Glucagon Patient Tips

Medically reviewed by Carmen Pope, BPharm. Last updated on July 29, 2025.

1. How it works

• Glucagon is used to treat very low blood sugar or to temporarily reduce movement of the gastrointestinal tract during radiological examinations. Glucagon as a medicine (synthetic glucagon) is identical to glucagon produced naturally by our bodies.
• Glucagon is a hormone produced by pancreatic alpha cells that raises blood glucose levels. It converts stored liver glycogen to glucose, stimulates new glucose production from amino acids, slows digestion, and breaks down fat stores. The body naturally releases glucagon when blood sugar levels drop. Synthetic glucagon injections treat severe hypoglycemia (low blood sugar levels) by rapidly releasing stored glucose from the liver into the bloodstream, increasing blood glucose levels. Glucagon also relaxes the smooth muscle of the GI tract, slowing down digestion, stomach and intestinal movements.
• Glucagon belongs to the drug class called glucose-elevating agents.

2. Upsides

• Glucagon injection is used to treat severe hypoglycemia (extremely low blood sugar levels) in adults or children with diabetes (Gvoke in patients 2 years and older, GlucaGen [discontinued]).
• Glucagon nasal powder (Baqsimi) is used to treat very low blood sugar (severe hypoglycemia) in adults and children aged 1 year and older with diabetes.
• Glucagon injection is also used as a diagnostic aid during radiologic examinations in adults to temporarily inhibit movement of the gastrointestinal tract (Gvoke VialDx). Gvoke VialDx is given intravenously under medical supervision.
• Administer as soon as possible when severe hypoglycemia is recognized. Can be administered to people with suspected severe hypoglycemia who are unconscious or having a seizure. Instruct patients and caregivers on the signs and symptoms of severe hypoglycemia, such as confusion, unclear thinking, blurry or double vision, extreme fatigue and weakness, fast heartbeat, nervousness, anxiety, or irritability, loss of consciousness, or seizures.
• Gvoke as the HypoPen auto-injector, pre-filled syringe, and the vial and syringe kit is given by subcutaneous (under the skin) injection. When giving SC administer into the upper arm, thigh, or buttocks.
• Administer glucagon nasal powder (Baqsimi) in one side of the nostril. It does not need to be inhaled. Each device contains only 1 dose of medicine and cannot be reused. It will work even if you have a cold or are taking cold medication.
• Gvoke VialDx is given intravenously.
• There does not appear to be a risk associated with using glucagon during pregnancy; however, studies have indicated that there is a lack of transfer of pancreatic glucagon across the placenta during early gestation. In breastfeeding infants, glucagon is likely to be broken down in an infant's digestive tract and is unlikely to cause harm.
• Reported to be safe and effective in children.
• The dose of glucagon is 1 mL (1mg) for everyone over 55 pounds (25kg) or 0.5 mL (0.5 mg) for everyone who weighs less than 55 pounds (25 kg).
• Glucagon is a generic.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Nausea, vomiting, transient tachycardia (fast heartbeat), and high blood pressure are the most common side effects reported. Vomiting was the most common side effect reported in children, followed by a headache. Allergic reactions have also been reported with glucagon preparations, including anaphylactic shock and a generalized rash.
• People with type 1 diabetes may have less of a response to glucagon than those with type 2 diabetes.
• Because glucagon depletes glycogen stores, administer supplemental carbohydrates to the patient as soon as he/she awakens and can swallow, especially children or adolescents. Medical evaluation is recommended for all patients who experience severe hypoglycemia.
• If there is no response to glucagon within 15 minutes, administer a second dose of glucagon. After glucagon has been administered, call for emergency help right away. Turn the person on their side and put them in the recovery position if they are unconscious.
• Glucagon is only effective in treating hypoglycemia if sufficient liver glycogen is present. Glucagon may not be effective in people who are malnourished, with adrenal insufficiency, or with longstanding hypoglycemia.
• Should not be given to people with pheochromocytoma because glucagon may stimulate the release of catecholamines (hormones such as dopamine; norepinephrine and epinephrine) from the tumor. If a person has a sudden increase in blood pressure after glucagon administration, consider the possibility of previously undiagnosed pheochromocytoma and administer 5 to 10 mg of phentolamine mesylate.
• Do not use in patients with insulinoma. In people with insulinoma, although glucagon may produce an initial increase in blood glucose, it may then directly or indirectly (through an initial rise in blood glucose) stimulate exaggerated insulin release from an insulinoma and cause hypoglycemia. If a person develops symptoms of hypoglycemia after a dose of glucagon, give oral or intravenous glucose.
• Continuous glucagon infusion has been associated with necrolytic migratory erythema (NME), a skin rash characterized by scaly, pruritic erythematous plaques, bullae, and erosions. This resolved on discontinuation of glucagon, but treatment with corticosteroids was ineffective.
• In people with cardiac disease, be careful using glucagon in endoscopic or radiographic procedures to inhibit gastrointestinal motility.
• There is a lack of data about the use of glucagon during pregnancy and breastfeeding. Only use during pregnancy if needed. It is not known if glucagon is excreted into human milk; however, glucagon is not active when taken orally because it is broken down by the gastrointestinal tract, and is unlikely to cause harm to a newborn.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Glucagon is used to treat severely low blood sugar levels (severe hypoglycemia) in adults and children with diabetes, or as a diagnostic aid in adults to slow stomach and intestinal movements during a radiologic examination. Family members and caregivers should recognize the signs of severe hypoglycemia and act quickly. Glucagon may be used when people are unconscious or having a seizure and works within 10 minutes. Emergency serivces should also be called as severe hypoglycemia can be life-threatening and lead to brain damage or death if left untreated.

5. Tips

• Make sure you and your caregivers understand the instructions for administering glucagon before you need to give it in an emergency.
• Severely low blood sugar levels are an emergency and if you are caring for somebody with suspected hypoglycemia (low blood sugar levels) you should not leave them alone. If untreated, very low blood sugar levels can cause seizures, coma, or death.
• Symptoms of very low blood sugar include confusion, coordination difficulties, difficulty eating or drinking due to the person being confused or uncooperative, unconsciousness, or seizures. Administer glucagon as soon as severely low blood sugar levels are recognized.
• The dose of glucagon injection for adults and children aged 2 years and older who weigh over 45 pounds (20 kg) or are 12 years and older is 1 mg (1 ml) and for those who weigh less than 45 pounds (20 kg) is 0.5 mg (0.5 ml).
• Administer the injection into the upper outer arm, thigh, or buttocks. Gently pinch the skin to form a bump, then insert the needle into the person’s skin and push the plunger down until the syringe is empty. Once the syringe is empty pull the needle out of the skin.
• After a glucagon injection put the person in the recovery position (roll them onto their side), and call for emergency help. Encourage the person to eat as soon as they can and can swallow safely. Initially give them a fast-acting source of sugar, such as juice, then a snack such as cheese and crackers or peanut butter. If a person does not respond within 15 minutes give them another dose of glucagon if available.
• Throw away the used glucagon syringe and arrange for a replacement injection as soon as possible.
• Tell your family, friends, and work colleagues that you have diabetes and explain what they should do if you develop severe hypoglycemia. Show them where you keep your glucagon injection and how to use it. Explain to them that hypoglycemia needs to be treated as quickly as possible because having low blood sugar levels for too long can cause seizures, coma, or death. Also tell them to call emergency services after administering glucagon if you are unconscious or having a seizure.
• Try to avoid large fluctuations on a day-to-day basis in your diet, insulin, or exercise. This will help keep your blood sugar levels in a more stable range. Always carry sugar, candy, or another kind of readily absorbable carbohydrate with you to eat if you start to feel early symptoms of low blood sugar levels, such as dizziness, tiredness, or sweating.
• Store your glucagon injection at room temperature 20°C to 25°C (68°F to 77°F). Do not keep it in the refrigerator or freeze it, and keep it in the original package to protect it from light. Do not use it after the expiry date. Discard any unused portion.
• Glucagon may not be suitable for some people with medical conditions such as kidney or pancreas disease, heart disease, glucagonomas (insulin-producing tumors), who are malnourished, or those with chronically low blood sugar levels. It should only be used during pregnancy if needed.

6. Response and effectiveness

• Starts working within 10 minutes of injection, with peak levels being reached 20 to 30 minutes after IM or IV administration. Maximal concentrations are reached 30 to 45 minutes after SC injection.
• One injection of glucagon given either IM or IV lasts 60 to 90 minutes.
• In clinical trials, 100% of people with severe hypoglycemia treated with glucagon responded within 30 minutes.
• Always follow up a dose with a fast-acting source of sugar (eg fruit juice, glucose gel) and a snack or small meal such as crackers with cheese or peanut butter because the effects of glucagon will start to wear off after at least 90 minutes. Seek emergency medical assistance immediately after administering glucagon.

7. Interactions

Medicines that interact with glucagon may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with glucagon. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may interact with glucagon include:

• beta-blockers, such as atenolol, propranolol, sotalol, or timolol (may cause a short-term increase in blood pressure and pulse)
• indomethacin (may interfere with glucagon's ability to raise blood sugar levels and may cause hypoglycemia)
• insulin (has the opposite effect as glucagon)
• warfarin (may increase the anticoagulant effect).

Concomitant use of anticholinergic drugs, such as benztropine, with glucagon for injection for use as a diagnostic aid is not recommended.

Note that this list is not all-inclusive and includes only common medications that may interact with glucagon. You should refer to the prescribing information for glucagon for a complete list of interactions.

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Frequently asked questions

• When should you use glucagon?
• How long does Baqsimi last?
• Are glucagon and glycogen the same thing?
• Insulin vs Glucagon - What do they have in common?
• How does the release of glucagon affect blood glucose levels?
• How much does Baqsimi cost?
• Is Baqsimi covered by Medicare?
• How do you use Baqsimi nasal powder?
• How do you administer a glucagon injection kit?

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use glucagon only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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