Insulin detemir

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Insulin detemir
Names
Trade namesLevemir
Clinical data
Drug classInsulin (long acting)[1]
Main usesDiabetes[1]
Side effectsLow blood sugar, allergic reactions, pain at the site of injection, weight gain[1]
Pregnancy
category
  • AU: B3[2]
  • US: B (No risk in non-human studies)[2]
Routes of
use
Subcutaneous
Duration of actionUp to 24 hours[1]
Defined daily dose40 units[3]
External links
AHFS/Drugs.comMonograph
MedlinePlusa606012
Legal
License data
Legal status
Pharmacokinetics
Bioavailability60% (when administered s.c.)
Elimination half-life5–7 hours
Chemical and physical data
FormulaC267H402N64O76S6
Molar mass5916.89 g·mol−1

Insulin detemir, sold under the brand name Levemir among others, is a long-acting insulin used to treat both type 1 and type 2 diabetes.[1] It is used by injection under the skin.[1] It is effective for up to 24 hours.[1]

Common side effects include low blood sugar, allergic reactions, pain at the site of injection, and weight gain.[1] Use in pregnancy and breastfeeding appears safe.[2] It works by increasing the amount of glucose that tissues take in and decreasing the amount of glucose made by the liver.[1]

Insulin detemir was approved for medical use in the European Union in June 2004 and in the United States in June 2005.[7][1][8] It is on the World Health Organization's List of Essential Medicines.[9] In the United Kingdom it costs the NHS about £2.80 per 100 units as of 2019.[10] In the United States the wholesale cost of this amount is about US$29.50.[11] In 2017, it was the 114th most commonly prescribed medication in the United States, with more than six million prescriptions.[12][13]

Medical use

It is used to treat both type 1 and type 2 diabetes.[1] With respect to blood sugar management, it appears to work at least as well as NPH insulin and insulin glargine.[1]

Dosage

The defined daily dose is 40 units by injection.[3]

Side effects

Common side effects include low blood sugar, allergic reactions, pain at the site of injection, and weight gain.[1] Use in pregnancy and breastfeeding appears safe.[2]

Chemistry

It is an insulin analogue in which a fatty acid (myristic acid) is bound to the lysine amino acid at position B29. It is quickly absorbed after which it binds to albumin in the blood through its fatty acid at position B29. It then slowly dissociates from this complex.

Society and culture

On June 13, 2009, the U.S. Food and Drug Administration (FDA) issued a public health advisory for insulin determir after learning that 129,000 stolen vials reappeared and were being sold in the U.S. market. The FDA warned that the stolen vials "may not have been stored and handled properly and may be dangerous for patients to use." The stolen vials were identified as lots XZF0036, XZF0037, and XZF0038.[14]

Cost

In the United Kingdom it costs the NHS about £2.80 per 100 units as of 2019.[10] In the United States the wholesale cost of this amount is about US$29.50.[11] In 2017, it was the 114th most commonly prescribed medication in the United States, with more than six million prescriptions.[12][13]

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 "Insulin Detemir Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Archived from the original on 19 March 2016. Retrieved 3 March 2019.
  2. 2.0 2.1 2.2 2.3 "Insulin detemir (Levemir) Use During Pregnancy". Drugs.com. 12 June 2019. Archived from the original on 13 June 2019. Retrieved 14 April 2020.
  3. 3.0 3.1 "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 7 August 2020. Retrieved 6 September 2020.
  4. "Levemir FlexPen 100 units/ml solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". (emc). 21 May 2018. Archived from the original on 7 January 2021. Retrieved 14 April 2020.
  5. "Levemir InnoLet 100 units/ml solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". (emc). 21 May 2018. Archived from the original on 8 January 2021. Retrieved 14 April 2020.
  6. "Levemir Penfill 100 units/ml solution for injection in cartridge - Summary of Product Characteristics (SmPC)". (emc). 21 May 2018. Archived from the original on 7 January 2021. Retrieved 14 April 2020.
  7. "Levemir EPAR". European Medicines Agency (EMA). Archived from the original on 5 July 2019. Retrieved 14 April 2020.
  8. "Drug Approval Package: Levemir Insulin Detemir[rDNA origin] Injection; NDA #021536". U.S. Food and Drug Administration (FDA). 26 July 2005. Archived from the original on 6 May 2015. Retrieved 14 April 2020.
  9. World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  10. 10.0 10.1 British national formulary : BNF 76 (76 ed.). Pharmaceutical Press. 2018. p. 701. ISBN 9780857113382.
  11. 11.0 11.1 "NADAC as of 2019-02-27". Centers for Medicare and Medicaid Services. Archived from the original on 2019-03-06. Retrieved 3 March 2019.
  12. 12.0 12.1 "The Top 300 of 2020". ClinCalc. Archived from the original on 12 February 2021. Retrieved 11 April 2020.
  13. 13.0 13.1 "Insulin Detemir - Drug Usage Statistics". ClinCalc. Archived from the original on 12 April 2020. Retrieved 11 April 2020.
  14. "FDA Issues Public Health Advisory Regarding Levemir Insulin". 13 June 2009. Archived from the original on 17 June 2009. Retrieved 9 March 2019.

External links

Identifiers:
  • "Insulin detemir". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 2020-10-21. Retrieved 2020-04-15.