Baqsimi Nasal Glucagon: How It Works and When to Use It

What Is Baqsimi Nasal Glucagon?

Baqsimi is a prescription nasal powder glucagon used to treat severe hypoglycemia (dangerously low blood sugar) in people with diabetes aged 4 years and older. Approved by the FDA in 2019, it was the first needle-free glucagon option available in the United States, making emergency treatment significantly easier for caregivers, family members, and bystanders to administer during a crisis.

Unlike traditional glucagon emergency kits that required mixing powder with liquid and injecting it, Baqsimi comes ready to use in a small, single-dose nasal device. No assembly, no needles, and no medical training required.

How Does Baqsimi Work?

Baqsimi contains 3 mg of glucagon in a dry powder form. When administered into one nostril, the powder is absorbed through the nasal mucosa (the lining of the nasal passages) and enters the bloodstream. From there, glucagon travels to the liver and signals it to break down stored glycogen into glucose — rapidly raising blood sugar levels.

The medication does not need to be inhaled or sniffed. Simply inserting the tip of the device into one nostril and pressing the plunger delivers the full dose. This makes it especially valuable when a person with diabetes is unconscious, unresponsive, or unable to swallow and cannot consume fast-acting sugar on their own.

When Should You Use Baqsimi?

Baqsimi is intended for severe hypoglycemia only — not for routine low blood sugar episodes that can be treated with juice, glucose tablets, or other fast-acting carbohydrates. Signs that indicate a need for Baqsimi include:

• Loss of consciousness or unresponsiveness
• Seizures caused by low blood sugar
• Severe confusion or inability to safely swallow food or liquids
• Inability to treat the hypoglycemia through normal means

If someone with diabetes collapses or cannot be roused, call 911 immediately and then administer Baqsimi if available. Emergency medical assistance should always be sought even after giving the dose, as the person will need further monitoring and care.

How to Administer Baqsimi: Step-by-Step

1. Remove the device from its protective case.
2. Hold the device with your thumb on the bottom and two fingers on top of the plunger.
3. Insert the tip gently into one nostril until your fingers touch the bottom of the person's nose.
4. Press the plunger firmly with your thumb all the way in to release the full dose.
5. Place the person on their side (recovery position) in case of vomiting.
6. Call 911 and wait for emergency responders to arrive.

Most people begin to respond within 15 minutes. If there is no response after 15 minutes and a second dose is available, it may be administered in the other nostril.

Important Considerations and Side Effects

Baqsimi works best when the liver has adequate glycogen stores. It may be less effective in people who have been fasting for long periods, have been drinking heavily, or have adrenal insufficiency. Common side effects include nausea, vomiting, headache, and nasal discomfort. These are generally mild and temporary.

Baqsimi should not be used if the patient has a pheochromocytoma (a rare adrenal gland tumor) or insulinoma (a tumor of the pancreas), as glucagon can worsen these conditions.

Storing and Replacing Baqsimi

Store Baqsimi at room temperature between 59°F and 77°F (15°C to 25°C). Check the expiration date regularly and replace it before it expires. Keep it in an easily accessible location that caregivers, family members, teachers, or coworkers know about. Consider carrying it with you, especially during exercise, travel, or other times when hypoglycemia risk is elevated.

Talk to Your Healthcare Provider

If you or a loved one has diabetes and uses insulin or other medications that can cause hypoglycemia, ask your doctor whether a Baqsimi prescription is appropriate. Ensure that anyone who might need to use it is familiar with the device before an emergency occurs. Being prepared can be life-saving.