Dasiglucagon (Zegalogue)_Dosage, benefits & legal status
Also known as Zegalogue, ZP4207, ZP-GA-1, dasiglucagon hydrochloride
Glucagon with seven amino acid changes so it stays stable as a liquid, with nothing to mix before an emergency injection. FDA-approved in March 2021; Novo Nordisk has discontinued the US autoinjector and syringe.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is Dasiglucagon (Zegalogue)?
Plain language first. The technical label stays, but it never stands alone.Overview
Severe low blood sugar is an emergency for people with diabetes, and older glucagon rescue kits had to be mixed from powder first. In the main adult trial, one 0.6 mg injection raised blood sugar by at least 20 mg/dL in a median 10 minutes against 40 minutes with placebo, and 99% recovered within 15 minutes against 2%. Nausea (57%) and vomiting (25%) are common, and the US product has been discontinued.
Dasiglucagon is a 29-residue glucagon analog from Zealand Pharma with seven substitutions, including the non-natural residue Aib at position 16, that make it stable in aqueous solution, so it is supplied as a ready-to-use 0.6 mg dose instead of a powder to reconstitute. It is a glucagon receptor agonist that makes the liver release glucose from stored glycogen, with a half-life of about 30 minutes; it is a glucagon receptor agonist, not a co-agonist like survodutide, a glucagon and GLP-1 drug being developed for long-term use in weight and liver fat. Novo Nordisk has held a global commercialization license since September 7, 2022.
What it's used for
A single emergency injection under the skin to treat severe low blood sugar in people with diabetes who weigh at least 20 kg. No longer sold in the US.
How does Dasiglucagon (Zegalogue) work?
What it does in the body, and where.Dasiglucagon does glucagon's emergency job in a form that stays stable as a liquid.
- 01A stable liquidNative glucagon is unstable in solution, so rescue kits traditionally had to be mixed from powder. Dasiglucagon's seven substitutions, including the non-natural Aib at position 16, let it be stored ready to inject; it also has no methionine.
- 02The liver releases glucoseIt binds glucagon receptors on liver cells, and the liver breaks down stored glycogen and releases glucose into the blood. It needs that glycogen, so it may not work after starvation or with adrenal insufficiency.
- 03Fast, then clearedIn adult trials blood sugar rose by at least 20 mg/dL in a median 10 minutes, and by a mean 168 mg/dL at 90 minutes. The drug peaks at about 35 minutes and is broken down by enzymes in the blood, liver and kidney, with a half-life of about 30 minutes.
What else is it used for?
Each group carries its own evidence level.Approved means regulators have cleared it for that purpose. Investigational means it is in trials. Early research means it is being studied and is not established.
Adults with type 1 diabetes (Trials A and B)
FDA-approved- Human trialTrial A: median recovery 10 minutes against 40 with placebo (p<0.001); 99% recovered within 15 minutes against 2%. Reconstituted GlucaGen, a reference arm, took 12 minutes.
- Human trialTrial B (reported in the US label, not this paper), 34 against 10 patients: 10 against 35 minutes (p<0.001).
Children aged 6 to 17 (Trial C)
FDA-approved- Human trial42 randomized: median 10 minutes against 30 with placebo; GlucaGen 10 minutes, not counting mixing time. Everyone on dasiglucagon or glucagon recovered within 20 minutes against 2 of 11 on placebo.
Congenital hyperinsulinism at home
Investigational- Human trial32 children aged 3 months to 12 years for 4 weeks: low blood sugar episodes 5.29 against 5.85 a week with standard care alone (rate ratio 0.85, 95% CI 0.54 to 1.36, p=0.5028); the primary endpoint was missed.
- No dataA post hoc analysis of continuous glucose monitoring found 43% fewer events (rate ratio 0.57, p=0.0029); this analysis was not prespecified.
- Human trialSkin and gut side effects were more frequent with dasiglucagon added to standard care.
Congenital hyperinsulinism in the hospital
Investigational- Human trial12 infants aged 7 to 364 days, double-blind crossover: IV glucose need in hours 36 to 48 was 4.33 against 9.51 mg/kg/min on placebo (p=0.0037). Zealand reports 7 of 12 off IV glucose at the end without pancreatic surgery; the trial was published by De León DD et al. in the Journal of Clinical Endocrinology & Metabolism (online November 2024, doi 10.1210/clinem/dgae818).
Low blood sugar after gastric bypass
Early research- Human trial10 people, crossover: lowest glucose after a meal 3.0 mmol/L on placebo against 3.9 with 80 mcg (p=0.002) and 4.5 with 200 mcg (p=0.0002); side effects mild to moderate.
It is often reported as approved for congenital hyperinsulinism; it is not. The FDA issued complete response letters in December 2023 and on October 9, 2024, a resubmission is planned for the second half of 2026, and that product is a continuous infusion, not the rescue pen. The homecare trial in that condition missed its primary endpoint (p=0.5028); the reductions often quoted (43% fewer glucose-monitor events, 37% to 61% on other measures) come from post hoc analyses of glucose monitoring. '10 minutes against 40' applies to adult Trial A only; Trial B was 10 against 35 and the pediatric trial 10 against 30. It was not shown to be faster than glucagon: GlucaGen was a reference arm, at 12 minutes in adults and 10 in children before mixing time. The approval is sometimes dated March 2022; it was March 22, 2021. The indication is still often given as 'aged six years and older', the wording until June 18, 2026; the US label now says 'weigh at least 20 kg', and summaries that leave out the US discontinuation are out of date. Novo Nordisk holds a commercialization license, not the application; Drugs@FDA still lists Zealand Pharma as the applicant. Ogluo is a native glucagon product, not dasiglucagon. Copying the GSRS sequence string without its modification shows alanine at position 16; that residue is Aib. The label gives 3,382 g/mol; GSRS gives an estimate of about 3,370 Da.
The published record
Papers and trials about Dasiglucagon (Zegalogue)
56 papers tagged human · 22 not reviews or lab · 13 clinical trial publications
24 registered trials · 9 with posted results
Furthest stage reached: Approved in the US, no longer sold
Counted from Europe PMC indexing, not read by a person; a human tag can land on reviews, commentary or lab papers; clinical trial publications is the narrower count.
At a glance
Four things to know about Dasiglucagon (Zegalogue)
Evidence
FDA-approved
Category
Weight loss and metabolic
Common vial
Varies
Half-life
About 30 minutes
How much, and do you cycle it?
The range, and whether you take breaks.0.6 mg once, with one repeat after 15 minutes if needed (label), once, as an emergency dose. Single emergency dose Discontinued
Used only when severe low blood sugar happens, with one repeat allowed after 15 minutes.
How long does it stay in the body?
The half-life, and where the figure comes from.About 30 minutesFDA label
Peak level 5,110 pg/mL (1,510 pmol/L) at about 35 minutes after 0.6 mg under the skin; apparent volume of distribution 47 to 57 L. Cleared like native glucagon, by enzymes in the blood, liver and kidney.
Source: Zegalogue US prescribing information (revised June 2026), section 12.3
You can compare this against the whole library to see where it sits.
How is it given?
Dosing context and source notes.Supplied as a pen or prefilled syringe, so there is nothing to mix.
Label dose: 0.6 mg per dose. Zegalogue US prescribing information (revised June 2026), section 2
The label dose is 0.6 mg under the skin of the lower abdomen, buttocks, thigh or outer upper arm, the same for adults and children; if there is no response after 15 minutes, a second 0.6 mg dose from a new device may be given. Since the June 18, 2026 label change it covers people with diabetes who weigh at least 20 kg (earlier labels said aged 6 and over); use under 20 kg is not established. Supplied ready to use as single-dose 0.6 mg/0.6 mL autoinjectors and prefilled syringes, stored refrigerated at 2 to 8°C, or at 20 to 25°C for up to 12 months. The US product has been discontinued.
How do you store it?
Before mixing, and after.Supplied ready to use. Store it as the label says.
Dasiglucagon (Zegalogue) comes as a ready-made solution, prefilled syringe or ampoule, not a powder, so there is no mixing step and no reconstitution clock. Keep it in its original pack and follow the storage and expiry dates on the label. Many ready-made peptide medicines are kept in the fridge and must not be frozen; a few are made to be stored at room temperature.
What are the side effects and cautions?
Known cautions and warnings for this compound.Solubility, computed: 34% charged residues, 31% hydrophobic. Water usually sufficient.
A first-pass rule from peptide manufacturers' guidance. It does not account for disulfide bridges, salt form or how the powder was dried, and it predicts what should be easy rather than what will happen in your vial.
Who should avoid it
- Pheochromocytoma, where it can sharply raise blood pressure
- Insulinoma, where it can cause low blood sugar
- Children who weigh under 20 kg: use is not established
- Low liver glycogen (starvation, adrenal insufficiency or chronic low blood sugar), where it may not work and glucose is given instead (label warning)
Stop and get help
- Rash, swelling or trouble breathing after the injection, possible allergic reaction (anaphylactic shock is rare)
- No response 15 minutes after the first dose: the label allows one second 0.6 mg dose from a new device
Common effects
- Nausea in 57% against 4% on placebo, and vomiting in 25% against 2%, within 12 hours (adults, 116 against 53)
- Headache in 11% against 4%, diarrhea in 5% against 0% and injection-site pain in 2% against 0% in adults
- In children aged 6 to 17, nausea in 65% (25% at 6 to 11, 92% at 12 to 17) and vomiting in 50%, against none on placebo
- Anti-dasiglucagon antibodies in 4 of 506 people (under 1%); one had transient neutralizing activity that cross-reacted with native glucagon
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is Dasiglucagon (Zegalogue) approved?
And where the numbers on this page come from.Approved, but no longer sold in the United States. Dasiglucagon (Zegalogue) was approved by the FDA, and the US product has since been discontinued. It is also approved in the European Union.
- Approval statusFDA-approved
- RouteUnder the skin (autoinjector or prefilled syringe)
- Checked17 October 2026
- Approved outside the USEuropean Union: EU marketing authorization on July 24, 2024 (EMEA/H/C/006214), after a positive CHMP opinion on May 30, 2024, for severe hypoglycemia in adults, adolescents and children aged 6 and over with diabetes; Zealand Pharma is listed as the holder. Whether it is on sale in the EU is not established, and no other approvals are established. The US product is discontinued, and the congenital hyperinsulinism use is not approved anywhere.This does not change the United States position above.
- DoseFrom a discontinued product or program. No current label supports this dose.
- Vial sizeFrom what vendors typically list; not a recommendation.
- SourcesZegalogue US prescribing information (revised June 2026)Drugs@FDA, NDA 214231FDA GSRS substance record, dasiglucagon (UNII AD4J2O47FQ)FDA GSRS substance record, glucagon (UNII 76LA80IG2G)EMA, Zegalogue EPARPieber TR et al., Diabetes Care 2021;44:1361-1367 (Trial A)Battelino T et al., Pediatric Diabetes 2021;22:734-741 (Trial C)Thornton PS et al., Journal of Clinical Endocrinology & Metabolism 2024;109:1071-1079ClinicalTrials.gov, congenital hyperinsulinism hospital trial (NCT04172441)Fierce Pharma, first complete response letter (January 2, 2024)Zealand Pharma, US regulatory update (October 9, 2024)Zealand Pharma, first half 2026 results (August 13, 2026)Zealand Pharma, license agreement with Novo Nordisk (SEC exhibit, September 2022)Kentucky Medicaid, Zegalogue notice (February 12, 2026)
What has happened recently
The FDA approved Zegalogue (Zealand Pharma, NDA 214231) on March 22, 2021, as a new molecular entity under standard review, for severe hypoglycemia in people with diabetes aged 6 and over; a supplement approved on June 18, 2026 changed this to adults and children who weigh at least 20 kg. Zealand gave Novo Nordisk a global commercialization license on September 7, 2022, and Novo Nordisk later announced the discontinuation of both the autoinjector and the prefilled syringe (as reported in a Kentucky Medicaid notice dated February 12, 2026, with no effective date given); Drugs@FDA lists both as discontinued, and the reason is not established. The EU authorized Zegalogue on July 24, 2024, for people aged 6 and over. For congenital hyperinsulinism, the FDA granted a priority review in August 2023, then issued complete response letters in late December 2023, over inspection findings at a third-party manufacturer, and on October 9, 2024, over the timing of that site's reinspection (covering use for up to 3 weeks), while separately asking for more analyses of existing glucose-monitoring data to support longer use; Zealand expects to resubmit in the second half of 2026. It holds an FDA orphan designation for that use. There are no generics.
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What else is like Dasiglucagon (Zegalogue)?
Others in Weight loss and metabolic, side by side.If you're weighing Dasiglucagon (Zegalogue), it's worth reading Semaglutide, Tirzepatide, and Retatrutide in the same class.
Glucagon with seven amino acid changes so it stays stable as a liquid, with nothing to mix before an emergency injection. FDA-approved in March 2021; Novo Nordisk has discontinued the US autoinjector and syringe.
- Dose
- 0.6 mg once, with one repeat after 15 minutes if needed (label)
- How often
- Once, as an emergency dose
The drug in Ozempic and Wegovy: a weekly shot that curbs hunger for steady weight loss.
- Dose
- 0.25 up to 2.4 mg per week (start low, increase slowly)
- How often
- Weekly
The drug in Mounjaro and Zepbound: a weekly shot for major weight loss and blood sugar.
- Dose
- 2.5 up to 15 mg per week (start low, increase slowly)
- How often
- Weekly
An experimental weekly shot with some of the biggest weight-loss numbers yet in trials.
- Dose
- 1 up to 12 mg per dose (start low, increase slowly)
- How often
- Weekly
Guides for this compound
- How to Reconstitute a Peptide
Mix peptide powder with bacteriostatic water, step by step.
- How to Read an Insulin Syringe
Read the units, convert to millilitres, and draw the exact dose.
- mcg vs mg: The Peptide Dosing Mistake to Avoid
Your vial says mg and your protocol says mcg. Here is the conversion and how to check it.
- Semaglutide vs Tirzepatide vs Retatrutide
One receptor, two, or three. Mechanism, trial weight loss, side effects, and real cost.
Sources
- Zegalogue US prescribing information (revised June 2026)(2026)Indication now people with diabetes who weigh at least 20 kg; 0.6 mg dose; nausea 57% against 4%; half-life about 30 minutes; C152H222N38O50, 3382 g/mol.
- Drugs@FDA, NDA 214231(2026)Approved March 22, 2021, new molecular entity, standard review; new patient population supplement June 18, 2026; both presentations discontinued.
- FDA GSRS substance record, dasiglucagon (UNII AD4J2O47FQ)(2026)CAS 1544300-84-6; codes ZP-4207 and ZP-GA-1; 29 residues with Aib at position 16.
- FDA GSRS substance record, glucagon (UNII 76LA80IG2G)(2026)Native human glucagon sequence, used to count the seven substitutions.
- EMA, Zegalogue EPAR(2024)EU authorization July 24, 2024 (EMEA/H/C/006214) for severe hypoglycemia in people with diabetes aged 6 and over.
- Pieber TR et al., Diabetes Care 2021;44:1361-1367 (Trial A)(2021)Adults with type 1 diabetes: median recovery 10 minutes against 40 with placebo (p<0.001); 99% recovered within 15 minutes against 2%.
- Battelino T et al., Pediatric Diabetes 2021;22:734-741 (Trial C)(2021)Children aged 6 to 17: median 10 minutes against 30 with placebo.
- Thornton PS et al., Journal of Clinical Endocrinology & Metabolism 2024;109:1071-1079(2024)Congenital hyperinsulinism homecare trial, 32 children: primary endpoint missed (rate ratio 0.85, p=0.5028); post hoc CGM events 43% lower.
- ClinicalTrials.gov, congenital hyperinsulinism hospital trial (NCT04172441)(2025)12 infants: IV glucose need 4.33 against 9.51 mg/kg/min on placebo in hours 36 to 48 (p=0.0037).
- Fierce Pharma, first complete response letter (January 2, 2024)(2024)Late December 2023 letter for congenital hyperinsulinism over inspection findings at a third-party manufacturer; no clinical or safety concerns raised.
- Zealand Pharma, US regulatory update (October 9, 2024)(2024)Second complete response letter, tied to the timing of the manufacturer's reinspection; more CGM analyses requested for longer use.
- Zealand Pharma, first half 2026 results (August 13, 2026)(2026)Expects to resubmit the congenital hyperinsulinism application in the second half of 2026.
- Zealand Pharma, license agreement with Novo Nordisk (SEC exhibit, September 2022)(2022)Global commercialization license to Novo Nordisk, September 7, 2022.
- Kentucky Medicaid, Zegalogue notice (February 12, 2026)(2026)Novo Nordisk announced the discontinuation of the Zegalogue autoinjector and prefilled syringe.
Beyond these, 69 records are indexed. Browse the records