Glucagon: Difference between revisions

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Latest revision as of 21:55, 20 March 2026

General

  • Type: Hyperglycemic, antidote
  • Dosage Forms:
  • Common Trade Names: GlucaGen

Adult Dosing

Hypoglycemia

  • 1mg SC/IM/IV x 1
  • May repeat q20 min PRN

Beta-blocker toxicity[1] [2]

  • 5mg IV bolus over one minute
  • Rebolus if no response after 10min
  • If effective, start infusion at 2-5mg/hr

Food bolus impaction

  • 1mg IV x 1

Pediatric Dosing

Hypoglycemia

  • 0.03mg/kg IM/SQ/IV x 1 (max = 1mg)
  • Alternative
    • <20kg: 0.5mg SC/IM/IV x 1
    • >20kg: 1mg SC/IM/IV x 1
  • May repeat q20 min

Beta-blocker toxicity [1] [2]

  • 50mcg/kg
  • Rebolus if no response after 10min
  • If effective, start infusion at 70mcg/kg/hr

Special Populations[3]

  • Pregnancy Rating: B
  • Lactation: Glucagon not absorbed in GI tract so unlikely to cause adverse reactions in infant
  • Renal Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined
  • Hepatic Dosing
    • Adult
      • Not defined
    • Pediatric
      • Not defined

Contraindications

  • Allergy to class/drug
  • insulinoma
  • pheochromocytoma

Adverse Reactions

Serious

  • hypersensitivity reaction
  • anaphylaxis
  • hypotension

Common

  • Nausea and vomiting
  • hyperglycemia

Pharmacology

  • Half-life: IV: 8-18 minutes IM: 45 minutes
  • Metabolism: Liver, kidney
  • Excretion: unknown
  • Mechanism of Action: Stimulates hepatic glycogenolysis. GI smooth muscle relaxent


Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

IndicationDoseContextRoutePopulation
Angioedema1-5 mg IVIf on beta-blockers and not responding to epinephrineIVAdult
Beta-blocker toxicity5 mg IV bolus over 1 min (adult); 50 mcg/kg (pediatric); repeat in 10 min if no response; then drip 2-5 mg/hrPositive inotrope/chronotrope (acts independently of beta receptors)IV/IV dripAdult
Beta-blocker toxicity50 mcg/kg IV bolus; then 70 mcg/kg/hr dripPositive inotrope/chronotrope (pediatric)IV/IV dripPediatric
Calcium channel blocker toxicity5 mg IV bolus q10min x2Adjunct for bradycardia/hypotensionIVAdult
Hypoglycemia1 mg SC or IMIf unable to achieve IV accessSC/IMAdult
Neonatal hypoglycemia0.03mg/kg IM/IV (max 1mg)If no IV access or refractory hypoglycemiaIM/IVPediatric

See Also

References

  1. 1.0 1.1 Kerns W. Management of beta-adrenergic blocker and calcium channel antagonist toxicity. Emerg Med Clin North Am. 2007;25(2):309-331. (Review)
  2. 2.0 2.1 Bailey B (2003). Glucagon in beta-blocker and calcium channel blocker overdoses: a systematic review. Journal of toxicology. Clinical toxicology, 41 (5), 595-602 PMID: 14514004
  3. Glucagon: Drug information. UpToDate. www.uptodate.com. Accessed April 2, 2019.