Ryzodeg dose
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Here is a consolidated summary of Ryzodeg dosing and pharmacokinetics from the textbooks:
Ryzodeg (Insulin Degludec/Aspart, IDegAsp) 70/30
Composition: 70% insulin degludec (basal) + 30% insulin aspart (rapid-acting bolus), U-100
Pharmacokinetics
| Parameter | Value |
|---|---|
| Onset | 10–15 min (some sources: 0.1–0.25 hr) |
| Peak (aspart component) | ~72 min (2–3 hr range reported) |
| Duration | >24–42 hr (governed by the degludec component; terminal half-life ~25 hr) |
| Steady state | Reached on day 3 of treatment |
The duration of action is dose-dependent (higher doses = longer action) — a property of degludec.
Dosing
Ryzodeg is a premixed insulin used for both basal and prandial coverage in a single injection. General principles for premixed insulin dosing apply:
- Typical use: Injected once or twice daily with the main meal(s)
- Starting dose (insulin-naive type 2 DM): ~0.1–0.2 units/kg/day, titrated to fasting and postprandial glucose targets
- Switching from basal insulin: Use the same total daily dose (unit-for-unit), then titrate
- Administration: Subcutaneous injection only; given immediately before a meal
Key Clinical Points
- The degludec component provides flat, long-lasting basal coverage (>24 hr, no pronounced peak)
- The aspart component provides rapid prandial coverage (onset ~10 min, peak ~1–2 hr)
- Because degludec accumulates to steady state by day 3, dose adjustments should not be made more frequently than every 3 days
- Not interchangeable unit-for-unit with other premixed insulins (e.g., 70/30 NPH/Regular) due to its prolonged basal component
Sources:
- Tintinalli's Emergency Medicine, Table 223-3
- Textbook of Family Medicine 9e, Table 34-22
- Katzung's Basic and Clinical Pharmacology, 16th Ed.
- Fuster and Hurst's The Heart, 15th Ed., Table 7-5
Note: Specific titration protocols (e.g., BEGIN trials algorithm: adjust by 2 units every 3 days to reach fasting glucose target of 4–5 mmol/L) are from manufacturer guidance and clinical trial data. Always refer to current prescribing information for exact titration.
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