Glucagon (Syringe)

Products

Glucagon is commercially available as an injectable (GlucaGen). It has been approved in many countries since 1965. It is available to patients as a powder and solvent for preparing a solution for injection in a prefilled syringe. The drug is stored in a cool place in the pharmacy until dispensed. Patients can store it at room temperature. A glucagon nasal spray was first approved in the United States in 2019 (Baqsimi) and in many countries in 2020. Later in 2019, a prefilled syringe and auto-injector, which can be stored at room temperature and are ready to use (Gvoke), were also released in the United States.

Structure and properties

Glucagon (C153H225N43O49S, Mr = 3483 g/mol) is a linear polypeptide of 29 amino acids that has the same structure as the hormone produced by alpha cells of the human pancreas. It exists as a white powder that is practically insoluble in water and most organic solvents. Structure: H-His-Ser-Gln-Gly-Thr-Phe-Thr-Ser-Asp-Tyr-Ser-Lys-Tyr-Leu-Asp-Ser-Arg-Arg-Ala-Gln-Asp-Phe-Val-Gln-Trp-Leu-Met-Asn-Thr-OH Glucagon contained in the drug is biotechnologically obtained from yeast.

Effects

Glucagon (ATC H04AA01) increases blood glucose levels, counteracting the effects of insulin. The effects are due to the breakdown of glycogen in the liver. Glucagon also inhibits the movements of the digestive tract. The effects occur within one minute and last up to twenty minutes.

Indications

  • Therapeutic: For the treatment of severe hypoglycemia in insulin-treated patients with diabetes mellitus.
  • Diagnostic: Motility inhibition in gastrointestinal tract examinations.

Dosage

According to the product information. The classic pre-filled syringe can not be injected directly: Before administration, the dry substance must be dissolved in the solvent and the mixture absorbed into the syringe. Administration is subcutaneous or intramuscular. The effect can be expected within about 10 minutes. Subsequently, oral carbohydrates must be administered.

Contraindications

  • Hypersensitivity
  • Insulinoma
  • Pheochromocytoma

For complete precautions, see the drug label.

Interactions

Drug-drug interactions have been described with insulins (reversing effects), beta-blockers, anticholinergics, indomethacin, and warfarin.

Adverse effects

The most common potential adverse effects include nausea and vomiting. Occasionally, hypoglycemia may recur. Glucagon may cause a rapid pulse and hypertension in the short term.