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Poisoning Information for the Public & Health Care Professionals
Last updated: 03/2017
Antidote
Adult

Glucagon

Glucagen

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Antidote
Adult

Glucagon

Glucagen

Indications

  • Hypotension, bradycardia or conduction defects due to beta-blocker toxicity.

NOTE: Glucagon is adjunctive treatment only. Intravenous fluids, vasopressors, and high-dose insulin with dextrose are considered first line treatments in beta blocker overdose. 

Dosage

  • 5 mg IV direct over 5 minutes. If after 10 minutes there is an inadequate effect, the 5 mg dose may be repeated once. 

Administration

  • Reconstitution: Add the contents of the supplied diluent to the glucagon vial. This will result in a 1 mg/mL solution. Glucagon should not be used at concentrations greater than 1 mg/mL.
  • IV Direct: Up to 10 mg/minute may be administered in treatment of beta-blocker or calcium channel blocker overdose. Blood pressure monitoring is required.

Compatibility, Stability

  • Glucagon should be used immediately after reconstitution. Discard any unused portion.

Potential Hazards of Administration

  • Nausea and vomiting (high incidence with rapid administration of large doses).
  • Hypersensitivity reactions.
  • Hypotension after large doses.
  • Hyperglycemia, hypocalcemia, hypokalemia.

Miscellaneous

  • Each 1 mg of glucagon = 1 unit of glucagon.

Bailey, B., Blais, R., Gaudreault, P., Gosselin, S., & Laliberte, M. (2009). Antidotes en toxicologie d'urgence (3rd ed.). Quebec, Canada: Centre antipoison du Quebec.

Eli Lilly Inc. (2012). Glucagon:  Product monograph

Goldfrank, L. R., Nelson, L. S., Lewin, N. A., Howland, M. A., Hoffman, R. S., (2015). Goldfrank's toxicologic emergencies(Tenth ed.). New York: McGraw Hill.

IWK Regional Poison Centre. (2011). Beta-adrenergic antagonists (beta-blockers): A brief overview for emergency departments. Unpublished manuscript.

IWK Regional Poison Centre. (2011). Calcium channel blockers: A brief overview for emergency departments. Unpublished manuscript.

Micromedex, T. H. A. (2014). Micromedex health care systems. Retrieved from http://www.micromedexsolutions.com

Novo Nordisk Canada Inc. (September 2009). Glucagen: Product monograph

Olson, K. R. (2007). Poisoning & drug overdose (Sixth ed.). New York: McGraw Hill.

Shannon, M. W., Borron, S. W., & Burns, M. J. (2007). Haddad and Winchester's clinical management of poisoning and drug overdose (Fourth ed.). Philadelphia: Saunders Elsevier.