If you or someone you love lives with type 1 or advanced type 2 diabetes, you know the quiet panic that hits when blood sugar drops fast. For years, many people have relied on Gvoke glucagon injections to pull someone out of a dangerous hypoglycemic episode. But not everyone tolerates Gvoke well, some can’t access it, and many are looking for reliable, accessible options. That’s why we’ve broken down 9 Alternatives for Gvoke, including both prescription and emergency options that work when every minute counts.

Hypoglycemia is no small risk. Every year, over 115,000 people in the United States visit the emergency room for severe low blood sugar events, according to 2024 CDC data. Many of these visits happen because someone didn’t have a working glucagon option on hand when they needed it most. Gvoke has advantages, like its pre-filled syringe, but it also comes with common side effects, supply chain gaps, and high out-of-pocket costs even with insurance.

In this guide, we will cover how each alternative works, who it is best suited for, cost comparisons, and important safety notes. You will walk away with clear information you can bring directly to your endocrinologist at your next appointment, no confusing medical jargon included.

1. Baqsimi Nasal Glucagon

Baqsimi is the most popular non-injectable glucagon option on the market today, and one of the most frequently requested alternatives to Gvoke. Unlike Gvoke which requires an injection into muscle, Baqsimi is a single-use nasal spray that works even if someone is unconscious. You do not need formal medical training to use it, which makes it ideal for family members, coworkers, or teachers who may need to help during an emergency.

This option works best for people who fear needles, or who regularly leave their emergency glucagon with people who have no medical experience. It was approved by the FDA in 2019, and has a 94% success rate for reversing severe hypoglycemia within 15 minutes, according to published clinical trial data. Common side effects include a runny nose, headache, or mild throat irritation, which almost always go away within 30 minutes.

Before choosing Baqsimi, note these key differences from Gvoke:

• No mixing or measuring required at time of use
• Works on unconscious people without repositioning
• Has a 2 year shelf life at room temperature
• Cannot be used for people with severe nasal injury or recent nose surgery

Out of pocket cost for Baqsimi averages $280 for a single dose without insurance, which is slightly lower than Gvoke’s average $310 price tag. Most major insurance plans cover Baqsimi as a preferred brand for emergency glucagon as of 2023. Always check your plan’s formulary before filling a prescription.

2. Zegalogue Auto-Injector

Zegalogue is the newest prescription glucagon auto-injector available, and it was designed specifically to fix many common complaints about Gvoke. It uses dasiglucagon, a newer form of glucagon that stays stable at room temperature for three full years, far longer than most competing options.

Many users prefer Zegalogue because it has the smallest needle of any injectable glucagon product. The device includes clear voice instructions that walk a helper through every step, even if they have never used an auto-injector before. Clinical testing found Zegalogue works 2 minutes faster on average than Gvoke, which can feel like an eternity during a severe low blood sugar event.

Follow these simple steps to use Zegalogue correctly:

1. Pull off the red safety cap
2. Press the end firmly against the outer thigh for 3 seconds
3. Hold in place while you count to 5
4. Remove the device and rub the injection site for 10 seconds

Most people report only mild pain at the injection site, if any. Zegalogue is covered by 92% of commercial insurance plans, and patient assistance programs are available for people without coverage. You will need a new prescription from your doctor to switch from Gvoke.

3. GlucaGen HypoKit

GlucaGen HypoKit is the original emergency glucagon product that has been used safely for over 20 years. This is the option most older adults with diabetes will already be familiar with, and it remains one of the most reliable alternatives to Gvoke during supply chain shortages.

This kit includes a vial of glucagon powder and a pre-filled syringe of sterile water. When needed, you mix the two together, draw up the dose, and inject it into the thigh or arm. While it requires a little more skill than pre-filled options, it has a well-documented safety record and works just as effectively as newer products.

People choose GlucaGen HypoKit for three main reasons: it is almost always in stock at pharmacies, it costs 40% less on average than Gvoke, and most medical first responders already know how to use it. The biggest downside is that you must mix it correctly during an emergency, so regular practice is required.

You can get free training kits from the manufacturer to practice mixing without real medication. Most people master the process in 2 or 3 practice runs. Always store this kit at room temperature, and never use it if the powder looks clumpy or discolored.

4. Generic Dasiglucagon Vials

Generic dasiglucagon became available in the United States in 2024, and it immediately became one of the most affordable alternatives for Gvoke. This is the exact same active ingredient used in Zegalogue, but sold as a standalone vial without the auto-injector device.

This option is perfect for people who are comfortable giving injections, or who need to keep multiple doses of glucagon at home, work, and school. It works exactly the same way as brand name products, but costs a fraction of the price. The FDA requires generic medications to meet identical safety and effectiveness standards as brand name versions.

Product	Average Cash Price	Shelf Life
Gvoke	$312	24 months
Generic Dasiglucagon	$78	36 months

As with all injectable medications, you should get proper training from your pharmacist before using generic dasiglucagon. You will also need to purchase separate syringes, which cost just a few dollars at any drug store. Most insurance plans now cover this generic option with zero or very low copay.

5. Traditional Powder Glucagon Kit

The traditional unbranded powder glucagon kit is the lowest cost prescription glucagon option available today. This is the product most hospitals and ambulance services carry, and it has been used successfully for decades during emergency hypoglycemia events.

While this kit does require mixing at the time of use, many people prefer it because there are almost never supply shortages. During the 2022 Gvoke national shortage, this was the only glucagon option available for thousands of people with diabetes. It works for all ages, including small children and older adults.

Many people worry about mixing the medication correctly during a panic. The good news is that the steps are very simple, and every kit includes large, picture instructions that work even for someone under stress. You can also watch free 2-minute demonstration videos online to practice ahead of time.

You can usually pick up this kit for under $50 without insurance. Most doctors will write this prescription without hesitation if you explain you want a low cost, reliable backup option. Always check the expiration date every time you restock your emergency bag.

6. Oral Glucose Gel (For Conscious Episodes)

Oral glucose gel is not a replacement for injectable glucagon during unconscious episodes, but it is one of the most important first line alternatives for Gvoke when someone is still awake and able to swallow. Most severe low blood sugar events do not require glucagon if you catch them early enough.

These small single-use packets contain concentrated glucose that raises blood sugar within 3 to 5 minutes. They are small enough to fit in a pocket, purse, or backpack, and they cost less than $1 each. You can buy them over the counter without a prescription at any pharmacy or grocery store.

Keep these tips in mind when using glucose gel:

• Use 15 grams of glucose, wait 15 minutes, then test blood sugar again
• Never use regular food or candy if gel is available
• Squeeze the gel inside the cheek, not on the tongue, for fastest absorption
• Always follow with a small snack once blood sugar returns to normal

Every person with diabetes should carry at least two glucose gel packets with them at all times. Many people keep an extra pack in their car, desk, and gym bag. This is the best first option for low blood sugar, and can prevent you from ever needing to use emergency glucagon at all.

7. Multi-Dose Glucagon Pens

Multi-dose glucagon pens are designed for people who experience frequent low blood sugar events, or who need small scheduled doses of glucagon overnight. This is a great alternative for Gvoke for people who use glucagon regularly, not just for emergencies.

Each pen holds 10 full doses of glucagon, and stays stable at room temperature for 30 days once opened. You can adjust the dose for children or adults, and no mixing is required. This option is very popular with parents of young children with type 1 diabetes, who often need small doses during the night.

These pens are not intended for severe unconscious hypoglycemia episodes. They work best for mild to moderate lows, or for preventing lows before exercise or missed meals. Talk to your doctor about proper dosing instructions if you are considering this option.

Out of pocket cost for a multi-dose pen averages $190, which works out to less than $20 per dose. That is over 75% cheaper per dose than single use Gvoke injections. Most insurance plans will cover this option if your doctor documents frequent low blood sugar events.

8. Xeris Generic Glucagon Pen

Xeris released the first authorized generic for Gvoke in late 2023, and it is an exact copy of the original brand name product. This means it uses the same formula, same delivery system, and same pre-filled design as regular Gvoke, but at a much lower price.

This is the perfect alternative for anyone who likes how Gvoke works, but cannot afford the brand name price. It works exactly the same way, so you will not need to learn any new steps to use it. All of the existing training materials for Gvoke work perfectly for this generic version.

Most pharmacies started carrying this generic in early 2024, but you may need to ask your pharmacist specifically for it. Many doctors still write prescriptions for brand name Gvoke by default, so you can also ask your provider to note generic substitution is allowed on your prescription.

The average cash price for the Xeris generic is $125 per dose, which is 60% cheaper than brand name Gvoke. Insurance copays are usually $10 to $25 for most plans. This is currently the closest direct replacement for Gvoke available on the market.

9. Emergency Glucagon Vial Kits For Schools

Schools and workplaces have special needs for emergency glucagon, and there are specific bulk alternatives for Gvoke designed for public settings. These kits include extra training materials, clear wall instructions, and multiple doses that can be used for anyone having an emergency.

Many states now require schools to keep emergency glucagon on hand for any student, even if the school does not have a nurse on site. These public use kits are designed so that any adult can use them after a short 15 minute training session. They have been proven to reduce emergency room visits for school related hypoglycemia events by 41% according to a 2023 study.

All public use glucagon kits include these standard items:

1. Two single dose glucagon units
2. Large picture instruction cards
3. Disposable gloves and alcohol wipes
4. Emergency contact check list
5. Incident report form

If you are a parent, teacher, or workplace manager, you can request these kits through most state diabetes advocacy organizations. Many groups will provide the kits for free for qualified public locations. This is the best option for anyone who needs to keep glucagon available for multiple people.

At the end of the day, the best alternative for Gvoke is the one that fits your lifestyle, your fears, your budget, and the people who will be helping you during an emergency. No single glucagon option is perfect for everyone, and that is okay. Many people even keep two different options on hand: one for when they are alone, and one for when family or friends are nearby. Always talk through every option with your doctor, and never make a switch without reviewing dosing and safety instructions first.

If you found this guide helpful, bookmark it for your next doctor appointment, or share it with someone else in your diabetes support group. Ask your care team for demonstration samples of any option you are considering, and practice using the training device at least once every six months. Being prepared is the best protection you can have against severe low blood sugar.