GVOKE VIALDX
Clinical safety rating: caution
Comprehensive clinical and safety monograph for GVOKE VIALDX (GVOKE VIALDX).
Glucagon receptor agonist; increases intracellular cAMP in hepatocytes, promoting glycogenolysis and gluconeogenesis, thereby elevating blood glucose levels.
| Metabolism | Primarily hepatic via proteolysis; also renal and plasma degradation. |
| Excretion | Renal: negligible; hepatic metabolism to inactive metabolites, with biliary/fecal elimination of metabolites. |
| Half-life | Terminal half-life: 5 minutes (intravenous); clinically, brief half-life allows rapid glucagon effect, but requires continuous infusion for sustained effect. |
| Protein binding | Approximately 50% bound to albumin and other plasma proteins. |
| Volume of Distribution | 0.3-0.4 L/kg; distributes into extracellular fluid with minimal tissue binding. |
| Bioavailability | Intramuscular: 100%; subcutaneous: 80-100%; intranasal: approximately 100% relative to intramuscular. |
| Onset of Action | Intravenous: 1 minute; intramuscular: 10-15 minutes; subcutaneous: 10-20 minutes; intranasal: 10-15 minutes. |
| Duration of Action | Intravenous: 5-10 minutes; intramuscular/subcutaneous: 10-20 minutes; intranasal: 30 minutes; duration is dose-dependent and influenced by glycogen stores. |
1 mg subcutaneously, intramuscularly, or intravenously; may repeat every 15 minutes if necessary.
| Dosage form | SOLUTION |
| Renal impairment | No dosage adjustment required for renal impairment. Not dialyzable. |
| Liver impairment | No dosage adjustment required for hepatic impairment. |
| Pediatric use | 0.01-0.03 mg/kg per dose (max 1 mg) subcutaneously, intramuscularly, or intravenously; may repeat every 15 minutes as needed. |
| Geriatric use | No specific dosage adjustment; use with caution due to potential cardiovascular effects (e.g., hypertension, tachycardia). |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for GVOKE VIALDX (GVOKE VIALDX).
| Breastfeeding | Glucagon is not orally bioavailable; minimal transfer into breast milk expected. M/P ratio unknown but considered safe; monitor infant for hypoglycemia. |
| Teratogenic Risk | First trimester: No evidence of teratogenicity in animal studies; limited human data. Second/third trimester: Not associated with major malformations; may cause transient neonatal hypoglycemia if used near term. |
| Fetal Monitoring |
■ FDA Black Box Warning
No FDA boxed warning.
| Serious Effects |
Hypersensitivity to glucagon or any product component; known pheochromocytoma; known insulinoma.
| Precautions | May cause nausea, vomiting; use caution in patients with insulinoma or pheochromocytoma due to potential for severe hypertension; ineffective in patients with low glycogen stores (e.g., starvation, adrenal insufficiency). |
Loading safety data…
| Monitor maternal blood glucose and signs of hypoglycemia; fetal heart rate monitoring during prolonged use; assess for neonatal hypoglycemia after delivery. |
| Fertility Effects | No known adverse effects on fertility in animal studies; no human data available. |