Baqsimi ® (glukagon näspulver)

För fullständig produktresumé för Baqsimi® se FASS.

Denna information är endast avsedd för sjukvårdspersonal verksam i Sverige och som svar på din fråga. Informationen nedan är på engelska

Baqsimi® (glukagon näspulver): Feokromocytom

Glukagon näspulver är kontraindicerat för patienter med feokromocytom.

Detailed Information

People with a history of phaeochromocytoma were excluded from the NG clinical studies.1

NG is contraindicated in people with phaeochromocytoma because glucagon may stimulate release of catecholamines from the tumor.2

If the person develops a dramatic increase in BP, use of non-selective α-adrenergic blockade has been shown to be effective in lowering BP.2

Tumor-Induced Release of Catecholamines

Phaeochromocytomas are a rare neuroendocrine tumor usually in the adrenal medulla3,4and less frequently occur in the form of extra-adrenal paragangliomas.3 Phaeochromocytoma tumor cells have specific glucagon-binding receptors, which are stimulated in response to glucagon administration and can cause the release of high levels of circulating catecholamines norepinephrine and epinephrine.3,4  

Clinical presentation varies considerably in people due to the hemodynamic and metabolic actions of the catecholamines (Table 1).3 

Table 1. Signs and Symptoms of a Phaeochromocytoma3

Signs

Symptoms

Hypertensiona

Headache

Tachydardia or reflex bradycardia

Excessive sweating

Postural hypotension

Palpitations

Pallor

Anxiety

Flushing

Tremors

Fasting hyperglycemia

Pain in chest or abdomen

Increased respiratory rate

Fatigue or weakness

Weight loss

Nausea or vomiting

Decreased GI motility

Dizziness

Psychosis

Paresthesias


Visual disturbances

Constipationb

Abbreviation: GI = gastrointestinal.

a Sustained or paroxysmal.

b Rarely diarrhea.

Injectable Glucagon

Phaeochromocytomas have caused multiorgan failure and rare, life-threatening hypertensive crises as a result of very high levels of catecholamines being released in response to injectable glucagon administration.3,4

At one time, injectable glucagon was used to confirm the diagnosis of phaeochromocytoma. This is no longer recommended due to the risk of causing a phaeochromocytoma crisis.3,4

References

1. Data on file, Eli Lilly and Company and/or one of its subsidiaries.

2. Baqsimi [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.

3. Eisenhofer G, Rivers G, Rosas AL, et al. Adverse drug reactions in patients with phaeochromocytoma: incidence, prevention and management. Drug Safety. 2007;30(11)1031-1062. https://doi.org/10.2165/00002018-200730110-00004

4. Hosseinnezhad A, Black R, Aeddula N, et al. Glucagon-induced pheochromocytoma crisis. Endocr Pract. 2011;17(3):e51-e54. https://doi.org/10.4158/EP10388.CR

Glossary

BP = blood pressure

IV = intravenous

NG = nasal glucagon (glucagon nasal powder)

Datum fӧr senaste ӧversyn 2019 M08 30


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