Levemir

How can this medicine affect other medicines?

If this insulin is mixed with other types of insulin, the onset and duration of action of one or both insulins is likely to change. You should avoid mixing this insulin with rapid acting insulins, such as insulin aspart (NovoRapid). You should only mix insulins on the advice of your doctor, pharmacist or diabetic nurse.

Insulin itself doesn't affect other medicines. However, it is important to be aware that some medicines can affect your blood sugar levels and may therefore alter your insulin requirements. You should tell your doctor if you are taking any other medicines, including herbal medicines and those bought without a prescription, before starting treatment with this medicine. You should also take care when starting and stopping any new medicines. Always ask your doctor or pharmacist before taking a new medicine to check whether it can affect your blood sugar, and if so what action, if any, you need to take.

The following medicines may decrease blood sugar levels. If you start treatment with any of these your insulin dose may therefore need decreasing:

- ACE inhibitors, eg captopril (these can cause unpredictable drops in blood sugar)
- anabolic steroids, eg testosterone, nandrolone, stanozolol
- antidiabetic medicines taken by mouth
- disopyramide
- fibrates, eg gemfibrozil
- fluoxetine
- MAOI antidepressants, eg phenelzine
- octreotide
- large doses of salicylates, eg aspirin (small pain relieving doses do not normally have this effect).

Beta-blockers, eg propranolol (including eye drops containing beta-blockers) can mask some of the signs of low blood sugar, such as increased heart rate and tremor. They also prolong episodes of low blood sugar and impair recovery back to normal glucose levels.

The following medicines may increase blood glucose levels. If you start treatment with any of these your insulin dose may therefore need increasing:

- some antipsychotic medicines, eg chlorpromazine, olanzapine
- corticosteroids, eg hydrocortisone, prednisolone
- danazol
- diazoxide
- diuretics, especially thiazide diuretics, eg bendroflumethiazide
- isoniazid
- lithium
- protease inhibitors, eg ritonavir
- somatropin (human growth hormone).

Oestrogens and progesterones, such as those contained in oral contraceptives, may affect blood sugar levels, and women taking these may need small adjustments up or down in their insulin dose.

Other medicines containing the same active ingredient

There are currently no other products available in the UK that contain this kind of insulin (insulin detemir).

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