Levemir Flexpen Injection
Insulin Detemir
Novo Nordisk India Pvt Ltd.
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| Retail Price | 1744.00 NPR |
Indications
Levemir Flexpen Injection is used for:
Diabetes mellitus
Adult Dose
Subcutaneous
Type I or II Diabetes Mellitus
Once daily dosage: Administer SC with evening meal or at bedtime
Twice daily dosage: Administer SC with morning meal and either with evening meal, at bedtime, or 12 hr after the morning dose
Initial dose
Type 1 diabetes: Approximately one third of the total daily insulin requirements SC; rapid-acting or short-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements; usual daily maintenance range is 0.5-1 unit/kg/day in divided doses; nonobese may require 0.4-0.6 unit/kg/day; obese may require 0.6-1.2 units/kg/day
Type 2 diabetes inadequately controlled on oral medication: 10 units/day SC (or 0.1-0.2 unit/kg/day) in evening or divided q12hr
Type 2 diabetes inadequately controlled on GLP-1 receptor agonist: 10 units/day SC given once daily in evening
Subsequently adjust dose based on blood glucose measurements
Conversion from other insulins
If converting from insulin glargine: Change can be accomplished on a unit-to-unit basis
If converting from NPH insulin: Change can be accomplished on a unit-to-unit basis; however, some patients with type 2 diabetes may require more insulin detemir than NPH insulin
Closely monitor blood glucose during transition and in the initial weeks thereafter; concurrent rapid-acting or short-acting insulins or other concomitant antidiabetic treatment may require dose adjustment
Dosing Considerations
Dosage of human insulin, , must be based on the results of blood and urine glucose tests and must be carefully individualized to optimal effect
Dose adjustments should be based on regular blood glucose testing
Adjust to achieve appropriate glucose control
Dose adjustments
Look for consistent pattern in blood sugars for >3 days
Child Dose
Subcutaneous
Type 1 Diabetes Mellitus
<2 years: Safety and efficacy not established
>2 years: Approximately one-third of the total daily insulin requirements SC; rapid-acting or short-acting, premeal insulin should be used to satisfy the remainder of the daily insulin requirements; usual daily maintenance range in adolescents is <1.2 units/kg/day during growth spurts
Renal Dose
Renal impairment: Dose adjustments may be needed.
Administration
Administer subcutaneously in the upper arm, thigh or abdominal wall. A subcutaneous injection into the abdominal wall results in a faster absorption than from other injection sites.
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.
Contra Indications
Do not admin by IV, IM or via insulin infusion pump.
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
Lactation: Safe
Pregnancy-Lactation
Interactions
Possible absence of hypoglycaemic warning symptoms with beta-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.
Adverse Effects
Side effects of Insulin Detemir :
Hypoglycaemia, lipodystrophy, pruritus, rash, wt gain, sodium retention and oedema. Inj site reactions e.g. pain, itching, hives, swelling and inflammation. Influenza-like symptoms, Pallor, Palpitation, Tachycardia, Mental confusion, Weakness, Blurred vision, Itching, Hunger, Nausea.
Mechanism of Action
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.
Note
Levemir Flexpen Injection manufactured by Novo Nordisk India Pvt Ltd.. Its generic name is Insulin Detemir. Levemir Flexpen is availble in Nepal.
Farmaco Nepal drug index information on Levemir Flexpen Injection is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.