glucagon

Hypoglycemia

IV IM SC (Adults and Children >25 kg): 1 mg; may repeat in 15 min if necessary.
SC (Adults and Children ≥12 yr): Gvoke: 1 mg; may repeat in 15 min if necessary.
IV IM SC (Children <25 kg ): 0.5 mg or 0.02–0.03 mg/kg; may repeat in 15 min if necessary.
IV IM SC (Children >6 yr and unknown weight): 1 mg; may repeat in 15 min if necessary.
IV IM SC (Children <6 yr and unknown weight): 0.5 mg or 0.02–0.03 mg/kg; may repeat in 15 min if necessary.
SC (Children 2–12 yr and ≥45 kg): Gvoke: 1 mg; may repeat in 15 min if necessary.
SC (Children 2–12 yr and <45 kg): Gvoke: 0.5 mg; may repeat in 15 min if necessary.
(Adults and Children ≥1 yr): 3 mg (one actuation) in one nostril; may repeat in 15 min if necessary.

Radiographic Examination of the GI Tract

IM IV (Adults ): 0.25–2 mg, depending on location and duration of examination (0.5 mg IV or 2 mg IM for relaxation of stomach; for examination of the colon, 2 mg IM 10 min before procedure).

Beta Blocker or Calcium Channel Blocker Overdose

IV (Adults ): Beta blocker overdose: 50–150 mcg (0.05–0.15 mg)/kg, followed by 1–5 mg/hr infusion. Calcium channel blocker overdose: 2 mg; additional doses determined by response.

US Brand Names ⬆ ⬇

Baqsimi, ~~GlucaGen,~~ Gvoke

Action ⬆ ⬇

Stimulates hepatic production of glucose from glycogen stores (glycogenolysis).
Relaxes the musculature of the GI tract (stomach, duodenum, small bowel, colon), temporarily inhibiting movement.
Has positive inotropic and chronotropic effects.

Therapeutic effects:

Increase in blood glucose.
Relaxation of GI musculature, facilitating radiographic examination.

Classifications ⬆ ⬇

Therapeutic Classification: hormones

Pharmacologic Classification: pancreatics

Pharmacokinetics ⬆ ⬇

Absorption: Well absorbed following IM, intranasal, and SUBQ administration; IV administration results in complete bioavailability.

Distribution: Extensively distributed to tissues.

Metabolism/Excretion: Extensively metabolized by the liver, plasma, and kidneys.

Half-Life: 8–18 min.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
IM (hyperglycemic action)	within 10 min	30 min	12–27 min
IV (hyperglycemic action)	1 min	5 min	9–17 min
SUBQ (hyperglycemic action)	within 10 min	30–45 min	60–90 min
Intranasal (hyperglycemic action)	within 15 min	unknown	unknown
IV (effect on GI musculature)	45 sec (for 0.25–2-mg dose)	unknown	9–17 min (0.25–0.5-mg dose); 22–25 min (2-mg dose)
IM (effect on GI musculature)	8–10 min (1-mg dose); 4–7 min (2-mg dose)	unknown	9–27 min (1-mg dose); 21–32 min (2-mg dose)

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication to patient. Advise patient to read Patient Information before starting therapy.
Instruct patient to notify health care provider of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care provider before taking other Rx, OTC, or herbal products.
Educate patient and family/caregivers on signs and symptoms of hypoglycemia. Instruct patient to take oral glucose as soon as symptoms of hypoglycemia occur; glucagon is reserved for episodes when patient is unable to swallow because of ↓ level of consciousness.
Home Care Issues: Instruct family/caregivers on correct technique to prepare, draw up, and administer injection. Health care provider must be contacted immediately after each dose for orders regarding further therapy or adjustment of insulin dose or diet.
Advise patient, family, and caregivers of hypersensitivity reactions and to seek immediate medical attention if any occur.
Instruct family/caregivers to position patient on side until fully alert. Explain that glucagon may cause nausea and vomiting. Aspiration may occur if patient vomits while lying on back.
Instruct patient to check expiration date monthly and to replace outdated medication immediately.
Review hypoglycemic medication regimen, diet, and exercise programs.
Patients with diabetes mellitus should carry a source of sugar (such as a packet of sugar or candy) and identification describing disease process and treatment regimen at all times.
Rep: Advise women of reproductive potential to notify health care provider if pregnancy is planned or suspected or if breastfeeding.

Pronunciation ⬆ ⬇

Code ⬆

NDC Code

0378- Mylan Pharmaceuticals Inc.
- 0378-8067- Glucagon
  - 0378-8067-90- 1 KIT in 1 KIT (0378-8067-90) * 1 mL in 1 VIAL (0378-8065-32) * 1 mL in 1 SYRINGE (0378-8066-32)

0548- Amphastar Pharmaceuticals, Inc.
- 0548-5850- Glucagon
  - 0548-5850-00- 1 KIT in 1 KIT (0548-5850-00) * 1 mL in 1 VIAL (0548-5905-00) * 1 mL in 1 SYRINGE (0548-5831-00)

0548- Amphastar Pharmaceuticals, Inc.
- 0548-8351- Baqsimi
  - 0548-8351-01- 1 TUBE in 1 CARTON (0548-8351-01) / 1 BOTTLE, UNIT-DOSE in 1 TUBE / 1 POWDER in 1 BOTTLE, UNIT-DOSE

0548- Amphastar Pharmaceuticals, Inc.
- 0548-8352- Baqsimi
  - 0548-8352-02- 2 TUBE in 1 CARTON (0548-8352-02) / 1 BOTTLE, UNIT-DOSE in 1 TUBE / 1 POWDER in 1 BOTTLE, UNIT-DOSE

11014- Catalent Pharma Solutions LLC
- 11014-0687-
  - 11014-0687-3- 1 BOTTLE, UNIT-DOSE in 1 TUBE (11014-0687-3) / 9720 POWDER in 1 BOTTLE, UNIT-DOSE

41524- Ambiopharm, Inc.
- 41524-0005-
  - 41524-0005-1- 1 g in 1 BOTTLE (41524-0005-1)

50090- A-S Medication Solutions
- 50090-6550- Glucagon
  - 50090-6550-0- 1 KIT in 1 VIAL (50090-6550-0) / 1 KIT in 1 KIT * 1 mL in 1 VIAL (0548-5905-00) * 1 mL in 1 SYRINGE (0548-5831-00)

51662- HF Acquisition Co LLC, DBA HealthFirst
- 51662-1498- GLUCAGON
  - 51662-1498-1- 1 KIT in 1 KIT (51662-1498-1) * 1 mL in 1 VIAL, SINGLE-DOSE * 1 mL in 1 SYRINGE, GLASS

55463- Bachem AG
- 55463-0009-
  - 55463-0009-1- 200 g in 1 BOTTLE, GLASS (55463-0009-1)

63323- Fresenius Kabi USA, LLC
- 63323-582- Glucagon
  63323-582-82- 1 KIT in 1 KIT (63323-582-82) * 1 mL in 1 VIAL, SINGLE-DOSE (63323-583-13) * 1 mL in 1 SYRINGE, GLASS (63323-185-82)

63323- Fresenius Kabi USA, LLC
- 63323-593- Glucagon
  - 63323-593-03- 1 KIT in 1 CARTON (63323-593-03) * 1 mL in 1 VIAL, SINGLE-DOSE (63323-596-03) * 1 mL in 1 VIAL, SINGLE-DOSE (63323-185-03)

63323- Fresenius Kabi USA, LLC
- 63323-594- Glucagon
  - 63323-594-03- 1 KIT in 1 CARTON (63323-594-03) * 1 mL in 1 VIAL, SINGLE-DOSE (63323-596-06) * 1 mL in 1 VIAL, SINGLE-DOSE (63323-185-03)

63323- Fresenius Kabi USA, LLC
- 63323-596- Glucagon
  - 63323-596-13- 10 VIAL, SINGLE-DOSE in 1 TRAY (63323-596-13) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-596-11)

63323- Fresenius Kabi USA, LLC
- 63323-596- Glucagon
  - 63323-596-16- 10 VIAL, SINGLE-DOSE in 1 TRAY (63323-596-16) / 1 mL in 1 VIAL, SINGLE-DOSE (63323-596-08)

66558- FRESENIUS KABI IPSUM SRL
- 66558-0195-
  - 66558-0195-1- 25 g in 1 JAR (66558-0195-1)

66558- FRESENIUS KABI IPSUM SRL
- 66558-0195-
  66558-0195-2- 50 g in 1 JAR (66558-0195-2)

66558- FRESENIUS KABI IPSUM SRL
- 66558-0195-
  66558-0195-3- 100 g in 1 JAR (66558-0195-3)

69097- Cipla USA Inc.
- 69097-027- Glucagon
  69097-027-50- 1 KIT in 1 CARTON (69097-027-50) * 1 mL in 1 VIAL, GLASS (69097-028-32) * 1 mL in 1 SYRINGE, GLASS (69097-029-31)

70748- Lupin Pharmaceuticals, Inc.
- 70748-311- GLUCAGON
  - 70748-311-01- 1 KIT in 1 CARTON (70748-311-01) * 1 mL in 1 VIAL (70748-309-01) * 1 mL in 1 SYRINGE (70748-310-01)

85766- Sportpharm, Inc. dba Sportpharm
- 85766-065- Glucagon
  - 85766-065-01- 1 KIT in 1 KIT (85766-065-01) * 1 mL in 1 VIAL (0378-8065-32) * 1 mL in 1 SYRINGE (0378-8066-32)

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Indications ⬇

Contraind./Precautions ⬆ ⬇

Adv. Reactions/Side Effects ⬆ ⬇

Interactions ⬆ ⬇

Availability ⬆ ⬇

Route/Dosage ⬆ ⬇