08/23 Eddie AMPS 439 +2.5 437 PMPS 344 +2.5 355

Jodey&Eddie&Blue

Member Since 2021
Sorry, I thought you were interested in the biosimilar to Lantus, which is what this thread is about. Levemir is completely different and does not sting. And there are no Levemir biosimilars that I have heard of.
Well, I was initially interested in the biosimilar to Lantus but it turns out not to really be relevant. The second part of the thought was that if this issue we discussing is the sting, then perhaps I can get the vet to prescribe Levemir, since it doesn't sting. But then I heard too that in spite of being a depot insulin it doesn't last as long as Lantus? Is this true?
 
This discussion would probably be better in Eddie's condo, as it's wandered off the topic of cheaper Lantus biosimilar.

But then I heard too that in spite of being a depot insulin it doesn't last as long as Lantus? Is this true?
Where did you hear that? So not true, Lev in fact in can have better duration. You did know that you don't need a prescription for Levemir in BC?
 
This discussion would probably be better in Eddie's condo, as it's wandered off the topic of cheaper Lantus biosimilar.


Where did you hear that? So not true, Lev in fact in can have better duration. You did know that you don't need a prescription for Levemir in BC?
I did not know that a prescription for Levemir is not required in BC. Why not? Or why is a prescription for Lantus required but not Levemir??
Ok, this can continue in Eddie's condo but can you remind me of the dose ratio when switching from Lantus to Levemir. Thanks, Wendy.
 
A prescription is not needed for Lantus for cats either. ;) To answer the dose switch question again, see post #19 in this thread.
Well, that's interesting. Why on earth am I calling in to renew prescriptions? I wonder if it costs the same with or without a prescription. Thanks, too, for directing me to post #19.
 
A prescription is not needed for Lantus for cats either. ;) To answer the dose switch question again, see post #19 in this thread.
One more thing, here, Wendy: given the sting, I am thinking maybe Levemir would make Eddie's breakfast/dinner shot time less stressful for him. But I'm concerned with the 70% reduction but would/could of course monitor and adjust. Do you think it would be worth switching from Lantus to Levemir? Are there any other downsides?
 
What do you think TR would have you do?
That's a good question. Thank you.
On the one hand, I don't see there would be any downside to using Levemir. The upside is no sting and, as you've said before, Levemir's depot may last longer than that of Lantus, another good reason to switch. I'm also thinking that a change might be something that Eddie needs as he seems to becoming entrenched in the 15-15.5-16 regime. I'm also just intuiting (or maybe it's hoping) that a change is as good as a rest.
 
Sorry, to make a bit of a jumble of the sequencing, but the post on the acro forum was getting very specific to Eddie and the content on Lantus vs Levemir is appropriate here.
given the sting, I am thinking maybe Levemir would make Eddie's breakfast/dinner shot time less stressful for him. But I'm concerned with the 70% reduction but would/could of course monitor and adjust. Do you think it would be worth switching from Lantus to Levemir? Are there any other downsides?
The 70% reduction is temporary. The reason we do it is that some cats have very strong reactions to the switch. I'd be especially concerned in a cat with IAA cause the new insulin can trick the antibodies at the start. If we find the dose is too low right away, we can fast track it back. Typically the Lantus and Levemir doses end up being relative close to each other, though not necessarily equal.

The only downsides to Levemir for you, might be the later onset and nadir. Typical onset is +4 (can be 3-5) and typical nadir is around +8. But of course can be earlier or later. You have to figure out how that works for your schedule and whether you can make it work. Both Neko and I loved the new schedule. The later nadir meant she could get snacks up to around +9 without impacting duration. For me, I get up around +9 4 days a week for a workout, so it was easy to add a "nadirish" test into the mix. Neko also nadired more in the +9 to +12 range on Lev.
 
Sorry, to make a bit of a jumble of the sequencing, but the post on the acro forum was getting very specific to Eddie and the content on Lantus vs Levemir is appropriate here.

The 70% reduction is temporary. The reason we do it is that some cats have very strong reactions to the switch. I'd be especially concerned in a cat with IAA cause the new insulin can trick the antibodies at the start. If we find the dose is too low right away, we can fast track it back. Typically the Lantus and Levemir doses end up being relative close to each other, though not necessarily equal.

The only downsides to Levemir for you, might be the later onset and nadir. Typical onset is +4 (can be 3-5) and typical nadir is around +8. But of course can be earlier or later. You have to figure out how that works for your schedule and whether you can make it work. Both Neko and I loved the new schedule. The later nadir meant she could get snacks up to around +9 without impacting duration. For me, I get up around +9 4 days a week for a workout, so it was easy to add a "nadirish" test into the mix. Neko also nadired more in the +9 to +12 range on Lev.

Hmm, so the reduction phase is cautionary and somewhat flexible in a return to original dose. When you say in a cat with IAA the new insulin can "trick the antibodies" at the start, do you mean trick the antibodies into being confused and possibly more receptive to insulin? Might this be a good thing?

I'm thinking the downside of shifting onset might be better or might be tricky. I typically test at +2.5 or even +3 so, if I give insulin @ 8:00 pm, then instead of 10:30 or 11:00, we're looking at midnight? I wouldn't mind the +9 because I've been setting alarm +5 or +6, which for me is 1:00 or 2:00 am. A +9 would, theoretically, at 3:00 am, allow me to get better sleep. Does this make sense? I typically get up at +10 or latest +11 (workout is later in the day) so a 3:00am nadir is far better than at 1:30 or 2:00.

How does this sound? I'm asking because I don't want to assume anything nor do i want to miss anything by virtue of not knowing...

Eddie is going to need a new pack of insulin (on the last cartridge) and I've already called the pharmacy and they have Levemir cartridges. They assured me no prescription necessary. Good to know. I emailed the IM vet asking if he would support this and he hasn't answered, not that it actually matters. I just want him on board...
 
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