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Glucagon (GlucaGen) Uses, Side Effects & Dosage

What is glucagon?

Glucagon is a hormone produced by the pancreas that, along with insulin, controls the level of
glucose in the blood. Glucagon has the opposite effect of insulin. It increases the glucose
levels in blood. Glucagon, the drug, is a synthetic (man-made) version of human glucagon and is manufactured by genetic engineering using the bacteria
Escherichia coli.

Is glucagon available as a generic drug?

yes

Do I need a prescription for glucagon?

yes

Why is glucagon prescribed to patients?

Glucagon is used to treat severe hypoglycemia in diabetic
patients. It is also used for radiologic examination of the stomach, duodenum,
small bowel, and colon.

What are the side effects of glucagon?

Nausea and vomiting may occur occasionally after injection of
glucagon, but this may be a symptom of the hypoglycemia for which glucagon is
being given. Rare allergic-type reactions may occur with glucagon including
itching, respiratory distress, or
low blood
pressure.

Glucagon should not be administered to hypoglycemic patients who
are also experiencing starvation, adrenal insufficiency or are suffering from
chronic hypoglycemia. These medical conditions may be associated with an
inability of the liver to produce glucose sufficiently in response to glucagon.
For these patients, oral glucose is more effective if the patient is conscious.
If the patient is not conscious, intravenous glucose should be given.

What is the dosage for glucagon?

For hypoglycemia, adults and children weighing 44 pounds or more
should receive 1 mg (1 unit) of glucagon from the glucagon emergency kit either
intravenously, subcutaneously or intramuscularly. Children weighing less than 44
pounds should receive 0.5 mg (0.5 units) of glucagon or an amount equal to 20-30
micrograms per kilogram or 0.009-0.014 milligrams per pound.

When using GlucaGen® the dose for adults and children weighing more than 25
kg (55 pounds) is 1 mg given intravenously, subcutaneously or intramuscularly.
Children weighing less than 25 kg should receive 0.5 ml. If weight is unknown
children 6 years of age and older should receive 1 ml and children younger than
6 years of age should receive 0.5 ml.

Before injecting, the mixture should appear clear and free of any floating
particles. It should not be used if it is discolored. Once glucagon is
administered, blood glucose measurements should be obtained until the patient is
no longer experiencing hypoglycemic symptoms. Intravenous or oral glucose should
be given to help restore glucose levels in the body and prevent further
hypoglycemia. A physician should be notified immediately after a hypoglycemic
episode to consider a change in the dose of drug being used to treat the
diabetes in order to prevent further episodes of hypoglycemia.

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Which drugs or supplements interact with glucagon?

Glucagon may increase the anticoagulant effect of
warfarin
(Coumadin) and other anticoagulants causing an increase in the slow clotting of
blood and a greater risk of developing an episode of bleeding. Careful
monitoring is necessary when glucagon is given to people wore also being treated
with anticoagulants.

Insulin reverses the effect of glucagon.

Glucagon should not be given with anticholinergic drugs due to increased risk
of stomach and intestine-related side effects.

Indomethacin
(Indocin, Indocin-SR) reduces the effect of glucagon.

Is glucagon safe to use during pregnancy or while breastfeeding?

There are no studies of the safety of glucagon in pregnant women. Glucagon does not cross the placenta and the risk to the fetus is considered to be low.

It is not known if glucagon is secreted in breast milk.




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What else should I know about glucagon?

What preparations of glucagon are available?

Glucagon is available as an emergency kit.

  • The kit contains
    freeze-dried glucagon as a powder for injection 1 ml syringe of diluent.
  • The
    powder contains 1 mg (1 unit) of glucagon and 49 mg of lactose.
  • The diluent
    contains 12 mg/ml of glycerine, water for Injection, and hydrochloric acid. The
    diluent is mixed with the glucagon powder prior to injection.
  • GlucaGen Hypokit® and GlucaGen Diagnostic Kit® have 1 vial containing 1 mg (1
    unit) of glucagon powder and a disposable syringe containing 1 ml sterile water
    for reconstitution (mixing). Glucagon is also available in a 10-pack containing
    ten 1 mg vials of glucagon.
How should I keep glucagon stored?

The glucagon emergency kit and GlucaGen® should be stored at room
temperature, 20 C to 25 C (68 F to 77 F) prior to mixing with diluent (glycerin
or sterile water). Once mixed with diluent, the prepared drug should be used
immediately.

How does glucagon work?

Glucagon is used to increase the blood glucose level in severe
hypoglycemia
(low blood glucose). Glucagon is a glucose-elevating drug. Other
glucose-elevating drugs are glucose itself and diazoxide (Proglycem). In
diabetic patients, low blood glucose (hypoglycemia) may occur from an unintended
excess of injected insulin or oral glucose-lowering medication, such as a
sulfonylurea like
glipizide (Glucotrol), that are being used to treat diabetes. Hypoglycemia
also may occur as a result of insufficient caloric intake or sudden, excessive
physical exertion. Symptoms of hypoglycemia include:

In any hypoglycemic situation, efforts
should be made to raise the glucose level in the blood. Glucagon raises blood
glucose levels by preventing the liver from storing glucose, increasing glucose
formation in the liver from dietary proteins and fats, and increasing the
release of glucose from the liver into blood. Glucagon transiently paralyzes the
muscles of the intestines and occasionally is used during testing that requires
the intestines to be flaccid, for example, endoscopic retrograde
cholangiopancreatography and barium enema.

When was glucagon approved by the FDA?

The FDA approved glucagon in November 1960.

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