Short answer: Both treat severe low blood sugar in people with diabetes and are given by someone nearby.12 Zegalogue is dasiglucagon, a 0.6 mg injection under the skin from age 6, kept in the fridge. Baqsimi is glucagon, a 3 mg powder pressed into one nostril from age 1, not inhaled. For both, call emergency help; a second dose from a new device may follow after 15 minutes.
| Zegalogue | Baqsimi | |
|---|---|---|
| Drug | Dasiglucagon, a glucagon analog1 | Glucagon2 |
| How given | Injection under the skin from an autoinjector or prefilled syringe1 | Powder pressed into one nostril; does not need to be inhaled2 |
| Ages | 6 years and older1 | 1 year and older2 |
| Dose | 0.6 mg for every age1 | 3 mg for every age2 |
| If no response | Another 0.6 mg from a new device after 15 minutes1 | Another 3 mg from a new device after 15 minutes2 |
| Compared in label trials with | Placebo; also 1 mg glucagon for injection in two trials, without a formal test1 | 1 mg intramuscular glucagon2 |
| Adult trial result | Median recovery 10 minutes vs 40 and 35 on placebo; 12 on glucagon1 | Success in 100% and 98.8% vs 100% on glucagon; mean 11.6 vs 9.9 and 15.9 vs 12.1 minutes2 |
| Common side effects, adults | Nausea 57% vs 4%, vomiting 25% vs 2%, headache 11% vs 4% on placebo1 | Nausea 26%, headache 18%, vomiting 15%, nose and throat irritation 12%2 |
| Storage | Fridge; up to 12 months at 68 F to 77 F, not put back in the fridge1 | Up to 86 F in its shrink-wrapped tube until use2 |
| Boxed warning | None1 | None2 |
Zegalogue's trials used insulin to lower blood sugar, then gave Zegalogue, placebo or (in two trials) glucagon for injection. Median time until blood sugar rose 20 mg/dL was 10 minutes vs 40 and 35 minutes on placebo in adults, and 10 vs 30 in children 6 to 17. Glucagon took 12 minutes in adults and 10 in children, with no formal test against Zegalogue.1
Baqsimi's adult crossover studies gave each person Baqsimi 3 mg and 1 mg intramuscular glucagon on separate days. Success within 30 minutes was 100% vs 100% in one study and 98.8% vs 100% in the other, with mean times of 11.6 vs 9.9 and 15.9 vs 12.1 minutes.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.
Baqsimi users also reported watery eyes (59%) and nasal congestion (43%) when asked directly.2 The Zegalogue autoinjector cap and syringe needle cover contain dry natural rubber (from latex).1 Both labels say to call for emergency help right away and give carbohydrates by mouth once the person responds; neither is used with pheochromocytoma or insulinoma.12
Which, if either, fits is for your prescriber. More detail: Zegalogue side effects, Baqsimi side effects, the Zegalogue and Baqsimi dosing pages, when glucagon is used, how to store glucagon, and Baqsimi vs Gvoke: how do the nasal and injected glucagon differ?.