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Levemir vs Toujeo
Introduction
For patients with diabetes, certain medications that help regulate blood sugar levels are crucial for managing their condition. Levemir and Toujeo are two such drugs prescribed for this purpose. Both of these insulin analogs play a vital role in maintaining optimal glucose levels in the body, but they function slightly differently and have variable effects based on individual patient needs. Levemir or insulin detemir is a long-acting basal insulin used to control high blood sugar in people with diabetes by helping glucose get into cells so it can be used for energy. On the other hand, Toujeo (insulin glargine) also works similarly but it has an extended duration of action up to 24 hours plus which makes it more concentrated than Levemir leading to fewer daily injections. Thus, both of them manage diabetes but their differences lie mainly in concentration and dosing frequency.
Levemir vs Toujeo Side By Side
| Attribute | Levemir | Toujeo |
|---|---|---|
| Brand Name | Levemir | Toujeo |
| Contraindications | Cannot be used with certain medications like thiazolidinediones (TZDs) without adjustment or discontinuation due to risk of heart failure. Potential interactions with drugs like beta-blockers, clonidine, guanethidine, and reserpine which can either potentiate or weaken the effect of insulin and can also hide signs of hypoglycemia. | Similar to Levemir, cannot be used with certain medications like thiazolidinediones (TZDs) without adjustment or discontinuation due to risk of heart failure. Potential interactions with drugs that can either potentiate or weaken the effect of insulin and can also hide signs of hypoglycemia. |
| Cost | Around $331 for a 10 mL vial (100 units/mL) | About $140 for a 1.5 mL pen (300 units/mL) |
| Generic Name | Insulin detemir | Insulin glargine |
| Most Serious Side Effect | Hypoglycemia with symptoms such as dizziness, confusion, sweating, hunger, irritability or mood changes; signs of allergic reactions; skin thickening or pits at the injection site (lipodystrophy); fluid retention causing swelling in the hands and feet; rapid weight gain; potassium level imbalances; low magnesium levels. | Signs of allergic reactions such as rash, itching or hives on the skin; shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body; swelling in your feet and ankles; rapid weight gain; unusual mood swings or behavioral changes; feelings of anxiety or depression; blurry vision; increased thirst and frequent urination. |
| Severe Drug Interactions | Interactions with TZDs, beta-blockers, clonidine, guanethidine, and reserpine. | Interactions with TZDs, beta-blockers, clonidine, guanethidine, and reserpine. |
| Typical Dose | Starts from 0.1 to 0.2 units/kg/day, can be administered once or twice daily depending on blood sugar control desired. | Typically initiated with a dosage of 0.2 units/kg once daily. The dose can then be adjusted to achieve target fasting plasma glucose levels. |
What is Levemir?
Insulin detemir (the generic name for Levemir) and insulin glargine (the generic name for Toujeo) are long-acting insulins that play a significant role in the management of both type 1 and type 2 diabetes. Insulin detemir, first approved by the FDA in 2005, differs from human insulin due to its longer duration of action; it helps control blood sugar levels throughout the day. It's typically injected once or twice daily and is devised to provide a steady level of basal glucose control.
On the other hand, Insulin glargine was introduced later, with two versions available: Lantus (approved in 2000), delivering insulin over 24 hours, and Toujeo (approved in 2015), which has three times more concentration than Lantus and provides even longer coverage—up to 36 hours. Both Levemir and Toujeo have been designed with modifications to delay absorption into systemic circulation after injection resulting in their prolonged effect.
In comparing these two medications, it’s important to note that while they are both used for similar purposes there can be differences regarding when effects start to kick-in as well as how long those effects last which could influence decisions around dosing schedules.
What conditions is Levemir approved to treat?
Levemir and Toujeo are both approved for the treatment of diabetes, however they have different indications:
- Levemir is used to improve glycemic control in adults and children with type 1 diabetes mellitus. It's also indicated to improve glycemic control in adults with type 2 diabetes mellitus.
- Toujeo, on the other hand, is primarily used to improve blood sugar control in adults with both type 1 and type 2 diabetes.
How does Levemir help with these illnesses?
Levemir and Toujeo are both long-acting insulin analogs used to manage blood glucose levels in individuals with diabetes. They work by mimicking the action of naturally occurring insulin, which is a hormone produced by the pancreas that allows cells to take in glucose from the bloodstream for energy.
Levemir functions by binding to insulin receptors on cell surfaces, facilitating the uptake of glucose into the cell and thereby reducing blood sugar levels. It has a duration of action up to 24 hours, allowing for once or twice daily dosing.
Toujeo, on other hand, provides constant glucose-lowering activity for more than 24 hours but less than 36 hours. Due its longer duration of action compared to Levemir, it can be administered once daily at any time during the day.
Both medications help patients maintain their blood sugar level within an appropriate range and thus limit negative effects associated with prolonged high or low blood sugars such as organ damage and mood instability.
What is Toujeo?
Toujeo, a brand name for insulin glargine, is a long-acting insulin analog used to control high blood sugar in adults with diabetes mellitus. It works by mimicking the body's natural release of insulin throughout the day and night, thus helping to keep glucose levels in check. Toujeo was approved by the FDA relatively recently in 2015. Unlike Levemir (insulin detemir), which also controls high blood sugar but may need to be taken twice daily depending on your doctor’s advice, Toujeo only needs to be administered once daily at any time during the day. This can offer added convenience for some patients who prefer or require fewer injections per day. Side effects of both drugs are similar, including low blood sugar and weight gain; however individuals' experiences vary widely due to personal health factors.
What conditions is Toujeo approved to treat?
Toujeo is a long-acting insulin approved for the treatment of both type 1 and type 2 diabetes. It helps to control blood sugar levels around the clock, and it's designed to release insulin slowly over time. Its main uses include:
- Type 1 diabetes, where it aids in controlling high blood sugar.
- Type 2 diabetes, where it serves as part of an overall management strategy that may also encompass diet changes and regular exercise.
How does Toujeo help with these illnesses?
Insulin glargine, the active ingredient in Toujeo, is a long-acting insulin analog that helps to control blood sugar levels in individuals with diabetes. Similar to Levemir, it mimics the body's natural release of insulin throughout the day and night, helping to manage glucose levels more consistently. However, Toujeo has three times the concentration of insulin glargine compared to other insulins like Lantus and provides steady delivery over 24 hours with less variability than Levemir. It also has a longer duration than Levemir making it suitable for once-daily dosing. This can be beneficial for patients who prefer fewer injections or have trouble remembering multiple doses throughout the day.
How effective are both Levemir and Toujeo?
Both insulin detemir (Levemir) and insulin glargine (Toujeo) are long-acting insulins, with proven efficacy in managing diabetes mellitus. Both were approved by the FDA within a decade of each other; Levemir was first introduced in 2005 while Toujeo was made available to patients in 2015. Since they both aim to control blood sugar levels but operate at different rates, they may be prescribed under varying circumstances.
The effectiveness of Levemir and Toujeo has been directly compared in several studies, one such comparison is a 26-week randomized controlled trial conducted on type 2 diabetics who were inadequately controlled on oral agents. Herein, both drugs displayed comparable effects on glucose control but differed slightly when it came to nocturnal hypoglycemia where Toujeo showed less incidence.
A review article published in Diabetes Therapy journal reports that Levemir provides predictable glycemic control thus reducing the risk of hypoglycemia particularly during nighttime. The recommended starting dose for adults is usually between 10 units or up to 0.1 -0.2 units/kg once daily which can be increased depending upon individual requirement.
An extensive meta-analysis study conducted in 2018 suggested that Toujeo seemed more effective than placebo and similar long-acting insulins like Lantus regarding HbA1C reduction without increasing hypoglycaemic events significantly. Despite being an effective treatment option for diabetes management, the use of Toujeo as a standalone treatment still requires further research especially because there's significant data involving its co-prescription with rapid-acting insulins rather than it being used solely. However, due to its unique pharmacokinetic properties resulting from higher concentration (300 U/ml), longer duration (>24 hrs) & stable action profile, this newer generation insulin analog seems promising especially for those requiring high doses or have inconsistent meal patterns thereby providing flexibility which could enhance adherence.
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At what dose is Levemir typically prescribed?
Dosages of Levemir, a long-acting insulin, are dependent on the individual's needs and typically start from 0.1 to 0.2 units/kg/day. It can be administered once or twice daily depending on blood sugar control desired. On the other hand, Toujeo is another long-acting insulin with a starting dosage of 0.2 units/kg/day administered only once daily due to its extended duration of action up to 36 hours in some cases. The dosage for both Levemir and Toujeo can be adjusted every few days based on blood glucose readings until optimal glycemic control is achieved. There isn't an absolute maximum dose for either as it depends upon the patient’s insulin requirement which could be higher in conditions like obesity or pregnancy.
At what dose is Toujeo typically prescribed?
Toujeo treatment is typically initiated with a dosage of 0.2 units/kg once daily. The dose can then be adjusted to achieve target fasting plasma glucose levels. For patients transitioning from another basal insulin, the initial Toujeo dose can be the same as their current basal rate. However, due to its longer duration of action (up to 36 hours), it may need to be administered less frequently than other insulins (once daily). It's important that each injection is spaced out by at least 24 hours and injected at the same time each day for consistency and efficacy. If there is no response after a few weeks, consulting with your healthcare provider about potential adjustments or alternatives should be considered.
What are the most common side effects for Levemir?
Common side effects when comparing Levemir (insulin detemir) to Toujeo (insulin glargine):
- Low blood sugar (hypoglycemia)
- Reactions at the injection site such as redness, swelling and itching
- Weight gain
- Swelling of your hands and feet
- Respiratory tract infections
- Headache
- Back pain
- Flu-like symptoms
- Diarrhea, nausea, abdominal pain These can occur with both types of insulin but may be more or less common depending on the individual. Always consult a healthcare professional for advice tailored to your specific needs.
Are there any potential serious side effects for Levemir?
While both Levemir and Toujeo are effective in managing blood sugar levels, they can cause side effects that need immediate medical attention. These include:
- Hypoglycemia (low blood glucose) with symptoms such as dizziness, confusion, sweating, hunger, irritability or mood changes
- Signs of allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Skin thickening or pits at the injection site (lipodystrophy)
- Fluid retention causing swelling in the hands and feet
- Rapid weight gain
- Potassium level imbalances - muscle weakness or limp feeling; leg cramps; irregular heartbeats
- Low magnesium levels - dizziness and fast heart rate
If these symptoms occur after using either Levemir or Toujeo insulin drugs it is crucial to seek emergency help immediately. It's important to note that like all medication the effect varies from person to person so regular consultation with a healthcare professional is advised.
What are the most common side effects for Toujeo?
Toujeo, an insulin glargine, can exhibit the following side effects:
- Injection site reactions like redness or irritation
- Weight gain
- Mild itching or rash
- Low blood sugar (hypoglycemia) causing symptoms such as headache, dizziness, sweating and fast heartbeat
- Swelling in your hands or feet
- Shortness of breath.
Keep in mind that these are common side effects and may not occur to everyone. Always discuss with your healthcare provider about any concerns you have regarding medication side effects.
Are there any potential serious side effects for Toujeo?
Taking Toujeo, like any other drug, comes with potential side effects. It's important to know and recognize these symptoms:
- Signs of allergic reactions such as rash, itching or hives on the skin; shortness of breath, wheezing or difficulty breathing; swelling of the face, lips, tongue or other parts of the body.
- Swelling in your feet and ankles
- Rapid weight gain
- Unusual mood swings or behavioral changes
- Feelings of anxiety or depression
- Blurry vision
- Increased thirst and frequent urination - this could be a sign that your blood sugar is too high even while using Toujeo.
If you notice these signs after starting treatment with Toujeo, it’s crucial to seek medical help immediately.
Contraindications for Levemir and Toujeo?
Both Levemir and Toujeo, as well as most other insulin medications, may lead to hypoglycemia (low blood sugar) in some individuals. Should you notice symptoms such as dizziness, confusion, irritability or extreme hunger and sweating that could indicate a drop in your blood glucose level, reach out for immediate medical attention.
Neither Levemir nor Toujeo can be used if you are taking or have recently taken certain types of medication such as thiazolidinediones (TZDs). Always inform your healthcare provider about all the medicines you take; TZDs may need adjustment or discontinuation before initiating insulin therapy due to risk of heart failure.
Furthermore, there are potential interactions with drugs like beta-blockers, clonidine, guanethidine and reserpine which can either potentiate or weaken the effect of insulin. They can also hide signs of hypoglycemia which is potentially dangerous.
How much do Levemir and Toujeo cost?
For the brand name versions of these drugs:
- The price of a 10 mL vial of Levemir (100 units/mL) averages around $331, which works out to roughly $11–22/day, depending on your dose.
- The price of 1.5 mL pen of Toujeo (300 units/mL) is about $140, working out to approximately $4–12/day.
Thus, if you are in the higher dosage range for Levemir (i.e., 30 units/day or higher), then brand-name Toujeo could be less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which insulin medication is right for you.
Currently there are no generic versions available for either Levemir(insulin detemir) or Toujeo(insulin glargine). So it's important to discuss with your healthcare provider and look into any patient assistance programs or insurance coverages that may help offset these costs.
Popularity of Levemir and Toujeo
Insulin detemir, available under the brand name Levemir, was estimated to have been prescribed to about 2.1 million people in the US in 2020. It is a long-acting insulin used for maintaining baseline insulin levels and accounts for just over 10% of basal insulin prescriptions in the US. The use of Levemir has remained relatively steady since its approval by the FDA in 2005.
Insulin glargine U300, marketed as Toujeo, is another long-acting insulin but with an even longer duration of action than Levemir. In comparison to Levemir's approximately 24-hour effectiveness, Toujeo can maintain steady blood sugar levels for up to 36 hours. Though it was only approved by the FDA in 2015, it quickly gained popularity due to its less frequent dosing requirement and lower risk of nocturnal hypoglycemia; it was prescribed to around 900 thousand people in America during last year alone.
Conclusion
Levemir (insulin detemir) and Toujeo (insulin glargine) are both long-acting insulins used for the management of diabetes mellitus, with a well-established record of efficacy backed by numerous clinical studies. These medications can often be used in tandem with other antidiabetic agents to ensure optimal blood glucose control, although this should always be done under the guidance of a healthcare provider due to potential interactions.
Levemir and Toujeo have slightly different action profiles; Levemir has a relatively consistent duration of action over 24 hours but might need twice-daily injections in some people while Toujeo is designed to last up to 36 hours providing once-daily dosing convenience.
Both insulin products are available as brand-name drugs, which can represent significant costs especially for patients paying out-of-pocket. However, patient assistance programs may help offset these costs.
The side effect profile is similar between Levemir and Toujeo — they're generally well-tolerated but hypoglycemia (low blood sugar), weight gain and injection site reactions are common adverse effects seen with all types of insulin therapy. Patients must closely monitor their blood sugar levels, particularly when starting treatment or changing doses, and seek medical help immediately if they notice symptoms indicative of severe hypoglycemia such as confusion, blurred vision or loss of consciousness.
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Refrences
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- Keating, G. M. (2012, December). Insulin Detemir. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/11470200-000000000-00000
- Chapman, T. M., & Perry, C. M. (2005). Spotlight on Insulin Detemir in Type 1 and 2 Diabetes Mellitus1. BioDrugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00063030-200519010-00008
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- Meneghini, L., Kesavadev, J., Demissie, M., Nazeri, A., & Hollander, P. (2013, March 13). Once‐daily initiation of basal insulin as add‐on to metformin: a 26‐week, randomized, treat‐to‐target trial comparing insulin detemir with insulin glargine in patients with type 2 diabetes. Diabetes, Obesity and Metabolism. Wiley.http://doi.org/10.1111/dom.12083
- Funnell, M. M. (2007, September 25). Insulin detemir: A new option for the treatment of diabetes. Journal of the American Academy of Nurse Practitioners. Wiley.http://doi.org/10.1111/j.1745-7599.2007.00258.x