Summary
Glucagon is the pancreatic peptide hormone that raises blood glucose by releasing glycogen (sugar stored in the liver), and injected glucagon has been the FDA approved emergency treatment for severe hypoglycemia (dangerously low blood sugar) in people on insulin for decades. Newer ready to use forms, nasal glucagon (2019), a liquid autoinjector (2019), and the modified version dasiglucagon (2021), match the traditional kit with recovery in roughly 10 to 15 minutes in randomized trials while being far easier to give. It is prescription only and not on the WADA Prohibited List.
What is Glucagon?
Glucagon is a 29 amino acid pancreatic peptide hormone (recombinant or synthetic) and the analog dasiglucagon. It is also known as Glucagon emergency kit, GlucaGen, Gvoke, Baqsimi (nasal glucagon), Zegalogue (dasiglucagon), Recombinant glucagon.
How does it work?
Glucagon activates the glucagon receptor on hepatocytes, stimulating glycogenolysis and gluconeogenesis and raising blood glucose within minutes, provided liver glycogen stores are present. It also relaxes gastrointestinal smooth muscle, which is why it is used as a diagnostic aid in radiology. Dasiglucagon is a 7 amino acid substituted analog that stays stable in solution.
| Cluster | Metabolic and growth hormone axis |
|---|---|
| Routes | Subcutaneous or intramuscular injection (kit, prefilled syringe, autoinjector); Intranasal powder (3 mg); Intravenous (hospital and diagnostic use) |
| Conditions studied | Type 2 diabetes; Type 1 diabetes |
| Record | v3, draft, verified Sep 23, 2026 |
FDA-approved uses of Glucagon
Yes. Glucagon injection kits have been approved for decades, nasal glucagon (Baqsimi) and the liquid autoinjector (Gvoke) were approved in 2019, dasiglucagon (Zegalogue) in 2021, and generic kits from 2020. Their labels cover treatment of severe hypoglycemia (dangerously low blood sugar) in people with diabetes; the kits and Gvoke VialDx are also labeled as a diagnostic aid to temporarily stop gut movement during radiologic (imaging) exams. All are prescription only in the US. [5] [6] [8] [9]
What does the evidence say about Glucagon?
Randomized crossover and placebo controlled trials in adults with type 1 diabetes under insulin induced hypoglycemia. Rickels 2016 (n = 75): 3 mg nasal glucagon was non-inferior to 1 mg intramuscular glucagon, with treatment success in 98.7% versus 100%. Pieber 2021 (n = 170): dasiglucagon 0.6 mg restored glucose in a median 10 minutes versus 40 minutes with placebo, with 99% of patients recovered within 15 minutes. Christiansen 2021: a ready to use liquid glucagon autoinjector was non-inferior to the emergency kit with 99 to 100% success. Pieber 2022: a room temperature liquid glucagon was non-inferior to lyophilized glucagon.
| Evidence type | Indexed studies | Participants (human) |
|---|---|---|
| Human randomized trials | 4 | 245 |
| Human observational studies | 0 | n/a |
| Animal studies | 0 | n/a |
| All indexed studies | 4 | 245 |
Human evidence
Rickels 2016: 75 adults with type 1 diabetes had hypoglycemia induced with insulin in a randomized crossover; nasal glucagon 3 mg achieved treatment success (glucose rise to 70 mg/dL or by 20 mg/dL within 30 minutes) in 98.7% versus 100% for 1 mg intramuscular glucagon, with mean time to success 16 versus 13 minutes. Pieber 2021: 170 adults randomized to dasiglucagon 0.6 mg, placebo, or reconstituted glucagon; median time to plasma glucose recovery was 10 minutes with dasiglucagon versus 40 minutes with placebo and 12 minutes with glucagon. Christiansen 2021: two crossover studies found the ready to use liquid glucagon autoinjector non-inferior to the conventional kit with success in 99 to 100% of episodes. Nausea and vomiting were the common effects across trials.
Animal evidence
Glucagon was identified as a hyperglycemic pancreatic factor in the 1920s and characterized in dogs and rodents; animal work established its receptor and hepatic actions. The clinical evidence base is human.
Key studies
| Study | Design and population | Outcome | Grade |
|---|---|---|---|
| Intranasal Glucagon for Treatment of Insulin-Induced Hypoglycemia in Adults With Type 1 Diabetes: A Randomized Crossover Noninferiority Study2016 PMID 26681725 | Randomized crossover non-inferiority trialn = 75 Adults with type 1 diabetes with insulin induced hypoglycemia | Treatment success 98.7% with 3 mg nasal glucagon versus 100% with 1 mg intramuscular glucagon; mean time to success 16 versus 13 minutes | Evidence: Human RCT evidence |
| Dasiglucagon, a next-generation glucagon analog for rapid and effective treatment of severe hypoglycemia: results of phase 3 randomized double-blind clinical trial2021 PMID 35239971 | Randomized, double blind, placebo controlled phase 3 trialn = 170 Adults with type 1 diabetes with insulin induced hypoglycemia | Median time to glucose recovery 10 minutes with dasiglucagon versus 40 minutes with placebo; 99% recovered within 15 minutes | Evidence: Human RCT evidence |
| Comparison of a ready-to-use liquid glucagon injection administered by autoinjector to glucagon emergency kit for the symptomatic relief of severe hypoglycemia: two randomized crossover non-inferiority studies2021 PMID 34620618 | Two randomized crossover non-inferiority studiesAdults with type 1 diabetes with insulin induced hypoglycemia | Liquid glucagon autoinjector non-inferior to the emergency kit with 99 to 100% treatment success | Evidence: Human RCT evidence |
| Efficacy, safety, tolerability, and noninferiority phase 3 study of glucagon as a ready-to-use room temperature liquid stable formulation versus a lyophilised formulation for insulin-induced severe hypoglycaemia in adults with type 1 diabetes2022 PMID 35322535 | Randomized crossover non-inferiority phase 3 trialAdults with type 1 diabetes with insulin induced hypoglycemia | Room temperature liquid glucagon non-inferior to lyophilized glucagon for glucose recovery and symptom relief | Evidence: Human RCT evidence |
Conditions studied
| Condition | Grade | Note |
|---|---|---|
| Type 2 diabetes | Not graded | Several peptide drugs are FDA approved for type 2 diabetes, including insulin, GLP-1 receptor agonists, tirzepatide, and pramlintide. GLP-1 agonists and tirzepatide lower HbA1c by about 1 to 2 percentage points and reduce weight; semaglutide also reduces cardiovascular events. |
| Type 1 diabetes | Evidence: Human RCT evidence | Nasal glucagon 3 mg matched intramuscular glucagon for insulin induced hypoglycemia (98.7% versus 100% success), and dasiglucagon restored glucose in a median 10 minutes versus 40 on placebo. |
Is Glucagon legal in the United States?
FDA and compounding status
FDA approved in multiple forms: glucagon emergency kits (animal derived from 1960 and recombinant from 1998), nasal glucagon (Baqsimi, July 2019), ready to use liquid glucagon autoinjector and prefilled syringe (Gvoke, September 2019), and dasiglucagon (Zegalogue, March 2021), with generic glucagon kits approved from 2020. All are prescription only. Glucagon is not compounded and is not on any FDA bulks list.
WADA status
Not WADA prohibited. Not named on the current prohibited list. Athletes should still confirm against the list in force for their season.
Regulatory timeline
No regulatory events recorded.
Glucagon dose on the FDA label
Doses below are quoted from the FDA label for its approved uses, plus the doses used in the pivotal trials where noted. The prescriber sets the dose; PeptideAgent does not recommend doses or protocols.
FDA labels (DailyMed). Glucagon for Injection emergency kit, severe hypoglycemia: 1 mg subcutaneously, intramuscularly, or intravenously for adults and children weighing 20 kg or more, and 0.5 mg (or 20 to 30 mcg/kg) under 20 kg, with one repeat dose after 15 minutes if there is no response; the kit is also labeled as a diagnostic aid to slow gut movement during radiologic exams. Gvoke: 1 mg subcutaneously for ages 12 and older and for children 2 to 11 weighing 45 kg or more, 0.5 mg for children 2 to 11 under 45 kg. Baqsimi nasal powder: 3 mg into one nostril for ages 1 and older. Zegalogue (dasiglucagon): 0.6 mg subcutaneously for ages 6 and older. Emergency help is called after every dose, and oral carbohydrates are given once the person responds.
Routes reported
| # | Route |
|---|---|
| 1 | Subcutaneous or intramuscular injection (kit, prefilled syringe, autoinjector) |
| 2 | Intranasal powder (3 mg) |
| 3 | Intravenous (hospital and diagnostic use) |
What are the side effects and interactions of Glucagon?
Side effects
| # | Reported side effect |
|---|---|
| 1 | Nausea and vomiting (most common, in roughly 20 to 40% in trials) |
| 2 | Headache |
| 3 | Injection site pain or nasal discomfort and watery eyes with the nasal form |
| 4 | Transient increase in heart rate and blood pressure |
| 5 | Hypersensitivity reactions (rare) |
| 6 | Rebound hypoglycemia if carbohydrate is not given after recovery |
Interactions
| # | Interaction |
|---|---|
| 1 | Beta blockers: transient rise in pulse and blood pressure after glucagon |
| 2 | Indomethacin: may blunt glucagon's glucose raising effect |
| 3 | Warfarin: glucagon may increase anticoagulant effect |
| 4 | Insulin: glucagon is the antidote; both are used in the same patients by design |
Contraindications
| # | Contraindication |
|---|---|
| 1 | Pheochromocytoma (glucagon can trigger catecholamine release and hypertensive crisis) |
| 2 | Insulinoma (glucagon can cause rebound hypoglycemia) |
| 3 | Known hypersensitivity to glucagon or lactose (for lactose containing kits) |
| 4 | Ineffective in states of depleted liver glycogen such as starvation, adrenal insufficiency, or chronic hypoglycemia (label warning, not a contraindication) |
How do people access Glucagon legally?
Typical cost: List prices for a single dose run roughly 100 to 350 USD depending on product, with generic kits at the low end; insurance copays are usually lower and manufacturer savings cards exist. Prices verified on the last verified date.
Verified access options
Step 1
Prescription from a licensed provider filled at a retail pharmacy as an emergency kit, autoinjector, or nasal powder.
Step 2
Administered by clinicians in hospitals and emergency settings; not available through compounding or telehealth peptide clinics.
Access paths are verified against public regulatory records and prescriber licensing. We never list unlicensed vendors.
Frequently asked questions
Does nasal glucagon work as well as the injection?
Yes. In a randomized crossover of 75 adults with type 1 diabetes, 3 mg nasal glucagon reversed insulin induced hypoglycemia in 98.7% of episodes versus 100% for intramuscular glucagon, with a mean time to success of 16 versus 13 minutes. Because it needs no mixing or needle, caregivers use it correctly far more often. [1]
What are the side effects of glucagon?
Nausea and vomiting are the main ones, affecting roughly 20 to 40% of people in trials, along with headache and a brief rise in heart rate and blood pressure. Nasal glucagon adds nasal discomfort and watery eyes. Rebound hypoglycemia can occur if the person does not eat after recovering. Serious reactions are rare. [2] [5]
What is the glucagon dose on the FDA label?
For severe hypoglycemia: the injection kit is 1 mg for adults and children 20 kg or heavier and 0.5 mg under 20 kg; Gvoke is 1 mg from age 12 (and for younger children 45 kg or heavier) and 0.5 mg for children 2 to 11 under 45 kg; Baqsimi is 3 mg into one nostril; Zegalogue is 0.6 mg under the skin. If there is no response after 15 minutes, one more dose can be given while waiting for emergency help, and oral carbohydrates follow once the person can swallow. [5] [6] [8] [9]
How much does glucagon cost?
A single dose lists at roughly 100 to 350 USD depending on the product, with generic kits at the low end and the newer ready to use forms at the high end. Insurance copays are usually much lower and manufacturers offer savings cards. Prices verified on the last verified date and change. [5]
Is glucagon banned by WADA?
No. Glucagon is not on the WADA Prohibited List. Athletes with diabetes can carry and use it freely, unlike insulin, which requires a therapeutic use exemption. [7]
Glucagon vs dasiglucagon: what is the difference?
Dasiglucagon is a glucagon analog with seven amino acid substitutions that keeps it stable in solution, so it comes as a ready to use autoinjector without mixing. In a 170 person randomized trial it restored glucose in a median 10 minutes versus 12 minutes for reconstituted glucagon and 40 minutes for placebo, with 99% recovered within 15 minutes. Efficacy is equivalent; convenience is the difference. [2]
Is glucagon used for weight loss?
Not on its own. Glucagon raises energy expenditure and reduces appetite in physiology studies, which is why glucagon receptor agonism is built into the investigational weight loss peptides retatrutide, survodutide, and mazdutide. Injected glucagon itself is a short acting rescue drug and is not a weight loss treatment. [5]
Decisions about starting, stopping, or combining any treatment belong with a licensed clinician who knows your history.
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Sources
Numbered citations above point to these primary sources. PubMed entries link to the indexed abstract.
- [1]Rickels MR et al. Intranasal glucagon for treatment of insulin-induced hypoglycemia in adults with type 1 diabetes: a randomized crossover noninferiority study. Diabetes Care 2016PubMed 26681725, 2016
- [2]Pieber TR et al. Dasiglucagon, a next-generation glucagon analog for rapid and effective treatment of severe hypoglycemia: phase 3 randomized double-blind clinical trial. Diabetes Care 2021PubMed 35239971, 2021
- [3]Christiansen MP et al. Comparison of a ready-to-use liquid glucagon injection administered by autoinjector to glucagon emergency kit for severe hypoglycemia: two randomized crossover non-inferiority studies. BMJ Open Diabetes Res Care 2021PubMed 34620618, 2021
- [4]Pieber TR et al. Phase 3 noninferiority study of ready-to-use room temperature liquid glucagon versus lyophilised glucagon for insulin-induced severe hypoglycaemia. Diabetes Obes Metab 2022PubMed 35322535, 2022
- [5]FDA prescribing information for Glucagon for Injection emergency kit, via DailyMedFDA, 2026
- [6]FDA prescribing information for Baqsimi (glucagon) nasal powder, via DailyMedFDA, 2025
- [7]WADA Prohibited ListWADA, 2026
- [8]FDA prescribing information for Gvoke (glucagon) injection, via DailyMedFDA, 2026
- [9]FDA prescribing information for Zegalogue (dasiglucagon) injection, via DailyMedFDA, 2026
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