Antidote/Diagnostic
PREGNANCY RECOMMENDATION:Limited Human Data—Animal Data Suggest Low Risk (Maternal Benefit May Outweigh Embryofetal Risk)
BREASTFEEDING RECOMMENDATION:Compatible
One report describing the use of glucagon in human pregnancy was located, which described the use of glucagon for severe hypoglycemia. Seven pregnant women received glucagon for severe hypoglycemia on 12 occasions during pregnancy, and no adverse effects were reported in the newborns at delivery. The gestational ages at which the drug was used were not provided. A second case report described the use of glucagon in treating a severe Beta-blocker overdose. A fetal demise occurred, but the drug was successful in reversing the severe Beta-blocker effects. Glucagon does not appear to cross the human placenta, so fetal exposure is not likely to occur. Animal data did not show any embryofetal toxicity in two species at doses greater than 10 times the RHD. Due to the indication for use of this drug, the mother’s clinical need for treatment should outweigh any potential fetal risk that might occur from exposure, especially when intravenous (IV) glucose cannot be administered in a timely manner.
No reports describing the use of glucagon during human lactation have been located. The drug will not likely be found in breast milk, so infant exposure will probably not occur. Additionally, if any of the polypeptide were to be ingested through breastfeeding, it would probably be digested in the infant’s gastrointestinal tract and not absorbed. Breastfeeding while using this drug should be based on the mother’s clinical need for treatment versus any potential infant risks that might occur. If used, the infant should be monitored for the most common reported adult side effects of nausea, headache, and dizziness (all leading to irritability), vomiting, decreased blood pressure, paleness, diarrhea, and lethargy.