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All about: Insulin Detemir

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Some commonly used brand names are:

In the U.S.—

  • Levemir

Not commercially available in Canada.

Category

  • Antidiabetic agent

Description

Insulin (IN-su-lin ) is one of many hormones that help the body turn the food we eat into energy. This is done by using the glucose (sugar) in the blood as quick energy. Also, insulin helps us store energy that we can use later. When you have diabetes mellitus, your body does not produce enough insulin, or the insulin produced is not used properly. This causes you to have too much sugar in your blood. Like other types of insulin, insulin detemir (DE-te-mir) is used to keep your blood sugar level close to normal. Insulin detemir is a long-acting insulin that works slowly over about 24 hours. You may have to use insulin detemir in combination with another type of insulin or with a type of oral diabetes medicine to keep your blood sugar under control.

This medicine is available only with your doctor's prescription, in the following dosage forms:

  • Parenteral
  • Injection (U.S.)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For insulin detemir, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to insulin detemir. Also tell your doctor and pharmacist if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—The amount of insulin or insulin detemir you need changes during pregnancy. It is especially important for your health and your baby's health that your blood sugar be closely controlled before you become pregnant and throughout pregnancy.

Breast-feeding—It is not known whether insulin detemir passes into human breast milk. Although most medicines, including human insulin, pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who are taking this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Studies on this medicine have been done only in adult patients, and there is no specific information comparing use of insulin detemir in children with use in other age groups.

Older adults—This medicine has been tested in a limited number of patients 65 years of age or older and has not been shown to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking insulin detemir, it is especially important that your doctor and pharmacist know if you are taking any of the following:

  • Beta-adrenergic blocking agents (acebutolol [e.g., Sectral], atenolol [e.g., Tenormin], betaxolol [e.g., Kerlone], bisoprolol [e.g., Zebeta], carteolol [e.g., Cartrol], labetalol [e.g., Normodyne, Trandate], metoprolol [e.g., Lopressor], nadolol [e.g., Corgard], oxprenolol [e.g., Trasicor], penbutolol [e.g., Levatol], pindolol [e.g., Visken], propranolol [e.g., Inderal], sotalol [e.g., Betapace], timolol [e.g., Blocadren]) or
  • Clonidine (e.g., Catapres, Duraclon) or
  • Guanethidine (e.g., Ismelin) or
  • Reserpine (e.g., Serpasil)—These medicines may hide symptoms of low blood sugar (such as fast heartbeat). Thus, a person with diabetes might not recognize that he or she has low blood sugar and might not take immediate steps to treat it.

Other medical problems—The presence of other medical problems may affect the use of insulin detemir. Make sure you tell your doctor if you have any other medical problems, especially:

  • Emotional disturbances or
  • Infection or
  • Stress—These conditions increase blood sugar and may increase the amount of insulin or insulin detemir you need.
  • Hypoglycemia (low blood sugar)—If you have low blood sugar and take insulin, your blood sugar may reach dangerously low levels.
  • Kidney disease or
  • Liver disease—Effects of insulin detemir may be increased or decreased; your doctor may need to change your insulin dose.

Proper Use of This Medicine

Dosing—Each package of insulin detemir contains a patient information sheet. Read this sheet carefully before beginning treatment and each time you refill for any new information, and make sure you understand:

  • How to prepare the medicine.
  • How to inject the medicine.
  • How to dispose of syringes, needles, and injection devices.

It is best to use a different place on the body for each injection (e.g., abdomen, thigh, or upper arm). If you have questions about this, contact a member of your health care team.

Follow carefully special instructions your doctor gave you . This is the most important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed.

Do not dilute or mix insulin detemir with any other insulins or solutions. This may cause the medicine to not work properly.

The dose of insulin detemir will be different for different patients. Follow your doctor's orders or the directions on the label .

  • For injection dosage form:
    • For diabetes mellitus:
      • Adults—The dose is based on your blood sugar and must be determined by your doctor.
      • Children—Use and dose must be determined by your doctor.

Storage—To store this medicine:

  • Keep out of the reach of children.
  • Store in the refrigerator. However, keep the medicine from freezing.
  • After a cartridge has been inserted into a pen, store the cartridge and pen at room temperature, not in the refrigerator.
  • Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

Your doctor will want to check your progress at regular visits , especially during the first few weeks you take this medicine.

It is very important to follow carefully any instructions from your health care team about :

  • Alcohol—Drinking alcohol may cause severe low blood sugar. Discuss this with your health care team.
  • Other medicines—Do not take other medicines during the time you are taking insulin detemir unless they have been discussed with your doctor. This especially includes nonprescription medicines such as aspirin, and medicines for appetite control, asthma, colds, cough, hay fever, or sinus problems.
  • Counseling—Other family members need to learn how to prevent side effects or help with side effects if they occur. Also, patients with diabetes may need special counseling about diabetes medicine dosing changes that might occur because of lifestyle changes, such as changes in exercise and diet. Furthermore, counseling on contraception and pregnancy is needed because of the problems that can occur in patients with diabetes during pregnancy.
  • Travel—Keep a recent prescription and your medical history with you. Be prepared for an emergency as you would normally. Make allowances for changing time zones and keep your meal times as close as possible to your usual meal times.

In case of emergency —There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:

  • Wear a medical identification (ID) bracelet or neck chain at all times. Also, carry an ID card in your wallet or purse that says that you have diabetes and a list of all of your medicines.
  • Keep an extra supply of insulin detemir and syringes with needles or injection devices on hand in case high blood sugar occurs.
  • Keep some kind of quick-acting sugar handy to treat low blood sugar.
  • Have a glucagon kit and a syringe and needle available in case severe low blood sugar occurs. Check and replace any expired kits regularly.

Too much insulin detemir can cause hypoglycemia (low blood sugar). Low blood sugar also can occur if you use insulin detemir with another antidiabetic medicine, delay or miss a meal or snack, exercise more than usual, or drink alcohol. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out) . Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly .

Symptoms of low blood sugar include anxiety; behavior change similar to being drunk; blurred vision; cold sweats; confusion; difficulty in thinking; dizziness or lightheadedness; drowsiness; excessive hunger; fast heartbeat; headache; irritability or abnormal behavior; nervousness; nightmares; restless sleep; shakiness; slurred speech; and tingling in the hands, feet, lips, or tongue.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes; or drink fruit juice, nondiet soft drink, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur . Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your household also should know how to use it.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, overeat or do not follow your meal plan, have emotional stress or infection, or do not exercise as much as usual.

Symptoms of high blood sugar include blurred vision; drowsiness; dry mouth; flushed, dry skin; fruit-like breath odor; increased urination; ketones in urine; loss of appetite; stomachache, nausea, or vomiting; tiredness; troubled breathing (rapid and deep); unconsciousness; and unusual thirst.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence unknown

Anxiety; blurred vision; chills; cold sweats; coma; confusion; cool pale skin; cough; depression; difficulty swallowing; dizziness; fast heartbeat; fever; headache; hives; hoarseness; increased hunger; irritation; itching; joint pain; nausea; nervousness; nightmares; puffiness or swelling of the eyelids or around the eyes, face, lips or tongue; redness of skin; seizures; shakiness; shortness of breath; skin rash; slurred speech; stiffness or swelling; swelling of eyelids, face, lips, hands, or feet; tightness in chest; troubled breathing or swallowing; unusual tiredness or weakness; wheezing

Symptoms of overdose

Get emergency help immediately if any of the following symptoms of overdose occur

Anxiety; blurred vision; chills; cold sweats; coma; confusion; cool pale skin; depression; dizziness; fast heartbeat; headache; increased hunger; nausea; nervousness; nightmares; seizures; shakiness; slurred speech; unusual tiredness or weakness

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome.

Incidence unknown

Bleeding, blistering, burning, coldness, discoloration of skin; feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at injection site; decrease in amount of urine; noisy, rattling breathing; redistribution or accumulation of body fat; swelling of fingers, hands, feet, or lower legs; swelling; troubled breathing at rest; weight gain

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Developed: 09/08/2005

The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

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