Insulin Solution for injection

INSULIN DETEMIR (IN su lin DE te mir) treats diabetes. It works by increasing insulin levels in your body, which decreases your blood sugar (glucose). It belongs to a group of medications called long-acting insulins or basal insulins. Changes to diet and exercise are often combined with this medication.

This medication is injected under the skin. Use it exactly as directed. It is important to follow the directions give to you by your care team. You will be taught how to prepare and give it. This insulin should never be mixed in the same syringe with other insulins before injection.You will be taught how to use this medication and how to adjust doses for activities and illness. Do not use more insulin than prescribed. Do not use it more or less often than prescribed.

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

If you use a pen, be sure to take off the outer needle cover before using the dose.

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 care team to get one.

This medication comes with INSTRUCTIONS FOR USE. Ask your pharmacist for directions on how to use this medication. Read the information carefully. Talk to your pharmacist or care team if you have questions.

Talk to your care team about the use of this medication in children. While it may be prescribed for children as young as 2 years for selected conditions, precautions do apply.

Side effects that you should report to your care team as soon as possible:

• Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
• Low blood sugar (hypoglycemia)—tremors or shaking, anxiety, sweating, cold or clammy skin, confusion, dizziness, rapid heartbeat
• Low potassium level—muscle pain or cramps, unusual weakness or fatigue, fast or irregular heartbeat, constipation

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

• Lipodystrophy—hardening or scarring of tissue at injection site
• Pain, redness, or irritation at injection site
• Weight gain

Keep out of the reach of children and pets.

Storage and expiration dates for different insulin products may vary. Check the label for information on how to store your insulin. Talk to your care team if you have any questions.

Do not freeze. Protect from direct light and heat. Do not use insulin if it is exposed to temperatures above 37 degrees C (98.6 degrees F). Do not use insulin if it has been frozen.

Multi-dose vials

• Unopened (not in-use): Store at room temperature up to 30 degrees C (86 degrees F) for up to 42 days, or refrigerated until the expiration date.
• Opened (in-use): Store at room temperature or refrigerated for up to 42 days.

Prefilled pens

• Unopened (not in-use): Store at room temperature up to 30 degrees C (86 degrees F) for up to 42 days, or refrigerated until the expiration date.
• Opened (in-use): Store at room temperature for up to 42 days. Do not refrigerate.

To get rid of medications that are no longer needed or have expired:

• Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
• If you cannot return the medication, ask your pharmacist or care team how to get rid of this medication safely.

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

• Episodes of low blood sugar
• Eye disease, vision problems
• Kidney disease
• Liver disease
• An unusual or allergic reaction to insulin, metacresol, other medications, foods, dyes, or preservatives
• Pregnant or trying to get pregnant
• Breast-feeding

Some medications may affect your blood sugar levels or hide the symptoms of low blood sugar (hypoglycemia). Talk with your care team about all of the medications you take. They may suggest changes to your insulin dose or checking your blood sugar levels more often.

Medications that may affect your blood sugar levels include:

• Alcohol
• Certain antibiotics, such as ciprofloxacin, levofloxacin, sulfamethoxazole; trimethoprim
• Certain medications for blood pressure or heart disease, such as benazepril, enalapril, lisinopril, losartan, valsartan
• Certain medications for mental health conditions, such as fluoxetine or olanzapine
• Diuretics, such as hydrochlorothiazide (HCTZ)
• Estrogen and progestin hormones
• Other medications for diabetes
• Steroid medications, such as prednisone or cortisone
• Testosterone
• Thyroid hormones

Medications that may mask symptoms of low blood sugar include:

• Beta blockers, such as atenolol, metoprolol, propranolol
• Clonidine
• Guanethidine
• Reserpine

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

Visit your care team for regular checks on your progress.

Your care team will monitor your hemoglobin A1C. This is a simple blood test. It measures your average blood sugar level over the past 3 months. It will help you and your care team manage your diabetes.

Learn how to check your blood sugar levels. Know the symptoms of low and high blood sugar and how to manage them.

Always carry a source of quick sugar with you for symptoms of low blood sugar. Examples include glucose tablets, juice, or sugar candy. Teach your family members, friends, and others how to help you if your blood sugar is too low and you are not awake enough to treat it.

Talk to your care team if you have high blood sugar. You may need to adjust your insulin dose. Many factors can cause high blood sugar, including illness, stress, or a change in activity.

Do not skip meals. Ask your care team if you should avoid alcohol. Many cough and cold products contain sugar or alcohol. These can affect blood sugar levels.

Make sure that you have the correct syringe for the type of insulin you use. Do not change the brand or type of insulin or syringe unless your care team tells you to. Switching insulin brand or type can affect your blood sugar enough to cause serious adverse effects.

Always keep an extra supply of insulin and related supplies on hand. Only use syringes once. Get rid of syringes and needles in a closed container to prevent accidental needle sticks.

Do not share insulin pens or cartridges with anyone, even if the needle is changed. Each pen should only be used by one person. Sharing could cause an infection.

Do not use a syringe to take insulin out of an insulin pen. Doing this may result in the wrong dose of insulin.

Wear a medical ID bracelet or chain. Carry a card that describes your condition. List the medications and doses you take on the card.