Anne is a visionary residency-trained, board-certified pharmacy leader with more than 10 years of healthcare experience. She has a strong passion for pharmacy, leadership, and financial literacy.

Alex Yampolsky, PharmD, is a clinical pharmacist at Elizabeth Seton Children’s Center, a pediatric long-term care facility in Yonkers, New York.

Levemir (insulin detemir ) is a long-acting human insulin injection prescribed to improve glycemic control (maintaining blood sugar levels) in people with diabetes mellitus. The medication often is prescribed to older adults since it results in fewer low blood sugar side effects than other insulin regimens.

Insulin is a hormone created by your pancreas. It controls the amount of glucose (the body's main source of energy) in your bloodstream. Insulins, such as insulin detemir, work by binding to insulin receptors. Receptor-bound insulin lowers blood glucose by creating uptake of glucose into skeletal muscle and fat and by inhibiting the output of glucose from the liver.

It's also important to understand that in the case of Levemir, long-acting human insulin is defined as insulin made by the body that controls blood sugar consistently for an entire day or more and can be used in people with type 1 or type 2 diabetes.

Levemir is a prescription medication that comes in a liquid solution to inject into fatty tissue under the skin (subcutaneously).

Generic Name: Insulin detemir 

Active Ingredient: Insulin detemir recombinant 

Levemir is used to control the blood sugar levels of adults and children with diabetes.

There are various forms of diabetes, but the most common are type 1 diabetes and type 2 diabetes. Type 1 diabetes is when your pancreas does not make or nearly stops making insulin. Type 2 diabetes occurs when your body does not properly use the insulin it does make and can even stop making insulin.

Type 2 diabetes also is considered a form of non-insulin-dependent diabetes. This is more common in adults than is type 1 diabetes, which develops earlier in life in most people. Insulin therapy is recommended for people with type 1 diabetes because people with the disease are incapable of making their own insulin to assist in lowering their blood sugar.

Levemir is taken subcutaneously as an injection medication for people with insulin deficiency or little to no insulin in their body. If you are taking this medication once daily, you should take it in the evening with your last meal of the day, or at bedtime. For people taking this medication twice daily, you can take your second dose at night with your last meal, at bedtime, or 12 hours from your first dose.

It is important to take this medication while measuring your blood sugar levels before taking another dose. Taking too much Levemir generally is more harmful than beneficial. It is best to use this injectable medication near a more fatty tissue area.

Common areas to inject insulin are:

Store unopened insulin Levemir vials and pens in the original carton in the refrigerator at 36-46 degrees F. This medication should not be stored in the freezer or directly placed next to the refrigerator cooling element.

Levemir should not be frozen, do not use Levemir if it has been frozen. The unopened insulin can be used until the medication expiration date on the packaging if it has been properly stored in the refrigerator.

Levemir should be kept in its original container so that it stays clean and protected from light. If there is no refrigeration available, this insulin can be kept unrefrigerated at room temperature or below 86 degrees as long as it is kept cool for as long as possible and away from any heat or light sources.

The unrefrigerated product should be thrown away 42 days after it was first removed from the refrigerator. Do not store insulin medications in direct sunlight or in a hot vehicle. These medications need to be stored in a cooler, but not directly placed on ice or a gel pack.

There are limited off-label uses that have been further studied for recommended use other than lowering high blood sugar levels. Please speak with your healthcare provider to make sure that you are using Levemir for lowering your blood sugar levels.

Levemir can start working in your body within three to four hours after the injection and consequently balances your sugar levels over a 24-hour period.

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the Food and Drug Administration (FDA) at www.fda.gov/medwatch or 800-FDA-1088.

As with all medications, Levemir can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

A low blood sugar level (hypoglycemia) is the most common side effect of insulin therapy and carries life-threatening consequences.

An injection site reaction is a common complaint with insulin therapy. It may be avoided by changing your injection site after each injection.

You may not experience all of these side effects. If you have questions about side effects, contact your healthcare provider.

Serious adverse events may occur with Levemir use that may require immediate medical care.  

Although severe side effects are rare with Levemir, get immediate medical attention if you experience a severe reaction to this drug. 

If you notice any unusual swelling in your feet, ankles, or the lower parts of your legs and have shortness of breath, contact your medical provider right away.

Long-term use of Levemir can cause lipodystrophy at the site of repeated insulin injections. Lipodystrophy includes lipohypertrophy (thickening of adipose tissue) and lipoatrophy (thinning of adipose tissue) and may affect insulin absorption.

Levemir may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

The following modifications (changes) should be kept in mind when using Levemir:

Severe allergic reaction: Avoid using Levemir if you have a known allergy to it or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: ​​Levemir can be used in pregnant individuals as the benefits outweigh the risks in terms of harm to the fetus. However, high blood sugar during pregnancy can be harmful to both the birthing person and the baby as it can lead to preterm delivery or other pregnancy problems. If you are pregnant or plan to become pregnant, consult with a healthcare professional before starting Levemir.

Breastfeeding: Caution is recommended with breastfeeding as there are limited data available on its effects. Talk with your healthcare provider if you plan on breastfeeding. A provider will help you weigh the benefits and risks of taking Levemir while nursing and offer alternatives to feeding your baby.

Adults over age 65: For older individuals with high blood sugar, the initial dose, dose change, and maintenance dose should be conservative to avoid low blood sugar, which can be difficult to recognize in the older population.  

Children: Dosing requirements for children 2 years of age and adolescents needs to be adjusted by weight. Moreover, their healthcare provider needs to give an additional rapid-acting or short-acting insulin shot to complete the balance of daily insulin required for children with high blood sugar (type 1 diabetes). 

The healthcare provider may need to adjust the dose depending on the child’s response to the medication. In addition, if medication is taken once a day, it should be take with the evening meal or at bedtime.

People who smoke: Smoking can lower Levemir’s effectiveness. Try to stop smoking before starting Levemir, and avoid smoking while taking Levemir. Your healthcare provider can help you with this goal.

If you miss your dose or do not take enough of your required dose, you may have high blood sugar levels (hyperglycemia). It is best to take the missed dose as soon as you remember and adjust your second dose accordingly.

Be on the lookout for symptoms associated with high blood sugar, which may include:

Never take two doses at the same time. If you forget whether you already took your dose, the best course of action would be to measure your blood glucose at home with your self-monitoring blood sugar meter. Test yourself before you eat and after your meal. This way you will get an accurate blood sugar reading, which may indicate the need for medication.

Taking an extra dose of too much insulin can cause low blood sugar to perform daily activities and cause more harm than benefit.

If you take too much Levemir, your blood sugar may fall too low. This can cause low blood sugar, which can be very harmful. It is recommended to not take more Levemir than directed by your healthcare provider.

You can treat low blood sugar levels by drinking or eating something sugary right away, including:

If you feel dizzy or are on the verge of passing out, sit or lie down. From there, seek help immediately from a healthcare provider. If there are no sugar products available for you to ingest after taking more units of insulin than what was prescribed originally.

If you think you or someone else may have overdosed on Levemir, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Levemir, call 911 immediately.

Never share insulin pens or cartridges with others under any circumstances. It is not safe for one pen to be used for more than one person. Sharing needles or pens can result in transmission of hepatitis viruses, HIV, or other bloodborne illnesses.

Your doctor will want to check your progress at regular visits, especially during the first few weeks you take this medicine. Blood tests will be needed to check unwanted effects.

It is very important to follow carefully any instructions from your health care team about:

In case of emergency: There may be a time when you need emergency help for a problem caused by your diabetes. You need to be prepared for these emergencies. It is a good idea to:

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash, itching, swelling of the face, tongue, and throat, trouble with breathing, or chest pain after you receive the medicine.

You may have some skin redness, rash, itching, or swelling at the injection site. If this irritation is severe or does not go away, call your doctor. Do not inject insulin detemir into a skin area that is red, swollen, or itchy.

Using this medicine together with other diabetes medicine (eg, pioglitazone, rosiglitazone, Actos®, Actoplus Met®, Avandia®) may cause serious heart problem or edema (fluid retention). Check with your doctor immediately if you are rapidly gaining weight, having chest pain or discomfort, extreme tiredness or weakness, trouble breathing, uneven heartbeat, or excessive swelling of the hands, wrist, ankles, or feet.

Too much insulin detemir can cause hypoglycemia (low blood sugar). Low blood sugar also can occur if you use insulin detemir with another antidiabetic medicine, changes in insulin regimen (eg, insulin strength, type of insulin, injection site), delay or miss a meal or snack, exercise more than usual, or drink alcohol. Symptoms of low blood sugar must be treated before they lead to unconsciousness (passing out). Different people may feel different symptoms of low blood sugar. It is important that you learn which symptoms of low blood sugar you usually have so that you can treat it quickly.

Symptoms of low blood sugar include: anxiety, behavior change similar to being drunk, blurred vision, cold sweats, confusion, difficulty in thinking, dizziness or lightheadedness, drowsiness, excessive hunger, fast heartbeat, headache, irritability or abnormal behavior, nervousness, nightmares, restless sleep, shakiness, slurred speech, and tingling in the hands, feet, lips, or tongue.

If symptoms of low blood sugar occur, eat glucose tablets or gel, corn syrup, honey, or sugar cubes, or drink fruit juice, non-diet soft drinks, or sugar dissolved in water to relieve the symptoms. Also, check your blood for low blood sugar. Get to a doctor or a hospital right away if the symptoms do not improve. Someone should call for emergency help immediately if severe symptoms such as convulsions (seizures) or unconsciousness occur. Have a glucagon kit available, along with a syringe and needle, and know how to use it. Members of your household also should know how to use it.

You may feel dizzy or have trouble in paying attention if you have low blood sugar. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.

Hyperglycemia (high blood sugar) may occur if you do not take enough or skip a dose of your antidiabetic medicine, changes in insulin regimen, overeat or do not follow your meal plan, have emotional stress or infection, or do not exercise as much as usual.

Symptoms of high blood sugar include: blurred vision, drowsiness, dry mouth, flushed, dry skin, fruit-like breath odor, increased urination, ketones in the urine, loss of appetite, stomachache, nausea, or vomiting, tiredness, troubled breathing (rapid and deep), unconsciousness, and unusual thirst.

If symptoms of high blood sugar occur, check your blood sugar level and then call your doctor for instructions.

This medicine may cause low levels of potassium in your blood. Do not use medicines, supplements, or salt substitutes that contain potassium unless you have discussed this with your doctor.

Levemir is not appropriate for everyone. You should not take this medication if you are allergic to insulin detemir or any of the inactive ingredients in Levemir.

Levemir may be used with caution in some people only if the healthcare provider determines it is safe. Users should be aware of the following occasions when the drug is discouraged:

Some medications may affect insulin levels and potentially increase or decrease your blood sugar levels. The blood sugar levels in your body will require insulin dose adjustments and close monitoring so that your healthcare provider can adjust them accordingly. 

Always consult with your healthcare provider or pharmacist to discuss the proper dose of your Levemir when taking these medications.

Drugs that may increase your risk of low blood sugar include:

There may be a decrease in your Levemir dose if you are taking the above medications. Frequent monitoring of your blood sugar levels by your healthcare provider may be required if you take these types of medications with Levemir.

Drugs that can increase your glucose levels:

Your provider may also increase your dose and the frequency of your blood sugar monitoring. Drinking alcohol can either reduce or increase the blood sugar lowering effects of Levemir.

There are various types of insulin. As such, some insulin medications are short-acting and work more quickly in the body than Levemir. 

The following medications work similarly as Levemir:

This is a list of drugs also used for blood sugar management. It is not a list of drugs recommended to take with Levemir. Discuss any questions or concerns with your pharmacist or a healthcare provider.

Levemir is used for treating high blood sugar and may be prescribed for use one or two times throughout the day to control your blood sugar levels. It is primarily used to maintain a healthy glucose level in the body in order to protect your organs from damage.

Levemir’s primary activity is lowering the blood sugar in the body. It binds to insulin protein receptors, which help your skeletal muscle and fat tissue to burn more sugar and stop your liver from making more sugar.

Unless you are directed by your healthcare provider to take additional diabetes medication, you should not take any medications that can reduce your blood sugar such as another insulin medication. Hypoglycemia (low sugar levels) can be more harmful than high blood sugar levels.

Levemir is a long-acting human insulin analog that can be taken once every 24 hours. Because it is a long-acting insulin, it may take a few hours before you see the full benefits of this medication. It can take three to four hours or even up to 14 hours for Levemir to exert 50% of its maximum effect after dose administration.

You should never stop taking Levemir unless instructed by a medical provider. Your healthcare provider may reduce or stop your Levemir if your high blood sugar is controlled and you no longer need the medication. Try to incorporate diet and exercise into your new routine. 

Diet and exercise are key to controlling high blood sugar. You can expect a better outcome from your medication if you stick with an exercise routine and continue eating a low-sugar diet. Avoiding alcohol would also improve your health while taking Levemir as alcohol can affect your blood sugar levels.

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

Food and Drug Administration. Levemir (insulin detemir) prescribing information.

International Diabetes Federation. About diabetes.

Centers for Disease Control and Prevention. What is type 1 diabetes?.

Centers for Disease Control and Prevention. Type 2 diabetes.

MedlinePlus. Insulin detemir (rDNA origin) injection.

Demssie YN, Younis N, Soran H. The role of insulin detemir in overweight type 2 diabetes management. Vasc Health Risk Manag. 2009;5(3):553-560. doi:10.2147/vhrm.s4326

Prescribers’ Digital Reference. Levemir (insulin detemir (rDNA origin)).

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