Glucagon Intranasal

Glucagon intranasal is a prescription medication indicated for severe hypoglycemic reactions in patients with diabetes.

• Glucagon intranasal is available under the following different brand names: Baqsimi

Common side effects of Glucagon intranasal include:

• nausea
• vomiting
• headache,
• upper respiratory tract irritation (ie, runny nose, nasal discomfort, nasal congestion, cough, and nosebleed)
• watery eyes
• eye redness
• sneezing
• itchy nose, throat, and eyes

Serious side effects of Glucagon intranasal include:

• rash
• hives
• swelling of the face, eyes, lips, or throat
• difficulty breathing or swallowing

Rare side effects of Glucagon intranasal include:

• none 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Intranasal powder

• 3 mg/actuation

Hypoglycemia

Adult dosage

• 3 mg administered as 1 actuation using the intranasal device into 1 nostril
• If no response after 15 minutes, administer an additional 3 mg dose from a new device while waiting for emergency assistance

Pediatric dosage

• Children younger than 4 years: Safety and efficacy not established
• Children aged 4 years and older: 3 mg administered as 1 actuation using the intranasal device into 1 nostril
• If no response after 15 minutes, administer an additional 3 mg dose from a new device while waiting for emergency assistance

Dosage Considerations – Should be Given as Follows:

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, 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, healthcare provider, or pharmacist first.

• Glucagon intranasal has severe interactions with no other drugs
• Glucagon intranasal has serious interactions with the following drugs:
  • aclidinium
  • atropine
  • benztropine
  • dicyclomine
  • glycopyrrolate
  • glycopyrrolate inhaled
  • hyoscyamine
  • hyoscyamine spray
  • ipratropium
  • methscopolamine
  • orphenadrine
  • propantheline
  • scopolamine
  • tiotropium
  • trihexyphenidyl
  • tropicamide
  • umeclidinium bromide
  • umeclidinium bromide/vilanterol inhaled
• Glucagon intranasal has moderate interactions with at least 43 other drugs
• Glucagon intranasal has minor interactions with the following drugs:
  • magnesium chloride
  • magnesium citrate
  • magnesium hydroxide
  • magnesium oxide
  • magnesium sulfate

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• Pheochromocytoma
• Insulinoma
• Hypersensitivity to glucagon or any excipients

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Glucagon intranasal?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Glucagon intranasal?”

Cautions

• Allergic reactions reported including anaphylactic shock with breathing difficulties and hypotension
• Contraindicated with pheochromocytoma; glucagon may stimulate catecholamine release from the tumor; if blood pressure (BP) increases dramatically and undiagnosed pheochromocytoma is suspected, administer phentolamine 5-10 mg IV to lower BP
• Contraindicated with insulinoma; glucagon administration may produce an initial increase in blood glucose; however, glucagon may directly or indirectly (through an initial rise in blood glucose) stimulate exaggerated insulin release from an insulinoma and cause hypoglycemia; treat with glucose orally or IV
• Effective for hypoglycemia only if sufficient hepatic glycogen is present; patients in states of starvation, with adrenal insufficiency, or chronic hypoglycemia may not have adequate levels of hepatic glycogen for glucagon to be effective; treat these patients with glucose
• Drug interaction overview
  • Patients taking beta-blockers may have transiently increased pulse and BP when administered glucagon
  • In patients taking indomethacin, glucagon may lose its ability to raise blood glucose or may even produce hypoglycemia
  • Glucagon may increase the anticoagulant effect of warfarin

Pregnancy and Lactation

• Available data from case reports and a small number of observational studies with glucagon use in pregnant women over decades of use have not identified a drug-associated risk for major birth defects, miscarriage, or adverse maternal or fetal outcomes
• Multiple small studies have reported a lack of transfer of pancreatic glucagon across the human placental barrier during early gestation
• Lactation
  • There is no information available on the presence of glucagon in human or animal milk, the effects of the drug on the breastfed infant, or the effects of the drug on milk production
  • However, glucagon is a peptide and would be expected to be broken down to its constituent amino acids in the infant's digestive tract and is, therefore, unlikely to cause harm to an exposed infant