What are Levemir PenFill Cartridges?

Levemir PenFill cartridges are cartridges filled with insulin detemir. Insulin detemir is a long-acting man-made insulin. Its structure has been slightly modified to allow it to be more quickly absorbed by your body and slowly released for a long duration of action. It belongs to a class of man-made insulins called basal, or background insulins, which provide you with all-day coverage for your insulin needs. Insulin detemir has been associated with a lower risk of causing weight gain than other man-made insulins. The Levemir Penfill is a pre-filled 3 mL glass cartridge designed to be used along with insulin delivery devices such as NovoPen, and for use with NovoFine, NovoFine Plus and NovoTwist needles. Levemir Penfills come with a clear, colorless solution. Each pack contains 5 cartridges of 3 mL.

What is it used for?

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

This insulin has been approved for the treatment of:

• Type 2 diabetes in adults who use insulin for the control of high blood sugar.
• Type 2 diabetes used in combination with liraglutide and metformin.
• Type 2 diabetes in adults when used in combination with other oral anti-diabetic drugs.
• Type 1 diabetes in adults, adolescents and children (2 years and older).

It is recommended for use together with a fast-acting mealtime insulin to help regulate blood sugar levels throughout the day and night, as well as during and between meals. However, it is not recommended for treating diabetic ketoacidosis (DKA). Instead, an intravenous fast-acting or short-acting insulin is the preferred treatment for DKA.

How does it work?

Levemir (insulin detemir) works by lowering your blood sugar level after injection just like naturally occurring insulin does, only it lasts for a longer period of time. It may last for up to 24 hours, but like all insulin, its duration of action varies according to your dose, injection site, blood flow, temperature and level of physical activity. Naturally occurring insulin is a hormone normally produced in the beta cells of your pancreas, which controls your metabolism. Levemir works the same as naturally occurring insulin by regulating the breakdown of food such as sugar, fat and protein. It promotes the absorption of sugar from your blood by your fat, liver and skeletal muscle cells. It also blocks your liver’s ability to produce and release sugar back into your blood. Studies have shown that people with type 2 diabetes gain less weight taking Levemir than those taking other man-made insulins.

Side effects

Like all medicines, Levemir has the potential to cause some side effects, although not everybody gets them. Taking too much Levemir may cause low blood sugar (hypoglycemia), which is generally the most common side effect of any insulin product.

Common negative effects may include:

• Hypoglycemia
• Injection site reactions

 Less common negative effects may include:

• Allergic reactions
• Rashes

Always make sure to closely monitor your blood sugar levels for low or high blood sugar. This is especially important if you change your insulin dose, change your diet, if you begin exercising more or less frequently, if you use other diabetic medications, and particularly if you have any kidney or liver issues. Severe hypoglycemia can be a serious condition that may cause seizures or even death. Injection site reactions such as swelling, pain, hives, redness, inflammation, itching and bruising may occur. These side effects usually go away after a few weeks of taking your insulin. If they do not disappear, contact your doctor. Other possible reactions around the injection site can include localized lipoatrophy (the localized loss of fat around the injection site), and lipohypertrophy (the accumulation of fat at and around the injection site). If signs of allergies appear, or if you begin to suddenly feel unwell, have a rapid heart beat and feel dizzy, you may be experiencing a serious allergic reaction to Levemir or other ingredients in the formulation. Contact your doctor immediately if you think you may be having a serious allergic reaction.

How to take this medication

Levemir is to be taken as an injection under the skin (subcutaneously), never directly into a vein or a muscle. With each injection, make sure to change your injection site within the particular area of skin that you use. This reduces the risk of developing injection site reactions, like lumps or skin pitting. The best places to give yourself the injection are in the front of your thighs, the front of your waist (abdomen), or in the upper arm. Levemir will likely work more rapidly if you inject it near your waist. You should always monitor your blood sugar regularly. If your doctor has switched you from one type or brand of insulin to another, your dose may have to be changed.

Dosage

Levemir is usually prescribed based specifically on your body’s own blood sugar response. Monitoring your blood sugar levels is essential when taking Levemir, as well as all insulin products. If you are changing your dose amount or timing of your dose, you should only do so under your doctor’s supervision. If you are treating your type 1 diabetes, Levemir must be used along with a rapid-acting or short-acting insulin. A typical starting dose, if you have type 1 diabetes, is approximately one-third of your total daily insulin requirement. To meet the rest of your daily insulin requirements, a rapid-acting or short-acting mealtime insulin should be added. If you have type 2 diabetes and you have not been using other oral antidiabetic medications, your recommended starting dose may be 10 units (or 0.1 to 0.2 Units/kg), once a day in the evening or divided into a twice-a-day schedule. If you are changing from insulin glargine to Levemir (insulin detemir), the change can be done on a unit-to-unit basis. If you are changing from NPH insulin, the change can also be done on a unit-to-unit basis. Although sometimes patients with type 2 diabetes need more Levemir than NPH insulin.

Warnings and Precautions

Do not use it if:

• You feel a hypoglycemic (low blood sugar) reaction coming on
• You are allergic or hypersensitive to insulin detemir, metacresol or any of the other ingredients
• You are using an insulin infusion pump
• The Penfill containing the cartridge is dropped, damaged or crushed
• The insulin has not been stored correctly or if it has been frozen
• The insulin is not clear and colorless

Talk to your doctor about any health conditions or problems you may have, including if you:

• Have problems with your liver or kidneys, or with your pituitary, adrenal, or thyroid glands
• Drink alcohol
• Have a fever, infection, or have had surgery
• Have diarrhea or vomiting
• Eat less than usual, or are planning to change your diet
• Exercise more than usual
• Are ill
• Are traveling across several time zones
• Are pregnant, or are hoping to become pregnant
• Are breastfeeding
• Have llow albumin levels
• Drive or use tools or machines

Thiazolidinediones (TZDs) are a class of oral antidiabetic drugs that when used together with insulin may increase the risk of edema (fluid retention) and heart failure. Contact your doctor immediately if you experience localized swelling or signs of heart failure, such as unusual shortness of breath.

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