Chemistry:Insulin detemir
| Clinical data | |
|---|---|
| Trade names | Levemir |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a606012 |
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| Routes of administration | Subcutaneous |
| ATC code | |
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| Pharmacokinetic data | |
| Bioavailability | 60% (when administered s.c.) |
| Elimination half-life | 5–7 hours |
| Identifiers | |
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| Chemical and physical data | |
| Formula | C267H402N64O76S6 |
| Molar mass | 5916.89 g·mol−1 |
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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]
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.[citation needed]
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
- ↑ "Levemir FlexPen 100 units/ml solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". 21 May 2018. https://www.medicines.org.uk/emc/product/5536/smpc.
- ↑ "Levemir InnoLet 100 units/ml solution for injection in pre-filled pen - Summary of Product Characteristics (SmPC)". 21 May 2018. https://www.medicines.org.uk/emc/product/7890/smpc.
- ↑ "Levemir Penfill 100 units/ml solution for injection in cartridge - Summary of Product Characteristics (SmPC)". 21 May 2018. https://www.medicines.org.uk/emc/product/7889/smpc.
- ↑ "Levemir- insulin detemir injection, solution". 24 March 2020. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d38d65c1-25bf-401d-9c7e-a2c3222da8af.
- ↑ 5.0 5.1 "Levemir EPAR". https://www.ema.europa.eu/en/medicines/human/EPAR/levemir.
- ↑ 6.0 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 "Insulin Detemir Monograph for Professionals". American Society of Health-System Pharmacists. https://www.drugs.com/monograph/insulin-detemir.html.
- ↑ 7.0 7.1 "Insulin detemir (Levemir) Use During Pregnancy". 12 June 2019. https://www.drugs.com/pregnancy/insulin-detemir.html.
- ↑ "Drug Approval Package: Levemir Insulin Detemir[rDNA origin Injection; NDA #021536"]. 26 July 2005. https://www.accessdata.fda.gov/drugsatfda_docs/nda/2005/021-536_LevemirTOC.cfm.
- ↑ World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. WHO/MHP/HPS/EML/2021.02.
- ↑ "The Top 300 of 2020". https://clincalc.com/DrugStats/Top300Drugs.aspx.
- ↑ "Insulin Detemir - Drug Usage Statistics". https://clincalc.com/DrugStats/Drugs/InsulinDetemir.
- ↑ 12.0 12.1 12.2 "(Ultra-)long-acting insulin analogues for people with type 1 diabetes mellitus". The Cochrane Database of Systematic Reviews 3 (3): CD013498. March 2021. doi:10.1002/14651858.cd013498.pub2. PMID 33662147.
- ↑ "FDA Issues Public Health Advisory Regarding Levemir Insulin". 13 June 2009. https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm166358.htm.
External links
- "Insulin detemir". Drug Information Portal. U.S. National Library of Medicine. https://druginfo.nlm.nih.gov/drugportal/name/insulin%20detemir.
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