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Drug overview & main differences | Conditions treated | Efficacy | Insurance coverage and cost comparison | Side effects | Drug interactions | Warnings | FAQ
The 2020 National Diabetes Statistics Report states that 10.5% of people in the U.S. have diabetes, and the number increases with age. Almost 27% of people age 65 and over have diabetes. If you or a loved one has diabetes, you may have heard of the various types of insulins.
Levemir and Lantus are two brand-name insulin medications used in the treatment of diabetes in adults and children. Both drugs are approved by the United States Food and Drug Administration (FDA). Novo Nordisk makes Levemir, and Sanofi makes Lantus. Both are classified as long-acting insulins. Although Levemir and Lantus are both long-acting insulins, they have some differences, which we will outline below.
What are the main differences between Levemir and Lantus?
Levemir and Lantus are both long-acting insulin injections. They are both available in brand name only, as a 10 ml vial or a pen injector.
Levemir contains insulin detemir and is injected once daily (with dinner or at bedtime), or twice daily.
Lantus contains insulin glargine and is injected as one daily dose at the same time each day.
| Main differences between Levemir and Lantus | ||
|---|---|---|
| Levemir | Lantus | |
| Drug class | Long-acting insulin | Long-acting insulin |
| Brand/generic status | Brand | Brand |
| What is the generic name? | Insulin detemir | Insulin glargine |
| What form(s) does the drug come in? | Injection (vial and prefilled Levemir Flextouch pen) | Injection (vial and prefilled Lantus Solostar pen) |
| What is the standard dosage? | Varies based on metabolic needs, blood glucose monitoring results, and glycemic control goal. Injected subcutaneously (under the skin) once daily with the evening meal or at bedtime, or twice daily | Varies based on metabolic needs, blood glucose monitoring results, and glycemic control goal. Injected subcutaneously (under the skin) once daily at the same time every day |
| How long is the typical treatment? | Long-term | Long-term |
| Who typically uses the medication? | Adults and children | Adults and children |
Conditions treated by Levemir and Lantus
Levemir and Lantus are used to improve blood sugar control in adults (with Type 1 or Type 2 diabetes mellitus) and children (with Type 1 diabetes). Levemir and Lantus are also known as basal insulin. Basal insulin keeps your blood sugar level consistent while fasting, such as when you are sleeping.
Levemir and Lantus should not be used to treat diabetic ketoacidosis.
| Condition | Levemir | Lantus |
| Improves glycemic control in adults and children with diabetes mellitus | Yes | Yes |
Is Levemir or Lantus more effective?
One study showed that patients might need a higher dose of Levemir to achieve control of blood glucose. Some patients need a second dose of Levemir if the effects wear off after about 12 hours. Lantus tends to last longer than Levemir. This data does not show that one is more effective than the other, but it tells more about dosing and duration of action.
A review of studies concluded that Levemir and Lantus are similar in terms of safety and efficacy. Patient preference and adherence determine the selection of the best product.
The best drug for you can only be determined by your healthcare provider, who can take into account your medical conditions and history as well as any medications you take that may interact with Levemir or Lantus.
Coverage and cost comparison of Levemir vs. Lantus
Levemir and Lantus are typically covered by insurance, but not Medicare Part D. However, as plans may vary, check with your plan for more coverage information.
One Levemir Flexpen costs about $129 out of pocket and one vial of Levemir costs $397 without insurance. You can use a free SingleCare card to bring the price of Levemir Flexpens down to less than $93 or reduce the cost of Levemir to $235.
A vial of Lantus costs approximately $413 out of pocket. A free Lantus coupon from SingleCare can bring the price down to less than $305.
| Levemir | Lantus | |
| Typically covered by insurance? | Yes | Yes |
| Typically covered by Medicare Part D? | No | No |
| Standard dosage | 1 vial | 1 vial |
| Cost without insurance | $397 | $413 |
| Lowest SingleCare cost | $235 | $115 |
Prescription drug prices often change. These are the most accurate medication prices at the time of publishing.
Common side effects of Levemir vs. Lantus
The most common side effect of both Levemir and Lantus is hypoglycemia (low blood sugar). The frequency varies based on individual patient factors.
Levemir’s other common side effects include upper respiratory tract infection, headache, sore throat, fever, back pain, peripheral edema (swelling in the arm or leg), and cough.
Other common adverse effects of Lantus are upper respiratory tract infection, headache, eye problems, swelling of the arms and legs, high blood pressure, and pain.
Additional side effects may occur. Contact your healthcare provider for medical advice regarding side effects.
| Levemir | Lantus | |||
| Side effect | Applicable? | Frequency | Applicable? | Frequency |
| Hypoglycemia | Yes | Varies | Yes | Varies |
| Upper respiratory tract infection | Yes | 26.1% | Yes | 22.4% |
| Headache | Yes | 22.6% | Yes | 5.5% |
| Peripheral edema | Yes | Varies | Yes | 20% |
| Sore throat | Yes | 9.5% | Yes | 7.5% |
| Hypertension | No | – | Yes | 19.6% |
| Retinal vascular disorder | No | – | Yes | 5.8% |
| Cataract | No | – | Yes | 18.1% |
| Accidental injury | No | – | Yes | 5.7% |
| Abdominal pain | Yes | 6% | No | – |
| Back pain | Yes | 8.1% | Yes | 12.8% |
| Cough | Yes | 8.2% | Yes | 12.1% |
| Fever | Yes | 10.3% | No | – |
| Nausea | Yes | 6.5% | No | – |
| Vomiting | Yes | 6.5% | No | – |
Source: DailyMed (Levemir), DailyMed (Lantus)
Drug interactions of Levemir vs. Lantus
Certain drugs can increase the risk of low blood sugar when taken with Levemir or Lantus. Other medications can interfere with the blood glucose-lowering effect of Levemir or Lantus. If these drugs are given together, the dosage may need adjustment, and blood sugar should be monitored more frequently.
Other drug interactions may occur. Consult your healthcare provider for a full list of drug interactions.
| Drug | Drug class | Levemir | Lantus |
| ACE inhibitors Angiotensin receptor blockers (ARBs) Antidiabetic medicines (oral such as metformin, or injected) Disopyramide Fibrates Fluoxetine Monoamine oxidase inhibitors (MAOIs) Sulfonamide antibiotics |
Drugs that increase the risk of low blood sugar | Yes | Yes |
| Albuterol Atypical antipsychotics Corticosteroids Diuretics Estrogen Glucagon Niacin Oral contraceptives Protease inhibitors Thyroid hormones |
Drugs that decrease the blood glucose-lowering effect of Levemir or Lantus | ||
| Alcohol Beta-blockers Clonidine Lithium |
Drugs that increase or decrease the blood glucose-lowering effect of Levemir or Lantus | ||
| Beta-blockers Clonidine Guanethidine Reserpine |
Drugs that may mask symptoms of low blood sugar | Yes | Yes |
| Pioglitazone Rosiglitazone |
Thiazolidinediones | Yes | Yes |
Warnings of Levemir and Lantus
- Do not use Levemir or Lantus when hypoglycemic.
- Do not use Levemir or Lantus if you have had an allergic reaction to the ingredients.
- Never share a pen (even if the needle is changed), needle, or syringe with anyone else. Sharing supplies increases the risk of transmitting disease.
- Changes in the insulin regimen may cause hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar). Closely monitor blood glucose levels with any changes in the insulin regimen.
- Weight gain may occur with insulin therapy.
- Injection site reactions may occur. These reactions may include local redness, pain, itching, hives, and swelling.
- Do not inject Levemir or Lantus intravenously (into the vein) or via an insulin pump.
- Low blood sugar is the most common side effect of insulin. Low blood sugar may come on suddenly and can impair concentration and reaction, which can affect driving. Severe low blood sugar can cause seizures. It can even be life-threatening or cause death. Do not use Levemir or Lantus during a hypoglycemic episode.
- Mix-ups between insulin products have occurred, which can cause low blood sugar. Double-check the insulin label before each injection.
- Severe, life-threatening allergy or anaphylaxis can occur. If a hypersensitivity reaction occurs, stop using Levemir or Lantus and seek medical treatment.
- Insulin can cause low potassium levels. If untreated, heart problems or death could occur.
- Thiazolidinedione medications can cause fluid retention, especially when taken with insulin. This can cause or worsen heart failure if this combination of medicines is taken together; monitor for signs of heart failure.
Frequently asked questions about Levemir vs. Lantus
What is Levemir?
Levemir is a long-acting insulin that improves blood sugar control in adults and children with diabetes. It contains the ingredient insulin detemir.
What is Lantus?
Lantus is a long-acting insulin that contains the ingredient insulin glargine. Lantus improves blood sugar control in adults and children with diabetes.
Are Levemir and Lantus the same?
Both medications are long-acting insulins that are injected under the skin (subcutaneously). However, they do have some differences, which are outlined above.
Is Levemir or Lantus better?
A review of clinical trials concluded that Levemir and Lantus are similar in terms of safety and efficacy. Your healthcare provider can determine if Levemir or Lantus is better for you, based on your individual medical conditions and history.
Can I use Levemir or Lantus while pregnant?
Tell your healthcare provider if you are pregnant or planning to become pregnant. There is a risk to the mother and baby if diabetes is poorly controlled during pregnancy. Levemir and Lantus have not been associated with congenital disabilities, miscarriage, or any adverse effects on the mother or baby. However, the studies have been small and did not study a lot of people. Your healthcare provider will decide if you need insulin during pregnancy, and if so, which insulin is most appropriate.
Can I use Levemir or Lantus with alcohol?
Although Levemir and Lantus’s manufacturer information does not list specific alcohol interactions, people who take Levemir or Lantus should avoid alcohol. If your blood sugar is well controlled and you don’t have any other conditions, you may be able to enjoy some alcohol in moderation. However, too much alcohol can cause low blood sugar, which can be dangerous. Check with your healthcare provider about drinking alcohol with Levemir or Lantus.
What insulin can replace Lantus?
Basaglar Kwikpen and Toujeo SoloStar both contain insulin glargine, like Lantus. Toujeo comes in a higher dosage. Regardless of the ingredient, only your healthcare provider can decide which product is right for you. If you are having problems with Lantus, contact your healthcare provider about an alternative.
What is the best time of day to take Levemir?
If you take Levemir once a day, the best time is at bedtime or with the evening meal. If you take Levemir twice a day, the best time to take it is in the morning and then 12 hours later.
Where is the best place to inject Levemir?
Inject Levemir subcutaneously (under the skin) at one of the following injection sites: the thigh, upper arm, or abdomen. Use a new needle with each injection.
Why is Levemir so expensive?
Insulin, like Levemir, is costly. Insulin is classified as a biologic, which is a complex molecule made from living cells. Some insulin products are “preferred” and cost less on your plan. Your healthcare provider can determine if there is an appropriate alternative for you.
