Glucagon
Pancreatic hormone and insulin antagonist for hypoglycemia
This article was imported from the BCEHS Handbook on 2026-04-12 and may require review.
Indications
- Confirmed hypoglycemia where patient mentation is unable to safely support administration of oral glucose
Contraindications
- Intranasal glucagon is contraindicated in patients under 4 years of age
- Hypersensitivity
- Pheochromocytoma
- Insulinoma
Adult Dosages
Suspected or confirmed hypoglycemia where patient mentation is insufficient to safely support administration of oral glucose
- 3 mg IN Q 15 minutes PRN (maximum 6mg)
- If no clinical response within 15 minutes is seen following the first dose, consider administration of second dose.
CliniCall consultation consultation is required prior to administration of second dose
Pediatric Considerations
Dosing same as adults, but intranasal glucagon is contraindicated in patients under 4 years of age.
Adverse Effects
- Nausea and vomiting can be common
- Possible transient increase in blood pressure and heart rate
Additional Information
Mechanism of Action
Glucagon accelerates the conversion of glycogen to glucose in the liver, elevating blood glucose levels. It is only effective in treating hypoglycemia if liver glycogen is available.
Pharmacokinetics
| Route | Onset | Peak | Duration |
|---|---|---|---|
| IN | 15 minutes | 15 minutes | 90 minutes |
Overdose
Excessive parenteral administration of glucagon can cause nausea, vomiting, and diarrhea. Ingestion of glucagon is unlikely to result in symptoms as it is rapidly broken down in the gastrointestinal tract.
Warnings and Precautions
In patients with pheochromocytoma, glucagon can cause a release of catecholamines that leads to significant hypertension and tachycardia and may provoke an intracerebral hemorrhage.
Drug Interactions
Hypoglycemia produced by excessive alcohol consumption is unlikely to be reversible with glucagon.