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Drugs for a condition called acromegaly
  • octreotide
  • pasireotide
  • lanreotide

These medications can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicine that thins the blood
  • pentoxyfylline

This medication can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicine used for ulcerative colitis or rheumatoid arthritis
  • sulfasalazine

This medication can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medications for high blood pressure
  • enalapril
  • lisinopril
  • captopril
  • other angiotensin converting enzyme (ACE) inhibitors

These medications can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicine for heart rate disorders
  • disopyramide

This medication can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicines to treat high triglycerides
  • fibrates

These medications can interact with insulin detemir and lower your blood sugar more. Your insulin detemir dose may need to be decreased.

Medicines for allergies or asthma
  • corticosteroids
  • epinephrine
  • albuterol
  • terbutaline

These drugs can increase your blood sugar levels. This can make insulin detemir less effective. Your insulin detemir dose may need to be increased.

Female hormones

Hormones commonly used in birth control, such as:

  • estrogen
  • progestogens

These drugs can increase your blood sugar levels. This can make insulin detemir less effective. Your insulin detemir dose may need to be increased.

Drugs used to treat human immunodeficiency virus (HIV)
  • ritonavir
  • saquinavir

These drugs can increase your blood sugar levels. This can make insulin detemir less effective. Your insulin detemir dose may need to be increased.

Antipsychotic medicines
  • olanzapine
  • clozapine
  • phenothiazine

These drugs can increase your blood sugar levels. This can make insulin detemir less effective. Your insulin detemir dose may need to be increased.

Medicines for the heart or cholesterol
  • niacin
  • diuretics

These drugs can increase your blood sugar levels. This can make insulin detemir less effective. Your insulin detemir dose may need to be increased.

Medicine for tuberculosis
  • isoniazid

This drug can increase your blood sugar levels. This can make insulin detemir less effective. Your insulin detemir dose may need to be increased.

Medicines for endocrine disorders
  • danazol
  • glucagon
  • somatropin
  • thyroid hormones

These drugs can increase your blood sugar levels. This can make insulin detemir less effective. Your insulin detemir dose may need to be increased.

Medications for high blood pressure (beta blockers)
  • propranolol
  • metoprolol
  • atenolol
  • clonidine 

These medicines may either increase or decrease your blood sugar levels when they’re taken with insulin detemir. Some of these drugs can also make it harder to spot the symptoms of low blood sugar.

The following medicines can make you not notice signs and symptoms of low blood sugars:

  • guanethidine
  • reserpine

Medicines to treat mood disorders
  • lithium salts 

These medicines can either increase or decrease your blood sugar levels when they’re taken with insulin detemir.

Medication that treats or prevents pneumonia
  • pentamidine

This drug can decrease your blood sugar at first and then increase your blood sugars when taken with insulin detemir.

Oral medicines for diabetes
  • pioglitazone
  • rosiglitazone

These medicines should be used with caution with insulin detemir. Using them together may increase your risk of water retention and heart failure.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Insulin detemir warnings
liver problems
People with liver problems

Your liver may not be able to make glucose and break down insulin detemir as well as it should. Your doctor may lower your dose of this medication.

kidney problems
People with kidney problems

Your kidneys may not be able to break down insulin detemir as well as they should. Your doctor may lower your dose of this medication.

heart failure
People with heart failure

Taking oral diabetes pills called thiazolidinediones (TZDs) with insulin detemir can trap fluid in the tissues of your body and worsen or cause heart failure.

pregnant women
Pregnant women

Insulin detemir is a pregnancy category B drug. That means two things:

  1. Studies of the drug in pregnant animals haven’t shown risk to the fetus.
  2. There aren’t enough studies done in pregnant women to show the drug poses a risk to the fetus.

Tell your doctor if you’re pregnant or plan to become pregnant. Insulin detemir should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

breastfeeding
Women who are breast-feeding

it isn’t known if insulin detemir passes through breast milk.

You and your doctor may need to decide if you‘ll take insulin detemir or breastfeed.

for seniors
For seniors

You may be more sensitive to insulin detemir, which may increase your risk of low blood sugar. Your doctor may start you at a lower dose and make smaller dose changes if needed.

for children
For children

The safety and effectiveness of insulin detemir haven’t been established in people younger than 18 years old with type 2 diabetes.

The safety and effectiveness of insulin detemir haven’t been established in children younger than 2 years old with type 1 diabetes.

Special Kid Safety:

  • Keep insulin detemir and additional equipment needed for injections out of reach of children.
    • Accidental injection can cause a severe low blood sugar reaction. This can be fatal.
    • An accidental needle stick can spread infection.
  • Syringes and needles are used to inject this medicine. Don’t reuse or share needles. Don’t share the insulin detemir pen even if you change the needle.
  • Don’t throw out individual needles into trashcans or recycling bins, and never flush them down the toilet.
  • Ask your pharmacist for a container to safely dispose of used needles and syringes.
  • Your community may have a program for disposing needles and syringes safely.
  • If you’re throwing out the container in the trash, label it “do not recycle”.   
contact with drug
Contact with drug

Don’t share insulin detemir with others even if they have the same medical condition. It can harm them.

call doctor
When to call the doctor

Tell your doctor if you’re sick, throwing up, or have changed your eating or exercise habits. Your insulin detemir dose may need to be adjusted or you may need to be checked for complications of diabetes.

Talk to your doctor before you start any new prescription or over-the-counter medicines, herbal products, or supplements.

allergies
Allergies

Insulin detemir can cause a severe allergic reaction. Symptoms may include: 

  • trouble breathing
  • swelling of your throat or tongue
  • itching
  • feeling faint
  • rash all over your body
  • fast heart rate
  • sweating 

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

SECTION 4 of 5

How to Take insulin-detemir (Dosage)

Injectable solution

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What are you taking this medication for?

Type 1 and type 2 diabetes
Form: Vial and pen-injector
Strengths: 100 unit/mL vial (same as 1000 units/10mL) and 100 unit/mL pen-injector (same as 300 units/3mL)
Adult Dosage (ages 18-64 years)

Type 1 diabetes: Insulin detemir will be one-third of your total daily insulin requirement. The rest of your daily dose will be short- or rapid-acting insulin.

Type 2 diabetes:

  • Your starting insulin detemir dose will be 10 units (0.1 to 0.2 units per kilogram) taken once per day with dinner or at bedtime. 
  • Your doctor may have you take insulin detemir two times per day. The starting dose would be 5 units taken two times per day (every 12 hours).

If you’re switching from other insulins to insulin detemir:

  • If you‘re changing from insulin glargine or NPH insulin to insulin detemir, use the same amount (units) of insulin for your starting insulin detemir dose.
  • Be sure to monitor your blood glucose closely for the first three weeks after switching to insulin detemir. Your doctor may adjust your insulin detemir dose based on your blood sugar readings.
Child Dosage (ages 2-17 years)
  • Type 1 diabetes: Insulin detemir will be one-third of your total daily insulin requirement. The rest of your daily dose will be short- or rapid-acting insulin.
  • Type 2 diabetes: A safe and effective dose for children with type 2 diabetes hasn’t been established.
Child Dosage (ages 0-1 year)

The safety and effectiveness of insulin detemir haven’t been established in children younger than 2 years old with type 1 diabetes.

Senior Dosage (ages 65 years and older)

You may be more sensitive to insulin detemir, which may increase your risk of low blood sugar. Your doctor may start you at a lower dose and make smaller dose changes if needed.

Special Considerations

Liver or kidney problems: Your blood sugar levels may need to be closely monitored and your dose may need to be adjusted.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

Insulin detemir comes with serious risks if you don't take it as prescribed.

If you don't take it at all or if you skip or miss doses

If you don't take insulin detemir on schedule or don’t take it at all, your blood sugar levels can become very high. This can cause complications from diabetes.

In type 1 diabetes, your body may try to break down fat to get energy. This can lead to the dangerous condition diabetic ketoacidosis. In type 2 diabetes, your blood sugar levels can keep increasing and you may pass out.

If you take too much

If you take too much insulin detemir, you can develop very low blood sugar (hypoglycemia). You should treat the low blood sugar reaction as directed by your doctor. If you feel like passing out due to low blood sugar, seek medical help right away or have someone call 9-1-1 for you.

What to do if you miss a dose

If you forget to take your dose, take it as soon as you remember. If it’s just a few hours before the time for your next dose, skip the missed dose and take one dose at your normally scheduled time.

Never try to catch up by taking two doses at once. This could result in a severe low blood sugar reaction (hypoglycemia).

How to tell if the drug is working

You may be able to tell if the drug is working if you notice a decrease in your blood sugar levels. Your symptoms of diabetes may also improve. For instance, you won’t urinate as much and you won’t be as thirsty or hungry.

Insulin detemir is a long-term drug treatment.

Take insulin detemir at the same time every day

Take it exactly as your doctor told you.

If you’re taking insulin detemir two times a day, take it with breakfast and dinner, about 12 hours apart.

Insulin detemir must be stored at the right temperature

Unopened insulin detemir:

  • Store in the refrigerator from 36–46°F (2–8°C).
    • Don’t store it next to the cooling component in the refrigerator.
    • You can keep unopened insulin detemir in the refrigerator until the expiration date on the vial.
  • If you can’t refrigerate it, you can store it at room temperature below 86°F (30°C) for up to 42 days.
    • Keep it as cool as possible and away from heat and light.
    • After 42 days at room temperature, insulin detemir should be thrown out, even if there is some left.
  • Don’t freeze insulin detemir.
    • If insulin detemir was frozen, don’t use it.
  • Keep insulin detemir vial in the carton that it comes with to protect it from light.

Opened insulin detemir vial:

  • Store insulin detemir vial in the refrigerator from 36–46°F (2–8°C).
  • If you can’t refrigerate it, you can store it at room temperature below 86°F (30°C) away from heat and light for up to 42 days.
  • Throw away the insulin detemir vial after 42 days even if there is some insulin left.

Opened insulin detemir pen:

  • Store it at room temperature below 86°F (30°C) for up to 42 days.
  • Don’t store an opened, used pen in the refrigerator.
  • Remove the needle after every injection. Use a new needle every time.
  • Don’t store insulin detemir with the needle attached to it. This will decrease the chance of contamination, infection, or leakage, and will help you get the correct dose.
  • Keep insulin detemir pens away from direct light and heat.
  • Throw away the pen after 42 days even if there is some insulin left.

Travel

When traveling with your medication:

  • Always carry insulin detemir and the supplies with you in your carry-on bag.
  • Don’t worry about airport X-ray machines. They can’t hurt this medication.
  • You may need to show your pharmacy’s label to clearly identify the medication. Keep the original pharmacy label with you when traveling.
  • Unopened medication needs to be refrigerated. You may need to use an insulated bag with a cold pack to maintain the temperature. Follow the storage instructions mentioned on the medication guide.
  • Don’t leave this medicine in the car, especially when the temperature is hot or freezing.
  • Needles and syringes are used to take this medicine. Check for special rules about traveling with medicine, needles, and syringes.

Self-management

  • Your doctor, pharmacist, nurse, or diabetes educator will show you how to withdraw insulin from the vial, attach needles, and give yourself the insulin detemir injection.
  • Inject insulin detemir into the fatty part or your skin (subcutaneous fat). The best places include your thigh, stomach, and the outer part of your upper arm.
  • Be sure to change (rotate) the injection site each time.
  • Don’t give the injection on irritated or red skin.
  • Insulin detemir is a clear and colorless insulin. Before each injection, check the vial or pen to make sure that there are no floating particles in the solution and that is hasn’t changed color. Don’t use insulin detemir if it’s thick, cloudy, or colored. 
  • Don’t mix insulin detemir with other insulins or solutions.
  • Take this medication at the same time every day.

In addition to the medication, you’ll also need:

  • needles
  • syringes (if using insulin detemir vials)
  • a safe needle disposal container
  • alcohol swabs
  • lancets to prick your finger to test your blood sugar
  • blood sugar test strips
  • blood glucose monitor to test your blood sugar at home

Clinical monitoring

Your doctor may do blood tests before you begin and during treatment with insulin detemir to make sure it’s safe for you to take. These include:

  • blood sugar levels
  • glycosylated hemoglobin (A1C) levels. This test measures your blood sugar control over the last 2–3 months.
  • Liver function test
  • Kidney function test
  • Blood potassium levels

Your doctor may need to adjust your dose of insulin detemir based on following:

  • blood sugar levels
  • kidney function
  • liver function
  • other medications that you’re taking
  • your exercise habits
  • your eating habits

Your doctor may also do other tests to check for complications of diabetes:

  • eye exam
  • foot exam
  • dental exam
  • tests for nerve damage
  • cholesterol levels
  • blood pressure and heart rate

Your diet

Follow the nutrition plan that your doctor, registered dietician, or diabetes educator prescribed to you.

Hidden costs

In addition to the medication, you’ll also need:

  • needles
  • syringes (if using insulin detemir vials)
  • a safe needle disposal container
  • alcohol swabs
  • lancets to prick your finger to test your blood sugar
  • blood sugar test strips
  • blood glucose monitor to test your blood sugar at home

Insurance

Insurance companies may require prior authorization before they approve the prescription and pay for insulin detemir.

Are there any alternatives?

There are other medicines available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

SECTION 5 of 5

How Much Does insulin-detemir Cost?

Injectable solution

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These prices represent the lowest priced national pharmacies for insulin-detemir on GoodRx. They may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on July 23, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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