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Levemir

insulin detemir
Used for Diabetes Type 2, Diabetes Type 1
Used for Diabetes Type 2, Diabetes Type 1

Levemir (insulin detemir) is a long-acting insulin that helps control high blood sugar levels in children and adults. It's injected under the skin, typically once or twice daily. Like all insulins, Levemir (insulin detemir) can raise your risk for low blood sugar, so make sure to keep fast-acting sugars with you in case your blood sugar level drops too low. This medication comes in vials. But it's also available as a Flexpen for people who have trouble drawing up insulin from the vial.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on February 15, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsReferencesPricesMedicare
basics-icon

What is Levemir (insulin detemir)?

What is Levemir (insulin detemir) used for?

How Levemir (insulin detemir) works

Levemir (insulin detemir) is an insulin, which is a hormone that helps lower glucose (sugar) levels in the blood. It's a long-acting insulin, which means it can help lower your blood sugar levels for up to a 24-hour period.

Are you looking for information on Lantus (insulin glargine) instead?

Drug Facts

Common BrandsLevemir, Levemir FlexPen
Drug ClassInsulin
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

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What are the side effects of Levemir (insulin detemir)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Shakiness, hunger, and other symptoms of low blood sugar (up to 93%, depending on what other blood sugar medications you're taking)
  • Common cold involving the nose, throat, and lungs (up to 27%)
  • Headache (up to 23%)
  • Pain or irritation of the throat (10%)
  • Back pain (8%)
  • Fever, chills, and other flu-like symptoms (up to 8%)
  • Stomach pain (6%)
Please note: These side effects were reported by people who took Levemir (insulin detemir) for type 1 diabetes. Your risk for side effects might be different if you have type 2 diabetes.

Other Side Effects

  • Weight gain
  • Swelling (from fluids) in the hands or feet
  • Redness, pain, itching, and other symptoms of injection site reactions

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Dangerously low blood sugar (severe hypoglycemia): feeling shaky, being nervous or anxious, fast heartbeat, sweating or body chills, confusion, feeling sleepy, weakness or low energy and excessive hunger
  • Serious allergic reactions: hives, itching, swelling of face or tongue, difficulty breathing
  • Dangerously low levels of potassium (hypokalemia): muscle twitches, muscle cramps, abnormal heart rhythms, fatigue

Source: DailyMed

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The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

Anxiety

blurred vision

chills

cold sweats

confusion

cool, pale skin

cough

depression

difficulty swallowing

dizziness

fast heartbeat

fever

headache

hives, itching, or skin rash

hoarseness

increased hunger

irritation

joint pain

nausea

nightmares

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

redness of the skin

seizures

shakiness

slurred speech

stiffness or swelling

swelling of the eyelids, face, lips, hands, or feet

tightness in the chest

trouble breathing

unusual tiredness or weakness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site

decrease in the amount of urine

noisy, rattling breathing

redistribution or accumulation of body fat

swelling of the fingers, hands, feet, or lower legs

trouble breathing at rest

weight gain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Levemir (insulin detemir)

thumbs-up

Pros

Lower risk of weight gain compared to some other types of insulin

Doses can be adjusted to meet your body's needs

Insulin pens available for people who've trouble using insulin vials

Provides blood sugar control for up to 24 hours

thumbs-down

Cons

Must be injected

Might need to inject it twice daily

Can cause low blood sugar

No generic option available

pharmacist-tips

Pharmacist tips for Levemir (insulin detemir)

pharmacist

  • For proper storage, unopened pens and vials should be kept in the fridge until the expiration date on the box, or at room temperature for up to 42 days. Once opened, pens should be kept at room temperature (not refrigerated) for up to 42 days, and vials can be kept in the fridge or at room temperature for up to 42 days.

    • If you've been using the Levemir (insulin detemir) Flextouch pen, let your provider know. The manufacturer has discontinued the Levemir (insulin detemir) Flextouch pen in February 2023, so you might have a hard time finding it at a pharmacy. The manufacturer released another pen in its place called the Levemir (insulin detemir) FlexPen. You might need to ask your provider for another prescription in order to receive the Levemir (insulin detemir) FlexPen.

      • Your provider will train you on how to give yourself Levemir (insulin detemir) correctly. Make sure to inject Levemir (insulin detemir) at the same time each day, but rotate injection sites to prevent skin irritation, lumps, pits, or thickened skin.

        • You can inject Levemir (insulin detemir) under your skin in your upper arm, abdomen (stomach area), or thigh (upper leg). Never inject it into a vein or muscle. Check out this step-by-step video on how to use the pen.

          • If you noticed areas of thickened skin from repeated Levemir (insulin detemir) injections, choose a different area for future injections. Injecting into areas with thickened skin will cause the insulin to not work as well and put you at risk for high blood sugar.

            • Don't dilute or mix Levemir (insulin detemir) with other types of insulin; it won't work as intended and you may lose blood sugar control, which could be serious.

              • Keep a consistent meal and exercise schedule to prevent any fluctuations (rises and falls) in your blood sugar.

                • Don't reuse insulin needles. Always use a new needle for each Levemir (insulin detemir) injection. Reusing needles raises your chance of having blocked needles, which can cause you to get the wrong dose of Levemir (insulin detemir). Using a new needle for each injection also lowers your risk of getting an infection.

                  • When changing to Levemir (insulin detemir) from other long-acting insulins, you might experience higher average fasting blood sugar levels during the first weeks of therapy. Check and record your blood sugar levels daily to make sure that they're within a healthy range. Let your provider know what your blood sugar numbers are so they can make adjustments to your Levemir (insulin detemir) dose, if needed.

                    • Levemir (insulin detemir) can put you at risk for low blood sugar and cause symptoms such as dizziness, feeling weak, and shakiness. If your blood sugar level drops too low, then it's important that you eat 15 grams of fast-acting sugar to bring your blood sugar level back to a safe range. After eating 15 grams of fast-acting sugar, wait 15 minutes and recheck your blood sugar level. If it's still too low, then call 911 and eat another 15 grams of carbohydrates while you wait for help to arrive. Recheck your blood sugar again in 15 minutes.

                      faqs

                      Frequently asked questions about Levemir (insulin detemir)

                      Can I take Levemir (insulin detemir) and metformin together?
                      Yes. You can use Levemir (insulin detemir) with other oral diabetes medications, like metformin, if your blood sugar level needs better control. If you have Type 2 diabetes, your provider might recommend that you continue metformin if you need to start insulin like Levemir (insulin detemir). Talk to your provider about your diabetes treatment and what medications might be right for you.
                      Can you use Levemir (insulin detemir) with fast-acting insulins?
                      Yes. You can use Levemir (insulin detemir) along with rapid-acting insulins. If you have Type 1 diabetes, it's recommended that you use a rapid-acting insulin (e.g., NovoLog, Humalog) around meal times, in addition to long-acting coverage (like with Levemir (insulin detemir)), to help manage your blood sugars.
                      When is the best time to inject Levemir (insulin detemir)?
                      Levemir (insulin detemir) is a long-acting insulin. If you're injecting it once daily, then you typically inject it in the evening. If your provider recommends that you inject Levemir (insulin detemir) twice daily, then you'll likely divide your dose into two doses (morning and evening). But if you have a hard time injecting Levemir (insulin detemir) at a particular time, let your provider know. They can talk with you about injecting this medication at a time that works for you because the important part is to use at the same time each day.
                      How long does it take for Levemir (insulin detemir) to start working?
                      Levemir (insulin detemir) starts working in about 2 hours after injection and continues working to lower your blood sugar for up to 24 hours.
                      Can I use Levemir (insulin detemir) if I'm pregnant?
                      Available research shows that Levemir (insulin detemir) is unlikely to cause harm to the unborn baby or mother if used by mothers during pregnancy. If you're pregnant or planning on becoming pregnant, speak to your provider about all possible options for treating your blood sugar.
                      What's the difference between Levemir (insulin detemir) and insulin glargine (Lantus)?
                      Both Levemir (insulin detemir) and insulin glargine (Lantus) are long-acting insulins. There's no noticeable difference between how well they work to lower blood sugar levels. One main difference between them is that insulin glargine (Lantus) is typically only injected once a day, whereas Levemir (insulin detemir) is used once or twice a day. How often you need to inject Levemir (insulin detemir) is likely related to your dose. If you're using a lower dose of Levemir (insulin detemir), you might need to have twice daily injections to maintain a safe blood sugar level. But if you're using a higher dose of Levemir (insulin detemir), its effect lasts closer to 24 hours.
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                      What are the risks and warnings for Levemir (insulin detemir)?

                      Levemir (insulin detemir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                      risk-warning

                      Infections

                      Never share Levemir (insulin detemir) pens, syringes, or needles with anyone else. Sharing Levemir (insulin detemir) with someone puts you at risk of getting serious infections.

                      risk-warning

                      Low blood sugar

                      • Risk factors: Changes in diet and exercise | Drinking alcohol | Taking other blood sugar medications | Over age 65 | Liver or kidney problems

                        The most common side effect of insulin, including Levemir (insulin detemir), is low blood sugar. Very low blood sugar can be life-threatening. Make sure you know how to recognize symptoms of low blood sugar, include feeling shaky, being nervous or anxious, confusion, or hunger. If you experience any of these symptoms, check your blood sugar level. Keep glucose tablets or other fast-acting sugars on you so that you're prepared to treat your low blood sugar. Follow the "15-15 Rule" to bring your blood sugar back to a safe level. Talk to your doctor or pharmacist if you experience frequent low blood sugar episodes while taking Levemir (insulin detemir) because they might need to adjust your insulin dose.

                        risk-warning

                        Severe allergic reactions

                        In some rare cases, Levemir (insulin detemir) can cause severe allergic reactions that can be life-threatening. Go to the emergency room right away if you suddenly have problems breathing, a fast heartbeat, or if you feel your face, mouth, or throat swell up.

                        risk-warning

                        Low blood potassium levels

                        • Risk factors: Taking medications that can lower potassium levels

                          Levemir (insulin detemir) can lower levels of potassium in your blood, which can be dangerous. You're more at risk if you're already taking medications that lower your potassium. Your doctor will check your potassium levels regularly and might give you medications to keep your potassium normal. Let your provider know right away if you experience symptoms of low blood potassium levels, such as muscle weakness, tiredness, fast heartbeat, and a tingling sensation in your hands, legs, or feet.

                          risk-warning

                          Swelling from fluids and risk of heart failure

                          • Risk factors: Taking a class of blood sugar medication called thiazolidinediones | Heart failure

                            If you're also taking a thiazolidinediones (TZD) blood sugar medication, let your provider know before you start Levemir (insulin detemir). Combining TZD with insulin can lead to swelling from fluids. This can worsen or lead to heart failure. Let your provider know if you noticed that you suddenly gained a lot of weight or if you have symptoms of heart failure, such as as trouble breathing, tiredness, headache. Your provider might need to make changes to your blood sugar medications.

                            dosage

                            Levemir (insulin detemir) dosage forms

                            The average cost for 1 vial of 10ml of 100 units/ml of Levemir (insulin detemir) is $116.22 with a free GoodRx coupon. This is 48.83% off the average retail price of $227.12.
                            carton
                            Carton
                            DosageQuantityPrice as low asPrice per unit
                            5 flexpens of 3ml1 carton$168.38$168.38
                            5 flextouch pens of 3ml1 carton$168.24$168.24
                            flexpen
                            Flexpen
                            DosageQuantityPrice as low asPrice per unit
                            3ml of 100 units/ml5 flexpens$38.79$7.76
                            flextouch pen
                            Flextouch pen
                            DosageQuantityPrice as low asPrice per unit
                            3ml of 100 units/ml5 flextouch pens$168.24$33.65
                            vial
                            Vial
                            DosageQuantityPrice as low asPrice per unit
                            10ml of 100 units/ml1 vial$116.22$116.22

                            Typical dosing for Levemir (insulin detemir)

                            • Type 1 diabetes: Your healthcare provider will help you calculate your total daily insulin (TDI) requirement based on your body weight. The typical starting dose ranges from about 30% to 50% of your TDI requirement, injected under the skin. It's injected either once daily in the evening, or split up into two doses and injected twice daily in the morning and evening.

                            • Type 2 diabetes: The typical starting dose is 10 units (or 0.1 units/kg to 0.2 units/kg of body weight) injected under the skin. It's injected either once daily in the evening, or split up into two doses and injected twice daily in the morning and evening.

                            If you're switching from another type of insulin, your provider will determine your new Levemir (insulin detemir) dose based on the type of insulin you're switching from.

                            More on Levemir (insulin detemir) dosage forms

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                            Written by Brian Leonard, PharmD, BCACP, BCGP
                            interactions

                            Interactions between Levemir (insulin detemir) and other drugs

                            Levemir (insulin detemir) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Levemir (insulin detemir). Please note that only the generic name of each medication is listed below.

                            More on Levemir (insulin detemir) interactions

                            Insulins: Interactions: holding insulin pen and pill bottle 1284259460

                            7 Insulin Interactions You Should Know About

                            Written by Hindu Rao, PharmD, APh, BCACP

                            Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                            Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

                            drug-cost

                            How much does Levemir (insulin detemir) cost?

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                            contraindications-icon

                            Levemir (insulin detemir) contraindications

                            Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Levemir (insulin detemir) will not be safe for you to take.

                            • Low blood sugars that aren't treated

                            alternatives

                            What are alternatives to Levemir (insulin detemir)?

                            There are a number of medications that your doctor can prescribe in place of Levemir (insulin detemir). Compare a few possible alternatives below.
                            Levemir (insulin detemir)
                            Used for:
                            $38.79 Lowest GoodRx priceView Prices
                            Insulin degludec (Tresiba)
                            Used for:
                            $71.99 Lowest GoodRx priceView Prices
                            Toujeo (insulin glargine)
                            Used for:
                            $367.08 Lowest GoodRx priceView Prices
                            latest news

                            What is the latest news about Levemir (insulin detemir)?

                            Insulin prices dropped 42% in 2024, marking a significant shift for millions of Americans.

                            Insulin Costs Plummet: A Decade-Long High Comes to an End

                            Insulin prices dropped 42% in 2024, marking a significant shift for millions of Americans.
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                            Levemir (insulin detemir) can cost hundreds of dollars per month. But there are ways to save on it. You can consider using your insurance, a savings card, or a patient assistance program.

                            Here Are 5 Tips to Save on Levemir

                            Levemir (insulin detemir) can cost hundreds of dollars per month. But there are ways to save on it. You can consider using your insurance, a savings card, or a patient assistance program.
                            Your health insurance can help you save money on insulin. But you can also research coupons and manufacturer savings cards to help you reduce your cost.

                            5 Ways to Save on Insulin — With or Without Insurance

                            Your health insurance can help you save money on insulin. But you can also research coupons and manufacturer savings cards to help you reduce your cost.
                            General insulin use may cause a few common side effects. Typical insulin side effects include irritation at the injection site, weight gain, and headaches.

                            6 Insulin Side Effects You Should Know About

                            General insulin use may cause a few common side effects. Typical insulin side effects include irritation at the injection site, weight gain, and headaches.
                            Insulin detemir is a treatment option for diabetes. It can cause low blood sugar. As an injectable, it may also cause redness, swelling, and itching at the injection site.

                            7 Insulin Detemir (Levemir) Side Effects You Should Know About

                            Insulin detemir is a treatment option for diabetes. It can cause low blood sugar. As an injectable, it may also cause redness, swelling, and itching at the injection site.
                            Taking insulin with alcohol and beta blockers may affect glucose levels and cause increased side effects. See more insulin interactions here.

                            7 Insulin Interactions You Should Know About

                            Taking insulin with alcohol and beta blockers may affect glucose levels and cause increased side effects. See more insulin interactions here.
                            A long-acting insulin gives a steady release of insulin over time in order to control your blood sugar. Compare Tresiba, Levemir, and other long-acting insulins here.

                            What Is the Best Long-Acting Insulin? A Review of Tresiba and Other Brands

                            A long-acting insulin gives a steady release of insulin over time in order to control your blood sugar. Compare Tresiba, Levemir, and other long-acting insulins here.
                            Both long-acting and rapid-acting insulins can be used to treat Type 1 and Type 2 diabetes. Learn the difference between long-acting and rapid-acting insulins here.

                            What’s the Difference Between Rapid-Acting and Long-Acting Insulins?

                            Both long-acting and rapid-acting insulins can be used to treat Type 1 and Type 2 diabetes. Learn the difference between long-acting and rapid-acting insulins here.
                            You may be prescribed different types of insulin depending on your lifestyle, the type of diabetes you have, and your blood sugar levels at various times of day. Insulins can range from rapid-acting to ultra-long-acting and may be combined to help control your blood sugar throughout the day and at mealtimes.

                            The 6 Types of Insulin: A Guide to Regular, Short, and Long-Acting Insulins

                            You may be prescribed different types of insulin depending on your lifestyle, the type of diabetes you have, and your blood sugar levels at various times of day. Insulins can range from rapid-acting to ultra-long-acting and may be combined to help control your blood sugar throughout the day and at mealtimes.

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                            References

                            Best studies we found

                            American Diabetes Association. (n.d.). Hypoglycemia (Low Blood Glucose).

                            Arnold, S. V., et al. (2019). Understanding Contemporary Use of Thiazolidinediones An Analysis From the Diabetes Collaborative Registry. Circulation: Heart Failure.

                            Association of Diabetes Care & Education Specialties. (2019). Managing Low Blood Sugar.

                            View All References (4)

                            GuidelineCentral. (2024). Diabetes standards of care 2024.

                            Mehta, R., et al. (2021). Practical guidance on the initiation, titration, and switching of basal insulins: a narrative review for primary care. Annals of Medicine.

                            Novo Nordisk. (2022). LEVEMIR- insulin detemir injection, solution [package insert]. DailyMed.

                            Novo Nordisk. (n.d.). What is Levemir?

                            GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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