Dosing & Uses
Dosage Forms & Strengths
injection, solution
- 0.6mg/0.6mL single-dose autoinjector or prefilled syringe
Hypoglycemia
Ready-to-use, stable glucagon analog indicated for treatment of severe hypoglycemia in pediatric and adult patients with diabetes
0.6 mg SC; if no response after 15 minutes, an additional 0.6-mg dose from a new device may be administered
Dosage Modifications
Renal or hepatic impairment
- No dosage adjustment recommended
Dosage Forms & Strengths
injection, solution
- 0.6mg/0.6mL single-dose autoinjector or prefilled syringe
Hypoglycemia
Ready-to-use stable glucagon analog indicated for treatment of severe hypoglycemia in patients with diabetes aged ≥6 yr
<6 years: Safety and efficacy not established
≥6 years: 0.6 mg SC; if no response after 15 minutes, an additional 0.6 mg dose from a new device may be administered
Dosage Modifications
Renal or hepatic impairment
- No dosage adjustment recommended
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (15)
- acebutolol
acebutolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- atenolol
atenolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- betaxolol
betaxolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- bisoprolol
bisoprolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- celiprolol
celiprolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- esmolol
esmolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- indomethacin
indomethacin decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor.
- metoprolol
metoprolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- nadolol
nadolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- nebivolol
nebivolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- penbutolol
penbutolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- pindolol
pindolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- propranolol
propranolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- sotalol
sotalol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
- timolol
timolol decreases effects of dasiglucagon by unknown mechanism. Use Caution/Monitor. Dasiglucagon may stimulate catecholamine release; whereas beta blockers may inhibit catecholamines released in response to dasiglucagon. Coadministration may also transiently increase pulse and BP.
Minor (0)
Adverse Effects
>10%
Adults
- Nausea (57%)
- Vomiting (25%)
- Headache (11%)
Children aged 12-17 yr
- Nausea (92%)
- Vomiting (67%)
- Headache (17%)
Children aged 6-11 yr
- Nausea (25%)
- Vomiting (25%)
1-10%
Adults
- Diarrhea (5%)
- Injection site pain (2%)
Children aged 12-17 yr
- Injection site pain (8%)
Frequency Not Defined
Hypertension
Hypotension
Bradycardia
Presyncope
Palpitations
Orthostatic intolerance
Warnings
Contraindications
Pheochromocytoma
Insulinoma
Cautions
Contraindicated with pheochromocytoma; glucagon may stimulate catecholamine release from the tumor; if substantial increase in blood pressure develops, phentolamine mesylate 5-10 mg IV has been shown to be effective in lowering blood pressure
Generalized allergic reactions, including urticaria, respiratory distress, hypotension, and in some cases anaphylactic shock, reported with glucagon products; if symptoms occur, discontinue and treat as indicated
Treatment for hypoglycemia only effective if sufficient hepatic glycogen present; patients in states of starvation, with adrenal insufficiency, or chronic hypoglycemia may not have adequate levels of hepatic glycogen for therapy to be effective; treat these conditions with glucose
Insulinoma
- Contraindicated with insulinoma
- Glucagon may initially produce increased glucose; however, administration may directly or indirectly (via initial rise in blood glucose) stimulate exaggerated insulin release from an insulinoma and cause hypoglycemia
- If hypoglycemia develops following administration, give PO or IV glucose
Drug interaction overview
-
Beta-blockers
- Use with caution
- Beta-blockers may cause transient increases in pulse and blood pressure
-
Indomethacin
- Use with caution
- When used with indomethacin, glucagon may lose its ability to raise blood glucose or may even produce hypoglycemia
-
Warfarin
- Use with caution
- Glucagon may increase anticoagulant effect of warfarin
Pregnancy & Lactation
Pregnancy
There are no available data on use in pregnant females to evaluate for drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
Untreated hypoglycemia in pregnancy can cause complications and may be fatal
Animal data
- Daily SC administration to pregnant rabbits and rats during organogenesis did not cause adverse developmental effects at exposures 7 and 709 times the human dose of 0.6 mg based on AUC, respectively
Lactation
There is no information available on presence in human or animal milk, effects on breastfed children, or on milk production
Dasiglucagon is a peptide and would be expected to be broken down to its constituent amino acids in infant's digestive tract, and is therefore unlikely to cause harm to an exposed infant
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.Pharmacology
Mechanism of Action
Glucagon receptor agonist; increases blood glucose concentration by activating hepatic glucagon receptors, thereby stimulating glycogen breakdown and release of glucose from the liver
Hepatic stores of glycogen are necessary for dasiglucagon to produce an antihypoglycemic effect
Absorption
Peak plasma time
- Adults: ~35 minutes
- Children and adolescents: ~21 minutes
Peak plasma concentration
- Adults: 5,110 pg/mL
- Children and adolescents: 3,920 pg/mL
Distribution
Vd: 47-57 L
Metabolism
Cleared like native glucagon through proteolytic degradation pathways in blood, liver, and kidney
Elimination
Half-life: ~30 minutes
Administration
SC Preparation
Visually inspect before administering; solution should appear clear, colorless, and free of particles; discard if discolored or contains particulate matter
SC Administration
For SC administration only
Inform patient and family members or caregivers on how to recognize signs and symptoms of severe hypoglycemia and risks of prolonged hypoglycemia
Do not inject through clothing; roll back clothing to expose bare skin
Inject in lower abdomen, buttocks, thigh, or outer upper arm
Call for emergency assistance immediately after administering
If no response after 15 minutes, administer additional dose while waiting for emergency assistance
When patient has responded to treatment, give oral carbohydrates to restore liver glycogen and prevent recurrence of hypoglycemia
Do not attempt to reuse autoinjector or prefilled syringe; each device contains 1 single dose
Storage
Store in red protective case it comes in; replace before expiration date
Protect from light
Gray cap on autoinjector and gray needle cover on prefilled syringe contain dry natural rubber (latex derivative)
Refrigerate at 2-8ºC (36-46ºF); do not freeze
Room temperature
- May store at room temperature of 20-25ºC (68-77ºF) for up to 12 months; discard if stored >12 months
- Mark package label with date when removed from refrigerator
- Do not return to refrigerator after storing at room temperature
Images
Formulary
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