Levemir FlexPen 100 IU/ml | Insulin Detemir Pre-filled Pen

Levemir FlexPen – Insulin Detemir 100 IU/ml by Novo Nordisk

What is Levemir FlexPen?

Levemir (insulin detemir) is a long-acting basal insulin analogue by Novo Nordisk. Detemir achieves its prolonged action via two mechanisms: self-association into hexamers at the injection site, and reversible albumin binding in the bloodstream. The result is a flat, relatively peakless 16–24 hour profile (dose-dependent). The FlexPen allows 1-unit increments from 1 to 60 IU. Levemir is clear — no resuspension required. Notably, Levemir is associated with less weight gain than NPH insulin and glargine in some trials, making it a preferred option in weight-conscious patients. Used for Type 1 and Type 2 diabetes in adults, adolescents, and children ≥2 years.

Generic Name & Composition

Each ml: 100 IU insulin detemir. Detemir is a modified human insulin: B30 threonine is removed and a C14 fatty acid (myristic acid) is attached to B29 lysine. The fatty acid promotes hexamer formation at the SC injection site and albumin binding in plasma — both slow absorption and extend duration to 16–24 hours with a flatter profile than NPH insulin.

Indications

• Type 1 diabetes — basal component in basal-bolus regimen
• Type 2 diabetes — once or twice-daily basal insulin
• Adults, adolescents, and children ≥2 years
• Patients where minimising weight gain is a priority

How It Works — Mechanism of Action

After SC injection, detemir hexamers form a subcutaneous depot. Albumin binding in interstitial fluid and plasma further delays and smooths absorption. This dual mechanism provides a flat plasma insulin profile over 16–24 hours. Detemir activates insulin receptors (GLUT-4 glucose uptake, gluconeogenesis suppression, glycogen synthesis), controlling fasting and overnight glucose with low peak-to-trough variability.

Dosage & Administration

Once daily (Type 2 start): 10 IU or 0.1–0.2 IU/kg with evening meal or at bedtime. Twice daily: If once-daily control is insufficient, split into 2 doses. Type 1: Individualised; typically replaces NPH dose. Titrate by 2 IU every 3 days. Inject subcutaneously (abdomen, thigh, or upper arm). Do not administer IV or IM.

Side Effects

Very common: Hypoglycaemia.

Common: Injection site reactions, lipohypertrophy, peripheral oedema. Less weight gain than NPH/glargine in comparative trials.

Uncommon: Lipoatrophy, visual refraction changes at therapy initiation.

Rare: Generalised hypersensitivity, anaphylaxis.

Drug Interactions

Increase hypoglycaemia: OADs, GLP-1 RAs, SGLT-2 inhibitors, ACE inhibitors, MAO inhibitors, salicylates, sulfonamides, alcohol.

Reduce hypoglycaemic effect: Corticosteroids, glucagon, thyroid hormones, growth hormone, sympathomimetics, danazol, oral contraceptives, thiazides.

Mask symptoms: Beta-blockers, clonidine, reserpine.

Contraindications

• Hypersensitivity to insulin detemir or any excipient
• Active hypoglycaemia; IV or IM administration

Pregnancy & Lactation

Pregnancy: Limited data — consider switching to human insulin (NPH) under specialist supervision. Lactation: No clinically relevant infant exposure expected via breast milk.

Precautions & Warnings

• Do not mix Levemir with other insulins in the same pen or syringe.
• Rotate injection sites — lipohypertrophy at same site impairs absorption.
• Renal/hepatic impairment: Dose reduction may be needed — monitor closely.
• Do not freeze. Protect from light.

Overdose

Hypoglycaemia. Mild: oral glucose. Severe: IV dextrose or IM glucagon 1 mg. Monitor glucose every 2–4 hours until stable given detemir's 16–24 hr duration.

Storage Instructions

• Unopened: 2–8°C. Do not freeze.
• In-use pen: Below 30°C. Do not refrigerate. Protect from light.
• Discard 42 days after first use.

Frequently Asked Questions (FAQs)

Q1: How is Levemir different from Lantus (glargine)?
Both are long-acting basal analogues. Key differences: Levemir uses albumin binding for prolonged action; glargine uses microprecipitation. Levemir may require twice-daily dosing in some Type 1 patients (duration 16–24 hrs), while glargine U100 usually covers 24 hrs. Clinical trials show Levemir is associated with less weight gain than glargine in some populations.

Q2: Can Levemir be taken twice daily?
Yes. For patients whose fasting glucose is not well-controlled with once-daily Levemir, splitting into a morning and evening dose provides better 24-hour basal coverage — particularly in Type 1 diabetes where duration may be shorter at lower doses.

Q3: Does Levemir need to be resuspended before use?
No. Levemir is a clear solution — no rolling or inverting required. This distinguishes it from NPH (cloudy) and premixed insulins (suspension) that must be resuspended.

Q4: Who manufactures Levemir?
Novo Nordisk A/S (Denmark). Levemir is the brand name for insulin detemir, part of Novo Nordisk's basal insulin portfolio alongside Tresiba (degludec).

⚕ Medical Disclaimer: For educational purposes only. Levemir is Rx-only. Consult your diabetologist before changing insulin therapy. DiabetesStore.com.bd is a licensed online pharmacy.