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insulin aspart and insulin degludec

Generic Name: insulin aspart and insulin degludec (IN su lin AS part and IN su lin de GLOO dek)
Brand Name: Ryzodeg 70/30 FlexTouch

What is insulin aspart and insulin degludec?

Insulin is a hormone that works by lowering levels of glucose (sugar) in the blood. Insulin aspart is a fast-acting insulin. Insulin degludec is a long-acting insulin. This combination insulin starts to work within 10 to 20 minutes after injection, peaks in about 1 hour, and keeps working for 24 hours or longer.

Insulin aspart and insulin degludec is a combination medicine used to improve blood sugar control in adults with diabetes mellitus. This medicine may be used for type 1 or type 2 diabetes.

Insulin aspart and insulin degludec may also be used for purposes not listed in this medication guide.

What is the most important information I should know about insulin aspart and insulin degludec?

Never share an injection pen with another person, even if the needle has been changed.

What should I discuss with my healthcare provider before using insulin aspart and insulin degludec?

You should not use this medicine if you are allergic to insulin aspart or insulin degludec, or if you are having an episode of hypoglycemia (low blood sugar).

Insulin aspart and insulin degludec is not approved for use by anyone younger than 18 years old.

To make sure this medicine is safe for you, tell your doctor if you have:

  • liver or kidney disease;

  • low levels of potassium in your blood (hypokalemia); or

  • diabetic ketoacidosis (call your doctor for treatment).

Tell your doctor if you also take pioglitazone or rosiglitazone (sometimes contained in combinations with glimepiride or metformin). Taking certain oral diabetes medicines while you are using insulin may increase your risk of serious heart problems.

Follow your doctor's instructions about using insulin if you are pregnant. Blood sugar control is very important during pregnancy, and your dose needs may be different during each trimester of pregnancy.

Ask your doctor about using insulin if you are breast-feeding a baby. Your dose needs may be different while you are nursing.

How should I use insulin aspart and insulin degludec?

Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Insulin is injected under the skin. You will be shown how to use injections at home. Do not give yourself this medicine if you do not understand how to use the injection and properly dispose of used needles and syringes.

Insulin aspart and insulin degludec must not be given with an insulin pump, or mixed with other insulins.

Insulin aspart and insulin degludec is usually given once or twice per day, with any main meal. You may need to use a separate fast-acting insulin at your other meals. Follow your doctor's dosing instructions very carefully.

Your care provider will show you the best places on your body to inject insulin aspart and insulin degludec. Use a different place each time you give an injection. Do not inject into the same place two times in a row.

Never share an injection pen with another person, even if the needle has been changed. Sharing these devices can allow infections or disease to pass from one person to another.

Use a disposable needle only once. Follow any state or local laws about throwing away used needles and syringes. Use a puncture-proof "sharps" disposal container (ask your pharmacist where to get one and how to throw it away). Keep this container out of the reach of children and pets.

Low blood sugar (hypoglycemia) can happen to everyone who has diabetes. Symptoms include headache, hunger, sweating, irritability, dizziness, nausea, fast heart rate, and feeling anxious or shaky. To quickly treat low blood sugar, always keep a fast-acting source of sugar with you such as fruit juice, hard candy, crackers, raisins, or non-diet soda.

Your doctor can prescribe a glucagon emergency injection kit to use in case you have severe hypoglycemia and cannot eat or drink. Be sure your family and close friends know how to give you this injection in an emergency.

Also watch for signs of high blood sugar (hyperglycemia) such as increased thirst or urination, blurred vision, headache, and tiredness.

Blood sugar levels can be affected by stress, illness, surgery, exercise, alcohol use, or skipping meals. Ask your doctor before changing your insulin dose or schedule.

This medicine is only part of a complete treatment program that may also include diet, exercise, weight control, regular blood sugar testing, and special medical care. Follow your doctor's instructions very closely.

Keep this medicine in its original container protected from heat and light. Do not freeze insulin or store it near the cooling element in a refrigerator. Throw away any insulin that has been frozen.

Storing unopened (not in use) insulin aspart and insulin degludec:

  • Refrigerate and use until expiration date.

Storing opened (in use) insulin aspart and insulin degludec:

  • Store the injection pen at room temperature (do not refrigerate) and use within 28 days. Do not store the injection pen with a needle attached.

Do not use the medicine if it has changed colors or looks cloudy. Call your pharmacist for new medicine.

Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

What happens if I miss a dose?

Skip the missed dose and use the medicine at your next main meal on the same day. Then continue your regular dosing schedule. Do not use extra insulin to make up the missed dose.

Keep insulin on hand at all times. Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Insulin overdose can cause life-threatening hypoglycemia. Symptoms include drowsiness, confusion, blurred vision, numbness or tingling in your mouth, trouble speaking, muscle weakness, clumsy or jerky movements, seizure (convulsions), or loss of consciousness.

What should I avoid while using insulin aspart and insulin degludec?

Avoid medication errors by always checking the medicine label before injecting your insulin.

Avoid drinking alcohol. It can cause low blood sugar and may interfere with your diabetes treatment.

Insulin aspart and insulin degludec side effects

Get emergency medical help if you have signs of an allergic reaction: hives, itching, skin rash; wheezing, tiredness, trouble breathing; feeling like you might pass out; nausea, diarrhea; swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • fluid retention--weight gain, swelling in your hands or feet, feeling short of breath; or

  • low potassium--leg cramps, constipation, irregular heartbeats, fluttering in your chest, extreme thirst, increased urination, numbness or tingling, muscle weakness or limp feeling.

Common side effects may include:

  • low blood sugar;

  • itching, mild skin rash; or

  • thickening or hollowing of the skin where you injected the medicine.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Insulin aspart and insulin degludec dosing information

Usual Adult Dose for Diabetes Type 1:

Dose should be individualized based on clinical response; Generally used in regimens with additional short or rapid acting insulin at meals not covered by this insulin mix.

Insulin-naive patients:
Initial dose: One-third to one-half the total daily insulin requirement subcutaneously once a day.
-The initial total daily insulin requirement in insulin naive patients is generally 0.2 to 0.4 units of insulin per kilogram of body weight.

Switching from Once or Twice Daily Premix Insulin:
-Initiate at the same unit dose and injection schedule as the current premix or self-mix insulin.
-Short or rapid-acting insulin should be used for meals not covered by this insulin mix.

Switching from Once or Twice Daily Basal Insulin:
-Initiate at the same unit dose as the basal insulin once a day with the main meal of the day.
-Short or rapid-acting insulin should be used for meals not covered by this insulin mix.

Comments:
-Adjust dosage according to metabolic needs, blood glucose measurements, and glycemic goals.
-Dose increases should occur no sooner than every 3 to 4 days; dose adjustment should be made based on morning fasting blood glucose measurement (before breakfast).
-When changing treatment regimens, the dose and frequency of short or rapid-acting insulin may need to be adjusted.
-To minimize hypoglycemia, closely monitor blood glucose, especially with changing regimens.

Use: To improve glycemic control in patients with diabetes mellitus.

Usual Adult Dose for Diabetes Type 2:

Initial dose: 10 units subcutaneously once a day

Switching from Once or Twice Daily Premix Insulin:
-Initiate subcutaneously at the same unit dose and injection schedule as the current premix or self-mix insulin.
-Short or rapid-acting insulin may be used for meals not covered by this insulin mix.

Switching from Once or Twice Daily Basal Insulin:
-Initiate at the same unit dose as the basal insulin once a day with the main meal of the day.
-For patients switching from once-daily basal insulin to this insulin mix, monitor blood glucose after starting therapy due to the rapid-acting insulin component.
-Short or rapid-acting insulin may be used for meals not covered by this insulin mix.

Comments:
-Adjust dosage according to metabolic needs, blood glucose measurements, and glycemic goals; dose increases should occur no sooner than every 3 to 4 days.
-When changing treatment regimens, the dose and frequency of short or rapid-acting insulin or other anti-diabetic medications may need to be adjusted.
-To minimize hypoglycemia, closely monitor blood glucose, especially with changing regimens.

Use: To improve glycemic control in patients with diabetes mellitus.

What other drugs will affect insulin aspart and insulin degludec?

Many other medicines can affect your blood sugar, and some medicines can increase or decrease the effects of insulin. Some drugs can also cause you to have fewer symptoms of hypoglycemia, making it harder to tell when your blood sugar is low. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using. This includes prescription and over-the-counter medicines, vitamins, and herbal products.

Where can I get more information?

  • Your pharmacist can provide more information about insulin aspart and insulin degludec.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02. Revision Date: 2016-06-15, 6:19:14 AM.

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