Glucagon (Baqsimi, Gvoke)_Dosage, benefits & legal status
Also known as Baqsimi, Gvoke, Gvoke HypoPen, Gvoke PFS, Gvoke Kit, Gvoke VialDx, GlucaGen, GlucaGen HypoKit, Ogluo, Glucagon Emergency Kit, glucagon for injection, glucagon hydrochloride, nasal glucagon
The body's own blood-sugar-raising hormone, sold as mix-before-use kits, a ready-to-inject pen and a nasal powder. FDA-approved since 1960; the GlucaGen and Lilly kits have left the US market.
Common vial size is what vendors typically sell, not a recommendation. Enter your own vial in the calculator.
What is Glucagon (Baqsimi, Gvoke)?
Plain language first. The technical label stays, but it never stands alone.Overview
When a person with diabetes has blood sugar so low they cannot safely eat or drink, someone else needs to raise it fast, and glucagon is the emergency medicine for that. In the clinic studies behind the newer products, one dose of nasal or ready-to-use injected glucagon brought blood sugar back up within 30 minutes in 98.7 to 100% of adults, matching a standard 1 mg glucagon injection. It works only if the liver has stored sugar to release, and nausea and vomiting are common afterward.
Glucagon is the natural 29-residue pancreatic hormone with no modifications; GlucaGen is made in yeast, Lilly's kit was made in E. coli and Fresenius Kabi's is chemically synthesized. It activates the glucagon receptor, a class B G protein-coupled receptor, on liver cells to drive glycogen breakdown and glucose release, and it relaxes gut smooth muscle, the basis of its radiology use. The same receptor is the "G" arm that retatrutide, survodutide, mazdutide and efinopegdutide add to GLP-1 agonism, while dasiglucagon is a separate, modified analog that stays dissolved in water.
What it's used for
An emergency treatment for severe low blood sugar in people with diabetes, given by injection or as a nasal powder. In adults it is also used to stop gut movement briefly during X-ray imaging.
How does Glucagon (Baqsimi, Gvoke) work?
What it does in the body, and where.Glucagon is the body's signal to release stored sugar, and the rescue products give a large dose of it at once.
- 01Sugar from the liverGlucagon binds glucagon receptors on liver cells, raising cAMP and switching on the breakdown of stored glycogen, so the liver releases glucose into the blood. It works only if that glycogen is there, so it may fail after starvation, with adrenal insufficiency or with chronic low blood sugar.
- 02A quiet gutIt also relaxes the smooth muscle of the stomach and bowel. Given into a vein at 0.25 to 0.5 mg it acts in about 1 minute and lasts 9 to 17 minutes; 1 mg into muscle acts in 8 to 10 minutes and lasts 12 to 27 minutes. That brief pause is what radiologists use.
- 03Keeping it readyNative glucagon does not keep well dissolved in water, so the classic kits are mixed from powder during the emergency. Gvoke keeps it in a DMSO-based solution, Baqsimi delivers it as a dry nasal powder, and dasiglucagon, a separate drug, changes the sequence itself so it stays stable in water.
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.
Nasal powder against injection (Baqsimi)
FDA-approved- Human trialStudy 1, 66 evaluable adults with type 1 diabetes: 100% against 100% recovered within 30 minutes after 3 mg in the nose or 1 mg into muscle (difference 0%, 95% CI -2.9% to 2.9%), at a mean 11.6 against 9.9 minutes.
- Human trialStudy 2, 80 evaluable adults: 98.8% against 100% (difference -1.3%, 95% CI -4.6% to 2.2%), at 15.9 against 12.1 minutes.
- No dataBoth studies lowered blood sugar with insulin in the clinic; neither used placebo or tested emergencies at home.
Ready-to-use injection (Gvoke)
FDA-approved- Human trial161 adults with type 1 diabetes in two crossover studies: 98.7% against 100% recovered within 30 minutes with Gvoke 1 mg or Lilly's mixed kit, at 13.8 against 10.0 minutes.
- Human trialPreparing and giving the dose took 27.3 against 97.2 seconds (p<0.0001).
Children
FDA-approved- Human trial48 children aged 4 to 16: every child in both arms rose by at least 20 mg/dL within 20 minutes, at mean times of 10.8 to 14.2 minutes with the nasal powder.
- Human trial7 children aged 1 to 3 after an overnight fast: all rose by at least 20 mg/dL within 30 minutes, the basis for the March 2025 age extension.
Published report of Baqsimi Study 2 (T1D Exchange)
peer-reviewed-human- Human trialThe 75 adults with type 1 diabetes from Study 2, at 8 centers: 98.7% of nasal visits against 100% of injection visits succeeded; nausea 35% against 38% of visits, head or facial discomfort 25% against 9%.
US market changes
FDA-approved- RegulatoryGlucaGen (NDA 020918) and Lilly's kit (NDA 020928) are listed as discontinued; Amphastar's 2020 kit is now the FDA reference standard for generics, and Mylan, Lupin and Cipla generics followed in 2024 and 2025.
GlucaGen is often listed beside Baqsimi and Gvoke as a current US brand, but Drugs@FDA lists every GlucaGen presentation (NDA 020918) as discontinued, and a November 2023 pharmacy notice set July 1, 2024 as the HypoKit's US exit date. Lilly's Glucagon Emergency Kit is still often cited as current, though its last manufacturing date was December 31, 2022, and Baqsimi is often called a Lilly product, though Amphastar has owned it since June 30, 2023. Baqsimi's age range is still often given as 4 and up; the US label has said 1 year and older since March 17, 2025, and the EMA page gives both ages. An FDA glucagon guidance dated July 28, 2026 is also cited; it is real, but it is a set of revised draft guidances telling generic makers how to show their copies of Baqsimi, Lilly's kit and Gvoke match the originals, not a change in how glucagon is used. A single half-life is usually quoted, often Lilly's 8 to 18 minutes, while the labels run up to an apparent 45 minutes for GlucaGen into muscle. The 75-adult Rickels 2016 paper is often treated as a separate study, but it is the published type 1 diabetes group of the label's Study 2 (NCT01994746, 83 adults including 6 with type 2 diabetes); the other adult study, Study 1, enrolled 70. Glucagon is approved for more than low blood sugar: it is also a radiology diagnostic aid, the use Gvoke VialDx added in March 2025. The products are made differently (yeast for GlucaGen, E. coli for Lilly's kit, chemical synthesis for Fresenius Kabi, Gvoke and Amphastar's generic), so "recombinant glucagon" does not describe them all, and the comparator in the Gvoke studies was Lilly's kit, not GlucaGen.
The published record
Papers and trials about Glucagon (Baqsimi, Gvoke)
184 papers tagged human · 67 not reviews or lab · 24 clinical trial publications
1,519 registered trials · 22 with posted results
Furthest stage reached: Approved in the US
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. 121 papers and 100 trials indexed in detail.
At a glance
Four things to know about Glucagon (Baqsimi, Gvoke)
Evidence
FDA-approved
Category
Weight loss and metabolic
Common vial
Varies
Half-life
8 to 45 minutes, by product and route
How much, and do you cycle it?
The range, and whether you take breaks.1 mg injected or 3 mg into one nostril, once, with a second dose after 15 minutes if needed (label), once, as an emergency dose. Single emergency dose FDA label
Used only when severe low blood sugar happens, with one repeat allowed after 15 minutes, or once before an imaging study.
How long does it stay in the body?
The half-life, and where the figure comes from.8 to 45 minutes, by product and routeFDA label
Lilly's label gives 8 to 18 minutes; Fresenius Kabi about 26 minutes into muscle and 42 minutes under the skin; Gvoke 32 minutes under the skin; Baqsimi a median of about 35 minutes in adults (21 to 31 minutes in children); GlucaGen an apparent 45 minutes into muscle; its label says this probably reflects slow absorption from the injection site. Blood levels peak about 10 to 50 minutes after a dose, depending on the product. It is broken down in the liver, kidney and plasma.
Source: US labels for Lilly's kit (2021), Fresenius Kabi (2022), Gvoke (2025), Baqsimi (2025) and GlucaGen (2021)
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How is it given?
Dosing context and source notes.Supplied as a kit with its own diluent, and the label sets the volume, so there is nothing to work out here.
Label range: 0.5 up to 1 mg per dose. Gvoke US prescribing information (revised March 2025), section 2
For severe low blood sugar, injection kits (Fresenius Kabi, Amphastar and other generics) are mixed from a 1 mg powder vial and a diluent syringe just before use, then injected under the skin, into muscle or, only under medical supervision, into a vein: 1 mg for adults and larger children and 0.5 mg for smaller children by each label's own rule (under 20 kg on Amphastar's kit, as on Lilly's old label; under 25 kg, or under 6 years when weight is unknown, on Fresenius Kabi's). Gvoke comes ready to inject under the skin as a 0.5 or 1 mg HypoPen, a 1 mg prefilled syringe or a 1 mg kit: 1 mg from age 12, and at ages 2 to 11, 0.5 mg under 45 kg or 1 mg at 45 kg or more. Baqsimi is one 3 mg puff of powder into one nostril for everyone aged 1 and over, with no need to breathe in. With every product, a second dose from a new device can be given after 15 minutes if there is no response. As a separate radiology use in adults, doses run from 0.2 to 0.75 mg into a vein or 1 to 2 mg into muscle, depending on the part of the gut being imaged. No kidney or liver adjustments appear on any label. The dose is set by the product rather than measured from a vial, and the nasal dose is a different scale, so the calculator starts with an empty dose field.
How do you store it?
Before mixing, and after.Follow the storage on the product label.
Glucagon (Baqsimi, Gvoke) is supplied as a finished product, so its label sets the storage. Pens, prefilled syringes, implants, tablets and ready-made solutions are used as supplied. Kits that include a powder are mixed just before the dose and usually used straight away, not kept for weeks. Many injectable products go in the fridge and must not be frozen, while others are kept at room temperature, so check the pack or ask the pharmacist.
What are the side effects and cautions?
Known cautions and warnings for this compound.Solubility, computed: 28% charged residues, 28% 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 cause a substantial rise in blood pressure
- Insulinoma, where it can end up causing low blood sugar
- Known allergy to glucagon or an ingredient of the product
- Glucagonoma, when used as a diagnostic aid
Stop and get help
- Rash, swelling or trouble breathing after a dose, possible serious allergic reaction
- No response 15 minutes after the first dose: the labels allow a second dose from a new device or kit
Common effects
- Nasal powder (Baqsimi), 153 adults: nausea 26%, headache 18%, vomiting 15% and upper respiratory tract irritation 12%; in 36 children aged 4 to 16, vomiting 31% and headache 25%
- Nasal symptoms when asked directly: watery eyes 59%, nasal congestion 43%, nasal itching 39%, runny nose 35% and red eyes 25%
- Injection (Gvoke), 154 adults: nausea 30%, vomiting 16%, injection-site swelling 7% and headache 5%; in 31 children, nausea 45% and vomiting 19%
- Against a glucagon injection in 75 adults, nasal glucagon caused similar nausea (35% against 38% of visits) but more head or facial discomfort (25% against 9%)
Where this page says nothing is established, that means nobody has studied it, not that a compound is safe.
Is Glucagon (Baqsimi, Gvoke) approved?
And where the numbers on this page come from.Yes. Glucagon (Baqsimi, Gvoke) is FDA approved and available on prescription in the United States. It is also approved in the European Union, Canada, and Japan.
- Approval statusFDA-approved
- RouteInjection (under the skin, into muscle or into a vein), or a dry powder puffed into the nose
- Checked19 October 2026
- Approved outside the USEuropean Union, Canada, Japan: In the EU, Baqsimi was authorized on December 16, 2019 and is now held by Amphastar France Pharmaceuticals; the EMA overview says ages 1 and over while its product details still say 4 and over. Xeris's liquid glucagon Ogluo, the EU counterpart of Gvoke, was authorized on February 11, 2021 for ages 2 and over. Baqsimi is also authorized in Canada, now under Amphastar. Canada's own glucagon injection products were discontinued in 2023; Health Canada allowed Amphastar to import the US product, with that permission extended to December 31, 2026, and authorized Lupin's glucagon on June 10, 2026, with launch still pending. In Japan, Lilly launched Baqsimi in October 2020.This does not change the United States position above.
- DoseFrom the drug label. The manufacturer tested this range and a regulator reviewed it.
- Vial sizeFrom what vendors typically list; not a recommendation.
- SourcesBaqsimi US prescribing information (revised March 2025)Gvoke US prescribing information (revised March 2025)GlucaGen US prescribing information (NDA 020918, 2021)Lilly Glucagon for Injection US prescribing information (NDA 020928, 2021)Fresenius Kabi Glucagon for Injection US prescribing information (NDA 201849, 2022)Drugs@FDA, NDA 020918 (GlucaGen)FDA GSRS substance record, glucagon (UNII 76LA80IG2G)Orange Book listing of all glucagon applications (drugfuture.com)Amphastar, completion of Baqsimi acquisition from Lilly (June 2023)diaTribe, Lilly discontinues its glucagon emergency kit (August 1, 2022)ProactRx, GlucaGen HypoKit discontinuation notice (November 13, 2023)Christiansen MP et al., BMJ Open Diabetes Research & Care 2021;9:e002137Rickels MR et al., Diabetes Care 2016;39:264-270Sherr JL et al., Diabetes Care 2016;39:555-562
What has happened recently
Lilly's first glucagon (NDA 012122) was approved on November 14, 1960. Novo Nordisk's GlucaGen (NDA 020918) followed on June 22, 1998 and Lilly's rDNA Glucagon for Injection (NDA 020928) on September 11, 1998; Drugs@FDA now lists both as discontinued. Lilly set December 31, 2022 as the last manufacturing date for its kit, and a pharmacy notice gave July 1, 2024 for the GlucaGen HypoKit's US exit, citing a shortage of prefilled syringes. Fresenius Kabi's synthetic glucagon (NDA 201849) was approved on May 8, 2015 as a diagnostic aid only and added the low blood sugar indication on September 9, 2019. Amphastar's kit (ANDA 208086, December 28, 2020) was the first generic of Lilly's kit and is now the FDA reference standard for later generics; Mylan (December 12, 2024), Lupin (July 22, 2025) and Cipla (September 15, 2025) generics followed. Baqsimi nasal powder (NDA 210134) was approved on July 24, 2019 for ages 4 and up and extended to age 1 and up on March 17, 2025; Amphastar bought it from Lilly in a deal that closed on June 30, 2023. Xeris's ready-to-use Gvoke (NDA 212097) was approved on September 10, 2019 for ages 2 and up, added a vial-and-syringe kit on August 20, 2021 and added the intravenous Gvoke VialDx for radiology on March 14, 2025; VialDx and the 0.5 mg prefilled syringe are now listed as discontinued. The FDA granted orphan designations for congenital hyperinsulinism or hyperinsulinemic hypoglycemia on December 5, 2012 (Biodel), September 25, 2014 and January 24, 2018 (both Xeris); none has led to an approval.
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What else is like Glucagon (Baqsimi, Gvoke)?
Others in Weight loss and metabolic, side by side.If you're weighing Glucagon (Baqsimi, Gvoke), it's worth reading Oxyntomodulin (OXM), PYY1875 (NNC0165-1875), and Semaglutide in the same class.
The body's own blood-sugar-raising hormone, sold as mix-before-use kits, a ready-to-inject pen and a nasal powder. FDA-approved since 1960; the GlucaGen and Lilly kits have left the US market.
- Dose
- 1 mg injected or 3 mg into one nostril, once, with a second dose after 15 minutes if needed (label)
- How often
- Once, as an emergency dose
A natural gut hormone that switches on both GLP-1 and glucagon receptors, the blueprint for mazdutide and survodutide. Never developed as a medicine; the human data are a few small studies of 4 weeks or less.
- Dose
- 400 nmol (about 1.8 mg) under the skin before meals, three times daily (research studies)
- How often
- Three times daily, before meals (research)
A long-acting copy of the gut fullness hormone PYY that Novo Nordisk tested on top of semaglutide. It added 2.15 points of weight loss with frequent nausea, and development ended in 2023.
- Dose
- 1.0 mg once weekly, added to semaglutide 2.4 mg (phase 2 trial)
- How often
- Once weekly (phase 2 trial)
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
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
- Baqsimi US prescribing information (revised March 2025)(2025)Ages 1 and up from SUPPL-4 (March 17, 2025); 3 mg into one nostril; median half-life about 35 minutes; Studies 1 to 4, with confidence intervals for the two adult studies; nausea 26%, headache 18% and vomiting 15% in adults.
- Gvoke US prescribing information (revised March 2025)(2025)Doses by age and weight; VialDx radiology indication; half-life 32 minutes; 98.7% against 100% success; nausea 30% and vomiting 16% in adults.
- GlucaGen US prescribing information (NDA 020918, 2021)(2021)Made in Saccharomyces cerevisiae; 25 kg dose cutoff; diagnostic doses; apparent half-life 45 minutes into muscle; sequence; molecular weight 3483.
- Lilly Glucagon for Injection US prescribing information (NDA 020928, 2021)(2021)Made in E. coli and identical to human glucagon; 20 kg cutoff; half-life 8 to 18 minutes; onset and duration for radiology.
- Fresenius Kabi Glucagon for Injection US prescribing information (NDA 201849, 2022)(2022)Made by solid-phase peptide synthesis; emergency and diagnostic kits; half-life about 42 minutes under the skin and 26 minutes into muscle.
- Drugs@FDA, NDA 020918 (GlucaGen)(2026)Every GlucaGen presentation listed as discontinued.
- FDA GSRS substance record, glucagon (UNII 76LA80IG2G)(2026)29-residue sequence with no modifications; CAS 16941-32-5; ATC H04AA01.
- Orange Book listing of all glucagon applications (drugfuture.com)(2026)NDA 012122 approved November 14, 1960; Amphastar, Mylan, Lupin and Cipla generic approvals, with dates matching Drugs@FDA.
- Amphastar, completion of Baqsimi acquisition from Lilly (June 2023)(2023)Closed June 30, 2023: $500 million at closing, $125 million at the first anniversary and up to $450 million in milestones.
- diaTribe, Lilly discontinues its glucagon emergency kit (August 1, 2022)(2022)Last manufacturing date December 31, 2022.
- ProactRx, GlucaGen HypoKit discontinuation notice (November 13, 2023)(2023)US discontinuation on July 1, 2024 because of a global shortfall of prefilled syringes from an outside vendor.
- Christiansen MP et al., BMJ Open Diabetes Research & Care 2021;9:e002137(2021)Gvoke phase 3 crossover studies in 161 adults against Lilly's kit (NCT02656069 and NCT03439072); preparing and giving the dose took 27.3 against 97.2 seconds.
- Rickels MR et al., Diabetes Care 2016;39:264-270(2016)Published report of label Study 2 (NCT01994746), 75 adults with type 1 diabetes at 8 centers: 98.7% of nasal against 100% of injection visits succeeded; non-inferior.
- Sherr JL et al., Diabetes Care 2016;39:555-562(2016)48 children and teenagers with type 1 diabetes (published report of label Study 3): all 24 injected doses and 58 of 59 nasal doses raised glucose by at least 25 mg/dL within 20 minutes; transient nausea in 42% of nasal against 67% of injection sessions (P=0.05).
Beyond these, 221 records are indexed. Browse the records