Skip to Content
New To Chronic Myeloid Leukemia? Get Information Today >>

Secretin

Pronunciation

(SEE kr tin)

Index Terms

  • Secretin, Human
  • Secretin, Porcine

Dosage Forms

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.

  • ChiRhoStim
  • SecreFlo

Pharmacologic Category

  • Diagnostic Agent

Pharmacology

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.

Distribution

Vd: Porcine formulation: 2 L (approximately); human formulation: 2.7 L

Metabolism

Metabolic fate is thought to be hydrolysis to smaller peptides

Excretion

Clearance: Porcine formulation: 487 ± 136 mL/minute; human formulation: 580.9 ± 51.3 mL/minute

Onset of Action

Peak output of pancreatic secretions: ~30 minutes

Duration of Action

1.5-2 hours

Half-Life Elimination

Porcine formulation: 27 minutes; human formulation: 45 minutes

Protein Binding

40%

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

Contraindications

Hypersensitivity to secretin or any component of the formulation; acute pancreatitis

Dosing: Adult

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: IV: 0.2 mcg/kg over 1 minute

Diagnosis of gastrinoma: IV: 0.4 mcg/kg over 1 minute

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in manufacturer’s labeling.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in manufacturer’s labeling.

Reconstitution

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.

Administration

Administer by direct IV injection slowly over 1 minute

Dietary Considerations

SecreFlo™: Patients should be in a fasting state (12- to 15-hour fast) prior to testing for gastrinoma.

Storage

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.

Drug Interactions

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

Adverse Reactions

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)

Warnings/Precautions

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.

Disease-related concerns:

• 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.

Other warnings/precautions:

• Vagotomy: Response may be blunted following vagotomy; blunted response is not indicative of pancreatic disease.

Monitoring Parameters

Refer to protocols for collection of pancreatic secretion and/or serum gastrin.

Pregnancy Risk Factor

C

Pregnancy Considerations

Reproduction studies have not been conducted.

Patient Education

• 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.

Hide