Baqsimi

Name: Baqsimi

Dosing & Uses

Dosage Forms & Strengths

intranasal powder

  • 3mg/actuation

Hypoglycemia

Indicated for severe hypoglycemic reactions in patients with diabetes

3 mg administered as 1 actuation using the intranasal device into 1 nostril

If no response after 15 minutes, administer an additional 3-mg dose from a new device while waiting for emergency assistance

Dosage Forms & Strengths

intranasal powder

  • 3mg/actuation

Hypoglycemia

Indicated for severe hypoglycemic reactions in children aged ≥4 years with diabetes

Adverse Effects

>10%

Adults

  • Watery eyes (58.8%)
  • Nasal congestion (42.5%)
  • Nasal itching (39.2%)
  • Nausea (26.1%)
  • Eye redness (24.8%)
  • Itchy eyes (21.6%)
  • Sneezing (19.6%)
  • Headache (18.3%)
  • Vomiting (15%)
  • Upper respiratory tract irritation (12.4%)
  • Throat itching (12.4%)

Children

  • Watery eyes (47.2%)
  • Nasal congestion (41.7%)
  • Vomiting (30.6%)
  • Nasal itching (27.8%)
  • Headache (25%)
  • Runny nose (25%)
  • Sneezing (19.4%)
  • Upper respiratory tract irritation (16.7%)
  • Itchy eyes (16.7%)
  • Eye redness (13.9%)

1-10%

Children

  • Throat itching (2.8%)
  • Ears itching (2.8%)

Adults

  • Ears itching (3.3%)

Frequency Not Defined

Adults and children

  • Dysgeusia
  • Pruritus
  • Tachycardia
  • Hypertension
  • Additional upper respiratory tract irritation (nasal pruritus, throat irritation, parosmia)

Warnings

Contraindications

Pheochromocytoma

Insulinoma

Hypersensitivity to glucagon or to any excipients

Cautions

Allergic reactions reported including anaphylactic shock with breathing difficulties and hypotension

Contraindicated with pheochromocytoma; glucagon may stimulate catecholamine release from the tumor; if blood pressure (BP) increases dramatically and undiagnosed pheochromocytoma is suspected, administer phentolamine 5-10 mg IV to lower BP

Contraindicated with insulinoma; glucagon administration may produce initial increase in blood glucose; however, glucagon may directly or indirectly (through an initial rise in blood glucose) stimulate exaggerated insulin release from an insulinoma and cause hypoglycemia; treat with glucose PO or IV

Effective for hypoglycemia only if sufficient hepatic glycogen is present; patients in states of starvation, with adrenal insufficiency, or chronic hypoglycemia may not have adequate levels of hepatic glycogen for glucagon to be effective; treat these patients with glucose

Drug interaction overview

  • Patients taking beta-blockers may have transiently increased pulse and BP when administered glucagon
  • In patients taking indomethacin, glucagon may lose its ability to raise blood glucose or may even produce hypoglycemia
  • Glucagon may increase anticoagulant effect of warfarin

Administration

Intranasal Administration

For intranasal use only

Instruct patients and their caregivers on the signs and symptoms of severe hypoglycemia

Severe hypoglycemia requires help of others to recover; instruct the patient to inform those around them about intranasal glucagon and how to use it

Administer as soon as possible when severe hypoglycemia is recognized

Emphasize the following instructions to the patient or caregiver

  • Do not push plunger or test the device before administering
  • Administer according to instructions on the shrink-wrapped tube label
  • Administer by inserting the tip into 1 nostril and pressing the device plunger all the way in until the green line is no longer showing; dose does not need to be inhaled
  • Call for emergency assistance immediately after administering
  • When patient responds to treatment, give oral carbohydrates to restore the liver glycogen and prevent recurrence of hypoglycemia
  • Do not attempt to reuse the glucagon intranasal device; each device contains 1 dose of glucagon and cannot be reused

Storage

May store up to 86ºF (30ºC) in the shrink-wrapped tube provided

Patient Handout

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