Levemir Flexpen Solution For Injection 5x3ml

Levemir Flexpen injection is used to lower the raised blood sugar level (diabetes mellitus). Levemir Flexpen is used to treat both type 1 and type 2 diabetes mellitus. It contains insulin detemir as an active ingredient.

It is a long-acting insulin that provides a steady level of insulin for a longer duration of time in the body. This medicine helps to maintain optimum blood sugar levels in diabetic patients. Insulin must be taken 15-20 minutes before or within 20 minutes of starting the meal.

Avoid skipping the meal and the dose of insulin. Rotate the site of the insulin administration site. The doctor will guide on the use of the injection.

While on the Levemir Flexpen injection, it is recommended to keep sugar candy or glucose handy as it has decreased blood sugar levels (hypoglycemia) as it common side effect. However, if you experience these symptoms quite often, contact your doctor he might change the dose of this medicine.

Dosage

Overdose

• Excess of injection leads to low blood sugar levels, called hypoglycemia.
• Symptoms like dizziness, fainting, sweating and tremors may be seen.
• If you have the blood glucometer with you, test and confirm.
• Whether or not you test the levels, it is important to take some glucose water/juice/eat sugar or chocolates and rush to the doctor.

Missed a Dose

• A missed dose may lead to high blood sugar levels that cause symptoms like feeling thirsty, excessive urination, loss of appetite, drowsiness, the fruity smell from breath, etc.
• If you have missed taking a dose of the injection take it as soon as you remember.
• If it's time for the next dose, skip the missed dose and continue with the regular dose schedule.
• Avoid taking a double dose of medicine to compensate for the missed as taking a double dose cause a drastic fall in blood glucose which is dangerous.

Mode of Action

How Does It Work?

• Insulin is important to allow the entry of blood glucose into each cell of the body, where glucose is used as fuel.
• In type 1 diabetes mellitus, the body fails to produce enough insulin.
• This leads to glucose accumulating in the blood and cause high blood glucose.
• Levemir Flexpen lowers blood sugars by stimulating glucose uptake by cells, tissue and muscles, by skeletal muscles and fat and inhibit glucose production by the liver.

Directions for Use

• Take injection as per the technique suggested by the doctor or nurse.
• The injection is to be taken under the skin of the thigh or upper arm or abdomen.
• Avoid taking the injection in the vein or muscles.
• Pull a skin, fold up to take the injection.
• Wait for 6 seconds before removing the needle from the injection site.
• Always rotate the site of injection, do not take concurrent injections at the same site.

Precautions and Warnings

Pregnancy

Can I take Levemir Flexpen injection during pregnancy?

Levemir Flexpen injection can be used during pregnancy if the doctor recommends. Monitoring of blood sugar levels is suggested as the dose requirements may change with each trimester of pregnancy.

Breast Feeding

Can I take Levemir Flexpen injection while breastfeeding?

Levemir Flexpen injection can be used while breastfeeding if the doctor recommends.

Driving

Can I drive after consuming Levemir Flexpen injection?

• Levemir Flexpen injection is known to cause low blood sugar levels and leads to impairment in the driving ability.
• Keep sugar or a bar of chocolate in the car while driving.
• In case you experience the symptoms of low blood glucose levels like dizziness, drowsiness, vision disturbances and sweating, stop driving and have sugar/ juice.

Alcohol

Can I consume alcohol while taking Levemir Flexpen injection?

• Avoid alcohol when you are taking Levemir Flexpen injection as it interferes with the way insulin works.
• Consumption of alcohol leads to an increased risk of both low blood glucose level and high blood glucose level.
• Avoid the use of alcohol while taking insulin.

Other General Warnings

Talk to your doctor if

• You suffer from recurrent low blood sugar levels. Be careful about symptoms of low blood sugar like sweating, anxiety, fast heartbeat, headache, intense hunger, restlessness, dizziness, irritability. If you experience these, have sugar (Avoid artificial sweeteners). Eat as soon as possible. Avoid insulin in such a scenario. If still the symptoms persist, seek medical help.
• You suffer from frequent fever and infections.
• You suffer from diseases related to the liver and kidney.
• You suffer from thyroid disorders.
• You are taking a different insulin medicine brand.
• You have pain, itching and swelling at the injection site, you must change the site of injection. Consult the doctor if you have skin changes at the injection site.
• You are changing your diet preferences.
• You must carry a sugar candy with you.
• You are using insulin but not taking adequate meals, the blood glucose drop drastically.
• Avoid heavy exercise.

Contraindications

• If you are allergic to insulin or other ingredients of Levemir Flexpen injection.
• If you suffer from hypoglycemia (low blood sugar level).

Side effects

• Low blood sugar (Hypoglycaemia)
• Dizziness
• Tiredness
• Feeling hungry
• Headache
• Sweating
• Pain, redness, swelling at the injection site.

Interactions

Interactions with other medicines

• Some medicines affect the way Levemir Flexpen injection works or the medicine itself reduce the effectiveness of other medicines taken at the same time.
• Inform the physician regarding the medicines, supplements or herbals you take or might take to avoid possible interaction.
• You may have symptoms of low blood sugar if you are taking other medicines for diabetes, depression (fluoxetine), medicines for fever and pain (salicylates), ramipril, lisinopril.
• You may experience high blood sugar if you are taking oral contraceptives, thiazide, steroids, thyroxine, medicines used to treat diarrhoea and abnormal growth of body organs like octreotide, lanreotide.
• If you are using the medicine pioglitazone to treat diabetes, be cautious, as some cases of heart attack and heart failure have been reported.
• Some medicines block the body's response to low blood sugar, you may not experience symptoms like headache, hunger pangs, sweating, anxiety when the blood sugar drops. This lead to a serious fall in blood sugar. Inform the doctor if you are using medicines like Betablockers (Metoprolol, Propranolol, Atenolol), Clonidine, Guanethidine and Reserpine.

Interactions with food items

• The injection is to be taken 15 mins before meals or after meals.
• Maintain a constant meal pattern is advisable when you are taking insulin.
• Avoid skipping or delaying meals when you are taking insulin.

Storage and disposal

• Store between 2°C to 8°C in the refrigerator.
• Do not freeze it.
• Keep it away from children and pets.

Frequently Asked Questions (FAQs)

Which food items must I avoid, as I'm a diabetic?

• Avoid using maida, white bread, noodles, corn flakes, poori, biryani, naan, fried rice, etc.
• Avoid using custard apple, mango, jack fruit, fruit salads with ice cream, fruit-based desserts.
• Avoid using cheese, milkshakes, ice creams.
• Avoid using pork, beef, soft drinks, sugarcane juice, sweetened health drinks and beverages.

Can I stop using the injection if I am feeling uncomfortable after taking the medicine?

No, avoid stopping the insulin without speaking with a doctor. It leads to high blood sugar levels and may worsen the disease condition and complications. In case of side effects or discomfort, inform the doctor. You may need a dose adjustment.

Why should I always change the site for the injection?

Taking injection at the same site may lead to a lump formation, local irritation and itching. Avoid taking injections at the same site or maintain a gap of one day.

What other lifestyle modifications I must follow to manage diabetes?

• Diet must include chapatis, multigrain bread, puffed rice with vegetables, sprouts, roasted grams, plain cooked daal, soups, steamed vegetables, cooked vegetables with less oil, Jamun, orange, guava, apple, watermelon, papaya, cow’s milk, curd, thin buttermilk, fish (grilled, baked or steamed), peanuts, cashew nuts and walnuts (handful).
• Limit sugar intake.
• Walk daily for 30 minutes.
• Exercise regularly.
• Monitor the blood glucose.
• Take the anti-diabetic medication on time.

I suffer from low blood sugar levels often, what is the possible reasons?

• Risk factors for low blood glucose levels include taking too much insulin, not taking adequate meals or missing meals, too much alcohol consumption, fever and too much exercise.
• Some medicines when used with insulin result in such episodes like other diabetes medicine glimepiride, medicines used for fever and pain (salicylates), ramipril, etc.
• Report to the doctor about these episodes. You may need a dose of adjustment.

Does the Levemir Flexpen injection need to be refrigerated?

• After opening the injection pen, you should use it within 6 weeks of opening and should be stored at 25°C to 30°C room temperature. Do not refrigerate it.
• Unused Levemir Flexpen should be stored in a refrigerator at 2°C to 8°C. Do not freeze it.