Neonatal Drug Therapy Manual

Glucagon

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Classification: 
Antihypoglycemic Agent (hormone)
Original Date: 
April 1998
Revised Date: 
December 2020
Indications: 
  • Hypoglycemia
Administration: 
  • IV direct: over 1 - 5 minutes undiluted
  • IV continuous infusion
  • SC
  • IM

 

  • Although GlucaGen (Novo Nordisk) is not approved by Health Canada for IV or SC administration, there is strong documentation in the literature supporting its efficacy and safety by these routes.
Dosage: 
  • IV direct, SC, IM:  
    • 0.03 mg/kg/dose (Maximum: 0.5 mg/dose)
    • May repeat prn
    • rise in glucose may last about 2 hours, typically between 30 minutes to 2 hours
  • IV continuous infusion:
    • Initial dose: 1 - 1.5 mg/day
    • Maintenance dose: 0.1 - 1.5 mg/day
Side Effects: 
  • CVS: hypotension
  • Endocrine and metabolic: hypocalcemia, hypokalemia, rebound hypoglycemia
  • GI: nausea and vomiting
  • Miscellaneous: hypersensitivity reactions
Parameters to Monitor: 
  • BP
  • Blood glucose
  • Serum electrolytes
Reconstitution and Stability: 
  • IV direct, SC, IM:
    • Glucagon 1 mg vial
      • Reconstitute content of vial with 1 mL of the diluent provided 
      • Final concentration: 1 mg/mL
  • IV continuous infusion:
    • Glucagon 1 mg vial
      • Reconstitute content of vial with 1 mL of the diluent provided
      • Take 1 mL (1 mg) and add to 23 mL of D10W
      • Final concentration: 0.04 mg/mL
Compatibility: 

- Solutions Compatible: D5W, D10W

 

- Incompatible: 0.9% NaCl

Notes: 
  • 1 mg  =  1 unit
References: 

- Thornton S, Stanley C, De Leon D, Harris D, Haymond M, Hussain K, et al. Recommendations from the Pediatric Endocrine Society for Evaluation and Management of Persistent Hypoglycemia in Neonates, Infants, and Children. The Journal of Pediatrics. 2015, Vol 167, No 2, 238-244

 

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