Other metabolic peptide drugs

Both are ruled out with pheochromocytoma, an adrenal tumor, because the tumor may release adrenaline-like hormones and sharply raise blood pressure, and with insulinoma, an insulin-making tumor, because blood sugar may rise and then fall. Glucagon’s radiology use is also ruled out with glucagonoma.

Common after a rescue dose: on glucagon, 26–30% of adults had nausea and 15–16% vomiting (Baqsimi, Gvoke); on dasiglucagon, 57% and 25% within 12 hours, vs 4% and 2% on placebo. The instructions say to turn an unconscious person on their side.

Serious allergic reactions, including anaphylactic shock, have been reported with glucagon products. Zegalogue’s device caps contain dry natural rubber, a latex derivative.

The glucagon labels share three: with beta-blockers, pulse and blood pressure may rise briefly; with indomethacin, they may fail to raise blood sugar or even lower it; and they may strengthen warfarin’s effect. Enlicitide’s label found no level changes with the common oral medicines it tested, but it must be taken fasting.

Decades of glucagon use haven’t shown a risk of birth defects or miscarriage. Dasiglucagon has no human pregnancy data, and its label notes that untreated severe lows in pregnancy can be fatal. Enlicitide’s label says to stop once pregnancy is recognized unless the benefits outweigh the risks, since lowering cholesterol may harm a fetus.

It has no boxed warning, contraindications or warnings section, and side effects overall were similar to placebo in its 2,904-person trial. Diarrhea (7% vs 2%) and dizziness (9% vs 4%) were more common in a 303-person trial in inherited high cholesterol.

None of the three is named on WADA’s 2026 list, and its S0 rule for non-approved substances doesn’t apply to approved drugs.

Glucagon and dasiglucagon are single rescue doses for severe low blood sugar in diabetes; glucagon is also a radiology aid in adults. Enlicitide is long-term treatment, with diet and exercise, to lower LDL cholesterol in adults, including inherited (familial) high cholesterol.

Glucagon comes as kits of 1 mg powder mixed just before use, Gvoke ready-to-use injections and Baqsimi nasal powder (3 mg matched a 1 mg injection). Dasiglucagon is a ready-to-use 0.6 mg autoinjector or prefilled syringe, not interchangeable with glucagon’s 1 mg. Enlicitide is a 20 mg tablet taken once daily, fasting.

Glucagon’s half-life is about 8–42 minutes depending on the product and route, and dasiglucagon’s about 30 minutes. Enlicitide’s effective half-life is about 14 hours with daily dosing, reaching steady state in about 7 days.

Glucagon has been FDA-approved since 1960; Lilly’s and Novo Nordisk’s kits are discontinued in the US, but generic kits, Gvoke and Baqsimi remain. Dasiglucagon (Zegalogue) was approved in 2021, but Novo Nordisk ended US sales in January 2026. Enlicitide (Lipfendra) was approved on July 15, 2026 and is under EU review.