Insulin Detemir 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. You will be taught how to prepare and give it. Take it as directed on the prescription label at the same time every day. This insulin should never be mixed in the same syringe with other insulins before injection. Do not vigorously shake insulin before use. 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 medication 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.

Unopened Vials:

Levemir vials: Store in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F) or at room temperature below 30 degrees C (86 degrees F). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat. If stored at room temperature, the vial must be discarded after 42 days. Throw away any unopened and unused medication that has been stored in the refrigerator after the expiration date.

Unopened Pens:

Levemir Flextouch pens: Store in a refrigerator between 2 and 8 degrees C (36 and 46 degrees F) or at room temperature below 30 degrees C (86 degrees F). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat. If stored at room temperature, the pen must be discarded after 42 days. Throw away any unopened and unused medication that has been stored in the refrigerator after the expiration date.

Vials that you are using:

Levemir vials: Store in the refrigerator or at room temperature below 30 degrees C (86 degrees F). Do not freeze. Keep away from heat and light. Throw the opened vial away after 42 days.

Pens that you are using:

Levemir Flextouch pens: Store at room temperature, below 30 degrees C (86 degrees F). Do not store in the refrigerator once opened. Do not refrigerate or freeze. Keep away from heat and light. Throw the pen away after 42 days, even if it still has insulin left in it.

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

• Alcohol
• Antivirals for HIV or AIDS
• Aspirin and aspirin-like medications
• Beta blockers, such as atenolol, metoprolol, propranolol
• Certain medications for blood pressure, heart disease, irregular heartbeat
• Chromium
• Clonidine
• Diuretics
• Estrogen or progestin hormones
• Fenofibrate
• Gemfibrozil
• Guanethidine
• Isoniazid
• Lanreotide
• MAOIs, such as Carbex, Eldepryl, Marplan, Nardil, and Parnate
• Medications for weight loss
• Medications for allergies, asthma, cold, or cough
• Medications for mental health conditions
• Niacin
• Nicotine
• NSAIDs, medications for pain and inflammation, such as ibuprofen or naproxen
• Octreotide
• Other medications for diabetes, such as glyburide, glipizide, or glimepiride
• Pasireotide
• Pentamidine
• Phenytoin
• Probenecid
• Quinolone antibiotics, such as ciprofloxacin, levofloxacin, ofloxacin
• Reserpine
• Some herbal dietary supplements
• Steroid medications, such as prednisone or cortisone
• Sulfamethoxazole; trimethoprim
• Testosterone or anabolic steroids
• Thyroid hormones

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.