Kyinsu
Multi peptide
ABOUT
Kyinsu is the European-authorised name for IcoSema, a once-weekly fixed-ratio pre-filled pen combining insulin icodec and semaglutide for selected adults with insufficiently controlled type 2 diabetes. It is a regulated combination medicine, unlike the research-market blends in this category.
WHAT IS IN IT · 2 COMPOUNDS
Check the amounts on the vial rather than assuming them from the blend name.
EVIDENCE OVERVIEW
Supported by controlled human trials
WHAT THIS MEANS
Established. Review the research and limitations before relying on this record.
IDENTITY
HALF-LIFE
HOW IT IS THOUGHT TO WORK
Insulin icodec supplies basal insulin-receptor activity across the week, increasing glucose uptake and suppressing hepatic glucose output. Semaglutide activates GLP-1 receptors to increase glucose-dependent insulin secretion, suppress glucagon, reduce appetite and slow early post-meal gastric emptying. The fixed ratio couples basal-insulin intensification to GLP-1 exposure.
PHARMACOKINETICS
The authorised solution contains 700 units/mL insulin icodec and 2 mg/mL semaglutide, a fixed ratio of 350 units per 1 mg. A crossover study found total exposure broadly preserved in the combination, but semaglutide reached a higher and earlier peak because the two albumin-binding molecules compete locally at the injection site.
REVIEW
PUBLISHED PAIR RECORDS
with Insulin icodec
Same substance taken twice: blend already contains this compoundKyinsu already contains Insulin icodec at 350 units per fixed-ratio unit per vial. Scheduling the standalone compound alongside the blend means taking it twice from two sources, and the blend's other components come with it whether or not they are wanted at that moment. This is the one exposure risk a blend creates that its individual parts do not, and it is arithmetic rather than pharmacology - the combined amount is whatever the two products add up to. Where a blend's ratio is fixed by the manufacturer, the only way to change one component's dose is to add or remove the whole vial. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Semaglutide
Same substance taken twice: blend already contains this compoundKyinsu already contains Semaglutide at 1 mg per fixed-ratio unit per vial. Scheduling the standalone compound alongside the blend means taking it twice from two sources, and the blend's other components come with it whether or not they are wanted at that moment. This is the one exposure risk a blend creates that its individual parts do not, and it is arithmetic rather than pharmacology - the combined amount is whatever the two products add up to. Where a blend's ratio is fixed by the manufacturer, the only way to change one component's dose is to add or remove the whole vial. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CagriSema
Overlapping blends: the same compounds appear in bothKyinsu and CagriSema both contain Semaglutide. Taking both means those shared components arrive from two vials at once, at a combined amount neither product states, while the components unique to each still arrive at their own. Because both are sold at fixed manufacturer ratios, neither can be adjusted to compensate for the other. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Tirzepatide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Tirzepatide: Semaglutide (prescription glp-1 coadministration is not recommended). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Retatrutide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Retatrutide: Semaglutide (overlapping glp-1 receptor activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Cagrilintide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Cagrilintide: Semaglutide (directly studied co-administration (cagrisema)). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Native GIP
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Native GIP: Semaglutide (direct native-gip plus semaglutide study). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Survodutide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Survodutide: Semaglutide (overlapping incretin-pathway activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Mazdutide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Mazdutide: Semaglutide (overlapping incretin-pathway activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with MK-677
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and MK-677: Semaglutide (opposing effects on glucose regulation). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Tesamorelin
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Tesamorelin: Semaglutide (opposing effects on glucose regulation). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CJC-1295 with DAC
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and CJC-1295 with DAC: Semaglutide (opposing effects on glucose regulation). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Sermorelin
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Sermorelin: Semaglutide (opposing effects on glucose regulation). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Ipamorelin
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Ipamorelin: Semaglutide (opposing effects on glucose regulation). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with PT-141
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and PT-141: Semaglutide (additive delay of gastric emptying). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Liraglutide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Liraglutide: Semaglutide (overlapping incretin-pathway activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Exenatide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Exenatide: Semaglutide (overlapping incretin-pathway activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Dulaglutide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Dulaglutide: Semaglutide (overlapping incretin-pathway activity). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Pramlintide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Pramlintide: Semaglutide (labelled caution: two agents that slow gastric emptying). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Teduglutide
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Teduglutide: Semaglutide (opposing effects on intestinal absorption). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Larazotide acetate
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Larazotide acetate: Semaglutide (delayed gastric emptying may alter delivery of an enteric-coated oral). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026HUMAN EVIDENCE
European authorisation followed the phase 3 COMBINE programme. COMBINE 1 found IcoSema superior to weekly icodec for HbA1c reduction with fewer clinically significant or severe hypoglycaemic episodes in adults previously using basal insulin. COMBINE 2 found superior HbA1c reduction versus semaglutide alone, while body-weight change favoured semaglutide alone. These results apply to the studied type 2 diabetes populations and manufactured fixed-ratio pen.
REPORTED EFFECTS
Hypoglycaemia from the insulin component and gastrointestinal effects from semaglutide are central risks. The product information also carries GLP-1-class warnings including pancreatitis, dehydration-related renal deterioration and diabetic-retinopathy complications, plus insulin-associated injection-site reactions, lipodystrophy, oedema and weight gain. The fixed ratio limits independent adjustment of the two components.
RESEARCH LIMITATIONS
This is a source-backed summary of the authorised Kyinsu fixed-ratio medicine, not a recommendation or a guide to switching insulin. The evidence and regulatory status belong to the manufactured pre-filled pen; separately sourced or co-mixed insulin icodec and semaglutide are not equivalent. Insulin errors can cause prolonged severe hypoglycaemia and require clinician-directed prescribing and monitoring.
CURATED SOURCES · 4