Ryzodeg

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Ryzodeg

Treatment option: Diabetes Mellitus

Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Ryzodeg

Quick Facts

Property Description
Active ingredients Insulin Degludec (70%), Insulin Aspart (30%)
Form Solution for injection (clear, colorless, aqueous)
Pharmacological class Antidiabetic, Combination Insulin Analogue (Fixed-Ratio)
General purpose To improve glycemic control and lower blood glucose levels
Origin Biosynthetic, produced via recombinant DNA technology

Ryzodeg: Definition and Classification as a Combination Insulin

Ryzodeg is a prescription-only medicine that functions as an antidiabetic agent and an advanced insulin analogue. It is recognized as a fixed-ratio combination product designed to support individuals managing diabetes mellitus. This unique medicine is supplied as a clear, colorless solution for injection, intended for subcutaneous administration.

Its key differentiating feature is its classification as a biphasic insulin, meaning it integrates two distinct metabolic actions into one dose. This approach is recognized for providing a comprehensive yet simplified strategy for controlling blood glucose levels.

Composition and Dual-Action Nature of Ryzodeg 70/30

The medicinal action of Ryzodeg stems from its two active ingredients: the long-acting basal component, Insulin Degludec, and the rapid-acting mealtime component, Insulin Aspart. Both insulin analogues are derived through recombinant DNA technology. The specific 70/30 ratio is central to the product’s identity, with the long-acting portion (Insulin Degludec) providing foundational coverage.

This strategic co-formulation ensures two distinct effects are delivered in a single dose. The Insulin Degludec component offers prolonged, continuous fasting plasma glucose control, while the Insulin Aspart component provides the immediate corrective action necessary for postprandial glucose control following food intake. The maintenance of these separate actions is supported by pharmacological studies, confirming the product’s stability.

Regulatory References

  1. EMA European Public Assessment Report (EPAR) for Ryzodeg

What side effects are possible with Ryzodeg?

Possible side effects and safety information

The official safety profile for Ryzodeg, a co-formulation of Insulin Degludec and Insulin Aspart, outlines adverse reactions and safety characteristics classified according to regulatory standards.

Frequency-Classified Adverse Reactions

The most frequent adverse reaction documented across all regulatory labeling for insulin products is hypoglycemia (low blood sugar), which is classified as Very Common

. Other adverse reactions have been classified based on their frequency in clinical studies:

  • Common (may affect up to 1 in 10 people): Injection site reactions (including pain, swelling, or redness), peripheral edema (swelling of the extremities), weight gain, pruritus (itching), rash, and general allergic reactions.
  • Uncommon (may affect up to 1 in 100 people): Lipodystrophy (changes in fat tissue at the injection site, such as lipohypertrophy or lipoatrophy).

Serious Adverse Reactions and Systemic Risks

The official labeling documents several clinically significant systemic risks that are primarily categorized under Immune System Disorders and Metabolism and Nutrition Disorders.

Serious Adverse Reactions highlighted in regulatory texts include severe hypoglycemia (a life-threatening event that can lead to unconsciousness), and severe generalized allergy, such as anaphylaxis. Other documented systemic risks include hypokalemia (low blood potassium), which is a risk associated with all insulin therapy, and the potential for fluid retention leading to or worsening cardiac failure when the product is used concomitantly with certain oral antidiabetic medicines, such as thiazolidinediones (TZDs).

Population and Duration-Related Safety Notes

Safety data indicate that increased glucose monitoring may be required for patients with renal impairment or hepatic impairment. The label also notes that young pediatric patients (2 to 5 years old) may have a potentially higher risk for severe hypoglycemia compared to older children and adults. To mitigate the risk of lipodystrophy associated with long-term use, regulatory documents specify that the injection site must be rotated within the same general area.

Overdose and Emergency Response

Overdose and when to seek help

An overdose of the Insulin Degludec/Insulin Aspart combination results primarily in hypoglycemia (low blood glucose), which is the principal adverse event documented in regulatory labeling. The severity of the overdose is directly related to the extent and duration of the blood glucose reduction.

Documented Manifestations and Severe Outcomes

Official prescribing information documents that clinical manifestations of overdose include neurological and metabolic symptoms such as confusion, drowsiness, slurred speech, and tremor. Untreated severe hypoglycemia can progress to life-threatening outcomes including seizures and loss of consciousness.

Regulators specify that untreated severe overdose carries the ultimate risk of brain damage or death.

Required Emergency Action

Patients or caregivers must seek emergency medical attention immediately upon suspicion of overdose or if severe symptoms are observed. This action is mandated by regulatory bodies in the official labeling. Due to the combined nature of the product, there is a risk of long-lasting or recurrent hypoglycemia, necessitating prolonged observation and supportive treatment in a medical setting, typically involving the administration of oral or intravenous glucose. No specific pharmacological antidote is known. Regulatory warnings also note increased risk of severe hypoglycemia in patients with renal or hepatic impairment.

Therapeutic Uses of Ryzodeg

Quick Facts

  • Type 1 Diabetes Mellitus: Used to support the management of blood sugar levels.
  • Type 2 Diabetes Mellitus: Used to support the management of blood sugar levels.

Main Uses and Benefits

Ryzodeg is an approved combination treatment option indicated for patients with diabetes mellitus. The primary goal of this medication is to help improve glycemic control, or the overall management of blood glucose levels, in both adults and pediatric patients aged 1 year and older with Type 1 or Type 2 diabetes.

The therapeutic approach aims to address high blood sugar by providing a two-part benefit. One component of the formulation works to provide a sustained background effect, helping to manage glucose between meals and overnight. The second component is designed to act more promptly, helping to control the blood sugar response that occurs after a meal.

As part of a comprehensive diabetes management plan, this medicine may help patients maintain their blood glucose within a target range. Consistent management of blood sugar is fundamental to reducing the risk of complications associated with diabetes.

Eligibility and Restrictions for Use

Eligibility Scope

Populations for whom use is contraindicated: Ryzodeg is contraindicated during episodes of hypoglycemia (low blood sugar) and in patients with known hypersensitivity to the medicine or its excipients.

Populations for whom use is not recommended: The medicine is not recommended for the treatment of diabetic ketoacidosis (DKA). Use is also not recommended for pediatric patients requiring less than 5 units daily (US label restriction).

Age-related eligibility rules: Population Eligibility Status
US Pediatric Indicated for patients 1 year of age and older.
EU Pediatric Indicated for patients from the age of 2 years.
Infants Safety and effectiveness are not established in children younger than 1 year.
Elderly Can be used in patients aged 65 years and older.

Condition-specific eligibility rules: Patients with renal impairment or hepatic impairment can use Ryzodeg, but intensified glucose monitoring is required. Use also requires special caution for children aged 2 to 5 years (EU/EMA label).

Pregnancy and lactation eligibility status: The official labeling notes a lack of clinical experience in pregnant women and nursing mothers; use is considered only if the potential benefit justifies the potential risk.


Connection to the Overall Eligibility Profile

Regulatory documents define eligibility by classifying populations into allowed, restricted, or prohibited use. The official profile strictly excludes individuals experiencing acute hypoglycemia and those with hypersensitivity, while mandating intensified monitoring for special populations such as those with organ impairment and the elderly. Age-based eligibility varies by region, setting a minimum threshold for pediatric use.

What should I know about interactions with other medicines?

The official regulatory profile for Ryzodeg (Insulin Degludec/Insulin Aspart) is defined primarily by pharmacodynamic interactions that directly affect the body's ability to control blood glucose levels. The regulatory labeling does not formally list any specific medicinal products as absolutely contraindicated for co-administration, nor is the product associated with clinically significant pharmacokinetic interactions involving CYP enzymes or drug transporters.

Substances that may Intensify the Glucose-Lowering Effect

Co-administration with certain medicinal products may increase the action of Ryzodeg, potentially raising the risk of low blood glucose. These products include other antidiabetic agents, monoamine oxidase inhibitors (MAOIs), ACE inhibitors, salicylates, and anabolic steroids. Beta-blockers may also intensify the effect while simultaneously masking the typical symptoms of low blood sugar.

Substances that may Reduce the Glucose-Lowering Effect

Certain drug classes may decrease the blood glucose-lowering action, which could lead to elevated blood glucose. These classes include glucocorticoids (corticosteroids), thyroid hormones, growth hormone, oral contraceptives, thiazides and loop diuretics, and sympathomimetics.

Alcohol and Substance Interactions

Consumption of alcohol is a documented substance interaction that may either potentiate or reduce the glucose-lowering effect of the insulin components. There are no mandatory timing separation rules documented for the co-administration of other medicinal products.

Mechanism of Action

How Ryzodeg Works

Ryzodeg operates through a dual-mechanism, with both components acting as agonists at the Insulin Receptor (IR) found on the surface of target cells in tissues such as muscle, fat, and the liver. This receptor binding initiates an intracellular signaling cascade that modulates the cellular machinery responsible for glucose uptake and utilization.


Sustained Basal Activity

The long-acting component, Insulin Degludec, forms soluble multi-hexamers following subcutaneous injection, establishing a stable depot. The subsequent slow, continuous dissociation of insulin monomers from this depot determines its prolonged duration of action. This consistent release profile engages pathways that establish a prolonged, consistent basal activity profile, critical for continuously suppressing hepatic glucose production and influencing metabolic activity during the inter-prandial state.


Rapid Pathway Modulation

The rapid-acting component, Insulin Aspart, quickly separates into active monomers, initiating a fast signaling sequence. This rapid receptor engagement provides quick adjustment of IR activity in contexts involving heightened pathway activation. It influences the dynamics of the pathway by immediately enhancing the rate of glucose uptake by peripheral tissues, increasing the rate of glucose disposal following nutrient intake.

Dosage and Administration Information

Administration Method

Ryzodeg is a solution for injection that is typically administered subcutaneously (under the skin). Common injection sites include the abdominal wall, the upper arm, or the thighs. It is recommended to rotate the injection site within the same body region for each administration to reduce the risk of changes to the skin tissue.

Formats and Delivery Systems

The medication is available in pre-filled pens or cartridges. These delivery systems are designed to allow the user to dial the required dose as determined by a healthcare provider.

Timing and Use

Ryzodeg is designed for administration with a main meal. It combines a long-acting basal insulin and a rapid-acting prandial insulin in a single formulation. The specific timing relative to meals and the frequency of administration are tailored to individual needs based on glucose monitoring and clinical assessment.

Handling and Storage

Before use, the solution should appear clear and colorless. If the solution is cloudy or contains particles, it should not be used.

  • Unopened units: Should be stored in a refrigerator.
  • In-use units: Can typically be kept at room temperature for a specific duration or refrigerated, away from direct heat and light.
  • Protection: The cap should be kept on the pen when not in use to protect the contents from light.

Individuals should ensure they have received proper training on how to operate the specific pen or delivery system before attempting an injection independently.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Ryzodeg

The research base for Ryzodeg (Insulin Degludec/Insulin Aspart) consists of studies that centered on comparisons with other established insulin regimens. The focus of this research is to understand the patterns observed when the fixed-ratio combination was used in different patient groups and for different types of diabetes.


Evidence Base for Adults with Type 2 Diabetes Mellitus

The majority of research used in the clinical evaluation of this medicine in adults with Type 2 Diabetes involves Randomized Controlled Trials (RCTs). These studies were used to compare the fixed-ratio combination against other treatment approaches, such as using basal insulin alone or other fixed-ratio insulin combinations. The research examined changes measured during the study period for biomarkers like Glycated Hemoglobin ( HbA1c) and Fasting Plasma Glucose (FPG).

Studies also monitored the rates of hypoglycemia (low blood sugar). Research describes patterns of change measured in HbA1c and glucose across the study groups, and some research highlights that differences in the frequency of nocturnal low blood sugar were measured when compared to certain established insulin combinations. Data for long-term outcomes remains insufficient, as the follow-up durations for the primary trials were limited.


Evidence in Pediatric and Other Special Populations

Specific research has been conducted in pediatric patients (children and adolescents) with Type 1 and Type 2 Diabetes, with studies evaluating populations as young as one year old. Studies observed responses in older adults (ge 65 years) primarily through pharmacokinetic research.

In pediatric trials, the main outcome monitored was the change in HbA1c. Regulatory reviews highlight that a higher frequency of severe hypoglycemia was observed in some studies in the 2 to 5 year age group compared to the comparator treatment. Research provides context, not individual predictions, and evidence quality was noted to vary across studies and age groups.


Key Limitations and Areas of Research Uncertainty

A primary limitation is the lack of extensive long-term outcomes data from controlled clinical trials, as most primary efficacy studies were designed to evaluate intermediate-term changes (six months to one year). Data regarding the long-term patterns of HbA1c and other functional outcomes are not fully established by controlled trials. The results apply only to the populations studied, meaning data for certain patient groups (such as those with advanced kidney disease) remain insufficient.

Frequently Asked Questions (FAQ)

Common questions about Ryzodeg (FAQ)


Q: How quickly does Ryzodeg start working after injection?

Ryzodeg is a combination product with a rapid-acting component, insulin aspart. According to official product information, it begins to act within 10 to 20 minutes after injection.


Q: How long does the effect of a single injection of Ryzodeg last?

The duration of effect is determined by its long-acting component, insulin degludec. Official product information states that the medicine keeps working for 24 hours or longer.


Q: Do you have to eat a meal right after taking Ryzodeg?

Ryzodeg should be administered once or twice daily along with the main meal(s). The timing of the injection is specified as being once or twice daily along with the main meal(s).


Q: What should be done if an injection site reaction occurs with Ryzodeg?

Injection site reactions, which can include pain, swelling, or redness, are common and often disappear within a few weeks of continued use. If reactions are serious or persistent, official guidance indicates that consulting a healthcare provider is appropriate, as a change in treatment may be required.


Q: Can Ryzodeg cause low blood sugar (hypoglycemia)?

Yes, like all insulin products, Ryzodeg can cause low blood sugar, which is also called hypoglycemia. This is the most frequent adverse reaction and is classified as Very Common in regulatory documents. Official patient information notes the signs of low blood sugar.


Q: Does Ryzodeg interact with blood pressure medications?

Official regulatory documents identify certain categories of medicines that can affect how Ryzodeg works. Specific types of blood pressure medications, such as beta-blockers and ACE inhibitors, may intensify the medicine's glucose-lowering effect, and co-administration may result in closer monitoring of glucose levels.


Q: Is it safe to drink alcohol while using Ryzodeg?

Alcohol consumption is a documented interaction that can either increase or decrease the glucose-lowering effect of insulin. Regulatory information states that alcohol consumption may increase the risk of low blood sugar, and that limiting intake or avoiding drinking on an empty stomach is advised.


Q: Are there any foods or drinks that should be avoided because of Ryzodeg?

No specific foods are listed as being restricted by the medicine, but alcohol consumption is a known interaction. Any significant change in diet may alter insulin needs and should be discussed with a healthcare provider.


Q: What does the research say about Ryzodeg and cardiovascular outcomes?

Regulatory reviews of the clinical trial data have examined the potential for cardiovascular risk. These reviews concluded that the data did not show an excess in major adverse cardiovascular events (MACE) compared to other approved long-acting insulin products.


Q: Are there official studies comparing the frequency of low blood sugar events with Ryzodeg?

Yes, clinical trials were conducted to compare Ryzodeg against other established insulin regimens. These studies monitored the rates of hypoglycemia (low blood sugar), and some research noted differences in the frequency of nocturnal low blood sugar when compared to certain established insulin combinations.


Q: Has Ryzodeg been studied in elderly patients?

Yes, regulatory documents indicate that the medicine's safety and response patterns have been observed in older adults (age 65 and older). These studies primarily focused on how the medicine is processed by the body, known as pharmacokinetic research.


Q: What is the official safety classification for Ryzodeg?

The safety profile is similar to other insulin products, with the primary risk being low blood sugar (hypoglycemia). Special monitoring or management is described as necessary for young pediatric patients and patients with renal (kidney) or hepatic (liver) impairment.


Q: Can Ryzodeg be used alongside non-insulin diabetes pills?

Yes, Ryzodeg may be used with some oral antidiabetic medicines, but co-administration with other medicines is determined based on individual patient circumstances. Official safety information specifies risks for certain combinations, such as the potential for fluid retention when used with thiazolidinediones (TZDs).


Q: What are the contraindications listed for Ryzodeg?

Ryzodeg is contraindicated if a patient has a known allergy or hypersensitivity to the active substances (insulin degludec or insulin aspart) or any of the inactive ingredients. It is also contraindicated if the patient is currently experiencing an episode of hypoglycemia.


Q: Is Ryzodeg the same as Tresiba, or is it different?

No, they are different medicines. Ryzodeg is a fixed-ratio combination of two active insulins: insulin degludec (long-acting) and insulin aspart (rapid-acting). Tresiba is a single-component product that contains only insulin degludec.


Q: What should I know about switching from another insulin to Ryzodeg?

Official protocols state that switching between different insulin regimens should be completed under medical supervision. This typically involves close blood glucose monitoring and individualized dose adjustments during and in the weeks following the transition to Ryzodeg.


Q: What non-prescription or herbal supplements might interact with Ryzodeg?

The use of certain vitamins, herbal supplements, and other non-prescription medicines may affect blood sugar control. Regulatory guidance emphasizes that patients should inform their healthcare provider about all products used.


Q: Can Ryzodeg affect vision?

Changes in vision are often listed as symptoms of both very high and very low blood sugar levels. Additionally, official documents state that a rapid improvement in blood sugar control when starting insulin can cause a temporary worsening of an existing condition called diabetic retinopathy.


Q: Is it normal to feel a stinging or burning sensation when injecting Ryzodeg?

Injection site reactions, including pain, swelling, or redness, are listed as common adverse reactions. If serious or continuing reactions occur, consulting a healthcare provider is noted as appropriate.


Q: What is the chemical name for the insulins found in Ryzodeg?

The active substances in the medicine are referred to by their non-proprietary names in official documents: insulin degludec (the long-acting component) and insulin aspart (the rapid-acting component).


Q: What are the official recommendations for monitoring while taking Ryzodeg?

Official monitoring recommendations include blood glucose monitoring, blood ketone, and Glycated Hemoglobin ( HbA1c) levels as clinically indicated. Intensified monitoring is described as necessary in certain patient populations.


Q: Does Ryzodeg have a long shelf life?

Official storage instructions define the in-use period for the medicine. Once the injection pen is opened and in use, it should be stored at room temperature and must be discarded after 28 days, even if there is still medicine remaining.


Q: Are there any restrictions on physical activity while using Ryzodeg?

No restrictions on physical activity are listed in regulatory documents. However, unplanned strenuous exercise may increase the risk of low blood sugar (hypoglycemia), and dose adjustments may be appropriate if a change occurs in the usual level of physical activity.


Q: What should a patient do if they accidentally inject too much Ryzodeg?

Accidental injection of too much Ryzodeg can lead to hypoglycemia (low blood sugar). Management focuses on treating low blood sugar by immediately consuming a quick source of sugar and seeking medical assistance for severe cases where consciousness is lost.


Q: Is it possible to be allergic to an ingredient in Ryzodeg?

Yes, official safety information indicates that Ryzodeg is contraindicated if a patient has an allergy or hypersensitivity to the active substances (insulin degludec or insulin aspart) or any of the inactive ingredients (excipients) in the pen.


Q: Does Ryzodeg require a prescription from a healthcare professional?

Official documents describe Ryzodeg as a prescription-only medication, indicating its use should be under the supervision of a licensed healthcare provider.

How should Ryzodeg be stored and disposed of?

Official Storage and Disposal Guidelines

Storage and disposal requirements for Ryzodeg (Insulin Degludec/Insulin Aspart injection) are strictly defined by regulatory documents to maintain product quality and ensure safety. Do not, under any circumstances, freeze Ryzodeg; discard the product if it has been frozen.

Storage Condition Requirement
Unopened Pens Store in a refrigerator (2 C to 8 C) in the original carton to protect from light.
Opened/In-Use Pens Store at room temperature (typically below 30 C) and discard after 28 days, regardless of remaining volume.
Handling Prohibition Do not share the pen, and do not dilute or mix the solution with other insulins. The solution must be clear and colorless.

For disposal, used needles must be placed in a designated puncture-resistant container. Expired or unused Ryzodeg must be handled according to local waste regulations, often requiring return to a pharmacy or an approved collection site. The medicine must be kept out of the sight and reach of children at all times.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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