(SEE kr tin)
- Secretin, Human
- Secretin, Porcine
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Intravenous:
ChiRhoStim: 16 mcg (1 ea)
SecreFlo: 16 mcg (1 ea)
Brand Names: U.S.
- Diagnostic Agent
Human and porcine secretin are both synthetically derived products and are equally potent on an osmolar basis. Secretin is a hormone which is normally secreted by duodenal mucosa and upper jejunal mucosa. It increases the volume and bicarbonate content of pancreatic juice; stimulates the flow of hepatic bile with a high bicarbonate concentration; stimulates gastrin release in patients with Zollinger-Ellison syndrome.
Vd: Human: 2.7 L; Porcine: 2 L
Onset of Action
Peak output of pancreatic secretions: ~30 minutes
Duration of Action
Human: 1.5-2 hours; Porcine: 1-1.5 hours
Human: 45 minutes; Porcine: 27 minutes
Use: Labeled Indications
Secretin-stimulation testing to aid in diagnosis of pancreatic exocrine dysfunction; diagnosis of gastrinoma (Zollinger-Ellison syndrome); facilitation of endoscopic retrograde cholangiopancreatography (ERCP) visualization
Hypersensitivity to secretin or any component of the formulation; acute pancreatitis
IV: Adults: Note: A test dose of 0.1 mL (0.2-0.4 mcg) is injected to test for possible allergy. Dosing may be completed if no reaction occurs after 1 minute.
Diagnosis of pancreatic dysfunction, facilitation of ERCP: 0.2 mcg/kg over 1 minute
Diagnosis of gastrinoma: 0.4 mcg/kg over 1 minute
Dosage adjustment in renal impairment: No dosage adjustment provided in manufacturer’s labeling.
Dosage adjustment in hepatic impairment: No dosage adjustment provided in manufacturer’s labeling.
Add 8 mL NS to the 16 mcg vial to yield concentration of 2 mcg/mL; add 10 mL NS to the 40 mcg vial to yield a concentration of 4 mcg/mL; shake vigorously.
Administer by direct IV injection slowly over 1 minute
SecreFlo™: Patients should be in a fasting state (12- to 15-hour fast) prior to testing for gastrinoma.
Prior to reconstitution, store frozen at -20°C. Protect from light. Human product may also be stored under refrigeration for up to 1 year or at room temperature for up to 6 months.
Anticholinergic Agents: May diminish the therapeutic effect of Secretin. Management: Avoid using drugs with substantial anticholinergic effects in patients receiving secretin whenever possible. If such agents must be used in combination, monitor closely for a diminished response to secretin. Consider therapy modification
1% to 10%:
Cardiovascular: Flushing (1%)
Gastrointestinal: Nausea (1% to 2%), abdominal discomfort (≤1%), abdominal pain (≤1%), vomiting (≤1%)
Miscellaneous: Bleeding (sphincterectomy, ≤1%)
<1% (Limited to important or life-threatening): Abdominal cramps, anxiety, bloating, bradycardia (mild), diaphoresis, diarrhea, dyspepsia, faintness, fatigue, fever, headache, heart rate increased, hypotension, leukocytoplastic vasculitis, lightheadedness, numbness/tingling in the extremities, oral secretions increased, oxygen saturation decreased, pallor, pancreatitis (mild), rash (abdominal), respiratory distress (transient), sedation, seizure, warm sensation (abdomen/face)
Concerns related to adverse effects:
• Allergic reaction: Potential for allergic reactions exists; test dose is recommended. Medications for the treatment of hypersensitivity should be available for immediate use. Patients with a history of asthma or atopy are at higher risk for reaction.
• Hepatic impairment: Use with caution in patients with hepatic impairment (including ethanol-induced disease); volume response to secretin may be exaggerated.
• Inflammatory bowel disease: Response may be blunted in the presence of inflammatory bowel disease; blunted response is not indicative of pancreatic disease.
Concurrent drug therapy issues:
• Anticholinergics: Response may be blunted in the presence of anticholinergic agents; blunted response is not indicative of pancreatic disease.
• Vagotomy: Response may be blunted following vagotomy; blunted response is not indicative of pancreatic disease.
Refer to protocols for collection of pancreatic secretion and/or serum gastrin.
Pregnancy Risk Factor
Reproduction studies have not been conducted.
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Patient may experience flushing or nausea. Have patient report immediately to prescriber severe dizziness, syncope, or considerable dyspepsia (HCAHPS).
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.