Levemir Flexpen100IU/ml

• Improvement of glycemic control in adults and children with diabetes mellitus

Adult Dose (Subcutaneous):

• Type 1 or 2 Diabetes (once daily): Administer SC with evening meal or at bedtime
• Type 1 or 2 Diabetes (twice daily): Administer SC with morning meal and either with evening meal, at bedtime, or 12 hours after morning dose
• Insulin-naïve Type 2: 10 units/day (or 0.1-0.2 units/kg/day) in evening or divided q12hr
• Conversion from other insulins (glargine or NPH): Unit-to-unit basis; type 2 patients may require more insulin detemir than NPH
• Dose adjustments: Based on blood glucose measurements; look for consistent pattern in blood sugars for >3 days

Child Dose (Type 1, ≥2 years): Approximately one-third of total daily insulin requirements; adolescents <1.2 units/kg/day during growth spurts

Side Effects:

• Hypoglycemia
• Lipodystrophy
• Pruritus
• Rash
• Weight gain
• Sodium retention and edema
• Injection site reactions (pain, itching, hives, swelling, inflammation)
• Influenza-like symptoms
• Pallor, Palpitation, Tachycardia, Mental confusion, Weakness, Blurred vision, Itching, Hunger, Nausea

Precautions:

• Caution in renal or hepatic impairment (dosage requirements may be reduced)
• Regular monitoring of blood glucose and HbA1c
• Continuous rotation of injection site within a given area to reduce injection site reactions
• Caution in pregnancy and lactation
• Dose adjustment: Look for consistent pattern in blood sugars for >3 days
• Dosage must be individualized based on clinical response