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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Baqsimi
Generic Name
Glucagon
Active Ingredient
GlucagonCategory
Antihypoglycemic Agent [EPC]
Variants
2
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Baqsimi, you must consult a qualified healthcare professional.
Detailed information about Baqsimi
Glucagon is a hormone and antihypoglycemic agent used for the emergency treatment of severe hypoglycemia and as a diagnostic aid in gastrointestinal imaging. It works by stimulating the liver to release stored glucose into the bloodstream.
For the treatment of severe hypoglycemia, the standard adult dose is 1 mg. This can be administered via subcutaneous (under the skin), intramuscular (into the muscle), or intravenous (into the vein) injection. If using the nasal powder formulation, the dose is 3 mg (one single-use device) administered into one nostril. If the patient does not respond within 15 minutes, a second dose may be administered while waiting for emergency medical services to arrive.
For diagnostic use (to inhibit GI motility), the dose varies based on the procedure and the desired duration of effect. Typical doses range from 0.25 mg to 2 mg given intravenously or intramuscularly. For example, a dose of 0.25 mg to 0.5 mg IV provides rapid onset (1 minute) with a short duration (9-17 minutes), whereas 1 mg IM provides a slower onset (4-10 minutes) but a longer duration (12-32 minutes).
Pediatric dosing for severe hypoglycemia is generally based on weight or age:
No specific dosage adjustments are required for patients with renal (kidney) impairment. However, since the kidneys contribute to the clearance of glucagon, the duration of effect might be slightly prolonged in patients with end-stage renal disease.
No dosage adjustment is typically necessary for hepatic (liver) impairment. However, Glucagon relies on liver glycogen stores to work. In patients with severe liver disease or cirrhosis, Glucagon may be significantly less effective or completely ineffective because the liver cannot store or release glucose.
Clinical studies have not identified significant differences in safety or effectiveness between patients over 65 and younger patients. Caution is advised in elderly patients with underlying cardiac disease, as Glucagon can cause a transient increase in heart rate and blood pressure.
Store Glucagon at room temperature (20°C to 25°C / 68°F to 77°F). Do not freeze. Keep the medication in its original packaging to protect it from light. Always check the expiration date; Glucagon is an emergency medication and must be replaced before it expires.
Glucagon is used on an 'as-needed' basis for emergencies or diagnostic procedures. There is no regular dosing schedule, so missed doses are not applicable. However, if a patient with diabetes does not have their Glucagon kit available during a severe hypoglycemic event, it is a medical emergency requiring immediate 911 intervention.
Signs of a Glucagon overdose include severe nausea, projectile vomiting, increased blood pressure, and a rapid heart rate. In some cases, it may cause a decrease in serum potassium (hypokalemia). Because Glucagon has a very short half-life, treatment is primarily supportive, focusing on hydration and monitoring electrolyte levels. If you suspect an overdose, contact a poison control center or seek emergency medical care.
> Important: Follow your healthcare provider's dosing instructions and ensure that family members, roommates, or coworkers are trained on how to administer Glucagon in an emergency.
The most frequent side effects associated with Glucagon administration are related to its primary physiological actions on the gastrointestinal tract and the metabolic system.
Glucagon is a life-saving medication, but it must be used with caution in specific clinical scenarios. The most critical warning is that Glucagon is ineffective in patients whose liver glycogen stores are depleted. This includes individuals who are in a state of starvation, those with adrenal insufficiency (Addison's disease), and those suffering from chronic alcoholism. In these patients, there is no stored sugar for the Glucagon to release, and emergency glucose must be administered intravenously by medical professionals.
No FDA black box warnings for Glucagon.
While there are no drugs that are strictly 'contraindicated' in a way that prevents emergency use, there are combinations that significantly alter the safety profile:
There are three primary conditions where Glucagon must NEVER be used:
Glucagon is generally considered safe for use during pregnancy. According to the FDA, it is classified as a medication that should be used if clearly needed. Because Glucagon is a large peptide hormone, it does not cross the placenta in significant amounts and is not expected to harm the developing fetus. Severe hypoglycemia in the mother is a much greater risk to the baby (potentially causing fetal distress or death) than the medication itself. There is no known evidence of teratogenicity (birth defects) in humans.
It is not known if Glucagon is excreted in human breast milk. However, even if it were, Glucagon is a protein that is rapidly broken down in the digestive tract. If an infant were to ingest Glucagon through breast milk, it would be digested like any other dietary protein and would not be absorbed into the infant's bloodstream. Therefore, Glucagon is considered compatible with breastfeeding. No special precautions are typically required for nursing mothers.
Glucagon is FDA-approved for use in children of all ages for the treatment of severe hypoglycemia. The dose is adjusted based on weight (0.5 mg for <20 kg, 1 mg for >20 kg). The nasal formulation (Baqsimi) is approved for children 4 years of age and older. Clinical trials have shown that the safety profile in children is similar to that in adults, with nausea and vomiting being the most frequent side effects. It is critical that school nurses, teachers, and coaches are trained in its administration.
Glucagon is an agonist at the glucagon receptor, a G-protein-coupled receptor located primarily on hepatocytes. Upon binding, it activates adenylate cyclase, which increases intracellular levels of cyclic AMP (cAMP). This 'second messenger' activates protein kinase A (PKA), which then phosphorylates and activates the enzyme phosphorylase kinase. This enzyme, in turn, activates glycogen phosphorylase, the rate-limiting enzyme that converts glycogen into glucose-1-phosphate, which is then converted to free glucose and released into the blood. This process is known as glycogenolysis.
The pharmacodynamic response to Glucagon is a rapid rise in blood glucose. Following a 1 mg IM injection, blood glucose typically begins to rise within 5 to 10 minutes and reaches a peak increase of approximately 20-50 mg/dL within 30 minutes. The duration of the hyperglycemic effect is approximately 60 to 90 minutes. In the GI tract, the pharmacodynamic effect is smooth muscle relaxation, which occurs within 1 minute of an IV injection and lasts up to 20 minutes depending on the dose.
| Parameter | Value |
Common questions about Baqsimi
Glucagon is primarily used as an emergency life-saving treatment for severe hypoglycemia (very low blood sugar) in people with diabetes who are unable to take sugar by mouth. It is also used by doctors during certain medical imaging tests, like X-rays or CT scans of the stomach and intestines, because it can temporarily stop the movement of these organs to provide a clearer picture. Additionally, it is used in emergency rooms as an antidote for overdoses of specific heart medications called beta-blockers or calcium channel blockers. It works by telling the liver to release stored sugar into the bloodstream quickly. Because it is for emergencies, it is usually administered by a caregiver or medical professional rather than the patient themselves.
The most common side effects of Glucagon are nausea and vomiting, which affect up to one-third of patients who receive it. Many people also experience a temporary headache or a fast heart rate shortly after the injection. If you are using the nasal powder version (Baqsimi), you might also experience a runny nose, watery eyes, or redness in the eyes. These side effects are usually short-lived because the medication leaves the body very quickly. However, because vomiting is so common, it is vital to turn the person on their side after giving them the drug to prevent them from choking. Always inform your doctor if these side effects are severe or do not go away.
Drinking alcohol can make Glucagon much less effective or even completely useless. Alcohol blocks the liver's ability to create and release new sugar into the blood, and chronic drinking can deplete the sugar stores that Glucagon relies on to work. If someone has a severe low blood sugar episode after drinking heavily, Glucagon may not wake them up, and they will likely need intravenous (IV) glucose at a hospital. It is very important for people with diabetes to be aware that alcohol increases the risk of severe lows while simultaneously making the emergency treatment less reliable. Always discuss your alcohol consumption habits with your healthcare provider to understand your specific risks.
Yes, Glucagon is generally considered safe and is the standard of care for treating severe hypoglycemia during pregnancy. Because it is a large protein molecule, it does not easily cross the placenta to reach the baby. The risk of leaving a severe low blood sugar event untreated is much higher for both the mother and the baby than the risk of using Glucagon. Severe hypoglycemia in a pregnant woman can lead to fetal distress or other complications. Doctors recommend that pregnant women with diabetes always have an emergency Glucagon kit available. As always, you should inform your obstetrician and endocrinologist if you have had to use Glucagon during your pregnancy.
Glucagon works very quickly, but not instantly. After an injection into the muscle or under the skin, blood sugar levels usually begin to rise within 5 to 10 minutes, and most people will regain consciousness within 10 to 15 minutes. The nasal powder version takes slightly longer to reach its peak, but it is still effective within a similar timeframe. If the person does not wake up or respond within 15 minutes of the first dose, a second dose should be given if available, and emergency medical services (911) must be called. Once the person is awake and able to swallow, they must eat a fast-acting sugar and a snack with protein to keep their levels stable.
Glucagon is not a daily medication that you 'stop' taking; it is an emergency treatment used only when needed. There are no withdrawal symptoms or physical dependencies associated with Glucagon. However, if you have been prescribed a Glucagon kit, you should never 'stop' having it available in your home, school, or workplace. If you no longer have a kit because it expired or was used, you must get a replacement immediately. If your doctor decides you no longer need to carry Glucagon, it is usually because your risk of severe hypoglycemia has decreased due to changes in your other medications or health status.
Since Glucagon is only used during a medical emergency (severe hypoglycemia), there is no such thing as a 'missed dose' in the traditional sense. You do not take it on a schedule. However, a 'missed opportunity' to use Glucagon occurs if the medication is not available when a severe low happens. This is why it is critical to check your kit regularly to ensure it has not expired and that the liquid (if it's a pre-filled version) is clear. If you find that your Glucagon has expired, call your pharmacy for a refill immediately. Always ensure that your family and friends know where you keep your Glucagon so they can find it in an emergency.
Glucagon itself does not cause weight gain, as it is used very infrequently and is cleared from the body in less than an hour. In fact, glucagon is sometimes studied for its potential to *help* with weight loss because it can suppress appetite and increase energy expenditure. However, people who experience frequent severe lows requiring Glucagon may find themselves eating extra calories to treat or prevent those lows, which can lead to weight gain over time. If you are concerned about weight changes, talk to your doctor about adjusting your insulin or other diabetes medications to prevent the lows from happening in the first place.
Glucagon can be administered even if you are taking other medications, but some drugs can change how well it works. For example, beta-blockers used for heart conditions can cause a temporary spike in blood pressure and heart rate when Glucagon is given. Some NSAIDs like indomethacin might make Glucagon less effective. Because Glucagon is used in life-threatening emergencies, you should always give it first and then let the emergency medical team know about all other medications the person is taking. It is especially important to tell them if the person is on blood thinners like warfarin, as Glucagon can slightly increase the risk of bleeding.
Yes, Glucagon is available as a generic injection kit. For many years, only brand-name versions like GlucaGen were available, but the FDA has recently approved generic versions of the emergency kit to help make the medication more affordable. However, some of the newer delivery methods, such as the nasal powder (Baqsimi) or the pre-filled auto-injectors (Gvoke, Zegalogue), are still protected by patents and may not have generic versions available yet. When your doctor writes a prescription, you can ask if a generic version is appropriate for you, but ensure that whoever might need to use it is trained on that specific device, as the instructions can differ between brands.
Other drugs with the same active ingredient (Glucagon)
> Warning: Stop taking Glucagon and call your doctor immediately if you experience any of these serious symptoms.
Glucagon is not intended for chronic, daily use. However, in rare cases where it is used more frequently (such as in some investigational pump therapies), potential long-term concerns include:
No FDA black box warnings for Glucagon. However, it carries significant warnings regarding its use in patients with pheochromocytoma or insulinoma, which are detailed in the 'Warnings' section of this guide.
Report any unusual symptoms or side effects to your healthcare provider. You may also report side effects to the FDA at 1-800-FDA-1088.
Patients should not drive or operate heavy machinery until they have fully recovered from the hypoglycemic event and their blood sugar has stabilized. The hypoglycemia itself, rather than the Glucagon, is the primary cause of impairment. However, since Glucagon can cause nausea and dizziness, wait until all side effects have subsided.
Alcohol consumption significantly interferes with the liver's ability to produce and release glucose. Chronic alcohol use depletes glycogen stores, making Glucagon ineffective. Even acute alcohol consumption (binge drinking) can block the liver's response to Glucagon. Patients who have been drinking alcohol may require IV glucose instead of Glucagon to treat a low.
There are no tapering requirements for Glucagon as it is an acute-use medication. There is no risk of a withdrawal syndrome. However, after using Glucagon, patients must review their diabetes management plan with their doctor to determine why the severe low occurred and how to prevent future episodes.
> Important: Discuss all your medical conditions, especially any history of tumors or liver disease, with your healthcare provider before an emergency arises.
There are no well-documented interactions between Glucagon and common herbal supplements like St. John's Wort or Ginkgo Biloba. However, any supplement that affects blood sugar (such as berberine or high doses of cinnamon) could theoretically influence the overall glycemic state, but they do not interact with the Glucagon molecule itself.
Glucagon administration can temporarily affect certain laboratory results:
For each major interaction, the management strategy is generally the same: prioritize the emergency treatment of hypoglycemia first, then monitor the patient closely for cardiovascular changes or rebound blood sugar issues.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, especially if you have a history of heart disease or are on blood thinners.
These are conditions where the benefit of saving a life from hypoglycemia usually outweighs the risk, but medical supervision is required:
There are no common cross-sensitivities with other drug classes, as Glucagon is a unique peptide hormone. However, patients with a severe 'dairy allergy' should check their specific Glucagon formulation, as some powders use lactose as a stabilizing agent.
> Important: Your healthcare provider will evaluate your complete medical history, including any history of rare tumors, before prescribing an emergency Glucagon kit.
Clinical studies of Glucagon did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Elderly patients with pre-existing heart disease may be at higher risk for the tachycardic (fast heart rate) effects of Glucagon.
The kidneys are responsible for approximately 30% of Glucagon clearance. In patients with renal impairment or kidney failure, the half-life of Glucagon may be slightly prolonged. However, because it is used as a single emergency dose, no dosage adjustment is recommended. The clinical effect may last slightly longer, which is generally not harmful in the context of treating low blood sugar.
Hepatic (liver) impairment does not change the way Glucagon is cleared, but it significantly changes how the drug works. Glucagon requires the liver to have stores of glycogen. In patients with end-stage liver disease or cirrhosis, the liver may be unable to respond to Glucagon. These patients must be treated with IV glucose. No dose adjustment is needed, but healthcare providers should be aware of the high risk of treatment failure.
> Important: Special populations require individualized medical assessment. Ensure your 'Diabetes Emergency Plan' accounts for these factors.
| Bioavailability | High (IM/SC); ~100% relative to IV |
| Protein Binding | Negligible |
| Half-life | 8 to 18 minutes |
| Tmax (Injection) | 10 to 15 minutes |
| Tmax (Nasal) | 30 minutes |
| Metabolism | Proteolysis in Liver, Kidney, and Plasma |
| Excretion | Renal (30%), Hepatic (70%) |
Glucagon is classified as an Antihypoglycemic Agent and a Gastrointestinal Motility Inhibitor. It is the only member of its class used for emergency hypoglycemia, though newer 'glucagon-like' analogs (such as dasiglucagon) have recently been developed to provide more stable liquid formulations.