Side Effects of GlucaGen (glucagon)

GlucaGen (glucagon) is a hormone produced by the pancreas that, along with insulin, controls the level of glucose in the blood and is used to treat severe low blood sugar (hypoglycemia) in diabetic patients. It is also used for radiologic examination of the stomach, duodenum, small bowel, and colon.

GlucaGen has the opposite effect of insulin. It increases the glucose levels in blood. Glucagon, the drug, is a synthetic version of human glucagon and is manufactured by genetic engineering using the bacteria Escherichia coli.

Common side effects of GlucaGen include

• nausea and vomiting may occur occasionally after injection, but this may be a symptom of the hypoglycemia for which GlucaGen is being given. 

Serious side effects of GlucaGen include

• rare allergic-type reactions including
  • itching,
  • respiratory distress, or
  • low blood pressure.

Drug interactions of GlucaGen include warfarin and other anticoagulants, because GlucaGen may increase their anticoagulant effects causing an increase in the slow clotting of blood and a greater risk of developing an episode of bleeding.

Insulin reverses the effect of GlucaGen.

GlucaGen should not be given with anticholinergic drugs due to increased risk of stomach and intestine-related side effects.

Indomethacin reduces the effect of GlucaGen.

There are no studies of the safety of GlucaGen in pregnant women. GlucaGen does not cross the placenta and the risk to the fetus is considered to be low.

It is unknown if GlucaGen is secreted in breast milk. Consult your doctor before breastfeeding. 

• Nausea and vomiting may occur occasionally after injection of glucagon, but this may be a symptom of the hypoglycemia for which glucagon is being given.
• Rare allergic-type reactions may occur with glucagon including itching, respiratory distress, or low blood pressure.
• Glucagon should not be administered to hypoglycemic patients who are also experiencing starvation, adrenal insufficiency or are suffering from chronic hypoglycemia.
• These medical conditions may be associated with an inability of the liver to produce glucose sufficiently in response to glucagon.
• For these patients, oral glucose is more effective if the patient is conscious. If the patient is not conscious, intravenous glucose should be given.

• Side effects may include nausea and vomiting at doses above 1 mg or with rapid injection.
• Hypotension has been reported up to 2 hours after administration in patients receiving GlucaGen as premedication for upper GI endoscopy procedures.
• GlucaGen exerts positive inotropic and chronotropic effects and may, therefore, cause tachycardia and hypertension.
• Adverse reactions indicating toxicity of GlucaGen have not been reported.
• A temporary increase in both blood pressure and pulse rate may occur following the administration of GlucaGen.
• Patients taking beta-blockers might be expected to have a greater increase in both pulse and blood pressure, an increase of which will be temporary because of GlucaGen's short half-life.
• The increase in blood pressure and pulse rate may require therapy in patients with pheochromocytoma or coronary artery disease. Anaphylactic reactions may occur in some cases.
• The following adverse reactions have been identified during postapproval use of GlucaGen.
• Because these reactions are reported voluntarily from a population of uncertain size, it is generally not possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Table 1 Frequency of Adverse Reactions

Beta-Blockers

• Patients taking beta-blockers might be expected to have a greater increase in both pulse and blood pressure, an increase of which will be temporary because of glucagon’s short half-life.
• The increase in blood pressure and pulse rate may require therapy in patients with pheochromocytoma or coronary artery disease.

Indomethacin

• When used with indomethacin, glucagon may lose its ability to raise blood glucose or may even produce hypoglycemia.
• Therefore, caution should be exercised for patients taking indomethacin when glucagon will be administered.

Anticholinergic Drugs

• Coadministration with an anticholinergic drug is not recommended due to increased gastrointestinal side effects.

Warfarin

• Glucagon may increase the anticoagulant effect of warfarin.
• Therefore, caution should be exercised for patients taking warfarin when glucagon will be administered.

Insulin

• Insulin reacts antagonistically towards glucagon. Therefore, caution should be exercised when glucagon is used as a diagnostic aid in diabetes patients.