Short answer: Both are glucagon for severe low blood sugar in people with diabetes, given by someone nearby.12 Baqsimi is a 3 mg powder sprayed into one nostril, for ages 1 and up. Gvoke is a ready-to-use injection under the skin, 1 mg (0.5 mg for some children), for ages 2 and up. For both, call emergency help; a second dose from a new device may follow after 15 minutes.
| Baqsimi | Gvoke | |
|---|---|---|
| Form | Glucagon 3 mg nasal powder in a single-use device; not inhaled1 | Glucagon solution in a HypoPen auto-injector, prefilled syringe or vial and syringe kit2 |
| Ages | 1 year and older1 | 2 years and older2 |
| Dose | 3 mg into one nostril, for every age1 | 1 mg for 12 and older; ages 2 to under 12: 0.5 mg under 45 kg, 1 mg at 45 kg or more2 |
| If no response | Another 3 mg from a new device after 15 minutes1 | Another dose from a new device after 15 minutes2 |
| Compared in label trials with | 1 mg intramuscular glucagon1 | 1 mg subcutaneous glucagon2 |
| Treatment success in adults | 100% and 98.8% vs 100% on intramuscular glucagon1 | 98.7% vs 100% on subcutaneous glucagon (pooled)2 |
| Common side effects, adults | Nausea 26%, headache 18%, vomiting 15%, nose and throat irritation 12%1 | Nausea 30%, vomiting 16%, injection site swelling 7%, headache 5%2 |
| Storage | Up to 86 F in its shrink-wrapped tube until use1 | 68 F to 77 F; not refrigerated or frozen2 |
| Not used with | Pheochromocytoma, insulinoma, glucagon allergy1 | Pheochromocytoma, insulinoma, glucagon allergy2 |
In Baqsimi's adult trials, insulin was used to bring blood sugar down, then each person got Baqsimi and 1 mg intramuscular glucagon on separate days. Treatment success within 30 minutes was 100% vs 100% in one study and 98.8% vs 100% in the other; mean time to success was 11.6 vs 9.9 and 15.9 vs 12.1 minutes.1 In Gvoke's adult trials against 1 mg subcutaneous glucagon, success was 98.7% vs 100%, with mean times of 13.8 and 10 minutes.2 These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Baqsimi users also reported watery eyes (59%) and nasal congestion (43%) when asked directly.1
Both labels say to call for emergency help right away and, once the person responds, give carbohydrates by mouth to restore liver glycogen and stop the low coming back. Both warn that glucagon may not work in people with low liver glycogen, such as with starvation or adrenal insufficiency.12 The Gvoke label also covers Gvoke VialDx, a separate IV form used by clinicians during radiology exams, not for rescue.2
Which, if either, fits is for your prescriber. More detail: Baqsimi side effects, Gvoke side effects, the Baqsimi and Gvoke dosing pages and how to store glucagon.