Baqsimi (Glucagon) - Nasal

What Is Baqsimi?

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.

Drug Facts

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

What Is Baqsimi Used For?

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:

  • Loss of consciousness
  • Seizures
  • Hunger
  • Trouble eating or drinking
  • Shaking or sweating
  • Confusion
  • Feeling anxious or weak
  • Lack of coordination
  • Difficulty speaking

Hypoglycemia can be a side effect of medication in people who have diabetes.

How to Take Baqsimi

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.

  • Tell your healthcare provider where you keep the medicine and how to use this device correctly when you need their help. Do not open the shrink wrap until you are ready to use it.
  • Do not push the plunger to check before using it. Baqsimi contains only one dose of medicine and cannot be reused.
  • Give Baqsimi on one side of the nose (nostril). You do not need to inhale the medicine. It will work even if you have a cold or are taking cold medicine. After giving Baqsimi, immediately call for emergency medical help.
  • If the person does not respond 15 minutes after the first dose, give another dose, if available. Tell your healthcare provider whenever you use this medicine. Don't give this medicine to anyone, even if they have similar symptoms. 
  • If unconscious, your family member or caregiver should turn you to lie on your side. Once you can swallow safely, you should immediately eat a fast-acting sugar product.
  • Throw away the used device. Each device contains only one dose and cannot be reused.

Storage

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.

Off-Label Uses

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.

How Long Does Baqsimi Take to Work?

Baqsimi starts working within five to 10 minutes of administration, with peak levels being reached 30 minutes after use.

What Are the Side Effects of Baqsimi?

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

Common side effects associated with the use of Baqsimi may include but may not be limited to:

  • Nausea
  • Vomiting
  • Headache
  • Runny nose
  • Discomfort in nose
  • Stuffy nose
  • Redness in your eyes
  • Itchy nose, throat, and eyes
  • Watery eyes

Severe Side Effects

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.

Report Side Effects

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).

Dosage: How Much Baqsimi Should I Take?

Drug Content Provided by IBM Micromedex®

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.

  • For nasal dosage form (powder):
    • For severe hypoglycemia:
      • Adults and children 4 years of age and older—3 milligrams (mg) (1 intranasal device in one nostril). An additional dose of 3 mg may be given if there has been no response after 15 minutes.
      • Children younger than 4 years of age—Use and dose must be determined by your doctor.

Modifications

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.

Missed Dose

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.

Overdose: What Happens If I Take Too Much Baqsimi?

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.

What Happens If I Overdose on Baqsimi?

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.

Precautions

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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:

  • Using too much insulin (“insulin reaction”) or as a side effect from oral antidiabetic medicines
  • Delaying or missing a scheduled snack or meal
  • Sickness (especially with vomiting or diarrhea)
  • Exercising more than usual.

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.

What Are the Reasons I Shouldn’t Take Baqsimi?

Avoid using Baqsimi if any of the following applies:

  • You are allergic to Baqsimi or any of its ingredients. Ask your healthcare provider for a complete list of the ingredients if you're unsure. It may cause anaphylactic shock with breathing difficulties and decreased blood pressure.
  • You have been previously diagnosed with a pheochromocytoma (tumor on the adrenal gland), due to the risk of an increase in blood pressure
  • You have previously been diagnosed with an insulinoma (tumor on the pancreas) due to the risk of hypoglycemia
  • Consult your healthcare provider if you become pregnant/are currently breastfeeding alongside the use of Baqsimi

What Other Medications Interact With Baqsimi?

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:

  • Beta-blockers: Simultaneous use of beta-blockers and Biaqsimi may cause a rapid rise in blood pressure and pulse
  • Warfarin: Baqsimi may increase the anticoagulant (prevention of blood thickening) effect of Jantoven (warfarin), causing easy bruising and nosebleeds.
  • Indomethacin: Nonsteroidal anti-inflammatory drugs (NSAIDs) may significantly reduce Baqsimi's ability to raise glucose levels or cause hypoglycemia.

Talk with your healthcare provider for more detailed information about medication interactions with Baqsimi.

What Medications Are Similar?

Glucagon is also available in several other dosage forms and brand names, such as:

  • GlucaGen (glucagon), injection
  • Gvoke (glucagon), injection
  • HypoPen (glucagon), injection
  • Gvoke PFS (glucagon), injection

Always use the brand prescribed to you by your healthcare provider. Ask your healthcare provider before switching to any brand or generic alternative.

Frequently Asked Questions

  • What is Baqsimi?

    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.

  • How does Baqsimi work?

    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).

  • What is Baqsimi used for?

    Baqsimi is used to manage severe hypoglycemia in people with diabetes over the age of 4.

  • What are the symptoms of hypoglycemia?

    Common symptoms of hypoglycemia include:

    • Loss of consciousness
    • Seizures
    • Hunger
    • Trouble eating or drinking
    • Shaking or sweating
    • Confusion
    • Feeling anxious or weak
    • Lack of coordination
    • Difficulty speaking
  • Is Baqsimi available as a generic drug?

    No, there is no generic alternative to Baqsimi approved by the FDA. The FDA approved Baqsimi (glucagon) for Eli Lilly and Company.

How Can I Stay Healthy While Taking Baqsimi?

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:

  • Take diabetes-related medications as recommended by your healthcare provider.
  • Consider telling your family, friends, healthcare provider, co-workers, and people you frequently meet about signs of hypoglycemia.
  • Tell them about where you keep Baqsimi to help you in an emergency.
  • Achieve a healthy lifestyle to prevent worsening diabetes.
  • Consider working with a registered dietitian nutritionist (RD or RDN) to help you with a diet plan to avoid hypoglycemia.
  • Don't skip meals. Skipping meals might trigger hypoglycemia.
  • Always call emergency help after using Baqsimi.

Medical Disclaimer

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.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. MedlinePlus. Glucagon nasal powder.

  3. Food and Drug Administration. FDA approves first treatment for severe hypoglycemia that can be administered without an injection.

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  5. MedlinePlus. Hypoglycemia.

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  7. 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.

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