Glucagon Kit
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Questions & Answers
Side Effects & Adverse Reactions
Glucagon should be administered cautiously to patients with a history suggestive of insulinoma, pheochromocytoma, or both. In patients with insulinoma, intravenous administration of glucagon may produce an initial increase in blood glucose; however, because of glucagon's hyperglycemic effect the insulinoma may release insulin and cause subsequent hypoglycemia. A patient developing symptoms of hypoglycemia after a dose of glucagon should be given glucose orally, intravenously, or by gavage, whichever is most appropriate.
Exogenous glucagon also stimulates the release of catecholamines. In the presence of pheochromocytoma, glucagon can cause the tumor to release catecholamines, which may result in a sudden and marked increase in blood pressure. If a patient develops a sudden increase in blood pressure, 5 to 10 mg of phentolamine mesylate may be administered intravenously in an attempt to control the blood pressure.
Generalized allergic reactions, including urticaria, respiratory distress, and hypotension, have been reported in patients who received glucagon by injection.
Legal Issues
There is currently no legal information available for this drug.
FDA Safety Alerts
There are currently no FDA safety alerts available for this drug.
Manufacturer Warnings
There is currently no manufacturer warning information available for this drug.
FDA Labeling Changes
There are currently no FDA labeling changes available for this drug.
Uses
Glucagon is indicated as a treatment for severe hypoglycemia.
Because patients with type 1 diabetes may have less of an increase in blood glucose levels compared with a stable type 2 patient, supplementary carbohydrate should be given as soon as possible, especially to a pediatric patient.
Glucagon is indicated as a diagnostic aid in the radiologic examination of the stomach, duodenum, small bowel, and colon when diminished intestinal motility would be advantageous.
Glucagon is as effective for this examination as are the anticholinergic drugs. However, the addition of the anticholinergic agent may result in increased side effects.
History
There is currently no drug history available for this drug.
Other Information
Glucagon for Injection (rDNA origin) is a polypeptide hormone identical to human glucagon that increases blood glucose and relaxes smooth muscle of the gastrointestinal tract. Glucagon is synthesized in a special non-pathogenic laboratory strain of Escherichia coli bacteria that has been genetically altered by the addition of the gene for glucagon.
Glucagon is a single-chain polypeptide that contains 29 amino acid residues and has a molecular weight of 3483.
The empirical formula is C153H225N43O49S. The primary sequence of glucagon is shown below.
Crystalline glucagon is a white to off-white powder. It is relatively insoluble in water but is soluble at a pH of less than 3 or more than 9.5.
Glucagon is available for use intravenously, intramuscularly, or subcutaneously in a kit that contains a vial of sterile glucagon and a syringe of sterile diluent. The vial contains 1 mg (1 unit) of glucagon and 49 mg of lactose. Hydrochloric acid may have been added during manufacture to adjust the pH of the glucagon. One International Unit of glucagon is equivalent to 1 mg of glucagon.1 The diluent syringe contains 12 mg/mL of glycerin, Water For Injection, and hydrochloric acid.
Sources
Glucagon Kit Manufacturers
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Physicians Total Care, Inc.
![Glucagon Kit [Physicians Total Care, Inc.]](/wp-content/themes/bootstrap/assets/img/loading2.gif)
Glucagon Kit | Physicians Total Care, Inc.
General Instructions for Use: The diluent is provided for use only in the preparation of glucagon for parenteral injection and for no other use. Glucagon should not be used at concentrations greater than 1 mg/mL (1 unit/mL). Reconstituted glucagon should be used immediately. Discard any unused portion. Reconstituted glucagon solutions should be used only if they are clear and of a water-like consistency. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Directions for Treatment of Severe Hypoglycemia:Severe hypoglycemia should be treated initially with intravenous glucose, if possible.
If parenteral glucose can not be used, dissolve the lyophilized glucagon using the accompanying diluting solution and use immediately. For adults and for pediatric patients weighing more than 44 lb (20 kg), give 1 mg (1 unit) by subcutaneous, intramuscular, or intravenous injection. For pediatric patients weighing less than 44 lb (20 kg), give 0.5 mg (0.5 unit) or a dose equivalent to 20 to 30 μg/kg.2-6 Discard any unused portion. An unconscious patient will usually awaken within 15 minutes following the glucagon injection. If the response is delayed, there is no contraindication to the administration of an additional dose of glucagon; however, in view of the deleterious effects of cerebral hypoglycemia emergency aid should be sought so that parenteral glucose can be given. After the patient responds, supplemental carbohydrate should be given to restore liver glycogen and to prevent secondary hypoglycemia. Directions for Use as a Diagnostic Aid:Dissolve the lyophilized glucagon using the accompanying diluting solution and use immediately. Discard any unused portion.
The doses in the following table may be administered for relaxation of the stomach, duodenum, and small bowel, depending on the onset and duration of effect required for the examination. Since the stomach is less sensitive to the effect of glucagon, 0.5 mg (0.5 units) IV or 2 mg (2 units) IM are recommended.
Dose Route of Administration Time of Onset of Action Approximate Duration of Effect* Administration of 2 mg (2 units) doses produces a higher incidence of nausea and vomiting than do lower doses.
0.25-0.5 mg (0.25-0.5 units) IV 1 minute 9-17 minutes 1-mg (1 unit) IM 8-10 minutes 12-27 minutes 2 mg* (2 units) IV 1 minute 22-25 minutes 2 mg* (2 units) IM 4-7 minutes 21-32 minutesFor examination of the colon, it is recommended that a 2 mg (2 units) dose be administered intramuscularly approximately 10 minutes prior to the procedure. Colon relaxation and reduction of patient discomfort may allow the radiologist to perform a more satisfactory examination.
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Eli Lilly And Company
Glucagon Kit | Eli Lilly And Company
General Instructions for Use:
The diluent is provided for use only in the preparation of glucagon for parenteral injection and for no other use. Glucagon should not be used at concentrations greater than 1 mg/mL (1 unit/mL). Reconstituted glucagon should be used immediately. Discard any unused portion. Reconstituted glucagon solutions should be used only if they are clear and of a water-like consistency. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.Directions for Treatment of Severe Hypoglycemia:
Severe hypoglycemia should be treated initially with intravenous glucose, if possible.
If parenteral glucose can not be used, dissolve the lyophilized glucagon using the accompanying diluting solution and use immediately. For adults and for pediatric patients weighing more than 44 lb (20 kg), give 1 mg (1 unit) by subcutaneous, intramuscular, or intravenous injection. For pediatric patients weighing less than 44 lb (20 kg), give 0.5 mg (0.5 unit) or a dose equivalent to 20 to 30 μg/kg.2-6 Discard any unused portion. An unconscious patient will usually awaken within 15 minutes following the glucagon injection. If the response is delayed, there is no contraindication to the administration of an additional dose of glucagon; however, in view of the deleterious effects of cerebral hypoglycemia emergency aid should be sought so that parenteral glucose can be given. After the patient responds, supplemental carbohydrate should be given to restore liver glycogen and to prevent secondary hypoglycemia.Directions for Use as a Diagnostic Aid:
Dissolve the lyophilized glucagon using the accompanying diluting solution and use immediately. Discard any unused portion.
The doses in the following table may be administered for relaxation of the stomach, duodenum, and small bowel, depending on the onset and duration of effect required for the examination. Since the stomach is less sensitive to the effect of glucagon, 0.5 mg (0.5 units) IV or 2 mg (2 units) IM are recommended.
* Administration of 2 mg (2 units) doses produces a higher incidence of nausea and vomiting than do lower doses.
Dose Route of Administration Time of Onset of Action Approximate Duration of Effect 0.25-0.5 mg
(0.25-0.5 units) IV 1 minute 9-17 minutes 1-mg (1 unit) IM 8-10 minutes 12-27 minutes 2 mg* (2 units) IV 1 minute 22-25 minutes 2 mg* (2 units) IM 4-7 minutes 21-32 minutesFor examination of the colon, it is recommended that a 2 mg (2 units) dose be administered intramuscularly approximately 10 minutes prior to the procedure. Colon relaxation and reduction of patient discomfort may allow the radiologist to perform a more satisfactory examination.
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Tya Pharmaceuticals
Glucagon Kit | Tya Pharmaceuticals
General Instructions for Use:
The diluent is provided for use only in the preparation of glucagon for parenteral injection and for no other use. Glucagon should not be used at concentrations greater than 1 mg/mL (1 unit/mL). Reconstituted glucagon should be used immediately. Discard any unused portion. Reconstituted glucagon solutions should be used only if they are clear and of a water-like consistency. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration.Directions for Treatment of Severe Hypoglycemia:
Severe hypoglycemia should be treated initially with intravenous glucose, if possible.
If parenteral glucose can not be used, dissolve the lyophilized glucagon using the accompanying diluting solution and use immediately. For adults and for pediatric patients weighing more than 44 lb (20 kg), give 1 mg (1 unit) by subcutaneous, intramuscular, or intravenous injection. For pediatric patients weighing less than 44 lb (20 kg), give 0.5 mg (0.5 unit) or a dose equivalent to 20 to 30 μg/kg. 2-6 Discard any unused portion. An unconscious patient will usually awaken within 15 minutes following the glucagon injection. If the response is delayed, there is no contraindication to the administration of an additional dose of glucagon; however, in view of the deleterious effects of cerebral hypoglycemia emergency aid should be sought so that parenteral glucose can be given. After the patient responds, supplemental carbohydrate should be given to restore liver glycogen and to prevent secondary hypoglycemia.Directions for Use as a Diagnostic Aid:
Dissolve the lyophilized glucagon using the accompanying diluting solution and use immediately. Discard any unused portion.
The doses in the following table may be administered for relaxation of the stomach, duodenum, and small bowel, depending on the onset and duration of effect required for the examination. Since the stomach is less sensitive to the effect of glucagon, 0.5 mg (0.5 units) IV or 2 mg (2 units) IM are recommended.
* Administration of 2 mg (2 units) doses produces a higher incidence of nausea and vomiting than do lower doses.
Dose Route of Administration Time of Onset of Action Approximate Duration of Effect 0.25-0.5 mg (0.25-0.5 units)
IV 1 minute 9-17 minutes 1-mg (1 unit) IM 8-10 minutes 12-27 minutes 2 mg* (2 units) IV 1 minute 22-25 minutes 2 mg* (2 units) IM 4-7 minutes 21-32 minutesFor examination of the colon, it is recommended that a 2 mg (2 units) dose be administered intramuscularly approximately 10 minutes prior to the procedure. Colon relaxation and reduction of patient discomfort may allow the radiologist to perform a more satisfactory examination.
![Glucagon Kit [Eli Lilly And Company]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=f143db10-e889-41c3-84ed-603a0ab02f61&name=glucagon-1mg-contain-1-0013.jpg)
![Glucagon Kit [Tya Pharmaceuticals]](http://dailymed.nlm.nih.gov/dailymed/image.cfm?setid=b53a7c5d-2de6-40a3-9015-ca18cf84df19&name=64725-8031.jpg)
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