Ryzodeg 70/30 combines two insulins in one pen — 70 percent insulin degludec (ultra-long-acting basal) and 30 percent insulin aspart (rapid-acting mealtime). It is given once or twice daily with main meals and provides both prandial coverage and extended basal insulin from a single injection. Ryzodeg is a clear solution (no rolling needed) and works in adults and children age 2 and older with type 1 or type 2 diabetes. Dose is individualized with a prescriber.
What Ryzodeg Is
Ryzodeg 70/30 is a co-formulated insulin product manufactured by Novo Nordisk that contains two distinct insulin analogs in a fixed ratio:
- Insulin degludec (the active ingredient in Tresiba) — 70 percent of the units
- Insulin aspart (the active ingredient in Novolog) — 30 percent of the units
Unlike traditional premix insulins (such as Novolog Mix 70/30, Humalog Mix 75/25, or Humulin 70/30), Ryzodeg is a clear, soluble formulation because degludec multihexamer structures do not interact with aspart. Each component therefore retains its own pharmacokinetic profile and acts independently after injection.
How Ryzodeg Works
After subcutaneous injection, the two insulins separate immediately and behave according to their individual properties:
- The aspart component is rapidly absorbed — onset within 10 to 15 minutes and peak around 30 to 90 minutes, covering the meal eaten with the injection
- The degludec component forms multihexamer chains at the injection site, then releases slowly into the bloodstream over more than 42 hours, providing flat basal coverage
Because the two insulins are physically separate at the molecular level rather than emulsified or suspended, Ryzodeg does not need to be resuspended or rolled before injection.
Pharmacokinetics
| Component | Onset | Peak | Duration |
|---|---|---|---|
| Insulin aspart (30 percent) | 10 to 15 minutes | 30 to 90 minutes | 3 to 5 hours |
| Insulin degludec (70 percent) | 30 to 90 minutes | No peak | Greater than 42 hours |
| Combined effect | 10 to 15 minutes | Mealtime spike from aspart | Continuous basal beyond 42 hours from degludec |
Who Ryzodeg Is For
- Adults with type 2 diabetes who want simplified insulin therapy with fewer injections than full basal-bolus
- Adults with type 1 diabetes when combined with additional rapid-acting insulin at uncovered meals
- Children age 2 years and older with type 1 or type 2 diabetes
- People transitioning from basal-only insulin who need additional mealtime coverage
- People transitioning from traditional premix insulin who want flexibility and no resuspension
- People who prefer a single combined pen for convenience
How Ryzodeg Is Used
- Injected subcutaneously into the abdomen, thigh, or upper arm using the FlexTouch pen
- Once daily with the largest meal, or twice daily with the two largest meals
- No need to roll or shake the pen — the solution should be clear
- Rotate injection sites within each anatomical area to reduce lipodystrophy
- Inject at the start of the meal (no advance timing required)
Switching from another insulin regimen, starting dose, and titration are individualized by the prescriber based on prior insulin use, A1C, body weight, and self-monitoring data. A typical switch from once-daily basal insulin to Ryzodeg keeps the same total daily dose initially, then titrates based on fasting glucose.
Clinical Trial Evidence
The BOOST clinical trial program studied Ryzodeg head-to-head against other insulin regimens:
- BOOST T1: In type 1 diabetes, Ryzodeg twice daily plus rapid analog at the third meal achieved A1C non-inferior to basal-bolus therapy with insulin detemir plus mealtime aspart
- BOOST T2: In type 2 diabetes, twice-daily Ryzodeg matched A1C reductions of twice-daily NovoMix 30 (Novolog Mix 70/30) with fewer overall confirmed hypoglycemia events and significantly fewer nocturnal hypoglycemia episodes
- BOOST Intensify Premix I: Switching from premix insulin to Ryzodeg twice daily reduced overall and nocturnal hypoglycemia at comparable A1C
Together these trials supported FDA approval and positioned Ryzodeg as an option for simplifying insulin therapy without compromising glycemic control.
Ryzodeg vs Traditional Premix Insulins
| Feature | Ryzodeg 70/30 | Novolog Mix 70/30 / Humalog Mix 75/25 / Humulin 70/30 |
|---|---|---|
| Appearance | Clear solution | Cloudy suspension |
| Resuspension before use | Not required | Required (roll 10 times) |
| Components | Degludec + aspart | Protaminated rapid + rapid analog (or regular + NPH) |
| Basal duration | >42 hours (degludec) | 12 to 18 hours (NPH-like component) |
| Dosing flexibility | Flexible meal timing within reason | Strict meal timing required |
| Typical schedule | Once or twice daily | Twice daily (breakfast and dinner) |
| Hypoglycemia risk | Lower in trials | Higher in trials |
Side Effects
- Hypoglycemia (low blood sugar) — most common side effect
- Weight gain — modest, typical of insulin therapy
- Injection site reactions — redness, itching, swelling
- Lipodystrophy — lipohypertrophy or lipoatrophy from repeated injections in the same spot
- Peripheral edema, especially with thiazolidinediones
- Hypokalemia (low potassium) — uncommon
- Allergic reactions — rare; can include rash, itching, or anaphylaxis
Storage and Handling
- Unopened pens: refrigerate at 36 to 46 °F (2 to 8 °C) until expiration date
- In use: room temperature up to 86 °F (30 °C) for up to 28 days, then discard
- Do not freeze; do not expose to direct heat or sunlight
- Solution should be clear and colorless — discard if cloudy, discolored, or contains particles
- Do not share pens between people
Cost and Access
- Ryzodeg typically costs around $300 to $500 per month at retail without insurance
- Coverage by commercial insurers varies; prior authorization is often required
- Novo Nordisk patient assistance and copay programs can lower out-of-pocket cost for eligible patients
- Medicare Part D applies federal $35 monthly cap for covered insulins
Practical Considerations
- Ryzodeg is a useful step-up from once-daily basal insulin when fasting glucose is at target but post-meal readings remain high
- It is not appropriate for diabetic ketoacidosis (DKA) — intravenous regular insulin is used for DKA
- It is not designed for use in insulin pumps
- People with hectic schedules benefit from the degludec component’s dosing flexibility
- If you skip a meal, talk to your prescriber — Ryzodeg should generally be given with food because of the aspart component
Related Reading
For broader context, see our treatment overview, the page on Tresiba (insulin degludec), and our guide to Novolog Mix 70/30.
The Bottom Line
Ryzodeg 70/30 combines two distinct insulin analogs — degludec for ultra-long basal coverage and aspart for rapid mealtime action — in a clear, soluble single-pen formulation. It is dosed once or twice daily with main meals, requires no resuspension, and offers A1C control comparable to basal-bolus therapy or traditional premix insulin with fewer hypoglycemia events in clinical trials. It is approved for adults and children age 2 and older with type 1 or type 2 diabetes. Side effects include hypoglycemia, weight gain, and injection site reactions. For people who want fewer injections than basal-bolus but more flexibility than premix insulin, Ryzodeg may help — talk to your prescriber to individualize dosing and timing.
