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Drug overview for GVOKE HYPOPEN 1-PACK (glucagon):
Generic name: glucagon (GLOO-ka-gon)
Drug class: Glucagon and Analogs
Therapeutic class: Endocrine
Glucagon, an antihypoglycemic agent, is a hormone synthesized and secreted by the alpha2 cells of the pancreatic islets of Langerhans that increases blood glucose concentration by stimulating hepatic glycogenolysis.
No enhanced Uses information available for this drug.
Generic name: glucagon (GLOO-ka-gon)
Drug class: Glucagon and Analogs
Therapeutic class: Endocrine
Glucagon, an antihypoglycemic agent, is a hormone synthesized and secreted by the alpha2 cells of the pancreatic islets of Langerhans that increases blood glucose concentration by stimulating hepatic glycogenolysis.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for GVOKE HYPOPEN 1-PACK (glucagon) have been approved by the FDA:
Indications:
Hypoglycemic disorder
Professional Synonyms:
Hypoglycemia
Indications:
Hypoglycemic disorder
Professional Synonyms:
Hypoglycemia
The following dosing information is available for GVOKE HYPOPEN 1-PACK (glucagon):
Glucagon has been used with some success as a cardiac stimulant for the management of cardiac manifestations (e.g., bradycardia, hypotension, myocardial depression) associated with beta-adrenergic blocking agent overdosage+ or calcium-channel blocking agent overdosage+. Resuscitation following cardiac arrest from beta-blocker or calcium-channel blocker overdosage should follow standard basic life support (BLS) and advanced cardiac life support (ACLS) algorithms. Some data indicate that administration of glucagon may be useful in treating severe cardiovascular instability associated with beta-blocker overdosage that is refractory to standard measures, including vasopressors, and some experts state that such use is reasonable.
Evidence of efficacy in calcium-channel blocker overdosage is more limited; however, some experts state that treatment with glucagon also may be considered in patients with severe, refractory cardiovascular instability associated with calcium-channel blocker overdosage.
Dosage of glucagon or glucagon hydrochloride is expressed in terms of glucagon.
For the treatment of severe hypoglycemia, the recommended subcutaneous, IM, or IV dose of glucagon administered as reconstituted glucagon for injection is 1 mg in adults and children weighing at least 20 kg and 0.5 mg in children weighing less than 20 kg; alternatively, a dose of 20-30 mcg/kg can be administered in children weighing less than 20 kg.
For the treatment of severe hypoglycemia, the recommended subcutaneous, IM, or IV dose of glucagon administered as reconstituted glucagon hydrochloride for injection (e.g., GlucaGen(R)) is 1 mg in adults and children weighing 25 kg or more and 0.5 mg in children weighing less than 25 kg. If the weight of the child is unknown, children younger than 6 years of age should receive a dose of 0.5
mg and those 6 years of age or older should receive 1 mg.
When glucagon prefilled syringes or auto-injectors (Gvoke(R)) are used for the treatment of severe hypoglycemia, the recommended subcutaneous dose of glucagon in adults and adolescents at least 12 years of age is 1 mg; in children 2 to less than 12 years of age, the recommended subcutaneous dose is 1 mg in those weighing at least 45 kg and 0.5 mg in those weighing less than 45 kg.
If the patient has not responded to the initial dose of glucagon after 15 minutes, an additional dose of the drug (equivalent to the initial dose) may be administered.
For the treatment of severe hypoglycemia in adults and children 4 years of age and older, the recommended intranasal dosage of glucagon is 3 mg (one actuation of the Baqsimi(R) intranasal device) administered into one nostril. If the patient has not responded to the initial dose after 15 minutes, a second 3-mg dose may be administered.
For the management of cardiac manifestations of beta-blocker overdosage+ in adults, glucagon has been administered as a direct IV injection at a dose of 3-10 mg administered slowly over 3-5 minutes, followed by an IV infusion of 2-5 mg/hour. Because of the amount of glucagon required to sustain this therapy, the availability of an adequate supply of glucagon must be considered.
For the management of cardiac manifestations of calcium-channel blocker overdosage+ in adults, glucagon has been administered as a direct IV injection at a dose of 3-10 mg over 3-5 minutes, followed by an IV infusion of 3-5 mg/hour.
Evidence of efficacy in calcium-channel blocker overdosage is more limited; however, some experts state that treatment with glucagon also may be considered in patients with severe, refractory cardiovascular instability associated with calcium-channel blocker overdosage.
Dosage of glucagon or glucagon hydrochloride is expressed in terms of glucagon.
For the treatment of severe hypoglycemia, the recommended subcutaneous, IM, or IV dose of glucagon administered as reconstituted glucagon for injection is 1 mg in adults and children weighing at least 20 kg and 0.5 mg in children weighing less than 20 kg; alternatively, a dose of 20-30 mcg/kg can be administered in children weighing less than 20 kg.
For the treatment of severe hypoglycemia, the recommended subcutaneous, IM, or IV dose of glucagon administered as reconstituted glucagon hydrochloride for injection (e.g., GlucaGen(R)) is 1 mg in adults and children weighing 25 kg or more and 0.5 mg in children weighing less than 25 kg. If the weight of the child is unknown, children younger than 6 years of age should receive a dose of 0.5
mg and those 6 years of age or older should receive 1 mg.
When glucagon prefilled syringes or auto-injectors (Gvoke(R)) are used for the treatment of severe hypoglycemia, the recommended subcutaneous dose of glucagon in adults and adolescents at least 12 years of age is 1 mg; in children 2 to less than 12 years of age, the recommended subcutaneous dose is 1 mg in those weighing at least 45 kg and 0.5 mg in those weighing less than 45 kg.
If the patient has not responded to the initial dose of glucagon after 15 minutes, an additional dose of the drug (equivalent to the initial dose) may be administered.
For the treatment of severe hypoglycemia in adults and children 4 years of age and older, the recommended intranasal dosage of glucagon is 3 mg (one actuation of the Baqsimi(R) intranasal device) administered into one nostril. If the patient has not responded to the initial dose after 15 minutes, a second 3-mg dose may be administered.
For the management of cardiac manifestations of beta-blocker overdosage+ in adults, glucagon has been administered as a direct IV injection at a dose of 3-10 mg administered slowly over 3-5 minutes, followed by an IV infusion of 2-5 mg/hour. Because of the amount of glucagon required to sustain this therapy, the availability of an adequate supply of glucagon must be considered.
For the management of cardiac manifestations of calcium-channel blocker overdosage+ in adults, glucagon has been administered as a direct IV injection at a dose of 3-10 mg over 3-5 minutes, followed by an IV infusion of 3-5 mg/hour.
No enhanced Administration information available for this drug.
| DRUG LABEL | DOSING TYPE | DOSING INSTRUCTIONS |
|---|---|---|
| GVOKE HYPOPEN 1-PK 1 MG/0.2 ML | Maintenance | Adults inject 0.2 milliliter (1 mg) by subcutaneous route once in the abdomen, thigh, or upper arm may repeat in 15 minutes if inadequate response |
No generic dosing information available.
The following drug interaction information is available for GVOKE HYPOPEN 1-PACK (glucagon):
There are 0 contraindications.
There are 0 severe interactions.
There are 1 moderate interactions.
The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.
| Drug Interaction | Drug Names |
|---|---|
| Coumarin Anticoagulants/Glucagon, Dasiglucagon SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Not defined. CLINICAL EFFECTS: Excess hypoprothrombinemia and possible bleeding complications. PREDISPOSING FACTORS: The risk for bleeding episodes may be greater in patients with disease-associated factors (e.g. thrombocytopenia). Drug associated risk factors include concurrent use of multiple drugs which inhibit anticoagulant/antiplatelet metabolism and/or have an inherent risk for bleeding (e.g. NSAIDs). PATIENT MANAGEMENT: If the duration of glucagon/dasiglucagon therapy is one day, a clinically important interaction is unlikely. Avoid using multiple doses of glucagon/dasiglucagon in anticoagulated patients. If this combination is necessary, decrease the warfarin dose prior to glucagon/dasiglucagon dosing. Monitor patients receiving concurrent therapy for signs of blood loss, including decreased hemoglobin and/or hematocrit, fecal occult blood, and/or decreased blood pressure and promptly evaluate patients with any symptoms. When applicable, perform INR to monitor efficacy and safety of anticoagulation. Discontinue anticoagulation in patients with active pathologic bleeding. Instruct patients to report any signs and symptoms of bleeding, such as unusual bleeding from the gums or nose; unusual bruising; red or black, tarry stools; red, pink or dark brown urine; acute abdominal or joint pain and/or swelling. The time of highest risk for a coumarin-type drug interaction is when the precipitant drug is initiated or discontinued. Contact the prescriber before initiating, altering the dose or discontinuing either drug. DISCUSSION: If the duration of glucagon/dasiglucagon therapy is one day, a clinically important interaction is unlikely. However, the potentiation effects of glucagon/dasiglucagon on the anticoagulant effect of warfarin seems to occur rapidly and can reverse within one day of stopping glucagon. |
ANISINDIONE, DICUMAROL, JANTOVEN, WARFARIN SODIUM |
The following contraindication information is available for GVOKE HYPOPEN 1-PACK (glucagon):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 2 contraindications.
Absolute contraindication.
| Contraindication List |
|---|
| Insulinoma |
| Pheochromocytoma |
There are 1 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Glucagonoma |
There are 0 moderate contraindications.
The following adverse reaction information is available for GVOKE HYPOPEN 1-PACK (glucagon):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 7 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Acute respiratory distress syndrome Anaphylaxis Dyspnea Hypersensitivity drug reaction Hypertension Hypotension Necrolytic migratory erythema |
There are 14 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Headache disorder Injection site sequelae Nausea Vomiting |
Acute abdominal pain Diarrhea Dizziness Drowsy General weakness Pallor Urticaria |
| Rare/Very Rare |
|---|
|
Hyperglycemia Skin rash Tachycardia |
The following precautions are available for GVOKE HYPOPEN 1-PACK (glucagon):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
No enhanced Pregnancy information available for this drug.
No enhanced Lactation information available for this drug.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for GVOKE HYPOPEN 1-PACK (glucagon):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for GVOKE HYPOPEN 1-PACK (glucagon)'s list of indications:
| Hypoglycemic disorder | |
| E08.64 | Diabetes mellitus due to underlying condition with hypoglycemia |
| E08.649 | Diabetes mellitus due to underlying condition with hypoglycemia without coma |
| E09.64 | Drug or chemical induced diabetes mellitus with hypoglycemia |
| E09.649 | Drug or chemical induced diabetes mellitus with hypoglycemia without coma |
| E10.64 | Type 1 diabetes mellitus with hypoglycemia |
| E10.649 | Type 1 diabetes mellitus with hypoglycemia without coma |
| E11.64 | Type 2 diabetes mellitus with hypoglycemia |
| E11.649 | Type 2 diabetes mellitus with hypoglycemia without coma |
| E13.64 | Other specified diabetes mellitus with hypoglycemia |
| E13.649 | Other specified diabetes mellitus with hypoglycemia without coma |
| E16.0 | Drug-induced hypoglycemia without coma |
| E16.1 | Other hypoglycemia |
| E16.2 | Hypoglycemia, unspecified |
| P70.3 | Iatrogenic neonatal hypoglycemia |
| P70.4 | Other neonatal hypoglycemia |
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