Gvoke HypoPen is a prefilled, ready-to-use autoinjector that delivers glucagon to treat severe low blood sugar (hypoglycemia) in people with diabetes. Unlike older glucagon emergency kits that require mixing a powder with liquid before injection, Gvoke comes as a liquid that’s stable at room temperature and ready to inject immediately. It’s approved for adults and children ages 2 and older, and it works similarly to an EpiPen: you press it against the skin, and it automatically delivers the dose.
Why Gvoke HypoPen Exists
Severe hypoglycemia is a medical emergency. When blood sugar drops dangerously low, a person can become confused, lose consciousness, or have seizures. They can’t swallow, so oral glucose isn’t an option. The standard treatment is glucagon, a hormone the pancreas naturally produces that signals the liver to release stored glucose into the bloodstream.
For decades, the only injectable glucagon available came as a powder that had to be reconstituted. A caregiver or bystander needed to inject liquid into a vial of powder, shake it until dissolved, draw the solution into a syringe, and then inject it into the patient. Under the stress of an emergency, this multi-step process proved difficult. In usability studies, only 31% of experienced caregivers successfully administered a traditional glucagon kit, compared to 88% who successfully used the Gvoke autoinjector.
The challenge in creating a pre-mixed liquid glucagon was that glucagon clumps together and forms unusable fibers when dissolved in water. Gvoke solved this by dissolving glucagon in a non-water-based solvent that prevents that clumping, creating a small, highly concentrated solution that stays stable without refrigeration.
Available Doses
Gvoke HypoPen comes in two strengths:
- 0.5 mg (0.1 mL): For children ages 2 to under 12 who weigh less than 45 kg (about 99 lbs)
- 1 mg (0.2 mL): For adults and anyone 12 or older, as well as children under 12 who weigh 45 kg or more
Each HypoPen is a single-use device. Once used, it cannot be refilled or reused.
How to Use It
The injection process has two main steps: remove the cap, then press and hold. Before injecting, check the expiration date and look through the viewing window to confirm the liquid is clear, colorless, or pale yellow. If it looks cloudy or contains particles, don’t use it.
To inject, pull off the red needle cap, choose an injection site (lower abdomen, outer thigh, or outer upper arm), and expose bare skin. Press the device straight down against the skin and listen for a click. Keep holding it down and count slowly to five. When the viewing window turns red, the injection is complete. Lift the device straight up, and a yellow needle guard will automatically lock over the needle.
You inject through the skin (subcutaneously), not into a vein or muscle. The person receiving the injection should be turned on their side afterward, since nausea and vomiting are common once they regain consciousness.
Common Side Effects
Nausea is the most frequent side effect, occurring in about 30% of adults and 45% of children in clinical trials. Vomiting follows at 16% in adults and 19% in children. These reactions are related to glucagon itself, not the delivery device, and they also occur with traditional glucagon kits.
Other reported side effects in adults include swelling at the injection site (7%) and headache (5%). Children in clinical trials also experienced headache, abdominal pain, and mild reactions at the injection site. In cases of overdose, symptoms can include nausea, vomiting, elevated blood pressure, and increased heart rate.
Who Should Not Use Gvoke
Gvoke is not safe for people with pheochromocytoma (a rare adrenal gland tumor), because glucagon can cause a dangerous spike in blood pressure in these patients. It’s also contraindicated for people with insulinoma (a tumor of the pancreas that produces excess insulin), because glucagon can paradoxically trigger even worse low blood sugar in this condition. Anyone who has had a prior allergic reaction to glucagon or any ingredient in Gvoke should not use it.
Storage
Gvoke HypoPen can be stored at controlled room temperature in its foil pouch until you’re ready to use it. This is a practical advantage over traditional kits, which required more careful storage considerations. Check the expiration date periodically and replace the device before it expires so you always have a usable pen available in an emergency.
Cost and Savings Programs
Gvoke HypoPen can be expensive without insurance. For people with eligible commercial insurance, the manufacturer (Xeris Pharmaceuticals) offers a copay card that can reduce the out-of-pocket cost to as little as $25. There’s also a Patient Assistance Program for people who can’t afford their medication, which provides Gvoke at no cost to qualifying patients. You can call 1-877-694-8653 or visit the Gvoke website for details on both programs.