Levemir® FlexTouch®

The Levemir® (LEV-uh-mere) FlexTouch® allows you to give your child insulin without having to get the medicine out of a vial with a separate syringe.

Levemir FlexTouch contains insulin detemir, also called Levemir, which is a long-acting insulin

• It is used to help patients with high blood sugar levels.
• It can provide blood sugar control for up to 24 hours.
• It is a clear, colorless liquid that is injected under the skin.

The Levemir FlexTouch is often called a Levemir FlexTouch pen, because it looks like a pen and can be carried in your pocket or purse.

The Levemir FlexTouch pen

The Levemir FlexTouch pen is a prefilled disposable device. It contains 300 units of U-100 Levemir. It uses a built-in spring mechanism to inject the insulin. The push button does not extend and requires a small amount of force to inject a dose. When your child’s dose is delivered, you should hear an audible click letting you know that the full dose has been received.

The pen can deliver doses from 1 to 80 units in a single injection. The large dose display shows the number of units you have selected to give as a dose.

Needles for the Levemir FlexTouch pen

You will receive needles made specifically for the Levemir FlexTouch pen. These are called NovoFine® needles.

• Common types of pen needles include standard pen needles and safety pen needles.
• Standard pen needles have an outer cover and a removable inner needle cover. You remove both before the injection.
• Safety pen needles have an outer cover that you remove and a fixed inner needle shield that you do not removed before the injection. This is meant to protect anyone handling the needle after the injection. It is commonly used in the hospital. If you were trained to give the injection with a safety needle, ask the doctor or nurse to train you on the proper use of the standard needles.

• With each new box of pen needles, check to see if they are the same type you were trained to use. If you are unsure, ask the doctor or nurse to show you how to use the needles. 
• Always use a new needle for each injection.
• Throw the needle away right after you give the injection.
• Do not store your Levemir FlexTouch pen with a needle attached.
• The medicine in your Levemir Flex Touch pen should be given using this device. Do not attempt to remove the medicine from the Levemir FlexTouch pen or transfer it from one Levemir FlexTouch pen to another.

How to store the Levemir FlexTouch pen

• Keep the Levemir FlexTouch pen you are currently using out of the refrigerator and at a temperature below 86°F.
• Store any unused Levemir FlexTouch pens in your refrigerator.
• Do not freeze a Levemir FlexTouch pen. Do not use the device if the Levemir has been frozen.
• Keep Levemir FlexTouch pen away from heat or light.
• The Levemir FlexTouch pen you are currently using should be thrown away 42 days after the first time it was used, even if it still has insulin left in it.
• An unused Levemir FlexTouch pen may be used until the expiration date printed on the label, if kept in the refrigerator.

Injection sites

The Levemir FlexTouch pen is used to give an injection (shot) of Levemir under the skin. This injection is given into the fatty areas of the body called injection sites.

The usual sites are:

• Stomach (abdomen)
• Upper thighs
• Back of upper arms

Rotate the injection sites each time so that the fat areas do not get irritated and scarred. Do not use the same site for each injection.

Getting ready

• Wash your hands with soap and water. Dry them well. Or, use an alcohol-based hand sanitizer.
• Check the Levemir FlexTouch pen label to make sure you are giving the right type of insulin. This is especially important if your child takes more than 1 type of insulin.
• Do not use the Levemir FlexTouch pen past the expiration date printed on the label or 42 days after the first time you used the pen.
• Always use a new needle for each injection to help ensure it is germ-free and to prevent clogged needles.
• Gather the following supplies:
  • Levemir FlexTouch pen
  • A new NovoFine needle
  • Alcohol swabs
  • Sharps container

Preparing the pen

• Pull the pen cap straight off.
• Check the liquid in the FlexTouch pen. Levemir should look clear and colorless. Do not use it if it looks cloudy or colored.
• Select a new needle. Pull off the paper tab from the outer needle cap.
• Push the capped needle straight onto the FlexTouch pen and twist the needle until it is tight.
• Pull off the outer needle cap.
• Pull off the inner needle cap if it can be removed and throw it away.

Air shots

• You should do an air shot before each injection, after the needle is attached.
• Performing an air shot helps you check that the insulin flow is good before you select and inject the dose. This way you can make sure that the full dose is received.

To do an air shot:

• Turn the dose selector to 2 units.

• Hold the FlexTouch pen with the needle pointing up. Tap the top of the FlexTouch pen gently a few times to let any air bubbles rise to the top.
• While still holding the FlexTouch pen with the needle pointing up, press and hold the dose button until the dose counter shows “0”. The “0” must line up with the dose pointer.

• A drop of insulin should be seen at the needle tip.
  • If you do not see a drop of insulin, repeat the air shot instructions. Do this no more than 6 times.
  • If you still do not see a drop of insulin, change the needle and then repeat the air shot instructions.

Selecting your child’s dose

Turn the dose selector to select the number of units you need to inject. The dose pointer should line up with your child’s dose.

If you select the wrong dose, you can turn the dose selector forward or backward to correct the dose.

• The even numbers are printed on the dial.
• The odd numbers are shown as lines.

Giving the injection

• Wipe the chosen injection site with an alcohol swab for 30 seconds.
• Let the area dry for 30 seconds. Do not blow on, blot, or wipe the area.
• Wrap your fingers around the FlexTouch pen with your thumb above the dose button.
  • Do not press the dose button before inserting the needle into the skin.
  • Make sure you can see the dose counter. Do not cover it with your fingers; this can stop the injection.
• Insert the needle into the skin.
• Press and hold down the dose button until the counter shows “0”. The “0” must line up with the dose pointer. You may then hear or feel a click.

• Keep the needle in your child’s skin after the dose counter has returned to “0” and slowly count to 6. 
  • When the dose counter returns to “0,” your child will not get the full dose until 6 seconds later.
  • If the needle is removed before you count to 6, you may see a stream of insulin coming from the needle tip and your child will not get the full dose.
  • If this happens, you should check your child’s blood sugar level more often because more insulin may be needed.
• Pull the needle out of your child’s skin.
  • If you see blood after you take the needle out of the skin, press the injection site lightly with a piece of gauze or an alcohol swab. Do not rub the area.
• Carefully remove the needle from the FlexTouch pen, and throw the needle away in a sharps container.
• Do not recap the needle.
• Replace the pen cap by pushing it straight on.

Check how much insulin is left in the pen

• To check how much insulin is left in the pen, use the dose counter. Turn the dose selector until it stops. The dose counter will line up with the number of units of insulin that are left.
  • If the dose counter shows 80, there are at least 80 units left.
  • If the dose counter shows less than 80, the number shown in the dose counter is the number of units left.

Possible side effects

Early side effects may include:

• Itching or rash at the injection site.
• Skin thickening or pits at the injection site 
• Allergic reactions

Later side effects may include:

• Low blood sugar (hypoglycemia)
• Skin rash, itching
• Weight gain

These are the most common side effects, but there may be others. Please report all side effects to the doctor or nurse. In case of a severe side effect or reaction, call your doctor, nurse, or pharmacist at 901-595-3300. If you are outside the Memphis area, dial toll-free 1-866-278-5833, and press 0 once the call is connected.

Special instructions

• Know the type and strength of insulin. Do not change the insulin type unless your child’s doctor tells you to do so.
• Do not share needles, insulin pens, or syringes.
• Check your needles to make sure they are the same needles you were trained to use. If they are not, ask the doctor or nurse to show you how to properly use your needles.
• While taking Levemir insulin, tell the doctor right away if your child has any of these symptoms:
  • Trouble breathing
  • Shortness of breath
  • Fast heartbeat
  • Swelling of the face, tongue, or throat
  • Sweating
  • Feeling very drowsy
  • Feeling dizzy or confused

Low blood sugar

Know the signs of low blood sugar. Young children may not understand the signs of low blood sugar.

If your child has any of these signs, check the blood sugar right away.

If the blood sugar is less than 70 mg/dL, give your child a quick source of sugar. Always carry some type of quick sugar source with you.

Check your child’s blood sugar 15 minutes after treating the low blood sugar. If the blood sugar is less than 70mg/dL the second time, treat again and call your child’s doctor. Once the blood sugar is above 70mg/dL, your child needs to eat a snack containing protein.

Quick sources of sugar to treat low blood sugar include:

• Glucose tablets
• Juice
• Regular soda (not sugar-free)
• Raisins
• Saltine crackers
• Sugar or corn syrup
• Cake frosting

Do not use chocolate, cookies or cake to treat low blood sugar. These foods have lots of sugar but are high in fat, which makes them slower at boosting your child’s blood sugar.

Contact the doctor right away or go to the hospital in these cases:

• Low blood sugar happens again
• You cannot fix low blood sugar
• Your child has a seizure
• Your child passes out
• Your child is not feeling better in 2–3 days or is feeling worse
   

Learn how to check your blood sugar

Questions?

If you have questions or concerns, please call 901-595-3300 and ask for your child’s primary clinic. If you are calling after hours or on the weekend, ask for the nursing coordinator. If you are outside the Memphis area, dial toll-free 1-866-278-5833.