Baqsimi
Baqsimi (glucagon) is a dry nasal spray used in an emergency to raise blood sugar in people with diabetes who are experiencing dangerously low blood sugar (hypoglycemia). You spray it into one nostril, but you don't need to inhale it. Like other emergency glucagon medications, you and your caregivers should know when and how to use Baqsimi (glucagon) before you need help.
What is Baqsimi (glucagon)?
What is Baqsimi (glucagon) used for?
Severely low blood sugar (hypoglycemia) in adults and children age 4 years and older with diabetes
How Baqsimi (glucagon) works
Baqsimi (glucagon) contains glucagon, which is a natural hormone your body releases to raise blood sugar.
Typically, your body stores the sugar you get from food in your liver until it needs the sugar at a later time. When your blood sugar is too low, glucagon tells your body to release the stored sugar into your bloodstream. When this happens, your blood sugar level goes up.
Usually, your body can sense and control your blood sugar levels. But this system doesn't work as well if you have diabetes or if you take too much insulin. Baqsimi (glucagon) works to raise your blood sugar levels if they become too low.
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What are the side effects of Baqsimi (glucagon)?
Common Side Effects
- Watery eyes (59%)
- Stuffy nose (43%)
- Itchy nose (39%)
- Runny nose (35%)
- Nausea (26%)
- Eye redness (25%)
- Sneezing (20%)
- Watery eyes (47%)
- Stuffy nose (42%)
- Vomiting (30%)
- Itchy nose (28%)
- Runny nose (25%)
- Headache (25%)
Other Side Effects
- Itchy throat
- Itchy ears
Serious Side Effects
- Serious allergic reactions: hives, itching, swelling of face or tongue, difficulty breathing
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Dryness or irritation inside the nose
- Headache
- Nausea
- Runny or stuffy nose
- Vomiting
Pros and cons of Baqsimi (glucagon)
Pros
Works very well to quickly raise blood sugar levels
Given as a puff in the nose rather than an injection like other glucagon products
Kept at room temperature, so you can carry it around with you
Still gets absorbed even if you have a cold or are taking medications for a cold
Cons
Can commonly cause watery eyes and itchy, stuffy, or runny nose
Could be difficult for some people to use correctly
Not known if it's safe for children younger than 4 years old
Might not work well if you haven't had anything to eat for a while (see Risks and Warnings)
Pharmacist tips for Baqsimi (glucagon)
Teach yourself and your family members how to recognize and treat symptoms of low blood sugar, including shakiness, anxiety, and hunger. Make sure to keep Baqsimi (glucagon) with you at all times so you can take it if your blood sugar level drops too low.
You should receive training from your provider or pharmacist on how to use Baqsimi (glucagon). Read the instructions for use or watch this helpful video for more information. Contact your provider or pharmacist if you have any questions.
Call 911 or get medical help right away after you use Baqsimi (glucagon), even if you start feeling better. It's best to have a medical professional keep an eye on your sugar levels. You can take a second dose after 15 minutes with a new device while you are waiting for medical help.
Only take Baqsimi (glucagon) out of the wrapper right before you need to use it. The medication won't work as well if the wrapper is opened for a while.
Eat something that contains sugar (e.g., candy, juice, or non-diet soda) as soon as you are able to swallow, to prevent your blood sugar from getting too low again.
Never share Baqsimi (glucagon) with anyone else. Doing so puts you and others at risk of spreading germs and getting severe and potentially life-threatening infections.
Let your provider know every time you use Baqsimi (glucagon) because this might mean that you need to adjust your diabetes medications.
Frequently asked questions about Baqsimi (glucagon)
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What are the risks and warnings for Baqsimi (glucagon)?
Baqsimi (glucagon) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
High blood pressure in people with pheochromocytoma
Risk factors: Pheochromocytoma (tumor above the adrenal glands)
Don't use Baqsimi (glucagon) if you have a rare tumor called pheochromocytoma. This is because Baqsimi (glucagon) can trigger the release of certain hormones that can cause your blood pressure to become dangerously high. If you have this condition, ask your provider about safer ways to treat dangerously low blood sugar.
Low blood sugar in people with insulinoma
Risk factors: Insulinoma (tumor in the pancreas)
Avoid Baqsimi (glucagon) if you have a type of tumor called insulinoma. Using Baqsimi (glucagon) can trigger the tumor to release more insulin, which can put you at high risk for dangerously low blood sugar. If you have this tumor, your provider might suggest other ways to manage low blood sugar.
Baqsimi (glucagon) not working well
Risk factors: Starvation | Problems with adrenal glands | Low blood sugar for long periods of time
Baqsimi (glucagon) only works if you've been eating a healthy diet and your liver has already stored up enough sugar. It won't work well if you have constantly low blood sugar because of a poor diet, or if you have issues with your adrenal glands. Talk to your provider about how to treat low blood sugar if you have these conditions.
Severe allergic reactions
Severe allergic reactions to Baqsimi (glucagon) are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). If you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using Baqsimi (glucagon), get medical attention right away.
Baqsimi (glucagon) dosage forms
Typical dosing for Baqsimi (glucagon)
The typical dose is 3 mg (1 intranasal device) sprayed into a single nostril as needed for very low blood sugar.
If your blood sugar is still low after 15 minutes, another 3 mg dose from a new device can be given while waiting for emergency medical help.
How much does Baqsimi (glucagon) cost?
Baqsimi (glucagon) contraindications
Pheochromocytoma (tumor above the adrenal glands)
Insulinoma (tumor in the pancreas)
What are alternatives to Baqsimi (glucagon)?
Severely low blood sugar (hypoglycemia) in adults and children age 4 years and older with diabetes
Severely low blood sugar (hypoglycemia) in adults and children age 2 years and older
Severely low blood sugar (hypoglycemia) in adults and children
Before certain diagnostic imaging procedures (e.g., MRI, CT scan) in adults
What is the latest news about Baqsimi (glucagon)?
Baqsimi (glucagon) images
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References
Best studies we foundAssociation of Diabetes Care & Education Specialties. (2019). Managing low blood sugar.
Baqsimi. (n.d.). How to use Baqsimi.
Drugs and Lactation Database (LactMed). (2021). Glucagon. National Institute of Child Health and Human Development.
Eli Lilly and Company. (2019). BAQSIMI- glucagon powder.
Eli Lilly and Company. (2021). BAQSIMI- glucagon powder [package insert]. DailyMed.
National Cancer Institute. (2020). Pheochromocytoma.
Okabayashi, T., et al. (2013). Diagnosis and management of insulinoma. World Journal of Gastroenterology.
Sherr, J. L., et al. (2016). Glucagon nasal powder: A promising alternative to intramuscular glucagon in youth With type 1 diabetes. Diabetes Care.
Suico, J. G., et al. (2020). Glucagon administration by nasal and intramuscular routes in adults With type 1 diabetes during insulin-induced hypoglycaemia: A randomised, open-label, crossover study. Diabetes Therapy: Research, Treatment and Education of Diabetes and Related Disorders.
You and Your Hormones. (2021). Glucagon.
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