Glucagon
| Evidence Level: L3 | Predicted Indications: 10 |
Table of Contents
Glucagon: From Hypoglycaemia Rescue to Irritable Bowel Syndrome
One-Sentence Summary
Glucagon is a pancreatic peptide hormone marketed in Singapore as an injectable product, though the approved indication text was not available in the data compiled for this report. The TxGNN model predicts it may be useful for irritable bowel syndrome (IBS). The support is indirect: 2 clinical trials (both on GLP-1 analogues, not glucagon) and 20 publications (mostly reviews and studies of GLP-1 receptor agonists).
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Not available (no approved indication text in the registration record) |
| Predicted New Indication | Irritable bowel syndrome |
| TxGNN Prediction Score | 99.24% |
| Evidence Level | L3 |
| Singapore Market Status | ✓ Marketed |
| Number of Registrations | 1 |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Detailed mechanism of action data is not available for this drug. Glucagon is a proglucagon-derived peptide. In clinical practice it is also known to relax gastrointestinal smooth muscle, and it is used as a spasmolytic during GI imaging.
Reducing gut motility could plausibly relate to IBS symptoms such as pain, cramping and altered transit. However, most of the supporting data concern GLP-1 receptor agonists such as ROSE-010, which are related peptides but act on a different receptor. The link to glucagon itself is therefore indirect and class-based. It should be treated as a hypothesis, not as evidence of efficacy.
Clinical Trial Evidence
| Trial Number | Phase | Status | Enrollment | Key Findings |
|---|---|---|---|---|
| NCT01056107 | Phase 1/2 | Completed | 52 | ROSE-010 (a GLP-1 analogue) and GI motor function in women with constipation-predominant IBS. This is the closest disease-specific study, but it does not involve glucagon. |
| NCT02731664 | Phase 1 | Completed | 12 | Native GLP-1 vs ROSE-010 on stomach, duodenum and jejunum motility in healthy humans. Mechanistic data only, not in IBS patients. |
Literature Evidence
| PMID | Year | Type | Journal | Key Findings |
|---|---|---|---|---|
| 40134805 | 2025 | Systematic review | Front Endocrinol | Meta-analysis of GLP-1 receptor agonists in IBS. GLP-1 and ROSE-010 reduce GI motility in IBS patients. |
| 35234561 | 2022 | Clinical study cross-analysis | Scand J Gastroenterol | ROSE-010 reduced pain during IBS attacks. Exploratory analysis to identify suitable patient subgroups. |
| 40697433 | 2025 | Cohort | Ann Gastroenterol | Prescription and discontinuation patterns of GLP-1 receptor agonists in IBS patients. |
| 30444291 | 2019 | Review | Exp Physiol | Role of GLP-1 and intestinal L-cells in IBS pathophysiology. |
| 25427821 | 2015 | Review | Adv Exp Med Biol | Aerosolised GLP-1 for diabetes and IBS. |
| 26765585 | 2016 | Review | Expert Opin Investig Drugs | Investigational drugs for constipation-predominant IBS. |
| 41974246 | 2026 | Review | Clin Gastroenterol Hepatol | Unmet needs in IBS and future therapies targeting visceral afferents. |
| 30023410 | 2018 | Review | Cell Mol Gastroenterol Hepatol | Brain-gut-microbiome axis. Background context only. |
Almost all of this literature concerns GLP-1 or its analogues, not glucagon. It supports a class-level signal only.
Singapore Market Information
| Authorization Number | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| SIN09070P | GLUCAGEN FOR INJECTION 1 mg/ml | Injection, powder, for solution | Not available in the registration record |
Safety Considerations
- Drug Interactions: 25 interactions were identified in total. All 20 entries listed in the data compiled for this report are rated Minor. They are warfarin and a broad group of beta-blockers (including acebutolol, atenolol, bisoprolol, carvedilol, metoprolol, propranolol, labetalol, nadolol, sotalol and timolol, plus ophthalmic beta-blocker forms).
Please refer to the package insert for warnings and contraindications.
Conclusion and Next Steps
Decision: Hold
Rationale:
- The only disease-specific clinical evidence for IBS involves a GLP-1 analogue (ROSE-010), not glucagon. The mechanistic link is indirect.
- No trial has tested glucagon in IBS, and package-insert safety data are not yet available for review.
To proceed, the following is needed:
- Package insert warnings, contraindications and approved indications for the Singapore-registered product
- Mechanism of action data for glucagon, particularly its effects on gut motility
- Direct evidence for glucagon in IBS (for example, a pilot or exploratory trial)
- Assessment of whether the existing injectable formulation and dosing are suitable for a chronic functional GI condition
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.