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Secretin

Medically reviewed by Drugs.com. Last updated on Jun 14, 2020.

Pronunciation

(SEE kr tin)

Index Terms

  • Secretin Acetate (Human)
  • Secretin, Human
  • Secretin, Porcine

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Reconstituted, Intravenous:

SecreFlo: 16 mcg (1 ea)

Solution Reconstituted, Intravenous [preservative free]:

ChiRhoStim: 16 mcg (1 ea)

Brand Names: U.S.

  • ChiRhoStim
  • SecreFlo

Pharmacologic Category

  • Diagnostic Agent

Pharmacology

Human secretin is a synthetic peptide hormone produced by cells in the duodenum in response to acidification; it stimulates pancreatic ductal cells to secrete pancreas fluid in large volumes that contain bicarbonate; may also work through vagal-vagal neural pathways since stimulation of the efferent vagus nerve stimulates bicarbonate.

Distribution

Vd: 2.7 L

Excretion

Clearance: 580.9 ± 51.3 mL/minute

Half-Life Elimination

45 minutes

Use: Labeled Indications

Diagnosis of gastrinoma: Stimulation of gastrin secretion to aid in the diagnosis of gastrinoma.

Diagnosis of pancreatic dysfunction: Stimulation of pancreatic secretions, including bicarbonate, to aid in the diagnosis of pancreatic exocrine dysfunction.

Endoscopic retrograde cholangiopancreatography: Stimulation of pancreatic secretions to facilitate in the identification of the ampulla of Vater and accessory papilla during endoscopic retrograde cholangiopancreatography.

Contraindications

There are no contraindications listed in the manufacturer's labeling.

Dosing: Adult

Diagnosis of gastrinoma: IV: 0.4 mcg/kg as a single dose

Diagnosis of pancreatic dysfunction/Endoscopic retrograde cholangiopancreatography: IV: 0.2 mcg/kg as a single dose

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Diagnostic agent for pancreatic function: Limited data available: Infants, Children, and Adolescents: IV: 0.2 mcg/kg as single dose over 1 minute (Horvath 2016)

Diagnostic agent for gastrinoma (Zollinger-Ellison): Limited data available: Adolescents ≥15 years: IV: 0.4 mcg/kg as single dose over 1 minute (Berna 2006). Dosing based on experience with the porcine product; a conversion of 1 unit = 0.2 mcg of human synthetic product has been suggested by the manufacturer.

Facilitation of endoscopic retrograde cholangiopancreatography/magnetic resonance cholangiopancreatography visualization: Limited data available: Infants, Children, and Adolescents: IV: 0.2 mcg/kg as a single dose over 1 minute; maximum dose: 16 mcg/dose (Delaney 2008; Trout 2013)

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 to ensure dissolution and use immediately. Discard any unused product.

Administration

IV: Administer by IV injection slowly over 1 minute.

Dietary Considerations

Patients should fast 12 to 15 hours prior to beginning the test.

Storage

Prior to reconstitution, store at -20°C (-4°F). Protect from light.

Drug Interactions

Anticholinergic Agents: May diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin. Consider therapy modification

Histamine H2 Receptor Antagonists: May diminish the diagnostic effect of Secretin. Specifically, use of H2-Antagonists may cause a hyperresponse in gastrin secretion in response to secretin stimulation testing, falsely suggesting gastrinoma. Management: Avoid concomitant use of histamine H2-antagonists (H2RAs) and secretin. Discontinue H2RAs at least 2 days prior to secretin administration. Consider therapy modification

Proton Pump Inhibitors: May diminish the diagnostic effect of Secretin. Specifically, use of PPIs may cause a hyperresponse in gastrin secretion in response to secretin stimulation testing, falsely suggesting gastrinoma. Management: Avoid concomitant use of proton pump inhibitors (PPIs) and secretin, and discontinue PPIs several weeks prior to secretin administration, with the duration of separation determined by the specific PPI. See full monograph for details. Consider therapy modification

Adverse Reactions

1% to 10%: Gastrointestinal: Nausea (2%)

<1%, postmarketing, and/or case reports: Abdominal distress, flushing, vomiting

Warnings/Precautions

Disease-related concerns:

• Hepatic impairment: Use with caution in patients with hepatic impairment (including ethanol-induced disease); may be hyperresponsive to secretin stimulation and mask the presence of coexisting pancreatic disease. Consider additional testing and clinical assessments to aid in diagnosis.

• Inflammatory bowel disease: Patients who have inflammatory bowel disease may be hyporesponsive to secretin stimulation falsely suggesting pancreatic disease; consider additional testing and clinical assessments for aid in diagnosis.

Concurrent drug therapy issues:

• Drug-drug interactions: Potentially significant interactions may exist, requiring dose or frequency adjustment, additional monitoring, and/or selection of alternative therapy. Consult drug interactions database for more detailed information.

Other warnings/precautions:

• Vagotomy: Patients who have undergone vagotomy may be hyporesponsive to secretin stimulation falsely suggesting pancreatic disease; consider additional testing and clinical assessments for aid in diagnosis.

Monitoring Parameters

Peak bicarbonate concentration of duodenal fluid aspirate (chronic pancreatitis); serum gastrin (gastrinoma). Refer to protocols for collection of pancreatic secretion and/or serum gastrin.

Pregnancy Considerations

Animal reproduction studies have not been conducted.

Patient Education

What is this drug used for?

• It is used to see if the pancreas is working the right way.

• It is used to see if there is a tumor in the pancreas or bowel.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Abdominal pain

• Flushing

• Vomiting

• Nausea

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

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