Glucagon


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Diagnostic aid in radiologic examination of GI tract Relaxation of stomach, duodenal bulb, duodenum, and small bowel: 0.2-0.5 mg. Relaxation of colon: 0.5-0.75 mg. IM Diagnostic aid in radiologic examination of GI tract Relaxation of stomach, duodenal bulb, duodenum, and small bowel: 1 mg. Relaxation of colon: 1-2 mg. IV/IM/SC Severe hypoglycaemia 1 mg. IV glucose should be given if no response w/in 10 min. May repeat glucagon dose if needed.
Dosage Details
Intramuscular
Diagnostic aid in the radiologic examination of the gastrointestinal tract
Adult: For relaxation of stomach, duodenal bulb, duodenum, and small bowel: 1 mg. For relaxation of colon: 1-2 mg.

Intravenous
Diagnostic aid in the radiologic examination of the gastrointestinal tract
Adult: For relaxation of stomach, duodenal bulb, duodenum, and small bowel: 0.2-0.5 mg. For relaxation of colon: 0.5-0.75 mg.

Parenteral
Severe hypoglycaemia
Adult: 1 mg given via SC, IM or IV inj. Administer oral carbohydrates once the patient has responded. If there is no response w/in 10 min, give IV glucose. Glucagon dose may be repeated if necessary.
Child: <25 kg: 0.5 mg; ≥25 kg: Same as adult dose.
Contraindications
Phaeochromocytoma, insulinoma, glucagonoma.
Special Precautions
Patient w/ adrenal insufficiency, DM (when used as diagnostic aid), cardiac disease, chronic hypoglycaemia, uraemia, hepatic disease. Childn. Pregnancy and lactation.
Adverse Reactions
Significant: Rarely, hypersensitivity reactions (e.g. anaphylactic shock, rash).
CV: Hypotension, HTN, tachycardia, bradycardia.
GI: Abdominal pain, diarrhoea, nausea, vomiting.
Resp: Resp distress.
Endocrine: Secondary hypoglycaemia, hypoglycaemic coma.
Dermatologic: Rash, urticaria.
Others: Hypokalaemia.
IM/IV/Parenteral: B
MonitoringParameters
Monitor BP, serum glucose, ECG, heart rate, mentation; signs and symptoms of hypersensitivity reactions.
Drug Interactions
Beta blockers may cause greater increase in heart rate and BP. Insulin antagonises the effect of glucagon.  Indomethacin may produce hypoglycaemia. May enhance the anticoagulant effect of warfarin. Anticholinergic drugs may increase GI reactions.
Action
Description: Glucagon is an endogenous polypeptide hormone produced by the α cells of the pancreatic islets of Langerhans. It stimulates adenylate cyclase to produce cyclic AMP, to activate hepatic glycogenolysis and gluconeogenesis, thus increasing serum glucose level.
Onset: GI relaxation: 45 seconds (IV); 4-10 min (IM).
Duration: Glucose elevation: 60-90 min (IV, IM, SC); GI relaxation: 9-25 min (IV), 12-32 min (IM).
Pharmacokinetics:
Absorption: Time to peak plasma concentration: W/in 30 min.
Distribution: Volume of distribution: Approx 0.25 L/kg.
Metabolism: Metabolised in the liver, kidneys and plasma.
Excretion: Elimination half-life: 8-18 min (IV); 26-45 min (IM).
Storage
Store between 20-25°C. Protect from light. Do not freeze.
ATC Classification
H04AA01 - glucagon ; Belongs to the class of glycogenolytic hormones. Used in the treatment of hypoglycemia.
References
Anon. Glucagon. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 29/05/2017.

Buckingham R (ed). Glucagon. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/05/2017.

Glucagon (Eli Lilly and Company). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 29/05/2017.

Glucagon Injection, Powder, Lyophilized for Solution (Fresenius Kabi USA, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 29/05/2017.

Joint Formulary Committee. Glucagon. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/05/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Glucagon. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 29/05/2017.

Disclaimer: This information is independently developed by MIMS based on Glucagon from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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