Glucagon question

Is there a generic form of glucagon? I went to pick up a new gluc. Rx today and my insurance co-pay has gone up to $75. I find that ridiculous b/c it's a necessary life-saving thing and as far as I know, there's no other brand. But, maybe there's another type that I don't know about?? Thanks for your help!

If there is I'm unaware of them.  I'm commenting to bump this back up for you :)

[quote user="Sarah"]

Is there a generic form of glucagon?


I think glucagon was around before modern drug copyrights.  I think Eli Lilly and Allscripts Healthcare Solutions both make glucagon.  I never heard of allscripts before but they came up on a google search.   I think glucagon is expensive because of it's relatively very low demand and that it's hard to make (r-DNA origin and sterile lyophilization). 

I am a school nurse interested in this topic.
Does any one know if there is a way to get glucagon into schools with out going through the family? For example: there is a program called Epipens for schools that provides epi pens to schools to have on hand for emergencies. I think this is so important for ALL emergency medications (for diabetes, seizures, etc.) If there isnt something like this - would anyone have any ideas on possibly how to get some advocacy going for this?

Hi, Katie @bortzk, and thanks for reviving this thread — what you’re describing is a great idea!

Glucagon is expensive, and thankfully most expire without ever being used. It sure would be more efficient for society if we had a common supply pool at schools, rather than each family paying individually.

I don’t know anything about who might be working on it, but a quick Google search turned up what sound like programs or efforts in various different states, and this relatively recent NPR story:
School Nurse Breaks A Rule To Save A Life | NPR Illinois.

I also found JDRF’s “Become an Advocate” signup page here:
Become an Advocate - JDRF,
which probably would connect you with someone who might know.

I hope it’s successful!

I don’t know the answer to your question but wanted to let you know there is now an inhalable version called Baqsimi. I don’t know the cost.

@bortzk Hi Katie, and Welcome to the JDRF TypeOneNation forum!

I hear and understand your desire, and certainly your need to want glucagon on hand for emergency use in your school setting. Possessing, and administering glucagon without specific doctor order or prescription may be an issue, and for you to administer to one of your students would require permission of a doctor and parent/guardian… As far as I know, glucagon use is prescription use only.

I know for a fact, in Florida, that licensed paramedics on ALS Trucks, who carry narcidics and other controlled substances for administering to emergency clients, are not permitted to administer glucagon, even when the glucagon is in the clients home.

This us only my thought based on what medics have told me several years ago [regulations may have changed]; I am neither a lawyer nor a medical professional.

Hi, Dennis @Dennis! I’m curious now, and not finding anything about paramedics not being able to administer glucagon in FL. Can you or one of your friends (or anyone else reading this who knows or has mad research skills!) point me in the right direction? It definitely doesn’t make sense, so I’m looking for a cite, if anyone can give me one.

@srozelle , I learned this by personal experience - the “hard way”, about 10 years ago.

I had the unfortunate experience of passing out because of a low blood sugar event [medics got readings of 11 & 9 mg/dl] for which I was administered an ampule of [maybe 2 ampules] of D-50 via IV. When I awakened , I asked why I got the D-50 instead of "just a shot of glucagon; the response by the charge Medic was that they are NOT permitted to administer glucagon. Fortunate for me, in a way, was the EMS ALS truck [Advanced Life Support Ambulance] that responded was staffed by three paramedics, one of them the training officer.

OMG, Dennis @Dennis, that’s awful! Fortunately for you, indeed!
Does anyone know if this is still the case? What a horrible rule!

I was fortunate, I guess @srozelle , no ill effects except for the 600+++ mg/dl the next day that took a long time to get back in range. The next day was when the endocrinologist [who has T1d] told me he never wants to see my HbA1c at 6.0% where it had been for years - I’ve been told by two endo to aim for 6.3 to 6.5%.

I will ask around to see if I can see if the glucagon restriction still applies. I put up a fuss a few years ago when the county began placing injectable Narcan in police and sheriff cruisers so untrained [medically] officers could save everyone who overdoses when illegibly shooting up with drugs - a double standard?

@Dennis even though that experience must have been really bad, I’d take IV glucose over glucagon ANY DAY.

Glucagon only works when there is sugar stored in your liver. NO Glycogen? NO effect. IV glucose works 100%. as long as your heart is beating.

Prior to surgery I was running low. I calculated grams carbs I needed to get to 150 so the surgeon would do his thing. I asked the nurse the concentration and converted it to mL The nurse administered my calculated glucose it in my IV line. HOLY COW it fixes a low fast! Also the surgeon saw my BS come up to exactly 150 and he gave me a nod for knowing my stuff.

Since an ambulance can start a line, and has to be efficient in what it carries, - its probably more efficient.

glad you are ok Dennis!

Your thoughts @joe on the advantage of IV glucose over glucagon is what our daughter explained to me after my event. In a past life , before her doctoral cancer research and teaching at the University, she had been charge EMS medic for the county and ER diagnostics.

In retrospect, i know I was fortunate that my wife came looking for me, she is more concerned than I was.

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Thank you Joe. With all my years of experience I had never thought about the distinction between IV glucose and Glucagon - which only shows you can never stop learning.
I consider Glucagon - or IV glucose - the treatment of last resort. With all the tools we have to track blood sugar - including remotely; 504 plans that can be put in place to accommodate a child’s diabetes needs, including eating outside of “assigned times” to keep from going low in the first place - which is ideal; and the ability to recognize the signals our body gives, which many of us relied on long before BG meters and CGMS, and which hopefully would not be compromised in a child. So I wonder how often school nurses see the need to utilize it? I understand it’s better to have it and not need it than need it and not have it, but how often have nurses encountered the situation? I realize I may be stirring up a hornet’s nest - I’m just asking to learn. Also I am grateful Dennis recovered with a “Glucagon alternative” if I might call it that. I’m specifically interested in the need for children in schools rather than adults - following up on the question from a school nurse.
Please don’t hate me🙁.

@wadawabbit Hate? Gosh I hope I don’t come across as mean or scary. Glucagon is usually a last resort and it’s the thing to do if the other person is unconscious, because you can’t give a person carbs if they’ve passed out. Glucagon is easier than starting an iv line so it’s ideal for less trained and less equipped situations. Glucagon is also finding a way into artificial pancreas programs as a way to mimic the way a non diabetic uses stored liver sugar. AP prototype pumps can administer a specially formulated glucagon if you hit your low low sugar alarm. My son doesn’t have diabetes but I have a 504 for when the nurse or nurses aid has to use epinephrine (also an injection). The 504 is written and approved by me, the school, and the doctor and I manage the epi pen and replace it when it hits expiry. When he’s at school and if he need it - it’s there. I bet the school, especially big schools, see a fair share of emergencies including when to need to use epi pens and glucagon. It’s part of the job. I don’t know if there’s data. :smiley:

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That wasn’t directed to you Joe. Just trying to deflect in general. I always enjoy your contributions - no offense taken or intended. Thanks also for the info.

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I sincerely love this forum — I learn so much from everyone here!

As to Katie’s @bortzk question, it sounds like Glucagon would be the tool of choice if we could convince legislators to have “school pools” of emergency supplies.

I don’t know how many kids have Epi-pens in the nurse’s office, either, but it’s a heck of a lot more than get used before they expire, that’s for sure.

Even if taxpayers generally didn’t think it was in their interest to chip in for other people’s emergency medical supplies (personally I think it is, but regardless), even just pooling the families who had a dr’s order for X on file would save a ton of supplies, money, and hassle for those families.

Of course, it also wouldn’t sell as many epi-pens and glucagons, and maybe that’s the end of the discussion. :confused:

Glucagon supplied by guardians/parents, and listed in a 504 plan can when provided conditions are met be administered by a school nurse or other trained person. One of the 504 conditions would be for a call to the parent or prescribing doctor. The glucagon would be kept locked, locked by the school, in the child’s medical cubby.

We had a similar arrangement at the school for our granddaughter who had severe medical conditions. Periodically we would deliver medications to the school to replenish what had been consumed.

Absolutely. We’ve got a 504 plan for our daughter, and we keep the school nurse supplied. I was endorsing the idea I understood Katie to be advocating for: a pool of such supplies for the students who might need them, rather than each family providing their own.

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Can you self-administer your own glucagon if you’re sick and vomiting and can’t keep fluids down? If you’re continuing to go low and your BG isn’t responding quick enough to glucose tablets or OJ? Any ideas on how low you go until you pass out? I’m trying to prevent it if it’s possible. I had an idea that when I was diagnosed with T1D that it wasn’t going to be easy. I hope to have a little sense of ease with this situation. Thanks.