Endocrine (other)

Dasiglucagon

Also called Zegalogue, ZP4207, ZP-GA-1

Dasiglucagon (brand name Zegalogue) is a lab-made version of the hormone glucagon. It is an FDA-approved rescue shot for severe low blood sugar in people with diabetes who weigh at least 20 kg. Unlike older glucagon kits, it comes as a ready-to-use liquid, so it does not need to be mixed first. It is also being studied as a pump infusion for babies and children with congenital hyperinsulinism, a rare disease that causes repeated low blood sugar, but that use is not approved yet.

FDA-approvedApproved by the FDA for at least one use after large human trials.

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Illustrative chain. The exact sequence has not been published in a source we could verify.

At a glance

Type: Peptide
Size: 29 amino acids
Sequence: HSQGTFTSDYSKYLD[Aib]ARAEEFVKWLEST
Formula: C152H222N38O50
Molecular weight: 3382 g/mol (anhydrous free base, FDA label) [1]
CAS number: 1544300-84-6
Origin: Synthetic glucagon analog of 29 amino acids. Position 16 is Aib (2-aminoisobutyric acid, a non-standard amino acid, written [Aib] in the sequence), shown in PubChem as 2-methylalanine [3]. The drug is supplied as the hydrochloride salt [1].
Evidence: FDA-approved
US FDA status: FDA-approved as Zegalogue (March 22, 2021) for severe hypoglycemia in people with diabetes; since June 2026 the label covers adults and children who weigh at least 20 kg ¹². Not approved for congenital hyperinsulinism: complete response letters in December 2023 and October 2024 were tied to a third-party manufacturing facility ⁷¹³. Zealand expected to resubmit in the second half of 2026 ⁹; no resubmission announcement was found as of October 29, 2026.

Overview

How it works

Established: dasiglucagon activates glucagon receptors in the liver. This makes the liver break down its stored sugar (glycogen) and release glucose into the blood ¹. It only works if the liver has enough glycogen stored, so it may not work in starvation, adrenal insufficiency or long-lasting low blood sugar ¹. Its half-life after an injection under the skin is about 30 minutes, and it is broken down like natural glucagon ¹. It stays stable in a water-based solution, which is why it can be sold ready to use and tested in pumps ⁴⁸.

What research shows

Trial A (human RCT, adults with type 1 diabetes, n=170, 2:1:1 to dasiglucagon, placebo or glucagon): after insulin-induced low blood sugar, median time to glucose recovery was 10 minutes on dasiglucagon vs 40 minutes on placebo, and 12 minutes on standard glucagon ¹.
Trial B (human RCT, adults with type 1 diabetes, n=45): median recovery time 10 minutes on dasiglucagon vs 35 minutes on placebo ¹.
Trial C (human RCT, children 6–17 with type 1 diabetes, n=42): median recovery time 10 minutes on dasiglucagon vs 30 minutes on placebo, and 10 minutes on standard glucagon ¹.
CHI infants (human Phase 2/3 trial, n=12 aged 7 days to 12 months, 48-hour placebo-controlled crossover then 21 days open-label): a pump infusion of dasiglucagon cut the IV glucose needed by about 55% vs placebo (4.3 vs 9.5 mg/kg/min). In the open-label part, 10 of 12 infants weaned off IV glucose at least for a time; 2 had pancreas surgery ⁵.
CHI children (human Phase 3 RCT, open-label, n=32 aged about 7 months to 11 years, 4 weeks): the main goal, fewer low-sugar events on finger-stick checks, was not met. A later (post hoc) analysis of continuous glucose monitor data showed 43% fewer low-sugar events with dasiglucagon added to usual care ⁴.

Doses studied in people

Study or label	Dose used	Source
FDA label (severe hypoglycemia; adults and children with diabetes weighing at least 20 kg)	0.6 mg single subcutaneous injection; one more 0.6 mg dose from a new device may be given if no response after 15 minutes	¹
Phase 2/3 randomized, placebo-controlled crossover trial in infants with congenital hyperinsulinism (n=12); investigational use, not approved	Continuous subcutaneous infusion started at 10 µg/hour and raised in 10 µg/hour steps up to a maximum of 70 µg/hour; mean rate about 58 µg/hour in the 48-hour randomized part (investigational)	⁵
Phase 3 open-label RCT in children with congenital hyperinsulinism (n=32); investigational use, not approved	Continuous subcutaneous infusion, 10 µg/hour up to a maximum of 70 µg/hour; mean about 30–34 µg/hour (investigational)	⁴

Doses shown come from the FDA label and published trials only; they are reported, not recommended. The CHI pump-infusion doses are from investigational trials and are not approved.

Read this first: these are the amounts given to participants in published studies or written on official prescribing labels, reported for reference. They are not recommendations. Trial doses were chosen for specific patients under medical supervision, and a dose that is safe in one person can be harmful in another.

Safety

Most common side effects in adult trials (label, within 12 hours, dasiglucagon vs placebo): nausea 57% vs 4%, vomiting 25% vs 2%, headache 11% vs 4%, diarrhea 5% vs 0%, injection-site pain 2% vs 0% ¹.
In children 6–17 (label, n=20 on drug): nausea 65% and vomiting 50%, with much higher rates in teens than in younger children ¹.
Do not use with pheochromocytoma (can sharply raise blood pressure) or insulinoma (can cause a rebound low blood sugar) ¹.
Label warnings: allergic reactions, lack of effect when liver sugar stores are low, and interactions with beta-blockers, indomethacin and warfarin ¹.
Less than 1% (4 of 506) of people developed antibodies to the drug in studies; one had antibodies that also reacted with natural glucagon ¹.
With long-term pump use in CHI trials, skin reactions and stomach upset were the most common side effects. Two confirmed cases of necrolytic migratory erythema (a rash linked to high glucagon) were reported in one trial and were managed by lowering the dose ⁴⁵. Long-term safety of continuous use is still being studied.

Report side effects of any drug or product to the FDA through MedWatch. For a possible poisoning in the US, call Poison Control at 1-800-222-1222.

Legal status

FDA: FDA-approved as Zegalogue (March 22, 2021) for severe hypoglycemia in people with diabetes; since June 2026 the label covers adults and children who weigh at least 20 kg ¹². Not approved for congenital hyperinsulinism: complete response letters in December 2023 and October 2024 were tied to a third-party manufacturing facility ⁷¹³. Zealand expected to resubmit in the second half of 2026 ⁹; no resubmission announcement was found as of October 29, 2026.
Compounding: No compounding-specific FDA action for dasiglucagon was found in the sources reviewed; it is an FDA-approved prescription product.
Sports (WADA): Not named on the WADA 2026 Prohibited List; glucagon and its analogs do not appear on the list (checked against a federation-hosted copy of the full List, because wada-ama.org could not be opened) ¹⁰¹¹.
Other: Prescription-only. The U.S. FDA and the European Commission have granted orphan drug designation to dasiglucagon for CHI ⁸.

Rules change often. See Legal status of peptides for how these categories work.

Storage and stability

Per the FDA label: refrigerate at 2–8°C and do not freeze; may be kept at room temperature (20–25°C) for up to 12 months in its protective case, away from light, and not returned to the fridge ¹.

General lab handling, not instructions for personal use. See Storage and stability.

History

Developed by Zealand Pharma (Denmark). The FDA approved Zegalogue on March 22, 2021, for severe low blood sugar in people with diabetes aged 6 and older ²¹². A label update approved on June 18, 2026 changed the indication to adults and children with diabetes who weigh at least 20 kg ¹². The current label lists Novo Nordisk Inc. as the contact for reporting side effects ¹. For congenital hyperinsulinism (CHI), Zealand filed a New Drug Application in June 2023 ⁶. The FDA issued complete response letters (not approvals) on December 23, 2023 and in October 2024; Zealand said both were tied to a third-party manufacturing plant (inspection findings, then the timing of a reinspection), and that the FDA raised no concerns about the clinical data or safety ⁷¹³. In its August 13, 2026 half-year report, Zealand said it expected to resubmit the CHI application in the second half of 2026 ⁹; no announcement that the resubmission had been made was found as of October 29, 2026.

Common questions

Is dasiglucagon FDA-approved?

Yes. The FDA approved it as Zegalogue on March 22, 2021, as a rescue treatment for severe low blood sugar in people with diabetes ². The current label covers adults and children who weigh at least 20 kg ¹.

How is it different from regular glucagon?

It is a modified glucagon that stays stable as a liquid, so it comes ready to inject instead of needing to be mixed ⁴⁸. In trials it raised blood sugar about as fast as standard glucagon, with a median of about 10 minutes ¹.

Is it approved for congenital hyperinsulinism?

No. The FDA declined to approve it twice, in December 2023 and October 2024, because of problems tied to an outside manufacturing plant; the company said the letters raised no concerns about safety or trial results ⁷¹³. Zealand said in August 2026 that it expected to resubmit in the second half of 2026 ⁹; no resubmission had been announced as of late October 2026.

What are the side effects?

Nausea and vomiting are the most common, followed by headache, diarrhea and injection-site pain ¹. It should not be used by people with pheochromocytoma or insulinoma ¹.

Is dasiglucagon banned in sport?

It is not named on the WADA 2026 Prohibited List, and glucagon is not listed either ¹¹.

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Sources

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Last reviewed 2026-10-29 · How we research · Found an error? See our corrections policy.