Insulin Detemir
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Insulin detemir
Levemir, Levemir FlexTouch (US discontinuation announced 2024)
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Summary
Common uses
Type 1 diabetes mellitus0, Type 2 diabetes basal coverage0
Pharmacy
Starting dose
~10 units SC at the same time daily, or 0.1-0.2 units/kg/d; titrate by fasting glucose. Frequently dosed BID at moderate-to-high doses
Preparations
100 U/mL FlexTouch pen, vial
US FDA Max
Titrated to glucose
Pharmacology
Routes
Subcutaneous
Onset
1-2 hours
Duration
~12-24 hours (dose-dependent; BID dosing often needed at higher doses)
Half-life
~7 hours apparent[1]
Bioavailability
~60% from subcutaneous depot (reduced by reversible albumin binding via the myristic acid side chain that also extends duration)[1]
Pregnancy
One of the better-studied basal insulin analogs in pregnancy; reassuring data.[citation needed]
Legal status
Rx-only in US
Purported mechanism
Insulin detemir has a 14-carbon myristic fatty acid attached to LysB29 that binds reversibly to plasma and tissue albumin; the slow albumin dissociation prolongs the apparent half-life and produces a less peaked basal profile than NPH.0 Generally associated with less weight gain than glargine, possibly via central appetite effects. Novo Nordisk announced US discontinuation in 2024 as part of basal-insulin portfolio rationalization (degludec, glargine biosimilars remain)[1].
References
edit- ↑ 1.0 1.1 1.2 FDA Prescribing Information, Levemir (insulin detemir), Novo Nordisk, current revision. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/021536s060lbl.pdf