Short answer: Both are ready-to-use rescue injections under the skin for severe low blood sugar in people with diabetes.12 Gvoke is glucagon, 1 mg (0.5 mg for some children), from age 2, stored at room temperature. Zegalogue is dasiglucagon, a glucagon analog, 0.6 mg from age 6, stored in the fridge. For both, call emergency help; a second dose may follow after 15 minutes.
| Gvoke | Zegalogue | |
|---|---|---|
| Drug | Glucagon1 | Dasiglucagon, a glucagon analog2 |
| Forms | HypoPen auto-injector, prefilled syringe, or vial and syringe kit1 | Autoinjector or prefilled syringe2 |
| Ages | 2 years and older1 | 6 years and older2 |
| Dose | 1 mg for 12 and older; ages 2 to under 12: 0.5 mg under 45 kg, 1 mg at 45 kg or more1 | 0.6 mg for every age2 |
| If no response | Another dose from a new device after 15 minutes1 | Another 0.6 mg from a new device after 15 minutes2 |
| Compared in label trials with | 1 mg subcutaneous glucagon1 | Placebo; also 1 mg glucagon for injection in two trials, without a formal test2 |
| Adult trial result | Success in 98.7% vs 100% on glucagon; mean 13.8 vs 10 minutes1 | Median recovery 10 minutes vs 40 and 35 on placebo; 12 on glucagon2 |
| Nausea and vomiting, adults | Nausea 30%, vomiting 16% (no comparison column)1 | Nausea 57% vs 4%, vomiting 25% vs 2% on placebo2 |
| Storage | 68 F to 77 F; not refrigerated or frozen1 | Fridge; up to 12 months at 68 F to 77 F, not put back in the fridge2 |
| Boxed warning | None1 | None2 |
In Gvoke's two adult crossover studies, insulin brought blood sugar below 50 mg/dL, then each person got Gvoke 1 mg and standard glucagon 1 mg under the skin on separate visits. Success (blood sugar above 70 mg/dL or up 20 mg/dL at 30 minutes) was 98.7% vs 100%, with mean times of 13.8 and 10 minutes.1
Zegalogue's trials measured time until blood sugar rose 20 mg/dL. In adults, the median was 10 minutes vs 40 minutes on placebo in Trial A and 35 minutes in Trial B; in children 6 to 17, 10 minutes vs 30. Glucagon for injection took a median 12 minutes in adults and 10 in children, but the label says it was not formally tested against Zegalogue.2 The two labels define success differently. These numbers come from separate trials with different people, lengths and methods, so they are not a head-to-head comparison.
Both labels say to call for emergency help right away and, once the person responds, give carbohydrates by mouth. Neither is used with pheochromocytoma or insulinoma, and both may not work when liver glycogen is low.12 The Zegalogue autoinjector cap and syringe needle cover contain dry natural rubber (from latex).2 The Gvoke label also covers Gvoke VialDx, a separate IV form for radiology, not for rescue.1
Which, if either, fits is for your prescriber. More detail: Gvoke side effects, Zegalogue side effects, the Gvoke and Zegalogue dosing pages, when glucagon is used, how to store glucagon, and Baqsimi vs Gvoke: how do the nasal and injected glucagon differ?.