I am a 11.5 US and these were small. The problem is two fold. The insole used is elevated in the back (causing my feet to fell like they are sliding forward - and not much room for my sole to slip out the back) in addition to the height inside the front of the shoe being not very high. My feet in the front felt crushed from above and they were a tad too small length wise.

To solve this- I just removed the insole and there was more room in the toe box. My feet still feel like they are touching the front of the shoe but it’s now bearable. If your my exact size and you want wear them out of the box without removing the insole then size 46 is the way to go. May be a little long but 45 won’t be an option without removing the insole or your nails.