Levemir

Levemir

insulin detemir

Manufacturer:

Novo Nordisk

Distributor:

DKSH
Concise Prescribing Info
Contents
Insulin detemir
Indications/Uses
DM in adult, adolescents & childn ≥1 yr.
Dosage/Direction for Use
SC In combination w/ oral antidiabetics or as add-on to GLP-1 receptor agonists Initially, 0.1-0.2 U/kg once daily or 10 U in adult patients. Dose titration: Adult type 2 diabetes: Ave pre-breakfast self-monitored plasma glucose (SMPG) >10 mmol/L (180 mg/dL): adjust dose to +8 U; 9.1-10 mmol/L (163-180 mg/dL): adjust dose to +6 U; 8.1-9 mmol/L (145-162 mg/dL): adjust dose to +4 U; 7.1-8 mg/dL (127-144 mg/dL) & 6.1-7 mg/dL (109-126 mg/dL): adjust dose to +2 U; 3.1-4 mmol/L (56-72 mg/dL): adjust dose to -2 U; <3.1 mmol/L (<56 mg/dL): adjust dose to -4 U. Adult type 2 diabetes self-titration: Ave pre-breakfast SMPG self-monitored plasma glucose >6.1 mmol/L (>110 mg/dL): adjust to +3 U; <4.4 mmol/L (<80 mg/dL): adjust dose to -3 U. Administer once daily or bd as part of basal-bolus regimen. For patients required of bd dosing, administer evening dose in the evening or at bedtime.
Administration
May be taken with or without food.
Contraindications
Special Precautions
May require adjustment of dose & timing of administration when transferring from intermediate or long-acting insulin products. Closely monitor glucose during transfer & in the initial wk thereafter. Concomitant antidiabetic treatment may need to be adjusted. Do not administer IV. Avoid IM administration. Do not use in insulin infusion pumps. Consult physician before travelling between different time zones. May lead to hyperglycaemia & diabetic ketoacidosis w/ inadequate dosing or discontinuation of treatment, especially in type 1 diabetes. Hypoglycemia may occur due to omission of a meal or unplanned strenuous physical exercise. Dose adjustment may be required in patients w/ concomitant illness, diseases in the kidney, liver or those affecting the adrenal, pituitary or thyroid gland. Transferring to another type or brand of insulin should be done under strict medical supervision. Inj site reactions. Continuously rotate inj site to reduce risk of developing lipodystrophy (including lipohypertrophy, lipoatrophy). Concomitant use w/ thiazolidinediones. May impair ability to drive or operate machinery. To minimize risk of hypoglycaemia in childn, when changing from basal insulin to insulin detemir, consider dose reduction in individual basis; match insulin doses (especially in basal-bolus regimens) w/ food intake & physical activities. Pregnancy & lactation.
Adverse Reactions
Hypoglycemia. Inj site reaction. Allergic reactions, potentially allergic reactions eg, urticaria, rash & eruptions; lipodystrophy.
Drug Interactions
CHF may develop in combination w/ thiazolidinediones, especially in patients w/ risk factors. May reduce patient's insulin requirements w/ oral antidiabetics, GLP-1 receptor agonists, MAOIs, β-blockers, ACE inhibitors, salicylates, anabolic steroids & sulfonamides. May increase insulin requirements w/ OCs, thiazides, glucocorticoids, thyroid hormones, sympathomimetics, growth hormone & danazol. Masked symptoms of hypoglycemia w/ β-blockers. Increased or decreased insulin requirement w/octreotide/lanreotide. Intensified or reduced hypoglycemic effect w/ alcohol.
MIMS Class
Insulin Preparations
ATC Classification
A10AE05 - insulin detemir ; Belongs to the class of long-acting insulins and analogues for injection. Used in the treatment of diabetes.
Presentation/Packing
Form
Levemir FlexPen 100 u/mL
Packing/Price
3 mL x 5 × 1's
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