Glucagon intravenous for adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

  • Usually given by the subcutaneous or intramuscular route for the treatment of severe hypoglycaemia reactions
  • Please ensure additional supplies are ordered by pharmacy if large doses by infusion are being administered
  • Protect the airway in case of vomiting (ref 2)
  • Equivalencies: a 1mg dose is the same as 1 unit

Available preparations

Glucagen Hypokit 1mg

Reconstitution

  • Add 1.1mL water for injection (provided) to the vial containing the powder to produce a 1mg/1mL solution
  • Shake gently until completely dissolved
  • A syringe with a thinner needle and a finer graduation may be more suitable in diagnostic procedures

Infusion fluids

Glucose 5% or Sodium chloride 0.9% (ref 1)

Methods of intravenous administration

Bolus intravenous injection (doses of 1mg or less) (ref 1)

  • Administer over one minute
  • Rapid injection may be associated with increased nausea and vomiting (ref 2)

Slow intravenous injection (doses greater than 1mg) (ref 1)

  • Administer over 3 to 5 minutes
  • Rapid injection may be associated with increased nausea and vomiting (ref 2)

Intermittent intravenous infusion (unlicensed) (ref 1)

  • There is no recommended final volume/concentration for dilution. It is usually convenient to dilute in 50 or 100mL, but larger or smaller volumes can be used if necessary

Dose in adults

Severe hypoglycaemia

  • Usually 1mg, given by the subcutaneous or intramuscular route

Diagnostic indication (inhibition of gastrointestinal motility)

  • Relaxation of stomach, duodenal bulb, duodenum and small bowel: 0.2 to 0.5mg as intravenous injection
  • Relaxation of colon: 0.5 to 0.75mg as intravenous injection
  • Higher doses may be given for these indications if by subcutaneous or intramuscular route- see SPC

Beta-blocker/calcium channel blocker toxicity (unlicensed) (ref 2)

  • Consult poisons centre
  • Give 3 to 10mg (0.05 to 0.15mg/kg) as a slow intravenous injection over 2 to 5 minutes, followed by an infusion of 3 to 5mg/hour (0.05 to 0.1mg/kg/hour)
  • Titrate the infusion to achieve an adequate clinical response

Anaphylactic reaction (refractory) in patients on beta-blocker therapy (unlicensed) (ref 2)

  • Give 1 to 5mg as a slow intravenous injection over 5 minutes, followed by an infusion of 5 to 15 micrograms/minute
  • Titrate the infusion to achieve an adequate clinical response

Renal or hepatic impairment

  • No dosage adjustment is required

Storage

  • Store in a refrigerator between 2 and 80C - for full shelf life of product
  • May be stored at room temperature for up to 18 months (providing the expiry date is not exceeded)

References

SPC December 2019
1: Injectable medicines guide - Medusa, downloaded 24th November 2021
2: Uptodate- downloaded 24th November 2021

Therapeutic classification

Glycogenolytic hormone