Glucagon Injection

WHY is this medicine prescribed?

Glucagon injection is used for emergency treatment of very low blood sugar (severe hypoglycemia). It is also used to slow down movement in the digestive system during certain X-ray lab tests. Glucagon is in a class of medications called glycogenolytic agents. It works by causing the liver to release stored sugar to the blood. It also works by relaxing digestive muscles for X-ray lab testing.

Are there OTHER USES for this medicine?

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

HOW should this medicine be used?

Glucagon comes as a solution (liquid) in a prefilled syringe, an auto-injector device, and a vial to inject subcutaneously (just under the skin). It also comes as a powder to be mixed with a provided liquid to be injected subcutaneously, intramuscularly (into the muscle), or intravenously (into a vein). Inject as needed to treat very low blood sugar. To slow down the digestive system during X-ray lab tests, it is injected by a doctor or nurse in a medical facility.

Inject at the first sign of severe hypoglycemia (low blood sugar). After the injection, turn the patient onto their side to prevent choking if they vomit. Immediately contact a doctor and get emergency medical treatment. An unconscious person with hypoglycemia will usually wake up within 15 minutes. If the person does not awaken within 15 minutes after an injection, inject one more dose. Feed the person a fast-acting source of sugar (e.g., regular soft drink or fruit juice) and then a long-acting source of sugar (e.g., crackers, cheese or a meat sandwich) as soon as they awaken and are able to swallow.

Use glucagon injection exactly as directed; do not inject it more often or inject more or less of it than prescribed by your doctor.

Ask your doctor or pharmacist to show you, family, or caregivers who could be injecting the medication how to use and prepare glucagon injection. Before a friend or family member uses glucagon injection for the first time, read the patient information that comes with it. This information includes directions for how to use the injection device. Be sure to ask your pharmacist or doctor if you or your caregivers have any questions about how to inject this medication.

Always look at the glucagon solution before it is injected. It should be clear, colorless to pale yellow, and free of particles. Do not use glucagon injection if it is cloudy, contains particles, or if the expiration date has passed. Ask your doctor or pharmacist how to dispose of the puncture-resistant container.

Glucagon can be injected with the prefilled syringe, syringe, or autoinjector in the upper arm, thigh, or stomach. Never inject glucagon injection into a vein or muscle.

It is important that all patients have a household member who knows the symptoms of low blood sugar and how to administer glucagon. If you have low blood sugar often, keep glucagon injection with you at all times. You and a family member or friend should be able to recognize some of the signs and symptoms of low blood sugar (i.e., shakiness, dizziness or lightheadedness, sweating, confusion, nervousness or irritability, sudden changes in behavior or mood, headache, numbness or tingling around the mouth, weakness, pale skin, sudden hunger, clumsy or jerky movements). Try to eat or drink a food or beverage with sugar in it, such as hard candy or fruit juice, before it is necessary to administer glucagon.

Follow the directions on your prescription label carefully, and ask your pharmacist or doctor to explain any part you or your household members do not understand. Use glucagon exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

What SPECIAL PRECAUTIONS should I follow?

Before using glucagon injection,

• tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.

• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while using glucagon injection. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• tell your doctor if you have pheochromocytoma (tumor on a small gland near the kidneys), insulinoma or glucagonoma (types of pancreatic tumors). Your doctor may tell you not to use glucagon injection.

• tell your doctor if you have or have ever had adrenal gland problems, diabetes or low blood sugar that doesn't go away (chronic hypoglycemia), malnutrition, high blood pressure, or heart disease.

• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding.

What SPECIAL DIETARY instructions should I follow?

Unless your doctor tells you otherwise, continue your normal diet.

What SIDE EFFECTS can this medicine cause?

Glucagon may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• nausea
• vomiting
• change in the ability to taste food
• injection site swelling or redness
• headache
• fast heartbeat

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• rash; hives; itching; swelling of the eyes, face, throat, tongue, or lips; difficulty breathing or swallowing
• dizziness, lightheadedness, fatigue, or fainting
• rash with scaly, itchy red skin on the face, groin, pelvis, or legs

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Do not refrigerate or freeze it. Dispose of the medication after the expiration date on the device or the carton and be sure to have a replacement available.

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

What should I do in case of OVERDOSE?

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

What OTHER INFORMATION should I know?

Keep all appointments with your doctor and the laboratory.

Do not let anyone else use your medication. If your glucagon injection is used, be sure to get a replacement right away. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.