Ryzodeg

This is a soluble insulin product consisting of the basal insulin degludec and the rapid-acting prandial insulin aspart. This is to be dosed in accordance with the individual patient's needs. Dose-adjustments are recommended to be primarily based on fasting plasma glucose measurements. Patients with type 2 diabetes mellitus : The recommended total daily starting dose is 10 units with meal(s) followed by individual dosage adjustments. Patients with type 1 diabetes mellitus : The recommended starting dose is 60-70% of the total daily insulin requirements. This is to be used once-daily at meal-time in combination.

Insulin degludec and insulin aspart binds specifically to the human insulin receptor and results in the same pharmacological effects as human insulin. The blood glucose-lowering effect of insulin is due to the facilitated uptake of glucose following the binding of insulin to receptors on muscle and fat cells and to the simultaneous inhibition of glucose output from the liver.

Hypoglycemia, allergic reactions, injection site reactions, lipodystrophy, pruritus, rash, edema and weight gain

Hypersensitivity to the active substances or to any of the excipients.

Hypoglycaemia: Omission of a meal or unplanned strenuous physical exercise may lead to hypoglycaemia. Hypoglycaemia may occur if the insulin dose is too high in relation to the insulin requirement. Concomitant illness, especially infections and fever, usually increases the patient's insulin requirement. Concomitant diseases in the kidney, liver or diseases affecting the adrenal, pituitary or thyroid gland may require changes in the insulin dose. Hyperglycaemia: Administration of rapid-acting insulin is recommended in situations with severe hyperglycaemia. Inadequate dosing and/or discontinuation of treatment in patients requiring insulin may lead to hyperglycaemia and potentially to diabetic ketoacidosis. Furthermore, concomitant illness, especially infections, may lead to hyperglycaemia and thereby cause an increased insulin requirement. Eye disorder: Intensification of insulin therapy with abrupt improvement in glycaemic control may be associated with temporary worsening of diabetic retinopathy, while long-term improved glycaemic control decreases the risk of progression of diabetic retinopathy. Avoidance of accidental mix-ups: Patients must be instructed to always check the insulin label before each injection to avoid accidental mix-ups between this and other insulin products. Older patients (> 65 years old): Insulin Degludec & Insulin Aspart Premixed can be used in older patients. Glucose-monitoring is to be intensified and the insulin dose adjusted on an individual basis. Paediatric population: This Insulin has been administered to children and adolescents up to 18 years of age for the investigation of pharmacokinetic properties. Safety and efficacy have not been investigated in children and adolescents.

There are no known drug interactions and none well documented.