Glucagon

Glucagon is the generic form of the brand-name drug GlucaGen, a prescription injection drug that's identical to the glucagon hormone that occurs naturally in humans.

Glucagon is used as an emergency medicine by people with diabetes to raise blood sugar levels that are dangerously low when they have hypoglycemia.

It's also used during certain medical tests to help spot disorders of the stomach or intestines.

Glucagon causes the liver to release glucose, a simple sugar your body needs to provide energy for vital functions.

Glucagon Emergency Kit

If you have diabetes and often experience low blood-sugar episodes, you should keep a glucagon emergency kit with you all the time.

This kit typically includes the medicine and supplies you need along with instructions on how to administer the drug.

Glucagon Warnings

Be sure you and your caregivers know how to give this medication in case of an emergency, because it's likely that a family member, caregiver, or friend will administer the dose of glucagon.

Glucagon should only be used to treat low blood sugar if you are not well enough to use food to raise your blood sugar, if you have passed out, or if you have a seizure.

You and your caregivers should know the symptoms of low blood sugar, which may include:

• Dizziness
• Lightheadedness
• Shakiness
• Sweating
• Confusion
• Irritability
• Headache
• Weakness
• Pale skin
• Sudden changes in mood or behavior.

After taking glucagon and regaining consciousness, you must contact your doctor, and your blood sugar levels should be checked hourly for three to four hours.

Before getting a prescription for glucagon, you should tell your doctor if you have or have ever had:

• An allergy to glucagon
• Any allergies to other drugs
• An allergy to beef or pork products
• Chronic low blood-sugar episodes
• Adrenal gland problems or tumors
• Blood-vessel disease
• Malnutrition
• A tumor in the pancreas

Pregnancy and Glucagon

Quickly treating dangerously low blood sugar outweighs any risks glucagon may pose.

Glucagon is a pregnancy category B drug, which means it's not expected to harm an unborn baby.

Nevertheless, if you are pregnant, let your doctor know as soon as possible after taking glucagon.

It's not known whether glucagon passes into breast milk or if it could harm a breastfeeding baby.

You should talk to your doctor about breastfeeding while using this medicine. Be sure to tell your doctor if you have taken glucagon before resuming breastfeeding.

• Lilly, Eli & Company

Glucagon is a prescription medication used to treat insulin coma or insulin reaction from very low blood sugar (severe hypoglycemia) in adults and children with diabetes. Glucagon is a hormone, which helps raise sugar levels in the blood.

This medication comes in an injectable form and is injected in the buttock, arm, or thigh during severe hypoglycemic attacks.

Common side effects of glucagon include nausea, vomiting, and reaction at the injection site.

Glucagon may be found in some form under the following brand names:

• Glucagen

DIRECTIONS FOR USE

TO PREPARE GLUCAGON FOR INJECTION

1. Remove the flip-off seal from the bottle of glucagon. Wipe rubber stopper on bottle with alcohol swab.
2. Remove the needle protector from the syringe, and inject the entire contents of the syringe into the bottle of glucagon. DO NOT REMOVE THE PLASTIC CLIP FROM THE SYRINGE. Remove syringe from the bottle.
3. Swirl bottle gently until glucagon dissolves completely. GLUCAGON SHOULD NOT BE USED UNLESS THE SOLUTION IS CLEAR AND OF A WATER-LIKE CONSISTENCY.

TO INJECT GLUCAGON

Use Same Technique as for Injecting Insulin

• Using the same syringe, hold bottle upside down and, making sure the needle tip remains in solution, gently withdraw all of the solution (1 mg mark on syringe) from bottle. The plastic clip on the syringe will prevent the rubber stopper from being pulled out of the syringe; however, if the plastic plunger rod separates from the rubber stopper, simply reinsert the rod by turning it clockwise. The usual adult dose is 1 mg (1 unit). For children weighing less than 44 lb (20 kg), give 1/2 adult dose (0.5 mg). For children, withdraw 1/2 of the solution from the bottle (0.5 mg mark on syringe). DISCARD UNUSED PORTION.

USING THE FOLLOWING DIRECTIONS, INJECT GLUCAGON IMMEDIATELY AFTER MIXING.

1. Cleanse injection site on buttock, arm, or thigh with alcohol swab.
2. Insert the needle into the loose tissue under the cleansed injection site, and inject all (or 1/2 for children weighing less than 44 lb) of the glucagon solution. THERE IS NO DANGER OF OVERDOSE. Apply light pressure at the injection site, and withdraw the needle. Press an alcohol swab against the injection site.
3. Turn the patient on his/her side. When an unconscious person awakens, he/she may vomit. Turning the patient on his/her side will prevent him/her from choking.
4. FEED THE PATIENT AS SOON AS HE/SHE AWAKENS AND IS ABLE TO SWALLOW. Give the patient a fast-acting source of sugar (such as a regular soft drink or fruit juice) and a long-acting source of sugar (such as crackers and cheese or a meat sandwich). If the patient does not awaken within 15 minutes, give another dose of glucagon and INFORM A DOCTOR OR EMERGENCY SERVICES IMMEDIATELY.
5. Even if the glucagon revives the patient, his/her doctor should be promptly notified. A doctor should be notified whenever severe hypoglycemic reactions occur.

Information on hypoglycemia - Early symptoms of hypoglycemia (low blood glucose) include:

• sweating
• dizziness
• palpitation
• tremor
• hunger
• restlessness
• tingling in the hands, feet, lips, or tongue
• lightheadedness
• inability to concentrate
• headache
• drowsiness
• sleep disturbances
• anxiety
• blurred vision
• slurred speech
• depressed mood
• irritability
• abnormal behavior
• unsteady movement
• personality changes

If not treated, the patient may progress to severe hypoglycemia that can include:

• disorientation
• unconsciousness
• seizures
• death

The occurrence of early symptoms calls for prompt and, if necessary, repeated administration of some form of carbohydrate. Patients should always carry a quick source of sugar, such as candy mints or glucose tablets. The prompt treatment of mild hypoglycemic symptoms can prevent severe hypoglycemic reactions. If the patient does not improve or if administration of carbohydrate is impossible, glucagon should be given or the patient should be treated with intravenous glucose at a medical facility. Glucagon, a naturally occurring substance produced by the pancreas, is helpful because it enables the patient to produce his/her own blood glucose to correct the hypoglycemia.

Specific Drugs

(GLOO ka gon)

• Glucagon HCl
• Glucagon Hydrochloride

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Kit, Injection:

Glucagon Emergency: 1 mg

Solution Reconstituted, Injection:

GlucaGen Diagnostic: 1 mg (1 ea)

GlucaGen HypoKit: 1 mg (1 ea)

Generic: 1 mg (1 ea)

• GlucaGen Diagnostic
• GlucaGen HypoKit
• Glucagon Emergency

Frequency not defined.

Cardiovascular: Hypertension, hypotension (up to 2 hours after GI procedures), increased blood pressure, increased pulse, tachycardia

Gastrointestinal: Nausea, vomiting (high incidence with rapid administration of high doses)

Miscellaneous: Anaphylaxis, hypersensitivity reaction

<1% (Limited to important or life-threatening): Hypoglycemia, hypoglycemic coma, respiratory distress, urticaria