Femi Aremu, PharmD, is a professional pharmacist with experience in clinical and community pharmacy. He currently practices in Chicago, Illinois.
Baqsimi (glucagon) is a prescription medication used to treat emergency and severe hypoglycemia (low blood sugar levels) in adults and children 4 and older with diabetes.
Baqsimi contains the active ingredient glucagon, a hormone made by the pancreas to regulate blood glucose (sugar) levels. Glucagon is categorized as a glycogenolytic (breaking glycogen in the liver into glucose) agent.
Baqsimi increases blood glucose levels by activating hepatic (liver) glucagon receptors, stimulating glycogen breakdown, and releasing glucose from the liver to produce an anti-hypoglycemic effect.
In 2019, Baqsimi became the first glucagon therapy approved by the United States (U.S.) Food and Drug Administration (FDA) can be administered without an injection via the nasal route. Currently, there is no other therapeutic equivalent to brand-name Baqsimi that is administered through the nose, either as a generic or brand-name product.
Baqsimi is administered as a nasal powder for individuals who are either conscious or unconscious and experiencing severe hypoglycemia.

Generic Name: Glucagon
Brand Name(s): Baqsimi
Drug Availability: Prescription
Therapeutic Classification: Antihypoglycemic
Available Generically: No
Controlled Substance: No
Administration Route: Nasal
Active Ingredient: Glucagon
Dosage Form(s): Nasal powder
The FDA has approved Baqsimi for the treatment of severe hypoglycemia in adults and children 4 and older with diabetes.
Diabetic hypoglycemia occurs when someone with diabetes doesn’t have enough glucose in their blood.
Severe hypoglycemia causes a decrease in blood sugar and causes symptoms such as:
Hypoglycemia can be a side effect of medication in people who have diabetes.
Baqsimi comes as a powder in a device to spray into the nose, meaning it does not need to be inhaled. Baqsimi is typically used as needed to treat hypoglycemia.
Consider the following instructions when using this product.
Store Baqsimi at room temperature (68 F to 77 F). Keep it in the shrink-wrapped tube until you are ready to use it. Keep your medications tightly closed and out of the reach of children and pets, ideally locked in a cabinet or closet. Do not store your medication in the bathroom.

Avoid pouring unused and expired drugs down the drain or in the toilet. Ask your healthcare provider about the best ways to dispose of this medicine.
You can also find disposal boxes in your area. Ask your healthcare provider if you have any questions about the best ways to dispose of your medications.
If you travel with Baqsimi, get familiar with your final destination’s regulations. In general, be sure to make a copy of your Baqsimi prescription.
Healthcare providers may prescribe medicines for conditions not approved by the FDA. This is called “off-label” use.
High-dose glucagon infusions (injections) are beneficial off-label to manage beta-blockers (drugs used for the treatment of heart disease), and calcium channel blockers (drugs used to treat hypertension [high blood pressure] and heart arrhythmias [irregular heartbeats]) overdoses.
Baqsimi starts working within five to 10 minutes of administration, with peak levels being reached 30 minutes after use.
This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.
Common side effects associated with the use of Baqsimi may include but may not be limited to:
Severe side effects of Baqsimi may include but may not be limited to:
This may not be a complete list of adverse effects. Call your healthcare provider immediately if you have any new or worsening symptoms.
Conversely, call 911 immediately if your symptoms feel life-threatening.
Baqsimi may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
The following modifications (changes) should be kept in mind when using Baqsimi:
Severe allergic reaction: Avoid using Baqsimi if you have a known allergy to it or any of its ingredients. Ask your healthcare provider for a complete list of the ingredients if you’re unsure.
Pregnancy: Data from a limited number of studies on glucagon use in pregnant people over decades have not identified a drug-associated risk of major birth defects, miscarriage, or adverse effects on pregnant people and their fetuses.
Discuss with your healthcare provider if you plan to become pregnant or are pregnant, and weigh the benefits and risks of taking Biqasmi during your pregnancy.
Breastfeeding: There is no information on the presence of glucagon in human or animal milk or its effects on breastfed infants or milk production. However, glucagon is a peptide that would break down into its constituent amino acids in the infant’s digestive tract and is unlikely to cause harm to an exposed infant.
Talk with your healthcare provider if you plan to breastfeed, to weigh the benefits and risks of taking Baqismi while nursing and the different ways to feed your baby.
Adults over 65: Clinical studies haven’t included enough people in this age group to see whether they respond differently from younger adults.
Also, limited clinical trial experience has not identified differences in response between older adults and younger people.
Children: The safety and effectiveness of Baqsimi have not been established in children under the age of 4.
Baqsimi is usually given as needed to treat hypoglycemia. It does not have a regular dosing schedule and is generally given as one dose, but if required due to non-response, another dose from a new device may be given after 15 minutes.
Try to keep your appointments with your healthcare provider and take your medication routinely to prevent hypoglycemia.
The symptoms of a suspected overdose of Baqsimi include:
If you think that you’re experiencing an overdose or life-threatening symptoms, seek immediate medical attention.
If you think you or someone else may have overdosed on Baqsimi, call a healthcare provider or the Poison Control Center (800-222-1222).
If someone collapses or isn’t breathing after taking Baqsimi, call 911 immediately.
Patients with diabetes should be aware of the symptoms of hypoglycemia (low blood sugar). These symptoms may develop in a very short time and may result from:
Unless corrected, hypoglycemia will lead to unconsciousness, convulsions (seizures), and possibly death. Early symptoms of hypoglycemia include: anxious feeling, behavior change similar to being drunk, blurred vision, cold sweats, confusion, cool pale skin, difficulty in concentrating, drowsiness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, restless sleep, shakiness, slurred speech, and unusual tiredness or weakness.
Symptoms of hypoglycemia can differ from person to person. It is important that you learn your own signs of low blood sugar so that you can treat it quickly. It is a good idea also to check your blood sugar to confirm that it is low.
You should know what to do if symptoms of low blood sugar occur. Eating or drinking something containing sugar when symptoms of low blood sugar first appear will usually prevent them from getting worse, and will probably make the use of glucagon unnecessary. Good sources of sugar include glucose tablets or gel, corn syrup, honey, sugar cubes or table sugar (dissolved in water), fruit juice, or non-diet soft drinks. If a meal is not scheduled soon (1 hour or less), you should also eat a light snack, such as crackers and cheese or half a sandwich or drink a glass of milk to keep your blood sugar from going down again. You should not eat hard candy or mints because the sugar will not get into your blood stream quickly enough. You also should not eat foods high in fat such as chocolate because the fat slows down the sugar entering the blood stream. After 10 to 20 minutes, check your blood sugar again to make sure it is not still too low.
Tell someone to take you to your doctor or to a hospital right away if the symptoms do not improve after eating or drinking a sweet food. Do not try to drive, use machines, or do anything dangerous until you have eaten a sweet food.
If severe symptoms such as convulsions (seizures) or unconsciousness occur, the patient with diabetes should not be given anything to eat or drink. There is a chance that he or she could choke from not swallowing correctly. Glucagon should be given and the patient's doctor should be called at once.
Keep your doctor informed of any hypoglycemic episodes or use of glucagon even if the symptoms are successfully controlled and there seem to be no continuing problems. Complete information is necessary for the doctor to provide the best possible treatment of any condition.
This medicine may cause a serious allergic reaction, called anaphylaxis. This can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, any swelling of your hands, face, or mouth, or lightheadedness or fainting after receiving this medicine.
Replace your supply of glucagon as soon as possible, in case another hypoglycemic episode occurs.
You should wear a medical identification (ID) bracelet or chain at all times. In addition, you should carry an ID card that lists your medical condition and medicines.
Avoid using Baqsimi if any of the following applies:
Some drugs can interact with Baqsimi and should be monitored by your healthcare provider.
Before starting treatment, tell your healthcare provider about any other medicines you take or plan to take, including over-the-counter (OTC) nonprescription products, vitamins, herbs, supplements, and plant-based medicines.
Use caution when taking Baqsimi with the following medications:

Talk with your healthcare provider for more detailed information about medication interactions with Baqsimi.
Glucagon is also available in several other dosage forms and brand names, such as:
Always use the brand prescribed to you by your healthcare provider. Ask your healthcare provider before switching to any brand or generic alternative.

Baqsimi, brand-name glucagon, is approved by the FDA for the emergency treatment of severe hypoglycemia in people with diabetes. It is available as a nasal powder and can be administered without an injection.
Baqsimi increases blood glucose concentration by activating hepatic (liver) glucagon receptors to release glucose from the liver. The quick release of stored glucose from the liver improves blood sugar levels to reduce the symptoms of hypoglycemia (low blood sugar).
Baqsimi is used to manage severe hypoglycemia in people with diabetes over the age of 4.
Common symptoms of hypoglycemia include:
No, there is no generic alternative to Baqsimi approved by the FDA. The FDA approved Baqsimi (glucagon) for Eli Lilly and Company.

If you’re taking diabetes medication, chances are you may have a low blood sugar level emergency sometime.
You may try different approaches or treatments to cope with this challenge; there are ways to help improve your quality of life.
Refer below for some general tips to support your health while using Baqsimi:
Verywell Health’s drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.
Eli Lily. Baqsimi (glucagon powder) prescribing information.
MedlinePlus. Glucagon nasal powder.
Food and Drug Administration. FDA approves first treatment for severe hypoglycemia that can be administered without an injection.
Nakhleh A, Shehadeh N. Hypoglycemia in diabetes: an update on pathophysiology, treatment, and preventionWorld J Diabetes. 2021;12(12):2036-2049. doi:10.4239/wjd.v12.i12.2036
MedlinePlus. Hypoglycemia.
American Diabetes Association. Hypoglycemia (low blood glucose).
Graudins A, Lee HM, Druda D. Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies. Br J Clin Pharmacol. 2016;81(3):453-461. doi:10.1111/bcp.12763.
Sherr JL, Ruedy KJ, Foster NC, et al. Glucagon nasal powder: a promising alternative to intramuscular glucagon in youth with type 1 diabetes. Diabetes Care. 2016;39(4):555-562. doi:10.2337/dc15-1606
Prescribers' Digital Reference. Glucagon – drug summary.

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