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Glucagon: Uses, Dosage, Side Effects & Emergency Kit Info
Summary or Key Points
Glucagon is a medication primarily used to treat severe low blood sugar (hypoglycemia) and other conditions such as beta-blocker overdose and gastrointestinal motility disorders. It works by raising blood sugar levels and relaxing the muscles in the stomach and intestines. Glucagon is typically administered as an injection in emergency situations. Always consult a healthcare provider before using or adjusting your dose. Our telemedicine providers are available to assist you with any questions or concerns.
Names of Medication
US Brand Name: GlucaGen, Glucagon Emergency Kit, Gvoke
Generic Name: Glucagon
The generic name refers to the active ingredient in the medication, while the brand name is assigned by the manufacturer. In this case, Glucagon is the generic name.
Pharmacologic Category
Glucose-Elevating Agents
Dosing
Glucagon is used to treat a variety of conditions, with the dosage depending on the specific condition being treated. Always follow your healthcare provider’s instructions and never adjust your dose without consulting them. Our telemedicine providers are available to help guide you through your treatment plan.
Hypoglycemia (Severe Low Blood Sugar)
Adults: 1 mg injected subcutaneously, intramuscularly, or intravenously. If there is no response after 15 minutes, a second dose may be administered. Seek emergency medical help immediately after administration.
Insulinoma
Adults: 0.5 to 1 mg intravenously. This dose is typically used to diagnose insulinoma by provoking symptoms of hypoglycemia.
Severe Hypoglycemia in Diabetes
Adults: 1 mg injected subcutaneously or intramuscularly. If the patient does not respond within 15 minutes, a second dose may be given. Always follow up with a healthcare provider after administration.
Adrenal Insufficiency
Adults: 1 mg subcutaneously or intramuscularly in cases of adrenal crisis when IV hydrocortisone is not available.
Gastrointestinal Motility Disorders
Adults: 0.2 to 0.5 mg intravenously. This dose helps relax the stomach and intestines during diagnostic procedures.
Congenital Hyperinsulinism
Adults: 0.5 to 1 mg intravenously. This dose is used to manage episodes of hypoglycemia caused by congenital hyperinsulinism.
Beta-Blocker Overdose
Adults: 3 to 10 mg intravenously over 1 to 2 minutes, followed by an infusion of 1 to 5 mg per hour if necessary.
Calcium Channel Blocker Overdose
Adults: 3 to 10 mg intravenously over 1 to 2 minutes, followed by an infusion of 1 to 5 mg per hour if needed.
Acute Pancreatitis
Adults: 1 mg intravenously every 6 hours as needed to reduce pancreatic secretions.
Cardiac Arrest
Adults: 2 to 5 mg intravenously, repeated every 5 minutes as needed.
Dosage Forms and Strengths
Injection: 1 mg/mL (available in emergency kits)
Pre-filled syringes: 0.5 mg or 1 mg (Gvoke)
Intranasal powder: 3 mg (Baqsimi)
Administration Instructions
Glucagon is typically administered as an injection under the skin (subcutaneously), into a muscle (intramuscularly), or directly into a vein (intravenously). In emergency situations, it is often given by a caregiver or healthcare professional. Some forms, such as the nasal powder, can be administered without an injection. Always follow your healthcare provider’s instructions and seek medical attention immediately after use.
Adverse Reactions and Side Effects
Like all medications, Glucagon can cause side effects. Most are mild, but some can be more serious. If you experience any side effects, contact your healthcare provider immediately. Our telemedicine providers are available to help you manage any concerns.
Nausea and Vomiting (Common): Many patients experience nausea or vomiting after taking Glucagon, especially when given in higher doses.
Allergic Reactions (Rare): Some individuals may experience an allergic reaction, including rash, difficulty breathing, or swelling of the face, lips, or throat.
High Blood Pressure (Rare): In some cases, Glucagon may cause a temporary increase in blood pressure.
Hypersensitivity (Rare): Severe allergic reactions, such as anaphylaxis, are rare but possible.
Low Potassium Levels (Rare): Glucagon may cause a drop in potassium levels, especially with repeated doses.
Contraindications
A contraindication is a specific situation where a medication should not be used because it may cause harm to the patient. It’s important to know if you have any conditions or factors that make taking Glucagon unsafe for you. Below are the main contraindications for Glucagon:
Pheochromocytoma: Glucagon can trigger the release of large amounts of catecholamines (stress hormones) from this type of tumor, which can lead to dangerous spikes in blood pressure.
Insulinoma: In patients with insulinoma, Glucagon may initially raise blood sugar levels, but it can also cause a subsequent drop in blood sugar, which could be harmful.
Known hypersensitivity to Glucagon: If you have had an allergic reaction to Glucagon in the past, you should not take it again, as this could lead to severe allergic reactions, including anaphylaxis.
Drug to Drug Interactions
Glucagon can interact with other medications, potentially altering its effectiveness or increasing the likelihood of side effects. It’s important to inform your healthcare provider about all the medications you are currently taking. Below are some drugs that may interact with Glucagon:
Indomethacin (Indocin): This nonsteroidal anti-inflammatory drug (NSAID) may reduce Glucagon’s ability to raise blood sugar levels.
Warfarin (Coumadin): Glucagon can enhance the blood-thinning effects of Warfarin, which may increase the risk of bleeding.
Beta-blockers (e.g., Propranolol, Metoprolol): These medications may increase the likelihood of Glucagon causing a rapid rise in blood pressure and heart rate.
Glucagon in Pregnancy
Is it safe to take Glucagon during pregnancy?
Yes, Glucagon is generally considered safe for use during pregnancy. It is classified as a Category B drug by the FDA, meaning that animal studies have not shown harm to the fetus, although there are no well-controlled studies in pregnant women. If you are pregnant and require Glucagon, consult your healthcare provider to ensure it is the best option for you.
Glucagon while Breastfeeding
Is it safe to take Glucagon while breastfeeding?
Yes, Glucagon is considered safe to use while breastfeeding. It does not pass into breast milk in significant amounts, making it unlikely to affect your baby. However, it’s always a good idea to consult your healthcare provider before taking any medication while breastfeeding.
Estimated Cost of Glucagon Medication
The cost of Glucagon can vary depending on the pharmacy and your location. Without insurance, a 30-day supply using a GoodRx coupon is estimated to cost between $250 and $300. Prices may differ, so it’s a good idea to check with your pharmacy or use a discount service like GoodRx to find the best available price.
Possible Alternatives to Glucagon
If you are considering alternatives to Glucagon, there are several treatment options and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine visit with one of our providers to discuss your options.
- Hypoglycemia: Alternatives include oral glucose tablets, fast-acting carbohydrates (such as juice or candy), and adjusting insulin doses under the guidance of your healthcare provider.
- Insulinoma: Surgical removal of the tumor is often the first-line treatment. Medications like diazoxide or octreotide may also help manage symptoms.
- Severe hypoglycemia in diabetes: In addition to Glucagon, continuous glucose monitoring (CGM) systems and adjustments to your insulin regimen can help prevent severe hypoglycemia. Discuss these options with your healthcare provider.
- Adrenal insufficiency: Treatment typically involves hormone replacement therapy, such as hydrocortisone or fludrocortisone, to manage symptoms.
- Gastrointestinal motility disorders: Prokinetic agents like metoclopramide (Reglan) or dietary changes may help improve symptoms. Consult your healthcare provider for the best approach.
- Congenital hyperinsulinism: Treatment may include medications like diazoxide or surgery to remove part of the pancreas. Your healthcare provider will guide you through the most appropriate treatment options.
- Beta-blocker overdose: In addition to Glucagon, intravenous fluids and medications like atropine may be used to manage symptoms. This is a medical emergency, so seek immediate care.
- Calcium channel blocker overdose: Glucagon is one option, but other treatments, such as calcium infusions or vasopressors, may be necessary. This is also a medical emergency, requiring immediate attention.
- Acute pancreatitis: Treatment typically involves fasting, intravenous fluids, and pain management. In severe cases, surgery or other interventions may be required.
- Cardiac arrest: Glucagon may be used in certain cases, but standard treatments like CPR, defibrillation, and medications such as epinephrine are the primary interventions.
Recent Updates on Glucagon Research
Recent studies have explored the use of intranasal Glucagon, a needle-free option for treating severe hypoglycemia. This form has shown promise in clinical trials, particularly for being easier to administer in emergency situations. Additionally, researchers are investigating Glucagon’s potential in treating conditions beyond hypoglycemia, such as heart failure and obesity, due to its effects on metabolism and cardiovascular function. While these studies are still in the early stages, they offer exciting possibilities for the future of Glucagon therapy.
