What are Levemir FlexTouch pens (Insulin Detemir)?

Levemir FlexTouch pens are prefilled injection pens containing insulin detemir, a long-acting insulin prescribed for the management of type 1 diabetes in adults and children above the age of two years, as well as type 2 diabetes in adults. This medication may be used alone or alongside additional medications to manage type 2 diabetes, and it is typically used alongside other forms of insulin in those with type 1 diabetes.

Levemir FlexTouch Pens (Insulin Detemir)

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What are Levemir FlexTouch pens (Insulin Detemir)

Levemir FlexTouch pens are prefilled injection pens containing insulin detemir, a long-acting insulin prescribed for the management of type 1 diabetes in adults and children above the age of two years, as well as type 2 diabetes in adults. This medication may be used alone or alongside additional medications to manage type 2 diabetes, and it is typically used alongside other forms of insulin in those with type 1 diabetes.

How are Levemir FlexTouch Pens Used?

These injections pens will typically be used once or twice per day to inject a patient’s prescribed dosage of insulin to manage their blood glucose levels.

Patients should follow the dosage and injection directions exactly as instructed by their prescribing physician. Insulin may be injected into the upper arms, the thighs, or the abdomen, and the patient should rotate the site of injection each time to avoid causing any damage to the skin.

Storage

Levemir FlexTouch pens that are unopened and unused should be stored in a refrigerator and kept between temperatures of 36°F (2°C) to 46°F (8°C). Once a pen has been removed from refrigeration and is actively being used, it should be stored at room temperature and outside of the refrigerator. However, it should never be exposed to temperatures exceeding 86°F.

When refrigerated, unused and opened injection pens may be stored until their listed expiration date. If stored at room temperature or currently in use, these pens should be disposed of after 42 days, even if some insulin still remains within the pen.

Keep this medication out of the reach of children at all times.

Levemir FlexTouch pens should be kept away from light and heat, and they should never be frozen. If the insulin within an injection pen has been frozen at any point in time, it should not be used.

Uses

Levemir FlexTouch is prescribed for a variety of insulin-related conditions, including but not limited to:

  • Type 1 Diabetes
  • Type 2 Diabetes
  • Diabetic Ketoacidosis
  • Diabetic Coma
  • Autoimmune Disorders

How Does Levemir FlexTouch Work?

The insulin contained in Levemir FlexTouch pens works as a replacement for the insulin that should naturally be made by the patient’s body. As a long-acting insulin, it is able to provide prolonged, steady, lower levels of insulin to help manage the patient’s blood glucose levels properly.

Dosage

This medication comes in a prefilled injection pen that contains 100 units of insulin detemir per mL.

The patient’s required daily dosage of insulin will be determined by their physician based on the amount of insulin produced by their pancreas as well as any additional health conditions, medications, or lifestyle aspects that may impact their blood glucose levels on a daily basis.

Overdose

If an overdose of insulin has occurred or is suspected, the individual’s doctor or local Poison Control Center should be contacted as soon as possible. If symptoms of hypoglycemia become significant, emergency medical attention should be sought immediately.

Too much insulin in the body can result in life-threatening hypoglycemia (low blood glucose levels). The symptoms of low blood glucose levels include the following:

  • feeling dizzy
  • having heart palpitations
  • losing consciousness
  • shakiness
  • sweating

Some cases of hypoglycemia may be counteracted by ingesting fast-acting carbohydrates to increase the individual’s blood sugar levels. This includes sugary products like candy, fruit juice, regular soft drinks (not diet), and glucose tablets.

However, if a patient’s blood sugar levels drop dangerously low, this can result in them going into a coma or experiencing seizures. If the individual’s response to hypoglycemia appears to be severe, emergency medical attention should be sought at once.

Side Effects

The most common side effects of using this medication are as follows:

  • allergic reactions
  • changes in the thickness of the skin at the site of injection
  • hyperglycemia (high blood glucose levels)
  • hypoglycemia (low blood glucose levels)
  • numbness in the arms and legs
  • pain in the arms or legs
  • reactions at the injection site
  • visions changes
  • weakness in the limbs
  • weight gain

Some of the following side effects may also occur and should be reported to your doctor immediately. Patients that experience any of the following serious side effects should seek medical attention if these symptoms worsen and appear to be life-threatening:

  • loss of consciousness
  • seizures
  • severe allergic reaction
    • breathing difficulties
    • flushing
    • itchiness
    • skin rash
    • swelling of the throat, mouth, or tongue
    • swelling under the skin of the feet, hands, or eyelids
  • severe hyperglycemia
    • blurry vision
    • excessive hunger or thirst
    • frequent urination
    • headache
    • heart or kidney problems
  • severe hypoglycemia
    • cold sweat
    • convulsions
    • dizziness
    • feeling lightheaded
    • inability to concentrate
    • losing consciousness
  • symptoms of hypokalemia (low potassium levels)
    • constipation
    • fatigue
    • muscle cramps
    • weakness
  • swollen joints

Warnings & Precautions

Allergic Reactions

Allergic reactions may occur in some individuals. If you inject this medication and experience any of the following symptoms, please seek medical attention immediately: dizziness, skin rash, itchiness, racing heart, sudden onset of sweating, breathing difficulties, or swelling of the throat or face.

Changes in Insulin Requirements

Certain conditions and activities may impact a patient’s insulin requirements, meaning that adjustments in the patient’s insulin regimen will be required. This may include changes in diet or exercise, surgery, stress, traveling, experiencing an injury, or getting sick. Additionally, some other medical conditions and medications may also result in changes that may affect a patient’s insulin needs. Any changes in a patient’s health or lifestyle should be discussed with the patient’s physician to ensure that they are receiving the correct amount of insulin to manage their condition each day.

Checking the Appearance of the Medication Before Use

Before injecting your insulin, you should also check the ensure that the solution is colorless and clear. If you notice any clumping, particles, discoloration, or cloudiness, this medication should not be used.

Hepatic Function

Patients with reduced hepatic function or liver disease should discuss these conditions with their physician, as these issues may impact their required daily dosage of insulin. Some individuals may need to have regular testing performed and monitoring of their blood glucose levels and hepatic function during treatment.

Hyperglycemia (High Blood Glucose Levels)

Patients that miss a dose of insulin or that inject a dose that is too low may experience high blood glucose levels. This condition may build up and escalate over the course of a few hours or a few days. If left untreated, dangerously high levels of blood glucose can result in diabetic ketoacidosis, which can become life-threatening and lead to a loss of consciousness, the patient becoming comatose, or the individual dying.

Patients who experience the following symptoms of hyperglycemia should contact their physician as soon as possible: drowsiness, dry mouth, dry and flushed skin, fruity breath odor, a loss of appetite, increased need to urinate, nausea, and vomiting.

Hypoglycemia (Low Blood Glucose Levels)

Patients that use too much insulin, engage in too much exercise, or skip meals are at an increased risk of experiencing hypoglycemia. Mild cases of low blood glucose levels may be managed and resolved by ingesting fast-acting carbohydrates to increase the individual’s blood sugar levels and then resting to allow these levels to become balanced again. Severe cases of hypoglycemia may result in seizures, losing consciousness, or becoming disoriented.

Patients that experience the following symptoms of low blood glucose levels are advised to ingest carbohydrates to counteract the condition or contact their doctor for additional medical advice: rapid heart rate, confusion, hunger, cold sweats, shakiness, nervousness, weakness, feeling lightheaded, or experiencing numbness of the fingers, lips, or tongue.

Regular Monitoring of Blood Glucose Levels

Although patients with diabetes need to check their blood glucose levels regularly, this is especially important for those who are making any changes to their insulin regimen or diet or who are experiencing increased stress levels or illness, as all of these factors may impact their blood glucose levels. Any significant variations in these levels should be reported to the patient’s physician as soon as possible.

Renal Function

Patients with reduced renal function or kidney disease should discuss such conditions with their physician, as these aspects of their health may impact the amount of insulin required to manage their condition. Some individuals may need to have regular testing performed and monitoring of their blood glucose levels and renal function during treatment.

Pediatric Patients

It has not been determined if this medication is effective or safe for use in children below the age of two years.

Pregnancy and Breastfeeding

Patients that are pregnant, planning to become pregnant, or that become pregnant while using this medication should consult with their physician regarding the safest and most appropriate dosage for each stage of their pregnancy, as insulin needs fluctuate throughout these periods.

It has not been determined if this medication is passed into breastmilk, so patients that are desiring to breastfeed while using Levemir are advised to consult with their physician regarding potential changes to their diet or their current dosage of this medication.

Drug Interactions

Speak with your doctor about any medications or herbal supplements you are currently taking before beginning treatment with this medication. Discuss any concerns you may have with your doctor or a trusted pharmacist.

The following medications and substances are known to interact with this medication and may increase your chances of experiencing adverse side effects or weakening the efficacy of Levemir:

  • acetylsalicylic acid (ASA)
  • alcohol
  • androgens
  • angiotensin-converting enzyme inhibitors (ACE inhibitors)
  • antipsychotics
  • aripiprazole
  • atazanavir
  • atenolol
  • beta-blockers
  • birth control pills
  • budesonide
  • buserelin
  • ciclesonide
  • ciprofloxacin
  • citalopram
  • clozapine
  • danazol
  • decongestants
  • dexamethasone
  • dienogest
  • diuretics
  • enalapril
  • epinephrine
  • fluoxetine
  • fluticasone
  • furosemide
  • gliclazide
  • glucagon
  • glyburide
  • goserelin
  • HIV protease inhibitors
  • hydrochlorothiazide
  • hydrocortisone
  • indinavir
  • inhaled corticosteroids
  • lanreotide
  • leuprolide
  • levonorgestrel
  • lisinopril
  • medroxyprogesterone
  • metoprolol
  • mifepristone
  • moclobemide
  • monoamine oxidase inhibitors (MAOIs)
  • niacin
  • norethindrone
  • norfloxacin
  • octreotide
  • ofloxacin
  • oral corticosteroids
  • oral diabetic medications
  • paroxetine
  • pasireotide
  • pegvisomant
  • pentamidine
  • phenelzine
  • pindolol
  • pioglitazone
  • prednisone
  • prednisolone
  • progestins
  • propranolol
  • pseudoephedrine
  • quinine
  • quinolone antibiotics
  • ramipril
  • rasagiline
  • ritonavir
  • rosiglitazone
  • saquinavir
  • selective serotonin reuptake inhibitors (SSRIs)
  • selegiline
  • sertraline
  • somatostatin
  • somatropin
  • sotalol
  • sulfamethoxazole
  • sulfisoxazole
  • sulfonamide antibiotics (“sulfas”)
  • sunitinib
  • tacrolimus
  • testosterone
  • thyroid replacement therapy
  • tranylcypromine
  • triamterene
  • vorinostat
  • water pills

Alternative Medications

For patients who are unable to use Levemir FlexTouch pens or are experiencing significant adverse side effects, alternative medications may be used to treat some of the associated conditions for which this medication is commonly prescribed:

  • insulin degludec (Tresiba)
  • insulin glargine (Basaglar, Lantus, Toujeo)
  • insulin glargine / lixisenatide (Soliqua)
  • linagliptin (Tradjenta)
  • metformin (Glucophage, Glumetza, Riomet)
  • saxagliptin (Onglyza)
  • semaglutide (Ozempic, Rybelsus, Wegovy)
  • sitagliptin (Januvia)

Frequently Asked Questions

This injection pen may be used with any universal needle. However, the manufacturer recommends opting for NovoFine 32G 6 mm needles.

Some patients using this medication have experienced skin itchiness, rash, reactions at the injection sites, lipodystrophy, allergic reactions, and low blood glucose levels.

This medication is not a mealtime insulin, and the sliding-scale dosing method should not be used. As a long-acting insulin, Levemir FlexTouch should simply be injected once or twice per day as instructed by your physician.

Most patients will begin with a once-daily injection with their Levemir FlexTouch pen. However, if the once-daily dose is ineffective at managing the patient’s blood glucose levels properly, some doctors will split the patient’s dose in half, requiring them to inject half of the same total daily dosage twice within the span of a day.

Pregnancy will likely change the required dosage of insulin as insulin needs will increase as a patient gets further along in their pregnancy and experiences a weight increase. Patients that are pregnant, planning to become pregnant, or who simply become pregnant unexpectedly while using Levemir should discuss this with their doctor to determine the safest and most effective dose of the medication for daily use.

The maximum dosage available per injection when using one of these pens is 80 units. Patients that require a dose that is above 80 units will need to perform two injections back-to-back when administering their required amount of daily insulin.

A patient’s prescribed dosage of this medication may vary based on additional health conditions they may have, additional medications they may be taking, previous insulin use, age, weight, and the severity and type of diabetes they have.

Patients will use these prefilled injection pens to subcutaneously inject their prescribed daily dosage of insulin to manage their diabetes. These injections may be done in the upper arms, the thighs, or the abdominal region.

Any missed doses of this medication should be injected as soon as the individual realizes they’ve missed their scheduled dose. However, if enough time has passed that the next scheduled dose is approaching, the patient may simply skip the missed dose and proceed as usual with their next injection. Patients should not inject a double dose of Levemir to compensate for a missed dose.

Injecting too much insulin can result in life-threatening cases of hypoglycemia. If an overdose has occurred or is suspected, the individual at risk should seek emergency medical assistance as soon as possible.

No. The needles required to use these pens are not included with the pens themselves, and patients will need to acquire these separately and install them before each use.

Changes in weight may require changes in a patient’s insulin use, as both weight gain and weight loss can cause shifts in how the body manages blood glucose levels.

Due to the risk of hypoglycemia, patients using this medication are advised to exercise caution before knowing how Levemir will affect them, as this may impact their ability to operate machinery or drive a vehicle. Additionally, patients are advised to avoid consuming alcohol.

The active ingredient in this medication is insulin detemir. The inactive ingredients in this medication include the following: water, zinc, sodium chloride, phenol, metacresol, glycerin, phosphate, and dibasic sodium.

Unopened and unused injection pens may be stored either at room temperature for up to 42 days or kept refrigerated until the expiration date listed on the medication. Once opened, these pens should not be refrigerated but should be stored at room temperature for up to 42 days. Levemir FlexTouch pens should not be stored with a needle attached.

Yes. The insulin contained within these injection pens is a long-acting type of insulin.

Some individuals may need to take mealtime insulin while using this medication. This is often the case for patients with type 1 diabetes. Most patients with type 2 diabetes will not require mealtime insulin, but the need for such should be discussed with the patient’s doctor.

Most patients that inject this medication only once per day will typically be advised to do so in the evenings. Those who are injecting a split dose of Levemir twice per day will perform their first injection in the morning and their second injection either 12 hours later or simply in the evening.