Insulin detemir


Concise Prescribing Info
Indications/Uses
DM.
Dosage/Direction for Use
Adult : SC In insulin-naive patients w/ type 2 DM who are not well controlled on oral antidiabetic drugs: Initial: 0.1-0.2 u/kg once daily in the evening or 10 u 1-2 times/day, adjust subsequently based on glycaemic control. In patients on basal insulin only: May substitute w/ insulin detemir on a unit-for-unit basis based on the current basal insulin dosage, adjust subsequently to achieve glycaemic targets.
Dosage Details
Subcutaneous
Diabetes mellitus
Adult: In insulin-naive patients with type 2 DM who are not well controlled on oral antidiabetic drugs: Initial dosage of 0.1-0.2 units/kg given once daily in the evening or 10 units given once or twice daily, with subsequent dosage adjusted based on glycaemic control. In patients on basal insulin only: Insulin detemir may be substituted on a unit-for-unit basis for the basal insulin currently in use, adjust dose to achieve glycaemic targets. Inj may be given once daily at evening meal or at bedtime or twice daily in the morning and the second dose admin after the evening meal, at bedtime, or 12 hr after the morning dose.
Renal Impairment
Dose adjustment may be needed.
Hepatic Impairment
Dose adjustment may be needed.
Administration
May be taken with or without food. For patients treated w/ once daily regimen, administer w/ evening meal or at bedtime. For patients who need twice daily dosing, the evening dose can be administered either w/ the evening meal or at bedtime or 12 hr after the morning dose.
Incompatibility
Do not mix with other insulin preparations.
Contraindications
Do not admin by IV, IM or via insulin infusion pump.
Special Precautions
Renal or hepatic impairment. Regular monitoring of blood glucose and HbA1c. Continuous rotation of the inj site within a given area to reduce inj site reactions. Pregnancy, lactation
Adverse Reactions
Hypoglycaemia, lipodystrophy, pruritus, rash, wt gain, sodium retention and oedema. Inj site reactions e.g. pain, itching, hives, swelling and inflammation.
Overdosage
Symptoms: Hypoglycaemia. Management: In mild hypoglycaemic episodes, treat with oral glucose. In severe hypoglycaemic episodes, where the patient has become unconscious, treat with IM/subcutaneous glucagon (0.5-1 mg) or IV glucose. If the patient does not respond to glucagon within 10-15 minutes, IV glucose must be given. Once consciousness is regained, admin oral carbohydrates to prevent a relapse.
Drug Interactions
Possible absence of hypoglycaemic warning symptoms with β-blockers. Increased blood sugar with thiazide diuretics, corticosteriods, chlorpromazine, tibolone, isoniazid, niacin, some calcium-channel blockers such as diltiazem or nifedipine, diazoxide, lithium and thyroid hormones. Increased risk of hypoglycemia with disopyramide, larges doses of aspirin, gatifloxacin, MAOIs, mebanazine, nandrolone, pegvisomant, testosterone. Decreased insulin resistance with octreotide and lanreotide. Increased risk of wt gain and peripheral oedema with pioglitazone, rosiglitazone. Decreased effect of sermorelin.
Action
Description: Insulin detemir is a recombinant human insulin analogue which is long-acting. It is prepared using recombinant DNA technology and genetically modified cultures of Saccharomyces cerevisiae. Slow systemic absorption and reversible binding to albumin may account for the prolonged duration of action of insulin detemir.
Duration: 24 hr
Pharmacokinetics:
Absorption: Max plasma concentration: 6-8 hr (SC admin). Absolute bioavailability: 60%.
Distribution: Protein binding: 98% (albumin). Volume of distribution: 0.1 L/kg. Terminal half-life: 5-7 hr (after SC admin).
Storage
Unopened preparation: Store between 2-8°C (36-46° F). Do not freeze. Once opened, the vial should be kept in refrigerator (do not freeze) or at room temperature, below 30°C (86°F) for up to 42 days. Once opened, cartridge or a prefilled syringe to be stored at room temperature, below 30°C (86°F) up to 42 days (do not refrigerate).
Disclaimer: This information is independently developed by MIMS based on Insulin detemir from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in