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It is essential to understand and adhere to the following safety information and warnings regarding the use of Levemir (insulin detemir). This will help ensure your well-being while using this medication. Should you have any concerns, please consult your healthcare provider promptly.

• Infection Risks: Do not share Levemir pens, syringes, or needles with others, as this could result in the transmission of serious infections.

• Low Blood Sugar (Hypoglycemia): Low blood sugar is a frequent side effect of insulin use, including Levemir. Symptoms such as shakiness, anxiety, confusion, or hunger indicate low blood sugar. If you experience these, check your blood sugar levels immediately. Always carry glucose tablets or other fast-acting sugars and use the "15-15 Rule" to stabilize your blood sugar. Consult your doctor if you have frequent episodes, as your insulin dose may need adjustment. Factors that increase risk include dietary and exercise changes, alcohol consumption, other blood sugar medications, age over 65, and liver or kidney issues.

• Severe Allergic Reactions: Though rare, Levemir may cause life-threatening allergic reactions. Seek emergency medical attention if you experience breathing difficulties, a rapid heartbeat, or swelling of the face, mouth, or throat.

• Low Blood Potassium Levels: Levemir can reduce potassium levels in your blood, which may be dangerous. You are at higher risk if you are on medications that lower potassium. Your doctor will monitor your potassium levels and may prescribe medications to maintain them. Notify your healthcare provider immediately if you encounter symptoms like muscle weakness, fatigue, a rapid heartbeat, or tingling in your extremities.

• Fluid Retention and Heart Failure Risk: If you are taking thiazolidinediones (TZD) for blood sugar control, inform your healthcare provider before starting Levemir. The combination can cause fluid retention, potentially worsening or leading to heart failure. Alert your provider if you experience sudden weight gain or heart failure symptoms like shortness of breath, fatigue, or headaches. Medication adjustments may be necessary.

Contraindications: Do not use this medication if you have untreated low blood sugars, as it can pose severe health risks. Always consult your healthcare provider if you have concerns or questions about these conditions.

When using Levemir FlexTouch, it's important to be aware of potential interactions with other medications and substances that can affect your blood sugar levels. Some drugs may increase the risk of hypoglycemia (low blood sugar), while others might reduce Levemir's effectiveness, leading to hyperglycemia (high blood sugar). Here's what you need to know:

Medications That May Increase Hypoglycemia Risk:

• Antidiabetic Agents: Combining Levemir with other diabetes medications, such as sulfonylureas or pramlintide, can enhance blood sugar-lowering effects, increasing the risk of hypoglycemia.

• Certain Antidepressants: Monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs) like Fluoxetine may amplify insulin's effects, leading to lower blood sugar levels.

• ACE Inhibitors and ARBs: Medications used for blood pressure control, such as Lisinopril (an ACE inhibitor) and Losartan (an angiotensin II receptor blocker), can enhance insulin sensitivity, potentially causing hypoglycemia.

Medications That May Decrease Levemir's Effectiveness:

• Corticosteroids: Drugs like Prednisone can raise blood sugar levels, counteracting Levemir's effects.

• Atypical Antipsychotics: Medications such as Olanzapine may increase blood sugar, reducing insulin efficacy.

• Thyroid Hormones: Treatments for thyroid conditions, like Levothyroxine, can affect blood sugar control.

Medications That May Mask Hypoglycemia Symptoms:

• Beta-Blockers: Used for heart conditions, these drugs can obscure typical hypoglycemia signs like rapid heartbeat, making it harder to recognize low blood sugar episodes.

Alcohol Consumption:

Alcohol can unpredictably affect blood sugar levels, sometimes causing hypoglycemia or hyperglycemia. It's advisable to limit alcohol intake and monitor blood sugar levels closely if you choose to drink.

Recommendations:

• Monitor Blood Sugar Levels: Regularly check your blood sugar to detect any changes that might result from medication interactions.

• Consult Your Healthcare Provider: Before starting or stopping any medication, including over-the-counter drugs and supplements, discuss potential interactions with your doctor or pharmacist.

• Be Aware of Symptoms: Learn to recognize signs of both high and low blood sugar to manage your diabetes effectively.

By staying informed and vigilant, you can safely use Levemir FlexTouch while minimizing the risk of adverse interactions.