In the U.S.—

In Canada—

• Antidote, to beta-adrenergic blocking agents
• antidote, to calcium channel blocking agents
• antihypoglycemic
• antispasmodic
• diagnostic aid adjunct, antispasmodic

Glucagon (GLOO-ka-gon) belongs to the group of medicines called hormones. It is an emergency medicine used to treat severe hypoglycemia (low blood sugar) in patients with diabetes who have passed out or cannot take some form of sugar by mouth.

Glucagon is also used during x-ray tests of the stomach and bowels to improve test results by relaxing the muscles of the stomach and bowels. This also makes the testing more comfortable for the patient.

Glucagon also may be used for other conditions as determined by your doctor.

Glucagon is available only with your doctor's prescription, in the following dosage form:

Parenteral
• Injection (U.S. and Canada)

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For glucagon, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to glucagon or to beef or pork products, including insulin. Also, tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Glucagon has not been studied in pregnant women. However, glucagon has not been shown to cause birth defects or other problems in animal studies.

Breast-feeding—It is not known whether glucagon passes into breast milk. However, this medicine has not been reported to cause problems in nursing babies.

Children—This medicine has been tested in children and, in effective doses, has not been shown to cause different side effects or problems than it does in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of glucagon in the elderly with use in other age groups, it is not expected to cause different side effects or problems in older people than it does in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the doses or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

• Diabetes mellitus—When glucagon is used for test or x-ray procedures in patients with diabetes that is well-controlled, a rise in blood sugar may occur; otherwise, glucagon is an important part of the management of diabetes because it is used to treat hypoglycemia (low blood sugar)

• Insulinoma (tumors of the pancreas gland that make too much insulin) (or history of)—Blood sugar concentrations may decrease

• Pheochromocytoma—Glucagon can cause high blood pressure

Glucagon is an emergency medicine and must be used only as directed by your doctor. Make sure that you and a member of your family or a friend understand exactly when and how to use this medicine before it is needed .

Glucagon is packaged in a kit with a vial of powder containing the medicine and a syringe filled with liquid to mix with the medicine. Directions for mixing and injecting the medicine are in the package. Read the directions carefully and ask your health care professional for additional explanation, if necessary.

Glucagon should not be mixed after the expiration date printed on the kit and on one vial. Check the date regularly and replace the medicine before it expires. The printed expiration date does not apply after mixing, when any unused portion must be discarded.

Dosing—

The dose of glucagon will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of glucagon. If your dose is different, do not change it unless your doctor tells you to do so.

• As an emergency treatment for hypoglycemia:
  • Adults and children weighing 20 kilograms (kg) (44 pounds) or more: 1 milligram (mg). The dose may be repeated after fifteen minutes if necessary.
  • Children weighing up to 20 kg (44 pounds): 0.5 mg or 20 to 30 micrograms (mcg) per kg (9.1 to 13.6 mcg per pound) of body weight. The dose may be repeated after fifteen minutes if necessary.

Storage—

To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Store the unmixed medicine at room temperature.
• Do not store the unmixed medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Patients with diabetes should be aware of the symptoms of hypoglycemia (low blood sugar). These symptoms may develop in a very short time and may result from:

• using too much insulin (“insulin reaction”) or as a side effect from oral antidiabetic medicines.
• delaying or missing a scheduled snack or meal.
• sickness (especially with vomiting or diarrhea).
• exercising more than usual.

Unless corrected, hypoglycemia will lead to unconsciousness, convulsions (seizures), and possibly death. Early symptoms of hypoglycemia include: anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in concentrating, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, and unusual tiredness or weakness.

Symptoms of hypoglycemia can differ from person to person. It is important that you learn your own signs of low blood sugar so that you can treat it quickly. It is a good idea also to check your blood sugar to confirm that it is low.

You should know what to do if symptoms of low blood sugar occur. Eating or drinking something containing sugar when symptoms of low blood sugar first appear will usually prevent them from getting worse, and will probably make the use of glucagon unnecessary. Good sources of sugar include glucose tablets or gel, corn syrup, honey, sugar cubes or table sugar (dissolved in water), fruit juice, or nondiet soft drinks. If a meal is not scheduled soon (1 hour or less), you should also eat a light snack, such as crackers and cheese or half a sandwich or drink a glass of milk to keep your blood sugar from going down again. You should not eat hard candy or mints because the sugar will not get into your blood stream quickly enough. You also should not eat foods high in fat such as chocolate because the fat slows down the sugar entering the blood stream. After 10 to 20 minutes, check your blood sugar again to make sure it is not still too low.

Tell someone to take you to your doctor or to a hospital right away if the symptoms do not improve after eating or drinking a sweet food. Do not try to drive yourself.

If severe symptoms such as convulsions (seizures) or unconsciousness occur, the patient with diabetes should not be given anything to eat or drink. There is a chance that he or she could choke from not swallowing correctly. Glucagon should be administered and the patient's doctor should be called at once.

If it becomes necessary to inject glucagon, a family member or friend should know the following:

• After the injection, turn the patient on his or her left side. Glucagon may cause some patients to vomit and this position will reduce the possibility of choking.
• The patient should become conscious in less than 15 minutes after glucagon is injected, but if not, a second dose may be given. Get the patient to a doctor or to hospital emergency care as soon as possible because being unconscious too long can be harmful.
• When the patient is conscious and can swallow, give him or her some form of sugar. Glucagon is not effective for much longer than 1½ hours and is used only until the patient is able to swallow. Fruit juice, corn syrup, honey, and sugar cubes or table sugar (dissolved in water) all work quickly. Then, if a snack or meal is not scheduled for an hour or more, the patient should also eat some crackers and cheese or half a sandwich, or drink a glass of milk. This will prevent hypoglycemia from occurring again before the next meal or snack.
• The patient or caregiver should continue to monitor the patient's blood sugar. For about 3 to 4 hours after the patient regains consciousness, the blood sugar should be checked every hour.
• If nausea and vomiting prevent the patient from swallowing some form of sugar for an hour after glucagon is given, medical help should be obtained.

Keep your doctor informed of any hypoglycemic episodes or use of glucagon even if the symptoms are successfully controlled and there seem to be no continuing problems. Complete information is necessary for the doctor to provide the best possible treatment of any condition.

Replace your supply of glucagon as soon as possible, in case another hypoglycemic episode occurs.

You should wear a medical identification (I.D.) bracelet or chain at all times. In addition, you should carry an I.D. card that lists your medical condition and medicines.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Get emergency help immediately if any of the following side effects occur:

• Less common
  • Dizziness;  lightheadedness;  trouble in breathing 
  
  

• Symptoms of overdose
  • Diarrhea;  irregular heartbeat;  loss of appetite;  muscle cramps or pain ;  nausea (continuing);  vomiting (continuing);  weakness of arms, legs, and trunk (severe) 
  
  

Check with your doctor as soon as possible if the following side effect occurs:

• Less common
  • Skin rash  
  
  

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

• Less common or rare
  • Fast heartbeat;  nausea;  vomiting 
  
  

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although these uses are not included in product labeling, glucagon is used in certain patients with the following medical conditions or undergoing certain medical procedures:

• Overdose of beta-adrenergic blocking medicines
• Overdose of calcium channel blocking medicines
• Removing food or an object stuck in the esophagus
• Hysterosalpingography (x-ray examination of the uterus and fallopian tubes)

Other than the above information, there is no additional information relating to proper use, precautions, or side effects for these uses.