Insulin detemir

Insulin detemir, sold under the brand name Levemir among others, is a long-acting modified form of medical insulin used to treat both type 1 and type 2 diabetes.[6] It is used by injection under the skin.[6] It is effective for up to 24 hours.[6]

Insulin detemir
Clinical data
Trade namesLevemir
AHFS/Drugs.comMonograph
MedlinePlusa606012
License data
Pregnancy
category
  • AU: A
Routes of
administration		Subcutaneous
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only) [1][2][3]
  • US: ℞-only [4]
  • EU: Rx-only [5]
  • In general: ℞ (Prescription only)
Pharmacokinetic data
Bioavailability60% (when administered s.c.)
Elimination half-life5–7 hours
Identifiers
CAS Number
DrugBank
ChemSpider
  • none
UNII
KEGG
Chemical and physical data
FormulaC267H402N64O76S6
Molar mass5916.89 g·mol−1
 NY (what is this?)  (verify)

Common side effects include low blood sugar, allergic reactions, pain at the site of injection, and weight gain.[6] Use in pregnancy and breastfeeding appears safe.[7] It works by increasing the amount of glucose that tissues take in and decreasing the amount of glucose made by the liver.[6]

Insulin detemir was approved for medical use in the European Union in June 2004, and in the United States in June 2005.[5][6][8] It is on the World Health Organization's List of Essential Medicines.[9] In 2020, it was the 124th most commonly prescribed medication in the United States, with more than 5 million prescriptions.[10][11]

Medical use

It is used to treat both type 1 and type 2 diabetes.[6] A recent Cochrane systematic review[12] also compared the effects of insulin detemir to NPH insulin and other insulin analogues (insulin glargine, insulin degludec) in both children and adults with Type 1 diabetes. With respect to blood sugar management, it appears to work better than NPH insulin, however this finding was inconsistent across included and previous studies.[6][12] In the same systematic review no other clinically significant differences were found between different insulin analogues in either adults nor children.[12]

Side effects

Common side effects include low blood sugar, allergic reactions, pain at the site of injection, and weight gain.[6] Use in pregnancy and breastfeeding appears safe.[7]

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 13 June 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.[13]

References
  1. "Levemir FlexPen 100 units/ml solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". (emc). 21 May 2018. Retrieved 14 April 2020.
  2. "Levemir InnoLet 100 units/ml solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". (emc). 21 May 2018. Retrieved 14 April 2020.
  3. "Levemir Penfill 100 units/ml solution for injection in cartridge - Summary of Product Characteristics (SmPC)". (emc). 21 May 2018. Retrieved 14 April 2020.
  4. "Levemir- insulin detemir injection, solution". DailyMed. 24 March 2020. Retrieved 19 October 2020.
  5. "Levemir EPAR". European Medicines Agency (EMA). Retrieved 14 April 2020.
  6. "Insulin Detemir Monograph for Professionals". Drugs.com. American Society of Health-System Pharmacists. Retrieved 3 March 2019.
  7. "Insulin detemir (Levemir) Use During Pregnancy". Drugs.com. 12 June 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. Retrieved 14 April 2020.
  9. World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.
  10. "The Top 300 of 2020". ClinCalc. Retrieved 7 October 2022.
  11. "Insulin Detemir - Drug Usage Statistics". ClinCalc. Retrieved 7 October 2022.
  12. Hemmingsen, Bianca; Metzendorf, Maria-Inti; Richter, Bernd (4 March 2021). "(Ultra-)long-acting insulin analogues for people with type 1 diabetes mellitus". Cochrane Database of Systematic Reviews. 2021 (4): CD013498. doi:10.1002/14651858.cd013498.pub2. ISSN 1465-1858. PMC 94220. PMID 33662147.
  13. "FDA Issues Public Health Advisory Regarding Levemir Insulin". Food and Drug Administration. 13 June 2009. Archived from the original on 17 June 2009. Retrieved 9 March 2019.
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