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Identification
NameInsulin Detemir
Accession NumberDB01307
TypeBiotech
GroupsApproved
DescriptionInsulin detemir is a long-acting human insulin analogue used to maintain basal levels of insulin in diabetic individuals. It is produced using recombinant DNA technology in yeast cells. This insulin analogue has a 14-C fatty acid, myristic acid, bound to the lysine amino acid at position B29. The myristoyl side chain increases self-association and albumin binding. This along with slow systemic absorption from the injection site prolongs distribution of the hormone into tissues and results in a long duration of action. Novo Nordisk markets insulin detemir under the trade name Levemir.
Protein structureNo structure small
Related Articles
Protein chemical formulaC267H402N64O76S6
Protein average weight5916.9 Da
Sequences
>Protein sequence for A chain
GIVEQCCTSICSLYQLENYCN
>Protein sequence for B chain 
FVNQHLCGSHLVEALYLVCGERGFFYTPK
Download FASTA Format
Synonyms
Detemir
Insulin detemir recombinant
Insulin,detemir,human
External Identifiers
  • NN-304
Approved Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 [iU]/mLSubcutaneousNovo Nordisk2006-03-272016-11-30Us
LevemirInjection, solution14.2 mg/mLSubcutaneousPhysicians Total Care, Inc.2008-03-31Not applicableUs
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 [iU]/mLSubcutaneousA S Medication Solutions2006-03-27Not applicableUs
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirImplant14.2 mg/mLSoft tissueDispensing Solutions, Inc.2006-03-27Not applicableUs
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 [iU]/mLSubcutaneousNovo Nordisk2006-03-27Not applicableUs
LevemirInjection, solution100 [iU]/mLSubcutaneousA S Medication Solutions2013-10-31Not applicableUs
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 [iU]/mLSubcutaneousNovo Nordisk2013-10-31Not applicableUs
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
LevemirInjection, solution100 U/mlSubcutaneousNovo Nordisk A/s2004-06-01Not applicableEu
Levemir FlextouchSolution100 unitSubcutaneousNovo Nordisk Canada Inc2013-11-25Not applicableCanada
Levemir PenfillSolution100 unitSubcutaneousNovo Nordisk Canada Inc2005-11-14Not applicableCanada
Approved Generic Prescription ProductsNot Available
Approved Over the Counter ProductsNot Available
Unapproved/Other Products Not Available
International Brands
NameCompany
Levemir FlexPen Novo Nordisk
Brand mixturesNot Available
SaltsNot Available
Categories
UNII4FT78T86XV
CAS number169148-63-4
Pharmacology
IndicationFor the treatment of type 1 or 2 diabetes mellitus. May be used in combination with oral anti-diabetic agents in type 2 diabetic patients who are not in adequate metabolic control with oral anti-diabetic agents alone.
Structured Indications
PharmacodynamicsInsulin is a natural hormone produced by beta cells of the pancreas. In non-diabetic individuals, a basal level of insulin is supplemented with insulin spikes following meals. Increased insulin secretion following meals is responsible for the metabolic changes that occur as the body transitions from a postabsorptive to absorptive state. Insulin promotes cellular uptake of glucose, particularly in muscle and adipose tissues, promotes energy storage via glycogenesis, opposes catabolism of energy stores, increases DNA replication and protein synthesis by stimulating amino acid uptake by liver, muscle and adipose tissue, and modifies the activity of numerous enzymes involved in glycogen synthesis and glycolysis. Insulin also promotes growth and is required for the actions of growth hormone (e.g. protein synthesis, cell division, DNA synthesis). Insulin detemir is a long-acting insulin analogue with a flat and predictable action profile. It is used to mimic the basal levels of insulin in diabetic individuals. The onset of action of insulin detemir is 1 to 2 hours and its duration of action is up to 24 hours. Interestingly, it has a lower affinity (30%) for the insulin receptor than human insulin.
Mechanism of actionInsulin detemir binds to the insulin receptor (IR), a heterotetrameric protein consisting of two extracellular alpha units and two transmembrane beta units. The binding of insulin to the alpha subunit of IR stimulates the tyrosine kinase activity intrinsic to the beta subunit of the receptor. The bound receptor autophosphorylates and phosphorylates numerous intracellular substrates such as insulin receptor substrates (IRS) proteins, Cbl, APS, Shc and Gab 1. Activation of these proteins leads to the activation of downstream signaling molecules including PI3 kinase and Akt. Akt regulates the activity of glucose transporter 4 (GLUT4) and protein kinase C (PKC), both of which play critical roles in metabolism and catabolism. Insulin detemir’s long duration of action appears to be a result of slow systemic absorption from the injection site and delayed distribution to target tissues. The myristic acid side chain on insulin detemir increases self-association and gives it a high binding affinity to serum albumin. These features slows its distribution into target tissues and prolongs its duration of action.
TargetKindPharmacological actionActionsOrganismUniProt ID
Insulin receptorProteinyes
agonist
HumanP06213 details
Related Articles
AbsorptionMaximum serum concentrations are reached 6 to 8 hours following subcutaneous injection. When single dose of 0.5 units/kg of insulin detemir was given to adult type 1 diabetes patients, the maximum serum concentration (Cmax) was 4,641 ± 2,299 pmol/L. Absorption is also dependent on the site of injection. When injected into the thigh, the AUC was lower than when injected into the deltoid and abdominal regions. Bioavailability is approximately 60%.
Volume of distribution
  • 0.1 L/kg
Protein binding> 98% bound to albumin
Metabolism

As with natural insulin, all metabolites formed are inactive.

Route of eliminationNot Available
Half life5 - 7 hours depending on dose. The half life also differs between age groups (type 1 diabetes patients): Children (6-12 years) = 302 ± 100 minutes; Adolescents (13-17 years) = 301 ± 107 minutes; Adults (18-65 years) = 425 ± 78 minutes
Clearance

Apparent clearance (CL/F), type 1 diabetes adult patients = 3.41 ± 1.00 L/min·kg

ToxicityHypoglycemia may occur with inappropriately high doses. Neurogenic (autonomic) signs and symptoms of hypoglycemia include trembling, palpitations, sweating, anxiety, hunger, nausea and tingling. Neuroglycopenic signs and symptoms of hypoglycemia include difficulty concentrating, lethargy/weakness, confusion, drowsiness, vision changes, difficulty speaking, headache, and dizziness. Mild hypoglycemia is characterized by the presence of autonomic symptoms. Moderate hypoglycemia is characterized by the presence of autonomic and neuroglycopenic symptoms. Individuals may become unconscious in severe cases of hypoglycemia. Injection site reactions may also occur. Symptoms include: redness, inflammation, bruising, swelling and itching at the injection site.
Affected organisms
  • Humans and other mammals
PathwaysNot Available
SNP Mediated EffectsNot Available
SNP Mediated Adverse Drug ReactionsNot Available
Interactions
Drug Interactions
DrugInteractionDrug group
7,8-DICHLORO-1,2,3,4-TETRAHYDROISOQUINOLINE7,8-DICHLORO-1,2,3,4-TETRAHYDROISOQUINOLINE may increase the hypoglycemic activities of Insulin Detemir.Experimental
AcarboseAcarbose may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
AcetohexamideAcetohexamide may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
Acetylsalicylic acidAcetylsalicylic acid may increase the hypoglycemic activities of Insulin Detemir.Approved, Vet Approved
AicarAicar may increase the hypoglycemic activities of Insulin Detemir.Experimental
AlogliptinAlogliptin may increase the hypoglycemic activities of Insulin Detemir.Approved
Aminosalicylic AcidAminosalicylic Acid may increase the hypoglycemic activities of Insulin Detemir.Approved
AripiprazoleThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Aripiprazole.Approved, Investigational
Arsenic trioxideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Arsenic trioxide.Approved, Investigational
ArticaineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Articaine.Approved
AsenapineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Asenapine.Approved
AtazanavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Atazanavir.Approved, Investigational
BalaglitazoneBalaglitazone may increase the hypoglycemic activities of Insulin Detemir.Investigational
BalsalazideBalsalazide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
BendroflumethiazideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Bendroflumethiazide.Approved
BenmoxinBenmoxin may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
BetamethasoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Betamethasone.Approved, Vet Approved
BrexpiprazoleThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Brexpiprazole.Approved
BuforminBuformin may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
BumetanideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Bumetanide.Approved
BuserelinThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Buserelin.Approved
CanagliflozinCanagliflozin may increase the hypoglycemic activities of Insulin Detemir.Approved
CaroxazoneCaroxazone may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
CastanospermineCastanospermine may increase the hypoglycemic activities of Insulin Detemir.Experimental
CeritinibThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Ceritinib.Approved
ChlorothiazideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Chlorothiazide.Approved, Vet Approved
ChlorpropamideChlorpropamide may increase the hypoglycemic activities of Insulin Detemir.Approved
ChlorthalidoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Chlorthalidone.Approved
CiglitazoneCiglitazone may increase the hypoglycemic activities of Insulin Detemir.Experimental
CinoxacinCinoxacin may increase the hypoglycemic activities of Insulin Detemir.Approved, Withdrawn
CiprofloxacinCiprofloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
CitalopramCitalopram may increase the hypoglycemic activities of Insulin Detemir.Approved
ClozapineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Clozapine.Approved
CorticotropinThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Corticotropin.Approved, Vet Approved
Cortisone acetateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Cortisone acetate.Approved
Cyproterone acetateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Cyproterone acetate.Approved, Investigational
DabrafenibThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Dabrafenib.Approved
DanazolThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Danazol.Approved
DapoxetineDapoxetine may increase the hypoglycemic activities of Insulin Detemir.Investigational
DarunavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Darunavir.Approved
DeoxyspergualinDeoxyspergualin may increase the hypoglycemic activities of Insulin Detemir.Investigational
dersalazinedersalazine may increase the hypoglycemic activities of Insulin Detemir.Investigational
DesogestrelThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Desogestrel.Approved
DesvenlafaxineDesvenlafaxine may increase the hypoglycemic activities of Insulin Detemir.Approved
DexamethasoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Dexamethasone.Approved, Investigational, Vet Approved
DiazoxideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Diazoxide.Approved
DienogestThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Dienogest.Approved
DiflunisalDiflunisal may increase the hypoglycemic activities of Insulin Detemir.Approved
DihydrotestosteroneDihydrotestosterone may increase the hypoglycemic activities of Insulin Detemir.Illicit
DisopyramideDisopyramide may increase the hypoglycemic activities of Insulin Detemir.Approved
DrospirenoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Drospirenone.Approved
DulaglutideDulaglutide may increase the hypoglycemic activities of Insulin Detemir.Approved
DuloxetineDuloxetine may increase the hypoglycemic activities of Insulin Detemir.Approved
EmpagliflozinEmpagliflozin may increase the hypoglycemic activities of Insulin Detemir.Approved
EnoxacinEnoxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
EpinephrineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Epinephrine.Approved, Vet Approved
EscitalopramEscitalopram may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
EstradiolThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Estradiol.Approved, Investigational, Vet Approved
Estrone sulfateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Estrone sulfate.Approved
Etacrynic acidThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Etacrynic acid.Approved
Ethinyl EstradiolThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Ethinyl Estradiol.Approved
Ethynodiol diacetateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Ethynodiol diacetate.Approved
EtonogestrelThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Etonogestrel.Approved, Investigational
EtoperidoneEtoperidone may increase the hypoglycemic activities of Insulin Detemir.Approved
EverolimusThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Everolimus.Approved
ExenatideExenatide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
FleroxacinFleroxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
FludrocortisoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Fludrocortisone.Approved
FlumequineFlumequine may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
FluoxetineFluoxetine may increase the hypoglycemic activities of Insulin Detemir.Approved, Vet Approved
FluoxymesteroneFluoxymesterone may increase the hypoglycemic activities of Insulin Detemir.Approved, Illicit
FluvoxamineFluvoxamine may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
FosamprenavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Fosamprenavir.Approved
FurazolidoneFurazolidone may increase the hypoglycemic activities of Insulin Detemir.Approved, Vet Approved
FurosemideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Furosemide.Approved, Vet Approved
GarenoxacinGarenoxacin may increase the hypoglycemic activities of Insulin Detemir.Investigational
GatifloxacinGatifloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
GemifloxacinGemifloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
GlibornurideGlibornuride may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
GliclazideGliclazide may increase the hypoglycemic activities of Insulin Detemir.Approved
GlimepirideGlimepiride may increase the hypoglycemic activities of Insulin Detemir.Approved
GlipizideGlipizide may increase the hypoglycemic activities of Insulin Detemir.Approved
GliquidoneGliquidone may increase the hypoglycemic activities of Insulin Detemir.Approved
GlyburideGlyburide may increase the hypoglycemic activities of Insulin Detemir.Approved
GoserelinThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Goserelin.Approved
GrepafloxacinGrepafloxacin may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
GusperimusGusperimus may increase the hypoglycemic activities of Insulin Detemir.Investigational
HistrelinThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Histrelin.Approved
HydracarbazineHydracarbazine may increase the hypoglycemic activities of Insulin Detemir.Approved
HydrochlorothiazideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Hydrochlorothiazide.Approved, Vet Approved
HydrocortisoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Hydrocortisone.Approved, Vet Approved
HydroflumethiazideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Hydroflumethiazide.Approved
Hydroxyprogesterone caproateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Hydroxyprogesterone caproate.Approved
IloperidoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Iloperidone.Approved
IndalpineIndalpine may increase the hypoglycemic activities of Insulin Detemir.Investigational, Withdrawn
IndapamideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Indapamide.Approved
IndinavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Indinavir.Approved
Insulin AspartInsulin Aspart may increase the hypoglycemic activities of Insulin Detemir.Approved
Insulin GlargineInsulin Glargine may increase the hypoglycemic activities of Insulin Detemir.Approved
Insulin GlulisineInsulin Detemir may increase the hypoglycemic activities of Insulin Glulisine.Approved
Insulin HumanInsulin Human may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
Insulin LisproInsulin Lispro may increase the hypoglycemic activities of Insulin Detemir.Approved
Insulin PorkInsulin Pork may increase the hypoglycemic activities of Insulin Detemir.Approved
IproclozideIproclozide may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
IproniazidIproniazid may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
IsocarboxazidIsocarboxazid may increase the hypoglycemic activities of Insulin Detemir.Approved
LanreotideInsulin Detemir may increase the hypoglycemic activities of Lanreotide.Approved
LeuprolideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Leuprolide.Approved, Investigational
LevofloxacinLevofloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
LevomilnacipranLevomilnacipran may increase the hypoglycemic activities of Insulin Detemir.Approved
LevonorgestrelThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Levonorgestrel.Approved, Investigational
LinagliptinLinagliptin may increase the hypoglycemic activities of Insulin Detemir.Approved
Lipoic AcidLipoic Acid may increase the hypoglycemic activities of Insulin Detemir.Approved, Nutraceutical
LiraglutideLiraglutide may increase the hypoglycemic activities of Insulin Detemir.Approved
LomefloxacinLomefloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
LopinavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Lopinavir.Approved
LurasidoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Lurasidone.Approved
MebanazineMebanazine may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
MecaserminMecasermin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
Medroxyprogesterone acetateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Medroxyprogesterone acetate.Approved, Investigational
Megestrol acetateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Megestrol acetate.Approved, Vet Approved
MesalazineMesalazine may increase the hypoglycemic activities of Insulin Detemir.Approved
MestranolThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Mestranol.Approved
MetforminMetformin may increase the hypoglycemic activities of Insulin Detemir.Approved
MethotrimeprazineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Methotrimeprazine.Approved
MethyclothiazideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Methyclothiazide.Approved
Methylene blueMethylene blue may increase the hypoglycemic activities of Insulin Detemir.Investigational
MethylprednisoloneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Methylprednisolone.Approved, Vet Approved
MethyltestosteroneMethyltestosterone may increase the hypoglycemic activities of Insulin Detemir.Approved
MetolazoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Metolazone.Approved
MifepristoneMifepristone may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
MiglitolMiglitol may increase the hypoglycemic activities of Insulin Detemir.Approved
MiglustatMiglustat may increase the hypoglycemic activities of Insulin Detemir.Approved
MilnacipranMilnacipran may increase the hypoglycemic activities of Insulin Detemir.Approved
MinaprineMinaprine may increase the hypoglycemic activities of Insulin Detemir.Approved
MitiglinideMitiglinide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
MoclobemideMoclobemide may increase the hypoglycemic activities of Insulin Detemir.Approved
MoxifloxacinMoxifloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
Nalidixic AcidNalidixic Acid may increase the hypoglycemic activities of Insulin Detemir.Approved
NateglinideNateglinide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
NCX 4016NCX 4016 may increase the hypoglycemic activities of Insulin Detemir.Investigational
NefazodoneNefazodone may increase the hypoglycemic activities of Insulin Detemir.Approved, Withdrawn
NelfinavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Nelfinavir.Approved
NemonoxacinNemonoxacin may increase the hypoglycemic activities of Insulin Detemir.Investigational
NiacinThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Niacin.Approved, Investigational, Nutraceutical
NialamideNialamide may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
NilotinibThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Nilotinib.Approved, Investigational
NitroaspirinNitroaspirin may increase the hypoglycemic activities of Insulin Detemir.Investigational
NorethisteroneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Norethisterone.Approved
NorfloxacinNorfloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
NorgestimateThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Norgestimate.Approved
OctamoxinOctamoxin may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
OctreotideOctreotide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
OfloxacinOfloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
OlanzapineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Olanzapine.Approved, Investigational
OlsalazineOlsalazine may increase the hypoglycemic activities of Insulin Detemir.Approved
OxandroloneOxandrolone may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
OxymetholoneOxymetholone may increase the hypoglycemic activities of Insulin Detemir.Approved, Illicit
PaliperidoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Paliperidone.Approved
PargylinePargyline may increase the hypoglycemic activities of Insulin Detemir.Approved
ParoxetineParoxetine may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
PasireotideInsulin Detemir may increase the hypoglycemic activities of Pasireotide.Approved
PazufloxacinPazufloxacin may increase the hypoglycemic activities of Insulin Detemir.Investigational
PefloxacinPefloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
PegvisomantPegvisomant may increase the hypoglycemic activities of Insulin Detemir.Approved
PentamidinePentamidine may increase the hypoglycemic activities of Insulin Detemir.Approved
PhenelzinePhenelzine may increase the hypoglycemic activities of Insulin Detemir.Approved
PhenforminPhenformin may increase the hypoglycemic activities of Insulin Detemir.Approved, Withdrawn
PheniprazinePheniprazine may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
PhenoxypropazinePhenoxypropazine may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
PioglitazonePioglitazone may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
PiperazineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Piperazine.Approved, Vet Approved
PipotiazineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Pipotiazine.Approved
PirlindolePirlindole may increase the hypoglycemic activities of Insulin Detemir.Approved
PivhydrazinePivhydrazine may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
PolythiazideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Polythiazide.Approved
PramlintidePramlintide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
PrednisoloneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Prednisolone.Approved, Vet Approved
PrednisoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Prednisone.Approved, Vet Approved
ProgesteroneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Progesterone.Approved, Vet Approved
PrulifloxacinPrulifloxacin may increase the hypoglycemic activities of Insulin Detemir.Investigational
QuetiapineThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Quetiapine.Approved
QuinethazoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Quinethazone.Approved
QuinineQuinine may increase the hypoglycemic activities of Insulin Detemir.Approved
RasagilineRasagiline may increase the hypoglycemic activities of Insulin Detemir.Approved
RepaglinideRepaglinide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
RisperidoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Risperidone.Approved, Investigational
RitonavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Ritonavir.Approved, Investigational
RosiglitazoneRosiglitazone may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
RosoxacinRosoxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
SafrazineSafrazine may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
Salicylic acidSalicylic acid may increase the hypoglycemic activities of Insulin Detemir.Approved, Vet Approved
SaquinavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Saquinavir.Approved, Investigational
SaxagliptinSaxagliptin may increase the hypoglycemic activities of Insulin Detemir.Approved
SelegilineSelegiline may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational, Vet Approved
SertralineSertraline may increase the hypoglycemic activities of Insulin Detemir.Approved
SirolimusThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Sirolimus.Approved, Investigational
SitagliptinSitagliptin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
SparfloxacinSparfloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved
StanozololStanozolol may increase the hypoglycemic activities of Insulin Detemir.Approved, Vet Approved
SulfadiazineSulfadiazine may increase the hypoglycemic activities of Insulin Detemir.Approved, Vet Approved
SulfamethoxazoleSulfamethoxazole may increase the hypoglycemic activities of Insulin Detemir.Approved
SulfisoxazoleSulfisoxazole may increase the hypoglycemic activities of Insulin Detemir.Approved, Vet Approved
SulodexideSulodexide may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
SunitinibSunitinib may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
TacrolimusThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Tacrolimus.Approved, Investigational
TemafloxacinTemafloxacin may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
TemsirolimusThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Temsirolimus.Approved
TestosteroneTestosterone may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
ThiazolidinedioneThiazolidinedione may increase the hypoglycemic activities of Insulin Detemir.Investigational
TipranavirThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Tipranavir.Approved, Investigational
TolazamideTolazamide may increase the hypoglycemic activities of Insulin Detemir.Approved
TolbutamideTolbutamide may increase the hypoglycemic activities of Insulin Detemir.Approved
ToloxatoneToloxatone may increase the hypoglycemic activities of Insulin Detemir.Approved
TorasemideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Torasemide.Approved
Trans-2-PhenylcyclopropylamineTrans-2-Phenylcyclopropylamine may increase the hypoglycemic activities of Insulin Detemir.Experimental
TranylcypromineTranylcypromine may increase the hypoglycemic activities of Insulin Detemir.Approved
TriamcinoloneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Triamcinolone.Approved, Vet Approved
TrichlormethiazideThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Trichlormethiazide.Approved, Vet Approved
TriptorelinThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Triptorelin.Approved, Vet Approved
TroglitazoneTroglitazone may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
TrovafloxacinTrovafloxacin may increase the hypoglycemic activities of Insulin Detemir.Approved, Withdrawn
VenlafaxineVenlafaxine may increase the hypoglycemic activities of Insulin Detemir.Approved
VildagliptinVildagliptin may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
VogliboseVoglibose may increase the hypoglycemic activities of Insulin Detemir.Approved, Investigational
VorinostatThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Vorinostat.Approved, Investigational
ZimelidineZimelidine may increase the hypoglycemic activities of Insulin Detemir.Withdrawn
ZiprasidoneThe therapeutic efficacy of Insulin Detemir can be decreased when used in combination with Ziprasidone.Approved
Food InteractionsNot Available
References
Synthesis ReferenceNot Available
General References
  1. Kurtzhals P: Pharmacology of insulin detemir. Endocrinol Metab Clin North Am. 2007 Aug;36 Suppl 1:14-20. [PubMed:17881328 ]
  2. Morales J: Defining the role of insulin detemir in Basal insulin therapy. Drugs. 2007;67(17):2557-84. [PubMed:18034591 ]
  3. Tibaldi J: Actions of insulin beyond glycemic control: a perspective on insulin detemir. Adv Ther. 2007 Jul-Aug;24(4):868-82. [PubMed:17901036 ]
  4. Danne T, Lupke K, Walte K, Von Schuetz W, Gall MA: Insulin detemir is characterized by a consistent pharmacokinetic profile across age-groups in children, adolescents, and adults with type 1 diabetes. Diabetes Care. 2003 Nov;26(11):3087-92. [PubMed:14578244 ]
  5. Owens DR, Bolli GB: Beyond the era of NPH insulin--long-acting insulin analogs: chemistry, comparative pharmacology, and clinical application. Diabetes Technol Ther. 2008 Oct;10(5):333-49. doi: 10.1089/dia.2008.0023. [PubMed:18715209 ]
External Links
ATC CodesA10AE05
AHFS Codes
  • 68:20.08
PDB EntriesNot Available
FDA labelDownload (911 KB)
MSDSDownload (504 KB)
Pharmacoeconomics
ManufacturersNot Available
Packagers
Dosage forms
FormRouteStrength
ImplantSoft tissue14.2 mg/mL
Injection, solutionSubcutaneous100 U/ml
Injection, solutionSubcutaneous100 [iU]/mL
Injection, solutionSubcutaneous14.2 mg/mL
SolutionSubcutaneous100 unit
Prices
Unit descriptionCostUnit
Levemir flexpen 100 unit/ml14.28USD ml
DrugBank does not sell nor buy drugs. Pricing information is supplied for informational purposes only.
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
CA2171424 No2002-06-042014-09-16Canada
US5750497 No1999-06-162019-06-16Us
US5866538 No1997-06-202017-06-20Us
US6004297 No1999-01-282019-01-28Us
US6011007 No1994-02-022014-02-02Us
US6899699 No2002-01-022022-01-02Us
US7686786 No2006-08-032026-08-03Us
US8672898 No2002-01-022022-01-02Us
US8684969 No2005-10-202025-10-20Us
US8920383 No2006-07-172026-07-17Us
US9108002 No2006-01-202026-01-20Us
US9132239 No2012-02-012032-02-01Us
US9265893 No2012-09-232032-09-23Us
USRE41956 No2001-01-212021-01-21Us
USRE43834 No1999-01-282019-01-28Us
Properties
StateLiquid
Experimental PropertiesNot Available
Taxonomy
DescriptionNot Available
KingdomOrganic Compounds
Super ClassOrganic Acids
ClassCarboxylic Acids and Derivatives
Sub ClassAmino Acids, Peptides, and Analogues
Direct ParentPeptides
Alternative ParentsNot Available
SubstituentsNot Available
Molecular FrameworkNot Available
External DescriptorsNot Available

Targets

Kind
Protein
Organism
Human
Pharmacological action
yes
Actions
agonist
General Function:
Receptor signaling protein tyrosine kinase activity
Specific Function:
Receptor tyrosine kinase which mediates the pleiotropic actions of insulin. Binding of insulin leads to phosphorylation of several intracellular substrates, including, insulin receptor substrates (IRS1, 2, 3, 4), SHC, GAB1, CBL and other signaling intermediates. Each of these phosphorylated proteins serve as docking proteins for other signaling proteins that contain Src-homology-2 domains (SH2 ...
Gene Name:
INSR
Uniprot ID:
P06213
Molecular Weight:
156331.465 Da
References
  1. Hennige AM, Sartorius T, Tschritter O, Preissl H, Fritsche A, Ruth P, Haring HU: Tissue selectivity of insulin detemir action in vivo. Diabetologia. 2006 Jun;49(6):1274-82. Epub 2006 Mar 29. [PubMed:16570163 ]
  2. Kurtzhals P, Schaffer L, Sorensen A, Kristensen C, Jonassen I, Schmid C, Trub T: Correlations of receptor binding and metabolic and mitogenic potencies of insulin analogs designed for clinical use. Diabetes. 2000 Jun;49(6):999-1005. [PubMed:10866053 ]
  3. Sorensen AR, Stidsen CE, Ribel U, Nishimura E, Sturis J, Jonassen I, Bouman SD, Kurtzhals P, Brand CL: Insulin detemir is a fully efficacious, low affinity agonist at the insulin receptor. Diabetes Obes Metab. 2010 Aug;12(8):665-73. doi: 10.1111/j.1463-1326.2010.01206.x. [PubMed:20590743 ]
  4. Wada T, Azegami M, Sugiyama M, Tsuneki H, Sasaoka T: Characteristics of signalling properties mediated by long-acting insulin analogue glargine and detemir in target cells of insulin. Diabetes Res Clin Pract. 2008 Sep;81(3):269-77. doi: 10.1016/j.diabres.2008.05.007. Epub 2008 Jun 27. [PubMed:18585815 ]
  5. Chen X, Ji ZL, Chen YZ: TTD: Therapeutic Target Database. Nucleic Acids Res. 2002 Jan 1;30(1):412-5. [PubMed:11752352 ]

Enzymes

Kind
Protein
Organism
Human
Pharmacological action
unknown
Actions
inducer
General Function:
Oxidoreductase activity, acting on paired donors, with incorporation or reduction of molecular oxygen, reduced flavin or flavoprotein as one donor, and incorporation of one atom of oxygen
Specific Function:
Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It oxidizes a variety of structurally unrelated compounds, including steroids, fatty acids, and xenobiotics. Most active in catalyzing 2-hydroxylation. Caffeine is metabolized primarily by cytochrome CYP1A2 in the liver through an initial N...
Gene Name:
CYP1A2
Uniprot ID:
P05177
Molecular Weight:
58293.76 Da
References
  1. Drug Interactions: Cytochrome P450 Drug Interaction Table [Link]

Carriers

Kind
Protein
Organism
Human
Pharmacological action
no
Actions
other/unknown
General Function:
Toxic substance binding
Specific Function:
Serum albumin, the main protein of plasma, has a good binding capacity for water, Ca(2+), Na(+), K(+), fatty acids, hormones, bilirubin and drugs. Its main function is the regulation of the colloidal osmotic pressure of blood. Major zinc transporter in plasma, typically binds about 80% of all plasma zinc.
Gene Name:
ALB
Uniprot ID:
P02768
Molecular Weight:
69365.94 Da
References
  1. Klein O, Lynge J, Endahl L, Damholt B, Nosek L, Heise T: Albumin-bound basal insulin analogues (insulin detemir and NN344): comparable time-action profiles but less variability than insulin glargine in type 2 diabetes. Diabetes Obes Metab. 2007 May;9(3):290-9. [PubMed:17391154 ]
  2. Kurtzhals P: Pharmacology of insulin detemir. Endocrinol Metab Clin North Am. 2007 Aug;36 Suppl 1:14-20. [PubMed:17881328 ]
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Drug created on June 30, 2007 08:45 / Updated on December 02, 2016 03:19