What’s the Difference Between Zegalogue and Glucagon for Hypoglycemia Treatment?

Severe low blood sugar (hypoglycemia) can be a big concern for people with diabetes. And repeated hypoglycemia episodes can have a negative impact on a person’s quality of life. It can also lead to other serious complications, such as heart attack, stroke, and even death. 

People who have severe hypoglycemia may become unconscious. They may also have physical limitations that prevent them from being able to safely bring their blood sugar up. Glucagon or glucagon-like products can help raise blood sugar quickly and act as life savers in these situations. 

Up until a few years ago, there was only one type of glucagon product available. It required a complicated mixing process prior to each use. Fortunately, there are now more user-friendly hypoglycemia treatments available, like Zegalogue (dasiglucagon). 

Read on to learn more about Zegalogue and other glucagon products that are available. We’ll also review how they compare to help you decide which one’s best for you.

What is Zegalogue?

Zegalogue (dasiglucagon) is the newest hypoglycemia treatment available on the market. It was approved by the FDA in early 2021 for the treatment of severe hypoglycemia in people with diabetes ages 6 years and older.

How does Zegalogue work for hypoglycemia?

Zegalogue is a glucagon receptor agonist. It works by triggering the liver to break down glycogen. Glycogen is a stored form of glucose (sugar). 

By doing this, more glucose is released in the bloodstream, which helps to raise blood sugar levels. A study showed that Zegalogue was able to achieve blood sugar recovery within 10 minutes. 

Since Zegalogue works by breaking down glycogen in the liver, it won’t be as effective in certain people. This is the case if you have low amounts of stored glucose in your body. Examples of people who may not be ideal candidates for Zegalogue include those who are starving, have adrenal problems, or have chronic low blood sugar.

How is Zegalogue given?

Zegalogue is available in a single-dose premixed autoinjector and prefilled syringe. There are a few different locations it can be injected, including:

• Lower abdomen

• Buttocks

• Thigh

• Outer upper arm

Your healthcare provider will tell you when and how to use Zegalogue. After the first dose is given, call 911 for emergency help as soon as possible. 

If the person is still unresponsive after 15 minutes, another injection may be given with a brand-new device. Once they become responsive to treatment, make sure to give them some carbohydrates (e.g., glucose tablets, fruit juice, regular soda) to eat or drink.

What side effects and risks are associated with Zegalogue?

Some common side effects of Zegalogue include:

• Nausea

• Vomiting

• Headache

• Diarrhea

• Pain at injection site

More serious side effects and risks associated with Zegalogue include:

• High blood pressure: People who have tumors in their adrenal glands shouldn’t use this medication. Zegalogue can cause those tumors to release hormones called catecholamines. Catecholamines can significantly raise your blood pressure.

• Low blood sugar: People who have tumors in their pancreas should avoid using this medication. Initially, Zegalogue will cause a rise in blood sugar. But in response, the tumor will release an amplified amount of insulin. Since insulin lowers your blood sugar, this can result in hypoglycemia.

• Serious allergic reactions: Zegalogue can cause serious allergic reactions in some people. If you notice an unusual rash, difficulty breathing, or feel like you’re going to pass out, seek medical attention immediately.

If you have any medical conditions or have concerns regarding Zegalogue, discuss with your healthcare provider if this medication is right for you.

How is Zegalogue different from other types of glucagon?

The biggest difference between Zegalogue and other glucagon products is the chemical structure. Products such as GlucaGen, Gvoke, and Baqsimi are chemically identical to naturally-occurring human glucagon. 

Zegalogue is unique because its chemical structure isn’t the same as glucagon. But it’s considered an glucagon analog. That means that it has the same effects and functions as human glucagon. 

What advantages does Zegalogue offer over GlucaGen?

A GlucaGen kit comes with a vial of dry powder and a prefilled syringe with sterile water. Prior to using it, the sterile water has to be injected into the vial of dry powder. The contents are mixed together and drawn back into the syringe before giving the injection. 

When someone is experiencing a severe hypoglycemic episode, time is of the essence to help them recover safely. Valuable time may be lost from when you begin the mixing process to the time of administration. 

Zegalogue offers the same efficacy as GlucaGen, but it’s much easier to use. It comes in a premixed autoinjector and prefilled syringe. So, it’s ready to use whenever a hypoglycemic emergency arises.

GlucaGen is also dosed by a person’s age and weight which adds another layer of complexity to its use. The dose for Zegalogue is the same for both adults and children ages 6 and older. 

Are there any reasons why someone would choose GlucaGen over Zegalogue?

As described above, GlucaGen is more complicated to use than Zegalogue. But there are certain situations where GlucaGen may be more beneficial than Zegalogue. 

GlucaGen can be used for adults and children of all ages, whereas Zegalogue is only approved for people aged 6 and older. GlucaGen would be a good option for severe hypoglycemia in very young children with diabetes. 

GlucaGen’s shelf life at room temperature is also longer than Zegalogue. GlucaGen can be stored at room temperature for up to 24 months (2 years). This is compared to 12 months (1 year) for Zegalogue. In this case, GlucaGen would be a better option for people who don’t want to get their hypoglycemia medications filled every year.

How do other hypoglycemia treatment alternatives, like Gvoke and Baqsimi, compare to Zegalogue?

Newer glucagon and glucagon-like products like Gvoke, Baqsimi, and Zegalogue have proven to be game changers with their ease of use for severe hypoglycemia. In terms of effectiveness, they are all quite similar. The response time after administration of these products should be within 15 minutes.

Gvoke and Zegalogue are similar in that they’re available as a premixed autoinjector and prefilled syringe. Gvoke is also available in a vial (premixed solution) and syringe kit. 

Gvoke can be used in adults and children ages 2 and older. But children have to be at least 6 years old to use Zegalogue. Gvoke is dosed by age and weight, whereas everyone gets the same dose for Zegalogue.

Baqsimi is a different dosage form compared to the other hypoglycemia treatments. It’s available as a nasal powder form of glucagon in a single-use intranasal device. It can be used in adults and children ages 4 and older. It’s a great option for people who don’t like needles or injections.

How to save on hypoglycemia treatments

There are ways to save on your hypoglycemia medications. GoodRx can help you navigate your options, which include copay savings cards and patient assistance programs.

• Save on Baqsimi. If you have commercial insurance and meet eligibility requirements, Baqsimi’s price is as little as $25 using a savings card from the manufacturer. If you’re uninsured or underinsured, you may be eligible for Baqsimi’s patient assistance program, which offers the medication free of cost.

• Save on GlucaGen. If you’re uninsured or underinsured, you may be eligible for Glucagen’s patient assistance program, which offers the medication free of cost.

• Save on generic glucagon.  If you have commercial insurance and meet eligibility requirements, generic glucagon’s price is as little as $5 using a savings card from the manufacturer.

• Save on Gvoke.  If you have commercial insurance and meet eligibility requirements, Gvoke's price is as little as $25 using a savings card from the manufacturer.

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Written by:

ThienLy Neal, PharmD

ThienLy Neal, PharmD, has over 10 years experience in the pharmacy field, including in such settings as retail, hospital, compounding, and managed care. She has led various clinical programs while focusing on medication adherence programs, specialty drug initiatives, and polypharmacy safety initiatives.

Edited by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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