Evidence review: Open Peptide Project (verified against primary PubMed, ClinicalTrials.gov & FDA records) · Last checked 2026-10-27. ← Back to Evidence Library

Glucagon (Gvoke, Baqsimi, generics): what the evidence says

Name: Glucagon (Gvoke, Baqsimi, generics)
Published: 2026-10-27

At a glance

What it is: a 29-amino-acid hormone from the pancreas that raises blood sugar. Synthetic versions are approved for severe hypoglycemia, as injections (e.g. Gvoke, Sep 2019) and a nasal powder (Baqsimi, Jul 2019), and as a diagnostic aid to relax the gut during imaging. ^{R1, R2, R3, R4}

What the evidence says: Human glucagon reliably reverses severe low blood sugar; a meta-analysis of 8 RCTs found nasal and injected glucagon similarly effective. ^R5 Newer weight-loss drugs (survodutide, mazdutide, retatrutide) add glucagon-receptor activity to GLP-1, but they are different molecules. ^{R6, R7, R8}

Biggest risks: nausea and vomiting are common. It must not be used with pheochromocytoma, and can backfire with insulinoma; a rare skin rash (necrolytic migratory erythema) is reported with prolonged use. ^R3

Rating


Human Human evidence	Strong: approved for decades; RCTs and meta-analysis of newer forms ^R5
Animal Animal / lab evidence	Not reviewed
Regulatory	FDA-approved ^R1 · not on FDA's 503A or 503B bulk-substance category lists and not on FDA's compounding safety-risk page ^{R9, R10, R11} · not named by WADA ^R12
Established human dose	Yes, label dose (see Study details)

Evidence verdict: Severe low blood sugar: Strong (decades of use; RCTs of new forms) · Diagnostic aid for GI imaging: Strong (approved use) · Weight loss as glucagon alone: No human data

This page reports what studies used. It is not dosing advice.

Legend: HUMAN data · ANIMAL / LAB data · UNKNOWN · UNVERIFIED: not yet confirmed against a primary source

About the evidence: the core rescue effect is long established; newer formulation trials are often small and in controlled settings.

What is it?

Related pages: dasiglucagon, survodutide, mazdutide, retatrutide, pemvidutide.

Does it work?

Human Rescue: nasal and injected glucagon were similarly effective in a meta-analysis of 8 RCTs. ^R5
🟨 Children: in a phase 1 study of 48 youth with type 1 diabetes, nasal glucagon raised blood sugar about as well as injected glucagon. ^R13
Human Glucagon-receptor co-agonists (different drugs): retatrutide −24.2% body weight at 48 weeks (top dose) ^R6; survodutide −13.0% vs −5.4% at 76 weeks ^R7; mazdutide also tested in GLORY-1. ^R8
⚪ Glucagon alone for weight loss: no human data.

Is it safe?

Contraindicated in pheochromocytoma; warnings for insulinoma, serious allergic reactions, poor effect when liver glycogen is low, and necrolytic migratory erythema. ^R3
Nausea, vomiting and headache are among the most common reactions. ^{R3, R4}

Gray-market vials: extra risks

A gray-market vial has no quality control and no guarantee of identity, strength or sterility. We test retail vials blind under the Open Peptide Standard; see /tests/. A passing test covers one batch on one date and does not mean the compound is safe.

Is it legal?

US: FDA-approved, prescription (Gvoke, Baqsimi, Fresenius Kabi glucagon and generics). ^{R1, R2, R14} openFDA lists GlucaGen and Lilly's glucagon as discontinued. ^{R15, R16}
Compounding: not on FDA's 503A or 503B bulk-substance category lists and not on FDA's compounding safety-risk page. ^{R9, R10, R11}
Sport: not named on WADA's 2026 Prohibited List. ^R12

Study details

These are amounts researchers used, not recommendations.

Study	People / model	Route	Amount used	Follow-up	Reported	Citation
Sherr 2016 (phase 1)	48 youth with T1D	Nasal vs IM	Per study	Single doses	58 of 59 nasal doses raised glucose ≥25 mg/dL within 20 min	PMID 26884472
Pontiroli 2020 meta-analysis	8 RCTs, T1D	Nasal vs injected	Per study	Single doses	Similar efficacy	PMID 32025860
Gvoke label	Adults and children 2+	SC	Per label	Rescue use	Approved for severe hypoglycemia	^R3

Full reference list (PubMed, CT.gov, FDA and WADA checked Oct 27, 2026)

^R1 Drugs@FDA, Gvoke (glucagon), application NDA212097 (openFDA drugsfda record checked Oct 27, 2026). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=NDA212097
^R2 Drugs@FDA, Baqsimi (glucagon nasal powder), application NDA210134 (openFDA drugsfda record checked Oct 27, 2026). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=NDA210134
^R3 Gvoke prescribing information, label published Jul 7, 2026 (DailyMed, checked Oct 27, 2026). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=359982a8-ec5c-4927-8c0f-89771e0f942b
^R4 Baqsimi prescribing information, label published Jun 19, 2026 (DailyMed, checked Oct 27, 2026). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=32ba41fa-4158-40af-8cb2-03693c248994
^R5 Pontiroli AE, et al. Acta Diabetol. 2020. PMID 32025860
^R6 Jastreboff AM, et al. N Engl J Med. 2023. PMID 37366315
^R7 le Roux CW, et al. N Engl J Med. 2026. PMID 42253238
^R8 Ji L, et al. N Engl J Med. 2025. PMID 40421736
^R9 FDA, 503A bulk drug substances categories list (updated May 14, 2026). https://www.fda.gov/media/94155/download
^R10 FDA, 503B bulk drug substances categories list (updated Mar 21, 2025). https://www.fda.gov/media/94164/download
^R11 FDA, Certain bulk drug substances for use in compounding that may present significant safety risks (content current Apr 22, 2026). https://www.fda.gov/drugs/human-drug-compounding/certain-bulk-drug-substances-use-compounding-may-present-significant-safety-risks
^R12 WADA. The 2026 Prohibited List, full list checked; compound not named. https://www.wada-ama.org/sites/default/files/2025-09/2026list_en_final_clean_september_2025.pdf
^R13 Sherr JL, et al. Diabetes Care. 2016. PMID 26884472
^R14 Drugs@FDA, Glucagon (Fresenius Kabi), application NDA201849 (openFDA drugsfda record checked Oct 27, 2026). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=NDA201849
^R15 Drugs@FDA, GlucaGen (glucagon), application NDA020918 (openFDA drugsfda record checked Oct 27, 2026). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=NDA020918
^R16 Drugs@FDA, Glucagon (Lilly), application NDA012122 (openFDA drugsfda record checked Oct 27, 2026). https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=overview.process&ApplNo=NDA012122

Disclaimer

This page is for education and harm reduction, not medical advice or a recommendation to use Glucagon (Gvoke, Baqsimi, generics). This is a prescription medicine. Use it only under the care of a licensed clinician; do not buy it from research-chemical or gray-market sellers. Report problems to FDA MedWatch (https://www.fda.gov/safety/medwatch).