Patient Medication Information: uses, side effects, how to take - Glucagen Hypokit
What is GlucaGen® used for?
GlucaGen® is used to treat severe hypoglycemic reactions (unconsciousness due to low blood sugar), which may occur if you are a person with insulin treated diabetes.
How does GlucaGen® work?
GlucaGen® is a high blood sugar agent that helps to release the glycogen in the liver to the blood as glucose.
Early symptoms of hypoglycemia may include:
- sweating
- drowsiness
- dizziness
Serious Warnings and Precautions
After intramuscular injection the patient will normally respond within 10 minutes. If they do not respond within 10 minutes, medical attention should be sought immediately; intravenous glucose must be administered as soon as an IV access can be established. When the patient has responded to the treatment give oral carbohydrate to restore the liver glycogen and prevent relapse of hypoglycemia. Because glucagon is of little or no help in states of starvation, acute or chronic alcohol use, adrenal insufficiency, or chronic hypoglycemia, intravenous glucose should be used for the treatment of hypoglycemia in these conditions. |
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- sleep disturbances
- irregular heartbeat (palpitation)
- anxiety
- tremor
- blurred vision
- hunger
- slurred speech
- depressed mood
- tingling in the hands, feet, lips, or tongue
- irritability
- abnormal behavior
- lightheadedness
- unsteady movement
- inability to concentrate
- personality changes
- headache
- restlessness
If not treated early, hypoglycemia may worsen and the person may have severe hypoglycemia.
Signs of severe hypoglycemia include:
- confusion
- unconsciousness
- seizures
- death
The occurrence of early symptoms calls for prompt and, if necessary, repeated administration of some form of carbohydrate, for example, candy, orange juice, corn syrup, honey or lumps of sugar. If improvement does not occur or if administration of carbohydrate is impossible, GlucaGen® should be given. Glucagon, a naturally occurring substance produced by the pancreas, is helpful because it enables the patient to produce his/her own blood glucose to correct the hypoglycemic state. The patient can then take carbohydrates by mouth. In this way, severe hypoglycemic reactions can be avoided, and diabetic control will be easier to accomplish.
Patients who are unable to take sugar orally, or who are unconscious, require an injection of GlucaGen® or should be treated with intravenous administration of glucose at a medical facility. The physician should always be notified promptly whenever severe hypoglycemic reactions occur.
What are the ingredients in GlucaGen®?
Medicinal ingredients: Glucagon 1 mg (1 IU) as hydrochloride.
Non-medicinal ingredients: Lactose monohydrate, hydrochloric acid and/or sodium hydroxide (pH adjusters) and water for injection.
GlucaGen® comes in the following dosage forms:
Powder (compacted) and solvent for solution for injection. After reconstitution the solution contains glucagon 1 mg/ mL.
Do not use GlucaGen® if:
- You are allergic or hypersensitive to glucagon or if you have an adrenal gland tumour.
Due to the instability of GlucaGen® in solution, the product should be used immediately after reconstitution and must not be given as an intravenous infusion.
GlucaGen® should be given only if the patient is unconscious or unresponsive and unable to ingest oral glucose.
To help avoid side effects and ensure proper use, talk to your healthcare professional before you take GlucaGen®. Talk about any health conditions or problems you may have, including if you:
Are fasting, or have low levels of adrenaline, chronic low blood sugar or low blood sugar caused by drinking too much alcohol.
- Have chronic hypoglycemia.
- Have an adrenal gland tumour.
- Have a tumour that releases glucagon or insulin.
- Are allergic to glucagon or lactose or components of the container.
Are pregnant or breast feeding.
Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.
Discard any unused portion.
The following may interact with GlucaGen®:
- insulin
- indomethacin
- warfarin
- beta-blockers
How to take GlucaGen®:
What to tell your friends, family, carer or co-workers
Your doctor may have given you GlucaGen® so that your friends or relatives can give you the injection, if you become severely hypoglycemic (unconsciousness due to low blood sugar) and cannot take sugar by mouth. Make sure they know:
- How to use GlucaGen® and where it is kept before an emergency arises.
- They must inject GlucaGen® into a muscle. Mix the GlucaGen® powder and solvent just before giving the injection into the muscle and follow the instructions given in the section below.
- You must be given a high sugar snack like sweets, biscuits or fruit juice after you have responded to treatment (as soon as you are able to take it). This is because GlucaGen® depletes glycogen stores. The high sugar snack will prevent relapse of the hypoglycemia.
- The unconscious person should be on their side to prevent choking.
After using GlucaGen®, you or someone else must contact your doctor or healthcare provider. You need to find out why you had severe hypoglycemia and how to avoid it happening again.
Usual dose:
- Adults: inject 1 mL (GlucaGen® HypoKit: marked as 1/1 on the syringe).
Children above 25 kg or older than 6 to 8 years: inject 1mL (GlucaGen® HypoKit: marked as 1/1 on the syringe).
- Children below 25 kg or younger than 6 to 8 years: inject ½ mL (GlucaGen® HypoKit: marked as 1/2 on the syringe).
Doses must be given by intramuscular injection.
Overdose:
If you have been given too much GlucaGen® it may cause nausea and vomiting. Specific treatment is not usually necessary.
| If you think you, or a person you are caring for, have taken too much GlucaGen®, contact a healthcare professional, hospital emergency department, or regional poison control centre immediately, even if there are no symptoms. |
Missed Dose:
Not applicable.
Reconstitution
GlucaGen® HypoKit:
1 
- 1. Remove the plastic cap from the vial. Pull the needle cover off the syringe. Do not remove the plastic back-stop from the syringe. Insert the needle through the rubber stopper (within the marked circle) of the vial containing GlucaGen® and inject all the liquid from the syringe into the vial.
2 
- 2. Without taking the needle out of the vial, gently shake the vial until GlucaGen® has completely dissolved, and the solution is clear.
3 
- 3.
Make sure the plunger is completely down. While keeping the needle in the liquid, slowly withdraw all the solution back into the syringe. Do not pull the plunger out of the syringe.
It is important to remove any air bubbles from the syringe as follows:
- With the needle pointing upwards, tap the syringe with your finger
- Push the plunger slightly to release any air that has collected at the top of the syringe.
Continue to push the plunger until you have the correct dose for injection (For how much to use, see How to take GlucaGen®). A small amount of liquid will be pushed out when you do this.
4 
- 4. Inject the dose into a muscle.
Do not attempt to put the cap back on the needle of the used syringe. Place the used syringe in the orange box and dispose the used needle in a sharps container at the next available opportunity.
GlucaGen®:
- 1. Remove both of the plastic caps from the vials. Draw up all the water into a disposable syringe. Insert the needle through the rubber stopper (within the marked circle) of the vial containing GlucaGen® and inject all the water from the syringe into the vial.
- 2. Without taking the needle out of the vial, gently shake the vial until GlucaGen® has completely dissolved, and the solution is clear.
- 3.
Make sure the plunger is completely down. While keeping the needle in the liquid, slowly withdraw all the solution back into the syringe. Do not pull the plunger out of the syringe.
It is important to remove any air bubbles from the syringe as follows:
- With the needle pointing upwards, tap the syringe with your finger.
- Push the plunger slightly to release any air that has collected at the top of the syringe.
Continue to push the plunger until you have the correct dose for injection (For how much to use, see Usual dose). A small amount of liquid will be pushed out when you do this.
4 
- 4. Inject the dose into a muscle.
What are possible side effects from using GlucaGen®?
These are not all the possible side effects you may feel when taking GlucaGen®. If you experience any side effects not listed here, contact your healthcare professional. Please also see 7 WARNINGS AND PRECAUTIONS.
Like all medicines, GlucaGen® (glucagon) can have side effects. The most common side effects are nausea and dizziness.
Serious side effects and what to do about them
| Symptom / effect | Talk to your healthcare professional | Stop taking drug and get immediate medical help | |
| Only if severe | In all cases | ||
COMMON (less than 1 in 10) | √ | ||
| Nausea: feeling sick | |||
UNCOMMON (less than 1 in 100) Vomiting | √ | ||
RARE (less than 1 in 1,000) Stomach: abdominal pain | √ | ||
VERY RARE (less than 1 in 10,000) Allergic reaction: wheezing, sweating, rapid heart beat, rash, swollen face), collapse (anaphylactic reaction) | √ (get medical help immediately) | ||
UNKNOWN (we do not know how often these may happen) Skin problems where the injection is given | √ | ||
If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, tell your healthcare professional.
Reporting Side Effects
You can report any suspected side effects associated with the use of health products to Health Canada by:
NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice. |
Storage:
Store between 2°C and 8°C (refrigerator). The User can also store GlucaGen® HypoKit outside refrigerator at temperature not exceeding 25ºC for 18 months provided that the expiry date is not exceeded.
Do not freeze to prevent damage to the product.
Store in the original package to protect from light.
Use immediately after preparation - do not store for later use.
Do not use if the solution in rare cases looks like a gel or if any of the powder has not dissolved properly.
Do not use if the plastic cap(s) is/are loose or missing when you receive the product - return the product to your local pharmacy.
Keep out of reach and sight of children.
If you want more information about GlucaGen®:
- Talk to your healthcare professional
- Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website: (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html; the manufacturer’s website www.novonordisk.ca, or by calling 1-800-465-4334.