Quick summary
Glucagon is a 29-amino acid pancreatic hormone and the principal counter-regulatory hormone to insulin. FDA-approved since 1960 as GlucaGen, it is the standard emergency treatment for severe hypoglycemia and is now also available as a nasal powder (Baqsimi).
Overview
Glucagon is a 29-amino acid peptide hormone produced by pancreatic alpha cells and is the principal counterregulatory hormone to insulin. FDA-approved since 1960 under the brand GlucaGen, it is the standard emergency treatment for severe hypoglycemia. It also serves as a diagnostic aid in gastrointestinal imaging. Endogenous glucagon is essential for hepatic glucose mobilization during fasting.
Mechanism of action
Glucagon binds the glucagon receptor (GCGR), a class B GPCR expressed predominantly in the liver. Receptor activation stimulates adenylate cyclase, raising intracellular cAMP and activating protein kinase A (PKA), which triggers glycogenolysis (glycogen breakdown) and gluconeogenesis (de novo glucose synthesis), rapidly raising blood glucose. In pharmacological use, it reverses insulin-induced hypoglycemia within minutes. It also relaxes GI smooth muscle, making it useful as a contrast aid during endoscopy and imaging.
Dosing protocols
| Purpose | Route | Dosage | Frequency | Notes |
|---|---|---|---|---|
| severe hypoglycemia (adults) | intramuscular | 1–1 mg | single dose, repeat once if no response in 15 min | |
| severe hypoglycemia (pediatric <44 lbs) | intramuscular | 0.5–0.5 mg | single dose | |
| GI diagnostic imaging | intravenous | 0.25–2 mg | single procedural dose |
Dosing information is for educational purposes only. Consult a qualified healthcare professional before using any peptide.
Research summary
Glucagon has an extensively documented clinical record spanning 60+ years. GlucaGen (Novo Nordisk) and Baqsimi (nasal powder) are FDA-approved formulations. Research is exploring glucagon dual agonism alongside GLP-1 for obesity treatment. Cotadutide and other GLP-1/glucagon co-agonists are in Phase 2–3 trials for NASH and metabolic disease. Glucagon excess (hyperglucagonemia) is increasingly recognized as a driver of type 2 diabetes pathophysiology.[1][2][3][4][5]
Evidence grading
Each claimed benefit is graded by the strength of available evidence. Grades reflect study quality, not effect size.
Strong = multiple RCTs · Moderate = limited trials or observational · Preliminary = animal or in vitro only · Insufficient = anecdotal or no published data
Side effects
Side effects vary by individual. This is not an exhaustive list. Report unusual symptoms to a healthcare professional.
Common stacks
Peptides commonly paired with Glucagon for synergistic effects.
Legal status
FDA-approved prescription drug (NDA 020918). Available as GlucaGen HypoKit (Novo Nordisk) and Baqsimi nasal spray. Requires a valid prescription in the United States.
Sourcing & access
Prescription required
Glucagon is an FDA-approved prescription medication available through licensed healthcare providers, telehealth platforms, and 503A/503B compounding pharmacies.
Frequently asked questions
Glucagon is primarily used as emergency treatment for severe hypoglycemia when a patient cannot eat or drink. It is also used as a diagnostic aid to relax GI smooth muscle during endoscopy and imaging procedures.
Glucagon binds the glucagon receptor (GCGR) in the liver, activating glycogenolysis (glycogen breakdown) and gluconeogenesis (new glucose synthesis), rapidly raising blood glucose within minutes. It reverses insulin-induced hypoglycemia by mobilizing hepatic glucose stores.
Baqsimi is an FDA-approved nasal powder formulation of glucagon that can be administered without injection. It delivers 3 mg of glucagon nasally and is designed for bystander use in hypoglycemic emergencies, eliminating the need for reconstitution and injection.
Adults and children over 44 lbs receive 1 mg intramuscularly as a single dose. Children under 44 lbs receive 0.5 mg. The dose may be repeated once if there is no response within 15 minutes.
Yes, glucagon dual agonism alongside GLP-1 is being explored for obesity and metabolic disease. Cotadutide and other GLP-1/glucagon co-agonists are in Phase 2-3 trials for NASH, leveraging glucagon's thermogenic effects while counterbalancing its glucose-raising action with GLP-1.
Research references
- Efficacy and Usability of Intranasal Glucagon for the Management of Hypoglycemia in Patients With Diabetes: A Systematic ReviewPubMed
- Efficacy and Safety of Mini-Dose Glucagon for Treatment of Nonsevere Hypoglycemia in Adults With Type 1 DiabetesPubMed
- The Role of Glucagon in the Pathophysiology and Treatment of Type 2 DiabetesPubMed
- Glucagon Receptor Signaling and Glucagon ResistancePubMed
- Clinical evaluation of biosynthetic glucagon treatment for recovery from hypoglycemia developed in diabetic patientsPubMed