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Insulin Detemir (Recombinant) Solution for injection

What is this medicine?

INSULIN DETEMIR (IN su lin DE te mir) is a human-made form of insulin. This drug lowers the amount of sugar in your blood. It is a long-acting insulin that is usually given once or twice a day.

How should I use this medicine?

This medicine is for injection under the skin. Use exactly as directed. It is important to follow the directions given to you by your health care professional or doctor. Your doctor or health care professional will teach you how to give yourself injections. If you utilize an insulin injector device, you will be taught how to use it, prime it, and how to refill the device with the insulin cartridges. You will be taught how to adjust doses for activities and illness. Do not use more insulin than prescribed. Do not use more or less often than prescribed.

Always check the appearance of your insulin before using it. This medicine should be clear and colorless like water. Do not use if it is cloudy, thickened, colored, or has solid particles in it.

It is important that you put your used needles and syringes in a special sharps container. Do not put them in a trash can. If you do not have a sharps container, call your pharmacist or healthcare provider to get one.

Talk to your pediatrician regarding the use of this medicine in children. While this drug may be prescribed for children as young as 2 years for selected conditions, precautions do apply.

What side effects may I notice from receiving this medicine?

Side effects that you should report to your health care professional or doctor as soon as possible:

Symptoms of low blood sugar:

  • You may feel nervous, confused, dizzy, hungry, weak, sweaty, shaky, cold, and irritable. You may also experience headache, blurred vision, rapid heartbeat and loss of consciousness.

Symptoms of high blood sugar:

  • You may experience dizziness, dry mouth, dry skin, fruity breath, loss of appetite, nausea, stomach ache, unusual thirst, frequent urination

Insulin also can cause rare but serious allergic reactions in some patients, including:

  • bad skin rash and itching

  • breathing problems

Side effects that usually do not require medical attention (report to your health care professional or doctor if they continue or are bothersome):

  • increase or decrease in fatty tissue under the skin, through overuse of a particular injection location

  • itching, burning, swelling, or rash where injected

What may interact with this medicine?

  • other medicines for diabetes

Many medications may cause an increase or decrease in blood sugar, these include:

  • alcohol containing beverages

  • aspirin and aspirin-like drugs

  • chloramphenicol

  • chromium

  • diuretics

  • female hormones, like estrogens or progestins and birth control pills

  • heart medicines

  • isoniazid

  • MAOIs like Carbex, Eldepryl, Marplan, Nardil, and Parnate

  • male hormones or anabolic steroids

  • medicines for weight loss

  • medicines for allergies, asthma, cold, or cough

  • medicines for mental problems

  • niacin

  • NSAIDs, medicines for pain and inflammation, like ibuprofen or naproxen

  • pentamidine

  • phenytoin

  • probenecid

  • quinolone antibiotics like ciprofloxacin, levofloxacin, ofloxacin

  • some herbal dietary supplements

  • steroid medicines like prednisone or cortisone

  • thyroid medicine

Some medications can hide the warning symptoms of low blood sugar. You may need to monitor your blood sugar more closely if you are taking one of these medications. These include:

  • beta-blockers such as atenolol, metoprolol, propranolol

  • clonidine

  • guanethidine

  • reserpine

What if I miss a dose?

It is important not to miss a dose. Your health care professional or doctor should discuss a plan for missed doses with you. If you do miss a dose, follow their plan. Do not take double doses.

Where should I keep my medicine?

Keep out of the reach of children.

Store unopened cartridges, FlexPens, or Levemir Innolet systems in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F.) Do not freeze or use if the insulin has been frozen. Once opened, the Levemir Innolet system, FlexPen, and cartridges that are inserted into pens should be kept at room temperature, below 30 degrees C (86 degrees F). Do not store in the refrigerator once opened. Once opened, the insulin can be used for 42 days. After 42 days, the cartridge, Levemir Innolet system or FlexPen should be thrown away.

Store unopened insulin vials in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F). Do not freeze or use if the insulin has been frozen. Opened vials (vials currently in use) should be stored in a refrigerator, never a freezer. If refrigeration is not possible, the opened vial can be stored unrefrigerated at room temperature, below 30 degrees C (86 degrees F) for up to 42 days. After 42 days, the vial of insulin should be thrown away. Keeping your insulin at room temperature decreases the amount of pain during injection.

Protect from light and excessive heat. Throw away any unused medicine after the expiration date or after the specified time for room temperature storage has passed.

What should I tell my health care provider before I take this medicine?

They need to know if you have any of these conditions:

  • episodes of hypoglycemia

  • kidney disease

  • liver disease

  • an unusual or allergic reaction to insulin, metacresol, other medicines, foods, dyes, or preservatives

  • pregnant or trying to get pregnant

  • breast-feeding

What should I watch for while using this medicine?

Visit your health care professional or doctor for regular checks on your progress. To control your diabetes you must use this medicine regularly and follow a diet and exercise schedule. Checking and recording your blood sugar and urine ketone levels regularly is important. Use a blood sugar measuring device before you treat high or low blood sugar.

Always carry a quick-source of sugar with you in case you have symptoms of low blood sugar. Examples include hard sugar candy or glucose tablets. Make sure family members know that you can choke if you eat or drink when you develop serious symptoms of low blood sugar, such as seizures or unconsciousness. They must get medical help at once.

Make sure that you have the right kind of syringe for the type of insulin you use. Try not to change the brand and type of insulin or syringe unless your health care professional or doctor tells you to. Switching insulin brand or type can cause dangerously high or low blood sugar. Always keep an extra supply of insulin, syringes, and needles on hand. Use a syringe one time only. Throw away syringe and needle in a closed container to prevent accidental needle sticks.

Insulin pens and cartridges should never be shared. Sharing may result in passing of viruses like hepatitis or HIV.

Wear a medical identification bracelet or chain to say you have diabetes, and carry a card that lists all your medications.

Many nonprescription cough and cold products contain sugar or alcohol. These can affect diabetes control or can alter the results of tests used to monitor blood sugar. Avoid alcohol. Avoid products that contain alcohol or sugar.