Health Library

Long-acting insulin (Injection)

Treats diabetes mellitus. Insulin is a hormone that helps get sugar from the blood to the muscles, where it is used for energy. This type of insulin usually works longer than regular insulin.

Brand Name(s):

Lantus, Levemir, Lantus SoloStar

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will prescribe your exact dose and tell you how often it should be given. This medicine is given as a shot under your skin.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• This medicine comes with patient instructions. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions.
• There are many different devices available for giving an insulin injection. You may be taught how to use a regular syringe or another delivery device. Each device has special instructions that you must follow. Make sure you understand all the instructions for your device before you use it.
• Do not mix one kind of insulin with another kind or with water, unless your doctor has told you to. Never mix Levemir® (insulin detemir) or Lantus® (insulin glargine) with any other insulin or with water.
• Know what your usual kind of insulin should look like. Before every injection, look at the insulin to make sure it still looks the same. Most insulin should not be used if it has changed color or looks too cloudy or thick.
• Levemir® (insulin detemir) and Lantus® (insulin glargine) should look clear before you use them. Do not shake the vial. If you use insulin once a day, it is best to use it at about the same time every day.
• You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas.
• Do not use Levemir® (insulin detemir) in an insulin infusion pump.
• Use only syringes that are specially made for insulin. It is best to always use the same brand and type of syringe and needle. Some types of insulin must be used with a certain type of syringe or needle. Ask your pharmacist if you are not sure which one to use.
• Use a new needle and syringe each time you inject your medicine. Some people might be able to use special reusable needles or syringes. Your doctor must teach you how to reuse needles and syringes before you give yourself an injection.
• Do not change the brand or type of your insulin unless your doctor tells you to. If you must change the brand or type, ask your doctor before giving yourself an injection.
• Carefully follow your doctor's instructions about any special diet. Your doctor may suggest that you follow an exercise program. You may also be taught to check your own blood sugar levels at home. Diet, exercise, medicine, and checking your blood sugar are all important to control your diabetes.

If a dose is missed:

• Call your doctor or pharmacist for instructions.

How to Store and Dispose of This Medicine:

• Store unopened insulin in the refrigerator. Do not freeze. If you cannot refrigerate the insulin you will use for the day, keep it in a cool place away from heat or sunlight. Do not use insulin that has been frozen or overheated. Follow any special storage instructions that come with your specific brand of insulin.
• If you use a PenFill® cartridge or a prefilled syringe (such as FlexPen® or InnoLet®), keep the medicine in the refrigerator until you are ready to use it. Once you start using a prefilled syringe or cartridge, keep it at room temperature. Never put a used pen or cartridge in the refrigerator and do not store them with the needle in place. The Levemir® (insulin detemir) medicine will keep for up to 42 days at room temperature if it is protected from direct heat and sunlight.
• Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine, containers, and other supplies. You will also need to throw away old medicine after the expiration date has passed.
• Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.
• Keep all medicine out of the reach of children. Never share your needles, syringes, or medicine with anyone else.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can make it harder for you to control your diabetes. Make sure your doctor knows if you are using steroid medicines (such as dexamethasone, prednisolone, prednisone, or Medrol®), danazol (Danocrine®), diuretics or "water pills" (such as hydrochlorothiazide, furosemide, torsemide, Demadex®, or Lasix®), albuterol (Ventolin®, Proventil®), terbutaline (Brethine®, Bricanyl®), isoniazid (Nydrazid®, Laniazid®), medicines for nausea (such as prochlorperazine, promethazine, Compazine®, or Phenergan®), medicines for mental problems (such as chlorpromazine, perphenazine, thioridazine, Thorazine®, or Trilafon®), somatropin (Nutropin®), thyroid hormones (such as levothyroxine, liothyronine), estrogen hormones, or birth control pills that contain progestogens (such as Nor-QD®, Ortho-Novum®, or Tri-Norinyl®).
• Tell your doctor if you are also using diabetes medicine that you take by mouth (such as glyburide, metformin, Actos®, or Glucotrol®), disopyramide (Norpace®), medicines to lower cholesterol or triglycerides (such as gemfibrozil, fenofibrate, Tricor®, or Lopid®), fluoxetine (Prozac®), depression medicine called MAO inhibitors (MAOI) (such as Eldepryl®, Marplan®, Nardil®, or Parnate®), propoxyphene (Darvon®), salicylates (such as aspirin), octreotide (Sandostatin®), or medicine to treat an infection (such as trimethoprim/sulfamethoxazole, Bactrim®, Cotrim®, or Septra®).
• Make sure your doctor knows if you are also using beta-blocker blood pressure medicine (such as atenolol, metoprolol, propranolol, or Toprol®), or ACE inhibitor blood pressure medicine (such as enalapril, lisinopril, Accupril®, Lotrel®, or Zestril®). Tell your doctor if you are using clonidine (Catapres®), guanethidine, or reserpine.
• Do not drink alcohol while you are using this medicine.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or planning to become pregnant. Tell your doctor if you have kidney disease or liver disease.
• 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 blood-borne illnesses.
• You may sometimes have low blood sugar while you are using insulin. This is more likely if you miss a meal, exercise for a long time, or drink alcohol.
• If your blood sugar gets too low, you may feel weak, drowsy, confused, anxious, or very hungry. You may also sweat, shake, or have blurred vision, a fast heartbeat, or a headache that will not go away. If you have symptoms of low blood sugar (hypoglycemia), check your blood sugar. If your blood sugar is 70 mg/dL (milligrams per deciliter) or below, do one of the following: Drink 4 ounces (one-half cup) of fruit juice, or eat 5 to 6 pieces of hard candy, or take 2 to 3 glucose tablets. Re-check your blood sugar 15 minutes later. If your blood sugar is above 70 mg/dL, eat a snack or a meal. If your blood sugar is still below 70 mg/dL, drink one-half cup juice, or eat 5 to 6 pieces of candy, or take 2 to 3 glucose tablets. Carry candy or some type of sugar with you at all times, especially if you are away from home. You can take this if you feel that your blood sugar is too low, even if you do not have a blood glucose meter. Always carefully follow your doctor's instructions about how to treat your low blood sugar. Learn what to do if your blood sugar gets too low. Teach friends, co-workers, and family members what they can do to help if you have low blood sugar.
• Your correct insulin dose may change slightly with changes in your diet or activity. Your dose may also change if you are ill (especially with vomiting or diarrhea), pregnant, traveling, using a new medicine, or exercising more or less than usual. Follow your doctor's instructions about changes in your insulin dose.
• Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
• Anxiety, confusion, restlessness, or mood or mental changes.
• Blurred vision.
• Dry mouth, increased thirst or hunger, muscle cramps, nausea, or vomiting.
• Fast, pounding, or irregular heartbeat.
• Fruit-like breath odor.
• Headache, lightheadedness, dizziness, or drowsiness.
• Increased sweating.
• Loss of appetite.
• Rapid weight gain.
• Seizures or tremors.
• Swelling in your hands, ankles, or feet.
• Unusual tiredness or weakness.
• Warmth or redness in your face, neck, arms, or upper chest.

If you notice these less serious side effects, talk with your doctor:

• Redness, pain, itching, burning, swelling, or a lump under your skin where the shot is given.
• Skin itching or rash.

Last Updated: 6/12/2013