Glucagon belongs to the group of medications called hyperglycemic agents. It is used to treat severe hypoglycemia (low blood sugar) when someone with insulin-treated diabetes is unable to give glucose to themselves (e.g., unconscious). Symptoms of severely low blood sugar include disorientation, unconsciousness, and seizures.

This medication works in the liver to produce glucose (sugar) and increase blood sugar. It usually works within 10 to 15 minutes. If a person does not respond to this medication within 10 to 15 minutes, get immediate medical attention.

Glucagon can also be used as part of certain radiologic tests to temporarily reduce the movement of the stomach and intestines.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are being given this medication, speak to your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.

The usual dose of this medication for adults and children who weight more than 20 kg (44 lbs) is 1 mg (1 unit) injected under the skin, into a muscle, or into a vein. For children who weight less than 20 kg (44 lbs), the dose is 0.5 mg (0.5 units) or is based on body weight.

Injections into a vein are given by health care professionals with the appropriate training and supplies to do so.

To give a glucagon injection under the skin, first prepare the injection. Once prepared, use it immediately and do not store for later use.

• Remove the flip-off seal from the vial (bottle) of glucagon.
• Remove the needle protector from the syringe, and inject the entire contents of the syringe into the bottle of glucagon. Do not remove the plastic clip from the syringe. Remove the syringe from the bottle.
• Swirl the bottle gently until the glucagon dissolves completely. Glucagon should not be used unless the solution is clear and completely dissolved.
• Using the same syringe, hold bottle upside down and, making sure the needle tip remains in solution, withdraw all of the solution (1 mg mark on syringe) from the bottle. The plastic clip on the syringe will prevent the plunger from being pulled out of the syringe; however, if the plastic plunger rod separates from the rubber stopper, simply reinsert the rod by turning it clockwise.
• Clean the injection site on the buttock, arm, or thigh with an alcohol swab.
• Insert the needle into the fatty tissue under the cleaned injection site, and inject the glucagon solution. There is no danger of overdose.
• Apply light pressure at the injection site, and withdraw the needle. Press an alcohol swab against the injection site.
• Turn the patient on their side. When an unconscious person awakens, they may vomit. Turning the patient on their side will prevent them from choking.

As soon as someone responds to this medication, they should eat glucose (e.g., candy, orange juice, regular pop) to prevent low blood sugar from returning, and they should contact their doctor.

Glucagon is not very helpful when the low blood glucose is due to prolonged fasting, starvation, reduced adrenal function, and chronic low blood sugar. Under these circumstances, it is important to get immediate medical help to treat the low blood sugar.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you use the medication without consulting your doctor.

It is important that this medication be used exactly as prescribed by your doctor.

Before adding the diluent to the glucagon vial, this medication may be stored at room temperature.

Keep it out of the reach of children.

Each kit contains 1 rubber-stoppered vial of lyophilized powder containing glucagon for injection USP 1 unit (1 mg) and 1 prefilled Hyporet of diluting solution. Nonmedicinal ingredients: lactose and glycerin. May contain hydrochloric acid for pH adjustment.

Do not use this medication if you:

• are allergic to glucagon or any ingredients of the medication
• have pheochromocytoma (a tumour on the adrenal glands)

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is used in normal doses.

Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who uses this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• dizziness
• nausea
• vomiting

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• fast, pounding heartbeat

Stop taking the medication and seek immediate medical attention if any of the following occur:

• signs and symptoms of a severe allergic reaction (hives, itchy skin, difficulty breathing or swallowing, swelling of the face, mouth, tongue, or throat)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are using this medication.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Alcohol: Alcohol ingestion (acute or chronic) can reduce the effectiveness of this medication.

Insulinoma/glucagonoma: If you have an insulinoma (a tumour of the pancreas that produces insulin) or a glucagonoma (tumour of the pancreas that produces glucagon), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Knowledge of use: This medication is usually given by family members, friends, or coworkers, as it should not be used unless the individual needing the medication cannot take glucose by mouth. Make sure that these people are familiar with when and how to use this medication and where you store it.

Pheochromocytoma: This is a tumour of the adrenal gland that affects how and when the body produces chemicals that increase heart rate and blood pressure. For people with pheochromocytoma, glucagon can cause the tumour to release larger than normal amounts of these chemicals, causing a rapid, possibly dangerous, climb in blood pressure. If you have a history of pheochromocytoma, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks, and only if sugar cannot be given.

Breast-feeding: It is not known if glucagon passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

There may be an interaction between glucagon and any of the following:

• alcohol
• indomethacin
• insulin
• warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.