Thread: Levemir in Dogs
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Old 06-11-2009, 11:46 AM
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What's said when you talk about Lantus vs Levemir is that Levemir has more consistency in both the same patient and from patient to patient than Lantus does.

There's also the way each one does its job. Lantus forms crystals under the skin and after that, they absorb very similarly to the way the rest of the suspended insulins do--by the crystals being absorbed gradually. Levemir's action is to bind to the albumin in the blood to produce its effect, so there's nothing to "break down", if you will, as in Lantus and the suspended insulins.

With Levemir, there's no waiting for any crystals, whether they're in the vial and injected or are formed under it after injection by the reaction between Lantus and the pH of the skin. Levemir's "suspension" takes place in the bloodstream, with the binding to the albumin in the blood.

Some people put the knock on Levemir because it's approved for being used once or twice a day, depending on the patient's needs. Lantus is approved for once daily use. But when you talk with people who use Lantus, it becomes clear that many of them didn't work out with once daily dosing; they're on twice daily split dosing, which would be considered "off label" (nothing wrong about using a drug off label). Have a friend who has been using it twice a day for a long time--once daily didn't work for her.

The big "sell" on Lantus from Sanofi-Aventis has always been once daily dosing. The big "sell" on Ultralente insulin was always that it was once daily dosing. That more often than not didn't work out for the people using it, and they needed to use it twice daily. Both Novo and Lily discontinued their Ultralente insulins in the period between 2003-2005 because neither of them were selling enough of it to keep up production.

I'd believe the Levemir onset is because of its action.