Request for inclusion in the Primary Care Bulletin: Urgent Levemir® Discontinuation Update: Accelerate Patient Switching

Urgent Patient Safety Action: Levemir® (Insulin Detemir) Discontinuation – Immediate Action Required Across North East London

Levemir® (insulin detemir) must no longer be prescribed. Any patient who remains prescribed Levemir® is at risk of treatment interruption if alternative insulin arrangements are not made urgently.

Failure to switch patients before supplies become unavailable may result in:

• Patients being unable to obtain their insulin.
• Missed insulin doses.
• Loss of glycaemic control.
• Emergency admission due to hyperglycaemia or diabetic ketoacidosis (DKA).
• Avoidable patient harm arising from treatment interruption.

Every Levemir® prescription issued today increases the risk of patients remaining dependent on a product with diminishing availability. Prompt action is required to ensure patients are switched safely and in a timely manner.

Immediate Action Required from GP Practices and Primary Care Networks

1. Identify All Patients Prescribed Levemir®

Run an urgent search of your clinical system or use Eclipse Live and establish a practice-level action list of all patients currently prescribed Levemir®.

2. Prioritise Clinical Review

Ensure all patients are reviewed by a clinician competent in insulin management and have an agreed plan to switch to an appropriate alternative basal insulin. Practices can also get specialist advice from Advice and Guidance (A&G) to support with switching.

3. Accelerate Patient Switching

Do not wait for stock shortages to occur. Practices should complete switching activity as a matter of priority and well ahead of national supply exhaustion.

4. Monitor Progress Weekly

Practices should actively monitor:

• Number of patients remaining on Levemir®.
• Number of patients switched.
• Outstanding reviews requiring action.

5. Escalate Complex Cases Without Delay

Patients requiring specialist diabetes support should be referred promptly to avoid delays in switching.

Practices Should Not:

• Initiate any new patients on Levemir®.
• Continue issuing repeat prescriptions without an active switching plan.
• Assume supplies will remain available until December 2026.

Immediate Action Required from Community Pharmacies

Every Levemir® Prescription Represents an Opportunity to Prevent Harm

Community pharmacy teams play a vital role in identifying patients who remain on Levemir® and helping to prevent disruption to treatment.

1. Identify Patients Still Receiving Levemir®

Review dispensing activity and actively flag patients who continue to receive Levemir®.

2. Contact the Prescriber

Where a patient remains on Levemir®, contact the GP practice and seek confirmation that a switching plan is in place.

3. Reinforce Key Messages with Patients

Advise patients that:

• Levemir® is being discontinued.
• Alternative insulin treatment will be required.
• They should not wait until supplies become difficult to obtain before contacting their GP practice or diabetes team.

4. Escalate Supply Concerns Urgently

Any patient at risk of running out of insulin or experiencing difficulty obtaining supplies should be escalated immediately to the prescriber.

Resources to support switching

• National clinical guidance
• NEL Levemir Guidance Note
• SPS safety considerations when switching insulin
• SPS Medicines Supply Tool

Practices and community pharmacies are asked to treat this work as an immediate priority.