Levemir Issues

[Jon88]

Hi, out of Interest trying to establish if others have encountered issues regarding performance of Levemir Insulin.

On and off for a year or so I appear to encounter pens of Levemir that simply don't perform as they should in terms of keeping levels under control. I have received new boxes of Levemir and found that some pens simply fail to perform correctly. Upon changing after a few days to an older box/different batch the issue is instantly resolved. When returning again to the box in question the issue instantly returns leading me to think the problem is somehow related to a particular box / batch. Insulin storage is checked, usual fluctuations are accounted for, but the difference at times is night and day. I have thought for some time maybe the issue lies with the pharmacy or transportation system associated with that pharmacy. Or just simply a possible manufacturing issue although have been advised this to be highly unlikely.
Just wondering if others had encountered similar issues, as with myself the problem definitely lies with the performance of the Levemir Insulin regardless of how old and issues can instantly be resolved by changing pens or starting a different box.

 

[Emck]

Yes! I have been having the same problems! Every few months I’ll hit a pen that just doesn’t do its job. Last month I had two in a row and had convinced myself that the problem lay with me.

I got a new box and the problem fixed itself overnight.

 

[Jon88]

Sounds exactly the same experience. I've had pens that just don't work, then by simply changing, problem solved.

I've been told it's very unlikely to be related to the production process, especially such a significant change of performance. My best conclusion was possibly somewhere in the supply chain related to my pharmacy, but can't really understand how it could only be a pen or two from a box, with the remaining unaffected.

When it happens it throws everything out, and as with the nature of this condition start to look for blame everywhere, from the weather to the day of the week! So many variables, but at times I've experienced huge differences in control that are simply corrected overnight by a pen change. With all the many things that impact maintaining control, I'm disappointed that at times the Insulin itself doesn't seem to help.

 

[Daibell]

May be changing to a cartridge pen like I have would be better. I've never had this problem with Novo pens and Levemir cartridges. These pens are also a bit more Eco.

 

[ert]

Like @Daibell I use cartridges and Novopen Echo. I've not experienced this problem.

 

[Jon88]

I used to use cartridges some years back and interesting that thinking back can't remember issues such as this.
I'll give it go and see if it can possibly resolve this issue. Although the issue with the current type of pens still shouldn't be happening. Many, many people use them so maybe I've just been unlucky going by the amount of responses, or maybe some people just don't notice. For me I'm very sensitive to Insulin so any differences tend to really show up.

 

[Ushthetaff]

I too use the cartridge and novo pen and haven’t encountered any probs as yet

 

[Fairygodmother]

I use the cartridge too, and the only problem I’ve encountered is that the strength of the Levemir seems to tail off after ten days, even though I keep my pens in a Frio. (It’s ‘supposed’ o last for fourteen.) In the words of the Consultant I see, “If in doubt, dump it.”

 

[Emck]

Does the pen for the levemir cartridges have the time since last injection feature? The one I have for my fiasp does and it is so handy!

 

[Fairygodmother]

I don’t think mine does, just last dose, but since Fiasp and Levemir are made by the same firm it should be available? What pen are you using?

 

[klynch]

I use levemir cartridges they have been rock solid. I dislike prefilled pens the space they take in my fridge is very wasteful.

In 20 years of insulin use the only certain insulin I had, was when some insulin went brown in my fridge in March 2020. I returned it to my pharmacy. The pharmacist sad she's never heard of the problem. She took the insulin off me and raised some formal medical paperwork - I think she reported it as the equivalent of a "near miss" that was in March in the middle of covid.

We still have had no response.

If you are finding the efficacy of levemir variable, apart from consulting your pharmacist, I would ask for an appointment with Diabetes specialist nurses to review for external factors and how to deal with the issue when it happens again.

 

[Daibell]

I use the cartridge too, and the only problem I’ve encountered is that the strength of the Levemir seems to tail off after ten days, even though I keep my pens in a Frio. (It’s ‘supposed’ o last for fourteen.) In the words of the Consultant I see, “If in doubt, dump it.”

The Levemir leaflet says it should last 6 weeks.

 

[Emck]

I don’t think mine does, just last dose, but since Fiasp and Levemir are made by the same firm it should be available? What pen are you using?

I’m using the novopen 5 at the moment. If the cartridges are the same I think I will change. It would be nice to waste less plastic!

 

[Jon88]

I use the cartridge too, and the only problem I’ve encountered is that the strength of the Levemir seems to tail off after ten days, even though I keep my pens in a Frio. (It’s ‘supposed’ o last for fourteen.) In the words of the Consultant I see, “If in doubt, dump it.”

Levemir should last just over a month once out the fridge and in use as long as kept within the temperature range indicated. 10 days seems a very short time period for the performance of the Insulin to start dropping, and should last well past 14 days without problems.

Some of the pens I've used are off from day one. I'm beginning to also question the accuracy of dosing with the Flex Pens. I'm really sensitive to Insulin so even a unit can show a difference.

I'm aware Novopens come in half units, and seem more robust in quality, so I think based on comments I'll switch back to cartridges.

 

[Jon88]

I use levemir cartridges they have been rock solid. I dislike prefilled pens the space they take in my fridge is very wasteful.

In 20 years of insulin use the only certain insulin I had, was when some insulin went brown in my fridge in March 2020. I returned it to my pharmacy. The pharmacist sad she's never heard of the problem. She took the insulin off me and raised some formal medical paperwork - I think she reported it as the equivalent of a "near miss" that was in March in the middle of covid.

We still have had no response.

If you are finding the efficacy of levemir variable, apart from consulting your pharmacist, I would ask for an appointment with Diabetes specialist nurses to review for external factors and how to deal with the issue when it happens again.

The brown Levemir sounds really odd. Luckily never seen or heard of that with any Insulin I've used during almost 30 years being Diabetic.

I've run this issue many, many times past my specialist nurse but have been unable to offer up any real explanation. I've had the impression at times reached the conclusion the issue lies with user error. Have recommended I simply change background Insulin, but I guess rather than starting over with a new Insulin there's a part of me that wanted some explanation as to the reasons behind the issues. Guess sometimes you just can't get them.

I think my high sensitivity to Insulin highlights any variables more so. As others have suggested shall try cartridges instead and see if things become more consistent. Not that there's ever much consistency with this condition anyway!

 

[Emck]

A dosage error could make a lost more sense than there being an issue with the insulin itself. I too have pens that are bad from day one, sometimes multiple in a box!

Definitely going to switch!

I would also recommend that anyone who is interested swaps to the novopen 5. The time since last dose is really useful for checking whether you have active insulin onboard and for avoiding double dosing if tired or distracted.

 

[Fairygodmother]

It’s not all batches of Levemir that decline for me, but some do indeed begin to decline after 10 days’ use. Basal dose is pretty steady, it’s definitely not a dosing issue. The Consultant wasn’t surprised: don’t go by the leaflet, go by practical experience. It’s stood me in good stead for the last 51 years with T1.