glucagon (Rx)

Brand and Other Names:Glucagen, Glucagon Emergency Kit, more...GlucaGen HypoKit
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection, powder

  • 1mg/vial
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Hypoglycemia

Indicated for severe hypoglycemic reactions in patients with diabetes treated with insulin

1 mg (1 unit) IM/SC/IV if no IV for dextrose

Repeat q15min once or twice; give dextrose as soon as it is available and if no response

Administer supplemental carbohydrate to replete glycogen stores

Radiography of GI

Indicated as diagnostic aid for decreased GI motility

To inhibit motility of stomach and small bowel: 0.2-0.5 mg IV over time period of 1 min or 1 mg IM

To inhibit motility of colon: 0.5-0.75 mg IV over time period of 1 min or 1 mg IM

Bolus doses >1 mg administered IV may cause nausea and vomiting and are not recommended

Beta-Blocker & Calcium Channel Blocker Toxicity (Off-label)

Indicated off-label for overdose of beta blockers or calcium channel blockers

Load: 50-150 mcg/kg IVP over 1 minute, THEN 

3-5 mg/hr or 50-100 mcg/kg/hr IV; titrate infusion to achieve adequate clinical response

Dosage Forms & Strengths

injection, powder

  • 1mg/vial
more...

Hypoglycemia

Indicated for severe hypoglycemic reactions in patients with diabetes treated with insulin

Administer oral glucose/IVdextrose to replete glycogen stores

GlucaGen

  • <6 years: 0.5 mg SC/IM/IV; may repeat in 15 min if necessary
  • >6 years: 1 mg SC/IM/IV; may repeat in 15 min if necessary
  • Alternatively,
  • <25 kg: 0.5 mg; may repeat in 15 min if necessary
  • ≥25 kg: 1 mg; may repeat in 15 min if necessary

Glucagon Emergency Kit

  • <20 kg: 0.5 mg SC/IM/IV q15min PRN, OR 0.02-0.03 mg/kg/dose SC/IM/IV; may repeat in 15 min if necessary
  • ≥20 kg: 1 mg SC/IM/IV; may repeat in 15 min if necessary q20min PRN

Chronic Hypoglycemia (Orphan)

Orphan designation for prevention of chronic, severe hypoglycemia related to congential hyperinsulinism

Sponsor

  • Xeris Pharmaceuticals, Inc; 3208 Red River Street, Suite 300; Austin, TX 78705
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Interactions

Interaction Checker

and glucagon

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      Serious - Use Alternative

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            Adverse Effects

            Frequency Not Defined

            Nausea and vomiting

            Rash

            Hypotension

            Tachycardia

            Increased blood pressure

            Increased pulse

            Respiratory distress

            Urticaria

            Hypoglycemic coma

            Hypoglycemia

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            Warnings

            Contraindications

            Hypersensitivity

            Pheochromocytoma

            Insulinoma

            Glucagonoma

            Cautions

            Generalized allergic reactions, including urticaria, respiratory distress, and hypotension 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 IV dextrose is required to replete glycogen stores

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: Excretion in milk unknown; use with caution

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Insulin antagonist

            Stimulates cAMP synthesis to accelerate hepatic glycogenolysis and gluconeogenesis, causing an increase in blood glucose levels

            Preexisting hepatic glycogen stores necessary to be effective in treating hypoglycemia

            Glucagon also relaxes smooth muscles of GI tract

            Pharmacokinetics

            Half-Life: 8-18 min IV; 45 min IM (apparent)

            Peak Plasma Time: 13 min IM; 20 min SC

            Bioavailability: IM: 30%

            Vd: 0.2-0.25 L/kg

            Metabolism: by blood, liver, & kidney

            Onset

            • Increase in glucose levels: 5-20 min IV; 30 min IM; 30-45 min SC
            • Diagnostic effect: 1 min IV; 4-10 min IM

            Duration

            • Increase in glucose levels: 60-90 min (IV/IM/SC)
            • GI relaxation: 9-25 min IV; 12-32 min IM

            Clearance

            • Renal: 19-21 mL/kg/min
            • Total Body: 135 mL/min/kg
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            Administration

            IV Preparation

            Reconstitute by adding 1 or 10 mL of sterile diluent to a vial containing 1 or 10 units of drug, respectively, to yield solutions containing 1 mg/mL

            If dose <2 mg, use only diluent provided by Mfr

            If >2 mg, use SWI

            Use immediately after reconstitution

            IV Administration

            Bolus may be associated with nausea and vomiting

            Continuous infusions may be used in beta-blocker overdose/toxicity

            Storage

            Before reconstitution, vials may be kept at controlled room temperature 20-25 degree C (68-77 degrees F)

            Use immediately following reconstitution; discard any unused portion

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            Images

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

            • View the formulary and any restrictions for each plan.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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