Glucagon

Glucagon is a prescription drug for injection is a gastrointestinal motility inhibitor indicated for use as a diagnostic aid during radiologic examinations to temporarily inhibit movement of the gastrointestinal (GI) tract.

Glucagon is available under the following different brand names: Glucagen, Glucagon Emergency Kit, and GlucaGen HypoKit.

Adult and Pediatric Dosages

Injection, powder

• 1 mg/vial

Oral liquid

• 55%

Dosage Considerations – Should be Given as Follows:

Hypoglycemia

Adults

• Indicated for severe hypoglycemic reactions in patients with diabetes treated with insulin
• 1 mg (1 unit) intramuscularly/subcutaneously/intravenously if no intravenous for glucagon
• Repeat every 15 minutes once or twice; give glucagon as soon as it is available and if no response
• Administer supplemental carbohydrate to replete glycogen stores

Pediatrics

• Indicated for severe hypoglycemic reactions in patients with diabetes treated with insulin
• Administer oral glucose/intravenous glucagon to replete glycogen stores
• GlucaGen
  • Children under 6 years: 0.5 mg subcutaneous/intramuscular/intravenous; may repeat in 15 minutes if necessary
  • Children over 6 years: 1 mg subcutaneous/intramuscular/intravenous; may repeat in 15 minutes if necessary
  • Alternatively
    • Children under 25 kg: 0.5 mg; may repeat in 15 minutes if necessary
    • Children 25 kg or over: 1 mg; may repeat in 15 minutes if necessary
• Infants over 6 months and children:
  • 0.5-1 g/kg up to 25 g (2-4 ml/kg/dose of 25% solution) intravenously; not to exceed 25 g/dose
• Adolescents
  • Intravenously: 10-25 g (20-50 ml 50% solution or 40-100 ml of 25%)
  • Orally: 4-20 g as a single dose; may repeat after 15 minutes if self-monitoring of blood glucose shows continued hypoglycemia

Glucagon Emergency Kit

• Children under 20 kg: 0.5 mg subcutaneous/intramuscular/intravenous every 15 minutes as needed, or 0.02-0.03 mg/kg/dose subcutaneous/intramuscular/intravenous; may repeat in 15 minutes if necessary
• Children 20 kg or over: 1 mg subcutaneous/intramuscular/intravenous; may repeat in 15 minutes if necessary every 20 minutes as needed

Radiography of Gastrointestinal

• Indicated as diagnostic aid for decreased gastrointestinal motility
• To inhibit motility of stomach and small bowel: 0.2-0.5 mg intravenously over time period of 1 minute or 1 mg intramuscularly
• To inhibit motility of colon: 0.5-0.75 mg intravenously over time period of 1 minute or 1 mg intramuscularly
• Bolus doses over 1 mg administered intravenously may cause nausea and vomiting and are not recommended

Beta-Blocker and Calcium Channel Blocker Toxicity (off-label)

• Indicated off-label for overdose of beta blockers or calcium channel blockers
• Load: 50-150 mcg/kg intravenous pyelogram over 1 minute, then 3-5 mg/hour or 50-100 mcg/kg/hour intravenously; titrate infusion to achieve adequate clinical response

Side effects of glucagon include:

• nausea
• vomiting
• rash
• low blood pressure (hypotension)
• fast heart rate
• increased blood pressure
• increased pulse
• respiratory distress
• hives
• low blood sugar coma
• low blood sugar (hypoglycemia)
• allergic reactions

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Glucagon has no known severe interactions with other drugs.
• Glucagon has no known serious interactions with other drugs.
• Moderate Interactions of glucagon include:
  • antithrombin alfa
  • antithromibin III
  • argatroban
  • bemiparin
  • bivalirudin
  • dalteparin
  • dichlorphenamide
  • enoxaparin
  • fondaparinux
  • heparin
  • insulin degludec
  • insulin degludec/insulin aspart
  • insulin inhaled
  • lepirudin
  • phenindione
  • protamine
  • tinzaparin
  • warfarin
• Mild Interactions of glucagon include:
  • magnesium chloride
  • magnesium citrate
  • magnesium hydroxide
  • magnesium oxide
  • magnesium sulfate

This information does not contain all possible interactions or adverse effects. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns or for more information about this medicine.

Warnings

• This medication contains glucagon. Do not take Glucagen, Glucagon Emergency Kit, or GlucaGen HypoKit if you are allergic to glucagon or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Hypersensitivity
• Pheochromocytoma (tumor on the adrenal gland)
• Insulinoma (tumor on the pancreas, causing excess insulin)
• Glucagonoma (tumor on the pancreas, causing excess production of the hormone glucagon)

Effects of Drug Abuse

• No information available

Short-Term Effects

• See "What Are Side Effects Associated with Using Glucagon?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Glucagon?"

Cautions

• Generalized allergic reactions, including hives, respiratory distress, and low blood pressure reported; if symptoms occur discontinue and treat as indicated
• Effective in treating hypoglycemia only if sufficient liver glycogen present
• Because glucagon is of little or no help in states of starvation, adrenal insufficiency, or chronic hypoglycemia, hypoglycemia in these conditions should be treated with glucose
• Increased blood pressure and heart rate in patients with cardiac disease reported; monitor patients with known cardiac disease
• Awaken patient following administration to provide oral glucose if possible, otherwise intravenous glucagon is required to replete glycogen stores

Pregnancy and Lactation

• Glucagon use during pregnancy may be acceptable. Either animal studies show no risk but human studies are not available or animal studies showed minor risks and human studies were done and showed no risk.
• Excretion of glucagon in breast milk is unknown; use with caution.