What is Baqsimi and How Does it Work? Side Effects, Uses, A Guide

Posted October 2, 2020 by Clint Kelly - See Editorial Guidelines

Individuals that require insulin or struggle with hypoglycemia may need to keep a certain medication on them in case of an emergency. Baqsimi is one of these medications that was approved by the FDA in July of 2019.

In this article, we will cover what Baqsimi is, how it works, side effects, and the cost. Here is a brief explanation to get you started, then we will get into the details.

What is Baqsimi? Baqsimi is a form of glucagon that is used to increase blood sugar levels. It is a nasal spray and the first glucagon medication that does not require an injection. This medication is used when the patient is unable to help themselves.

What is Baqsimi?


Those living with diabetes, particularly those on insulin, are at an increased risk of having low blood sugar levels. Therefore, they should be prescribed glucagon to have on them in the event of an emergency. 

Baqsimi is a glucagon nasal spray that is manufactured by Eli Lilly. The FDA approved this medication on July 24, 2019. This medication is the first of its kind, as it is the first non-injectable glucagon medication. It comes in a single dose dispenser where the powder is administered into the nose.

The older, injectable glucagon medications are still available and are effective, but the process of administration is much more difficult. It requires powder to be mixed with a liquid, which is then pulled from a vial with a syringe and then injected into the patient.

How Does Baqsimi Work?

Baqsimi works to increase blood glucose levels rapidly. It does this by triggering the liver to release stored glucose into the bloodstream.

The liver stores glycogen, which is turned into glucose when the liver releases it into the bloodstream. Glycogen is stored in case the body’s blood sugar levels drop below normal levels. Typically, the pancreas will produce glucagon, which is what triggers the liver to release glucose.

However, in a person with type 1 diabetes, the pancreas does not do this. So, there needs to be an outside source that triggers the liver to do its job. This is why Baqsimi, or a glucagon injection, is needed.  

When Should Patients Use Baqsimi?

Baqsimi must be used during a severe hypoglycemic event. A severe hypoglycemic event is when a person’s blood sugar drops so far below the normal level that they are unable to treat themselves.

Under less severe low blood sugar moments, the individual should be able to treat themselves by having a snack or drinking a sugary drink. However, if their blood sugar continues to drop, it can cause them to be unconscious and unable to help themselves.

Therefore, someone else needs to administer aide. This is why it is crucial for those with type 1 diabetes to talk to their family members and close friends about what to do in the event of an emergency such as this.

They should discuss with those close to them where they keep Baqsimi or other glucagon medication and how to administer it.

Without immediate treatment of severe hypoglycemia, it can be fatal.

How to Use Baqsimi

As mentioned above, during severe hypoglycemic events, someone else will have to administer Baqsimi to the patient. Follow these three steps for delivering the dose.

How to use Baqsimi
  1. After pulling the device out of its packaging, hold it between your fingers and thumb. Do not push down on the plunger yet.
  2. Insert the tip of the device gently into one nostril until fingers are touching the outside of the nose.
  3. Push the plunger down fully. The full dose is administered once the green line on the plunger disappears.

After administering the dose there may be additional ways to help the patient. Turn them on their side if they are unconscious. Call an ambulance to get emergency help.

As soon as the person is conscious and able to safely swallow, encourage them to drink juice or some other source of fast-acting carbohydrates.

Side Effects and Warnings

The most common side effects of Baqsimi may include:

  • Nausea
  • Vomiting
  • Headache
  • Runny nose
  • Stuffy nose
  • Discomfort of the nose
  • Redness of the eyes
  • Itchy nose, eyes, and throat
  • Watery eyes

More rare side effects that may be severe include:

  • High or low blood pressure
  • Serious allergic reactions
  • Changes in sense of smell
  • Skin rash
  • Changes in taste

Certain medical conditions may make taking Baqsimi unsafe. Those that have pheochromocytoma, a tumor of the adrenal gland, should not receive this medication. It may trigger certain hormones of the adrenal glands, which can lead to severe high blood pressure.

Insulinoma, which is a tumor of the pancreas, can also cause adverse reactions if this medication is taken. Insulinoma can cause the pancreas to produce too much insulin, leading to more severe hypoglycemia.

Patients should also never take Baqsimi if they have had an allergic reaction to glucagon before. Allergic reactions can cause a severe rash, breathing problems, and low blood pressure.


The out-of-pocket cost for Baqsimi can range between $300-$600 depending on the pharmacy that you go to. This does not take into account insurance coverage, so the actual price you pay will vary. Baqsimi discount cards are also available that can decrease the amount you pay.

Some insurance companies have refused to cover this medication since it is a fairly new medication. There are forms, such as a letter of medical necessity, that patients and their doctors can fill out to receive coverage if the insurance company originally refuses to cover the product.

Possible Interactions

Before having your doctor prescribe you a medication, talk to them about all the other medications you are taking. This includes over-the-counter medicines and vitamins or supplements.

There are possible drug interactions that may occur with Baqsimi. However, most of them are minor interactions. Drugs that may cause an interaction include beta-blockers, certain nonsteroidal anti-inflammatory drugs (NSAID), and certain blood thinners (warfarin).

Alcohol can also lead to a dangerous interaction in those with type 1 diabetes. Binge drinking can lead to severe hypoglycemic events and may prevent glucagon from working correctly. Patients must talk to their doctor about taking preventative measures before drinking alcohol.

Shelf Life and Storage

Baqsimi comes in a tube with a cap. Avoid opening the tube or removing the device from the tube until it is ready to be used. It does not need to be refrigerated and can be stored in temperatures up to 86 degrees Fahrenheit.

The medication is expected to stay stable at room temperature for 18-24 months. An expiration date is printed on the packaging. Replace the device before the current one exceeds its expiration.  


We hope that you have a better understanding of Baqsimi and how it works after reading this article. This medication should not be administered unless a severe hypoglycemic event is occurring; otherwise, it can lead to severe hyperglycemia. For more questions regarding the medications you have been prescribed, consult your healthcare provider.

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