Parenteral Manual


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Alternate Name(s): 
Pancreatic polypeptide
Hyperglycemic agent
Original Date: 
August 2005
Revised Date: 
March 2013
  • Counteracts severe hypoglycemic reactions in diabetic patients; only useful if liver glycogen stores are normal
  • Adjunct in the treatment of refractory heart failure
  • Anaphylaxis in the emergency department
Reconstitution and Stability: 
  • Stable at room temperature
  • Reconstitute with diluent provided for a 1 mg/mL solution
  • Reconstituted solution stable 48 hours refrigerated
  • For continuous IV infusions, reconstitute vial with 1 mL D5W or D10W (NOT diluent provided); shake well to dissolve.  Further dilute with D5W or D10W.  This solution is stable 24 hours

- Solutions Compatible: D5W, D10W

- Additives/Above Cassette Compatible: no information

- Y-site Compatible: no information

- Incompatible: NS, DO NOT mix with any other drugs


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct YES
Usual dilution: 1 mg/mL   
Infusion time: 1 minute
IV Intermittent Infusion NO
IV Continuous Infusion YES
Usual dilution: 0.04 mg/mL

(For neonatal dosages, refer to Neonatal IV Drug Manual.)


  • <20 kg: 0.02-0.03 mg/kg/dose SC/IM/IV (Maximum: 1 mg/dose)
  • >20 kg: 0.5 - 1 mg SC/IM/IV
  • May repeat in 20 minutes

- Continuous IV Infusion:              

  • 0.2 mcg/kg/hr (usual maximum:  1 mg/day)
  • Dose is titrated to maintain blood glucose at a level determined by the physician (usually 3-4 mmol/L)
  • Indicated for endogenous hyperinsulinism or resistant hypoglycemia

- Anaphylaxis in the emergency department

  • 20 - 30 mcg/kg/dose, MAX 1 mg IV over 5 min x 1 dose followed by
    IV infusion of 5 - 15 mcg/min - titrated to clinical effect
    (consider use in patients who remain hypotensive despite multiple doses of epinephrine, patients on beta blockers, pregnant adolescents and in patients with sodium metabisulfite allergy


  • 0.5-1 mg SC/IM/IV
  • May repeat in 20 minutes  


Potential hazards of parenteral administration: 
  • Hypotension - especially with large doses
  • Hypersensitivity reactions (rash, urticaria, rarely hypotension or anaphylaxis)                           
  • Hyperglycemia due to excessive dosage
  • Hypokalemia
  • Nausea and vomiting
  • Monitor BP and blood glucose
  • 1 unit of glucagon = 1 mg glucagon                                           
  • Patient should respond in 10-20 minutes    
  • Do not delay initiation of glucose infusion while awaiting the effects of glucagon  
  • Upon responding from coma, the patient should be given oral carbohydrates
  • Discontinue infusions gradually to avoid rebound hypoglycemia
  • Bolus glucagon in idiopathic hyperinsulinism produces rebound hyperglycemia



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