If you have diabetes with episodes of hypoglycemia (low blood sugar), your doctor may prescribe Gvoke. Gvoke is used to treat severely low blood sugar in people with diabetes. It’s prescribed for use in adults and some children.

To learn more about how Gvoke is used, see the “What is Gvoke used for?” section below.

Gvoke basics

Gvoke contains the active ingredient glucagon. This is a type of drug called an anti-hypoglycemic agent.

You’ll inject Gvoke subcutaneously (under your skin). It comes in two forms:

  • the Gvoke prefilled syringe
  • the HypoPen auto-injector

Gvoke is available only in its brand-name form. However, glucagon is available in different generic forms.

Read on to learn about Gvoke’s cost, dosage, and more.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Gvoke prefilled syringes or HypoPen auto-injectors in your area, visit GoodRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Gvoke manufacturer’s website to see if they have support options.

Your doctor will explain how you should take Gvoke. They will also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Taking Gvoke

If you have diabetes and your blood sugar level drops too low, this is known as hypoglycemia. You should take Gvoke if you:

  • can’t get your blood sugar level to rise by eating or drinking
  • aren’t able to swallow safely
  • feel like you might lose consciousness (pass out)

In certain situations, you may need help taking Gvoke. For instance, if you’ve lost consciousness or are having a seizure, someone else will need to give you Gvoke.

Make sure to show a family member or someone close to you how to give you Gvoke if needed. Also help them recognize the signs that indicate you may be close to having a seizure or losing consciousness. These signs may include confusion, irritability, or sweating.

Depending on whether your doctor prescribes the Gvoke prefilled syringe or HypoPen auto-injector, the instructions for use will differ. Both forms are injected subcutaneously (under the skin) of your upper arm, stomach, or thigh, as follows:

  • For the HypoPen auto-injector: Pull off the red cap and push the exposed yellow end into your skin until you hear a click. Hold the auto-injector in place for 5 seconds until the window turns red.
  • For the prefilled syringe: Pull the cap off the syringe. Then pinch your skin, and insert the needle at a 90-degree angle. Push the plunger all the way down.

After you receive Gvoke, someone should call 911 or your local emergency number so you can receive follow-up care. And if you’ve passed out, someone will need to turn you on your side after injecting Gvoke. This will prevent you from choking in case you have nausea and vomiting (see “What are Gvoke’s side effects?” below).

If you have not regained consciousness within 15 minutes of the first dose, you should be given another dose of Gvoke while waiting for emergency services to arrive. Once you wake up and can swallow, you should have something sugary, such as a soft drink or hard candies. This will help prevent your blood sugar level from dropping again.

Dosage

Each Gvoke auto-injector (HypoPen) or prefilled syringe contains one dose of glucagon. The recommended doses are:

  • For adults and children ages 12 and older: 1 milligram (mg).
  • For children ages 2 to 12 years who weigh less than 99 pounds (lb) or 45 kilograms (kg): 0.5 mg.
  • For children ages 2 to 12 years who weigh 99 lb (45 kg) or more: 1 mg.

Questions about taking Gvoke

The following are some common questions people ask about taking Gvoke.

  • What if I don’t have Gvoke with me during an episode of low blood sugar? If you’ve been prescribed Gvoke, you should always carry it with you. Not having Gvoke during a severe case of hypoglycemia (low blood sugar) is dangerous. This is because you may lose consciousness, have seizures or, in rare cases, go into a coma. If you’re having symptoms of severe hypoglycemia and you don’t have Gvoke, you’ll need emergency medical care. If you’re unable to take Gvoke, call 911 right away.
  • Will I need to use Gvoke long term? This depends on how long you continue to have episodes of hypoglycemia. Gvoke is meant to be taken only when needed. However, if you have diabetes and are at risk for severely low blood sugar, you’ll need to always have a supply of Gvoke nearby.
  • Should I take Gvoke with food? If you’re conscious (awake and aware of your surroundings) and able to swallow, you should have something containing sugar before taking Gvoke. This can help raise your blood sugar level. If this first step doesn’t work, then you’ll need to inject Gvoke. If Gvoke helps, you should still eat or drink something sugary, such as hard candies or a soft drink. This will help keep your blood sugar level from dropping again.
  • How long does Gvoke take to work? Gvoke works immediately to help raise your blood sugar level. If your symptoms don’t improve or you have not regained consciousness 15 minutes after the first dose, you should be given a second dose of Gvoke.
Questions for your doctor

You may have questions about Gvoke and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • How will Gvoke affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare providers are available to help you. And they want you to get the best care possible. So, don’t be afraid to ask questions or offer feedback on your treatment.

Find answers to some commonly asked questions about Gvoke.

How does Gvoke compare with glucagon?

Gvoke contains the active ingredient glucagon. It’s available in either a prefilled syringe or a HypoPen auto-injector. This means Gvoke is easy to access in an emergency.

Glucagon comes in some forms that are injected into your vein or muscle. But those forms must be given by a healthcare provider. Other forms of glucagon come in a powder that needs to be mixed with sterile water. These forms may not be as readily available in an emergency as Gvoke.

Glucagon and Gvoke are both used to treat severe hypoglycemia (low blood sugar). Whether you inject Gvoke or receive glucagon, you’ll receive the same medication at the same dosage to help raise your blood sugar level. So glucagon and Gvoke both have similar side effects. (To learn about Gvoke’s side effects, see the section below called “What are Gvoke’s side effects?”)

Is Gvoke similar to Baqsimi?

Gvoke and Baqsimi both contain glucagon, a drug used to treat severely low blood sugar in adults and some children. Gvoke is prescribed for children 2 years of age and older. But Baqsimi is approved only in children ages 4 years and older.

You’ll inject Gvoke under your skin. Baqsimi is available in a powder within a device, which you spray into one nostril during an episode of severely low blood sugar. To use Baqsimi, you place the tip of the device into one nostril. Then you press the plunger all the way until the green line is no longer showing.

With both Gvoke and Baqsimi, someone will need to give you your dose if you lose consciousness (pass out). You’ll need a second dose if you don’t regain consciousness within 15 minutes. For the second dose, a new device of either drug will be needed since each device holds only one dose. Once you’re awake and able to swallow, you should eat or drink something sugary, such as hard candies or a soft drink. This will help keep your blood sugar level from dropping again.

What’s the shelf life of Gvoke?

Gvoke should be stored in its original packaging at room temperature. Under these conditions, Gvoke should be stable for up to 2 years after the manufacturing date on the package. Before taking Gvoke, check the expiration date. Make sure to safely discard any expired Gvoke.

Gvoke is used to treat severe hypoglycemia (low blood sugar) in people with diabetes. Gvoke can be prescribed for adults and for children ages 2 years and older.

When you take Gvoke for a severe low blood sugar episode, glucagon (its active ingredient) works to break down glycogen. Glycogen is a protein that stores extra glucose (blood sugar) in your liver. Glucagon helps release this glucose from your liver, allowing your blood sugar level to rise. For Gvoke to work, you need to have glycogen stores in your liver.

People with certain conditions, such as adrenal gland problems (Addison’s disease), may not have enough glycogen for Gvoke to work. In this case, you should take a glucose tablet or try to eat or drink something sugary to raise your blood sugar levels.

Like most drugs, Gvoke may cause mild or serious side effects. The lists below describe some of the more common side effects that Gvoke may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you may be taking

Your doctor or pharmacist can tell you more about the possible side effects of Gvoke. They can also suggest ways to help relieve its side effects.

Mild side effects

Here’s a short list of some of the mild side effects that Gvoke can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Gvoke’s prescribing information.

Mild side effects that have been reported with the use of Gvoke include:

  • nausea and vomiting*
  • injection-site reaction* (a small bump on your skin where the injection was given)
  • headache

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information on this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from Gvoke can occur, but they aren’t common. If you have serious side effects from Gvoke, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects that have been reported with the use of Gvoke include:

* For more information on this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects Gvoke may cause.

Nausea and vomiting

Nausea and vomiting are the most common side effects in both adults and children who take Gvoke. You may also have nausea when your blood sugar level is too low. This may make it hard to tell whether Gvoke is the cause.

People sometimes lose consciousness (pass out ) from low blood sugar episodes. In such cases, someone else has to give them Gvoke. If this happens, be sure to turn the person on their side after injecting Gvoke. This will prevent them from choking if they have nausea and vomiting.

What might help

After receiving Gvoke and responding to the medication, you’ll need to eat or drink something sugary to raise your blood sugar level. Nausea and vomiting are usually mild side effects that go away over time. But if you have severe vomiting after receiving Gvoke, you may experience another episode of hypoglycemia. This is one of the reasons it’s important to call 911 after taking Gvoke.

Injection-site reaction

After receiving a Gvoke injection, you may have a reaction on your skin where the injection occurred. This may appear as a small bump on the skin. This is a mild reaction that disappears with time.

People can be allergic to Gvoke or any of its ingredients. Symptoms of an allergy to Gvoke may include rash, itchiness, and swelling of the skin. Some people may have more serious allergic reactions that affect their breathing or raise their blood pressure.

What might help

If you have a reaction from Gvoke at the injection site, check the area often to see if the symptoms disappear with time.

If the reaction worsens, you may have an allergy that requires emergency medical attention. Notify your doctor or the emergency service team immediately if you notice symptoms of an allergy. Symptoms may include trouble breathing or swelling of your eyes, face, mouth, tongue, or throat. This is one of the reasons it’s important to call 911 after taking Gvoke.

If a reaction affects just the injection site, ask your doctor or pharmacist what you can do to relieve your symptoms. They may suggest applying a cold compress to reduce swelling. In some cases, they might recommend a pain reliever or an anti-itch medication.

Necrolytic migratory erythema

Some people develop a rare skin rash after receiving continuous infusions of glucagon, the active ingredient in Gvoke. This skin rash is called necrolytic migratory erythema (NME).

Gvoke is not a continuous infusion of glucagon, and the maker of Gvoke did not identify any cases of NME in clinical trials for Gvoke. However, the FDA often requires potential serious risks to be included in a drug’s prescribing information. This is regardless of how rare the side effect may be or whether there is a known connection between the drug and the side effect.

Because Gvoke contains glucagon, this rare but serious side effect is included in Gvoke’s prescribing information.

What might help
If you have questions about this potential side effect, talk with your doctor. They can tell you more about NME and let you know if you might be at risk for this side effect.

Allergic reaction

Some people may have an allergic reaction to Gvoke. Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth or redness/deepening of skin color for a brief time)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Gvoke. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Some important things to discuss with your doctors when considering Gvoke treatment include your overall health and any medical conditions you may have. Tell your doctor if you’re taking any medications. This is important because some medications can interfere with Gvoke.

These and other considerations to discuss with your doctor are described below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Gvoke, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Gvoke.

Interactions with drugs or supplements

Gvoke can interact with several types of drugs. These drugs include:

This list does not contain all types of drugs that may interact with Gvoke. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with the use of Gvoke.

Warnings

Gvoke may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Gvoke. Factors to consider include those in the list below.

  • Pheochromocytoma. If you have pheochromocytoma, a rare type of cancer, you shouldn’t take Gvoke. Taking Gvoke may release a type of chemical called catecholamine from the cancer cells. High levels of catecholamines can raise your blood pressure and heart rate.
  • Allergic reaction. If you’ve had an allergic reaction to Gvoke or any of its ingredients, you shouldn’t take Gvoke. Ask your doctor what other medications are better options for you.
  • Insulinoma. Insulinoma is a type of cancer that releases insulin, a hormone that allows glucose (sugar) to enter your cells. While Gvoke may still release glucose after the injection, it will also cause excess insulin to be released from the insulinoma. Because too much insulin can lead to low blood sugar, taking Gvoke when you have insulinoma could worsen hypoglycemia. If you have insulinoma, ask your doctor about other options for treating your hypoglycemia.

Use with alcohol

There are no known interactions between Gvoke and alcohol. However, alcohol may lower your blood sugar level. This increases your risk for hypoglycemia.

Ask your doctor or pharmacist if you can drink alcohol if you take Gvoke. You may need to monitor your blood sugar level more closely if you do.

Pregnancy and breastfeeding

Studies haven’t shown a link between Gvoke and pregnancy loss, birth defects, or other negative side effects during pregnancy or after birth.

It isn’t known if Gvoke passes into breast milk. Researchers suggest that if it does, breastfed children will likely digest it without any problems. So if you take Gvoke while breastfeeding, it’s unlikely to harm your child.

Don’t take more Gvoke than your doctor prescribes. Using more than prescribed can lead to serious side effects. Since you or someone else may give the injection, it’s important to follow dosage directions carefully to avoid overdose.

Symptoms of overdose

Symptoms caused by an overdose can include:

What to do in case you take too much Gvoke

Call your doctor if you think you’ve taken too much Gvoke. Your doctor may order blood tests to check your potassium level. If your potassium level drops too low, your doctor may give you a supplement. A low potassium level may cause symptoms such as a fast heart rate or muscle cramps.

You may have a severe increase in blood pressure if you take too much Gvoke. If this happens, your doctor may prescribe a blood pressure medication called phentolamine.

You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

If you have questions about taking Gvoke, talk with your doctor or pharmacist. Your doctor can tell you about other treatments you can use for severe hypoglycemia (low blood sugar). They can also explain how to prevent and manage low blood sugar episodes.

Some questions to ask your doctor about Gvoke may include:

  • In an emergency, can I inject Gvoke through my clothing?
  • Where should I store Gvoke in my house?
  • After I use Gvoke, what should I do with the empty product?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.