Classifications: hormone; antihypoglycemic agent; Therapeutic:antihypoglycemic; diagnostic test aid
Pregnancy Category: B
1 mg powder for injection
Recombinant glucagon identical to glucagon produced by alpha cells of islets of Langerhans. Stimulates uptake of amino acids
and their conversion to glucose precursors. Promotes lipolysis in liver and adipose tissue with release of free fatty acid
and glycerol, which further stimulates ketogenesis and hepatic gluconeogenesis. Action in hypoglycemia relies on presence
of adequate liver glycogen stores.
Increases blood glucose secondary to gluconeogenesis, the breakdown of glycogen to glucose in the liver.
Emergency treatment of severe hypoglycemic reactions in diabetic patients who are unconscious or unable to swallow food or
liquids and in psychiatric patients receiving insulin shock therapy. Also radiologic studies of GI tract to relax smooth muscle
and thereby allow finer detail of mucosa; to diagnose insulinoma.
GI disturbances associated with spasm, cardiovascular emergencies, and to overcome cardiotoxic effects of beta blockers, quinidine,
tricyclic antidepressants; as an aid in abdominal imaging.
Hypersensitivity to glucagon or protein compounds; depleted glycogen stores in liver; insulinemia; pheochromocytoma.
Cardiac disease, CAD; pregnancy (category B), lactation.
Route & Dosage
Adult: IM/IV/SC 1 mg, may repeat q520min if no response for 12 more doses
Child: IM/IV/SC >20 kg, 1 mg; <20 kg, 2030 mcg/kg (max: 1 mg/dose), may repeat q520min if no response for 12 more doses
Insulin Shock Therapy
Adult: IM/IV/SC 1 mg usually 1 h after coma develops, may repeat in 25 min if no response
Diagnostic Aid to Relax Stomach or Upper GI Tract
Adult: IM/IV 0.252 mg 10 min before procedure
Diagnostic Aid for Colon Exam
Adult: IM/IV 2 mg 10 min before procedure
Note: 1 mg = 1 unit Subcutaneous/Intramuscular
- Dilute 1 unit (1 mg) of glucagon with 1 mL of diluent supplied by manufacturer.
- Use immediately after reconstitution of dry powder. Discard any unused portion.
- Note: Glucagon is incompatible in syringe with any other drug.
PREPARE: Direct: Prepare as noted above. Do not use a concentration >1 unit/mL.
ADMINISTER: Direct: Give 1 unit or fraction thereof over 1 min. May be given through a Y-site D5W (not NS) infusing.
INCOMPATIBILITIES Solution/additive: Sodium chloride.
- Store unreconstituted vials and diluent at 20°25° C (68°77° F).
Adverse Effects (≥1%)GI:
Nausea and vomiting. Body as a Whole:
Hypersensitivity reactions. Skin: Stevens-Johnson syndrome
May enhance effect of oral anticoagulants
520 min. Peak:
30 min. Duration:
11.5 h. Metabolism:
In liver, plasma
, and kidneys. Half-Life:
Assessment & Drug Effects
- Be prepared to give IV glucose if patient fails to respond to glucagon. Notify physician immediately.
- Note: Patient usually awakens from (diabetic) hypoglycemic coma 520 min after glucagon injection. Give PO carbohydrate as
soon as possible after patient regains consciousness.
- Note: After recovery from hypoglycemic reaction, symptoms such as headache, nausea, and weakness may persist.
Patient & Family Education
- Note: Physician may request that a responsible family member be taught how to administer glucagon SC or IM for patients with frequent
or severe hypoglycemic reactions. Notify physician promptly whenever a hypoglycemic reaction occurs so the reason for the
reaction can be determined.
- Review package insert and directions (see ADMINISTRATION).