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Sincalide

Medically reviewed on Feb 18, 2019

Pronunciation

(SIN ka lide)

Index Terms

  • C8-CCK
  • OP-CCK

Dosage Forms

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

Solution Reconstituted, Injection:

Kinevac: 5 mcg (1 ea) [contains sodium metabisulfite]

Brand Names: U.S.

  • Kinevac

Pharmacologic Category

  • Diagnostic Agent

Pharmacology

Stimulates contraction of the gallbladder; inhibits gastric emptying by causing pyloric contraction, and increases intestinal motility; stimulates pancreatic secretion; causes smooth muscle contraction

Onset of Action

Contraction of the gallbladder: ~5 to 15 minutes

Use: Labeled Indications

Barium meal transit time acceleration: To accelerate the transit of a barium meal through the small bowel, thereby decreasing the time and extent of radiation associated with fluoroscopy and x-ray examination of the intestinal tract.

Gallbladder contraction stimulation: To stimulate gallbladder contraction, as may be assessed by various methods of diagnostic imaging, or to obtain by duodenal aspiration a sample of concentrated bile for analysis of cholesterol, bile salts, phospholipids, and crystals.

Pancreatic secretion stimulation: To stimulate pancreatic secretion (especially in conjunction with secretin) prior to obtaining a duodenal aspirate for analysis of enzyme activity, composition, and cytology.

Contraindications

Hypersensitivity to sincalide or any component of the formulation; intestinal obstruction

Dosing: Adult

Barium meal transit time acceleration:

IV: 0.04 mcg/kg over 30 to 60 seconds initiated once the barium meal is beyond the proximal jejunum; if movement of barium has not occurred in 30 minutes, a second dose of 0.04 mcg/kg may be administered

IV infusion: 0.12 mcg/kg; administered over 30 minutes

Gallbladder contraction stimulation:

IV: 0.02 mcg/kg over 30 to 60 seconds; if satisfactory contraction does not occur in 15 minutes, a second dose of 0.04 mcg/kg may be given

IV infusion: 0.12 mcg/kg; administered over 50 minutes

IM: 0.1 mcg/kg

Pancreatic secretion stimulation: IV: 0.02 mcg/kg; administered over 30 minutes; initiated 30 minutes after the start of the secretin infusion

Dosing: Geriatric

Refer to adult dosing.

Reconstitution

To reconstitute, add 5 mL of sterile water for injection to vial.

Contraction of gallbladder: Total dose of reconstituted product may be further diluted in 100 mL with sodium chloride 0.9%

Pancreatic function: Total dose of reconstituted product should be further diluted in 30 mL with sodium chloride 0.9%

Accelerate barium transit through small bowel: Total dose of reconstituted product should be further diluted in 100 mL with sodium chloride 0.9%

Administration

IV: Administration via infusion may help manage some adverse events or increase GI tolerance.

Contraction of gallbladder: Administer as an IV push over 30 to 60 seconds, or as an IV infusion mixed in 100 mL of NS at a rate of 2 mL/minute.

Pancreatic function: Administer over 30 minutes beginning 30 minutes after the initiation of secretin infusion.

Accelerate barium transit through small bowel: Administer as an IV push over 30 to 60 seconds, or as an IV infusion mixed in 100 mL NS over 30 minutes. Administer dose after the barium meal is beyond the proximal jejunum. .

Storage

Store intact vials at 25°C (77°F); excursions permitted to 15°C to 30°C (59°F to 86°F). Once reconstituted, store at room temperature for up to 8 hours. Discard any unused portion. If further diluted for infusion, may be kept at room temperature; use within 1 hour.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

>10%: Gastrointestinal: Abdominal distress (≥20%), abdominal pain (≥20%), nausea (≥20%)

<1%, postmarketing, and/or case reports: Abdominal cramps, anaphylactic shock, anaphylaxis, bowel urgency, bradycardia, diaphoresis, diarrhea, dizziness, dyspnea, facial numbness, flushing, headache, hypersensitivity reaction, hypertension, hypotension, loss of consciousness, pharyngeal edema, pruritus, seizure, skin rash, sneezing, syncope, urticaria, vomiting

Warnings/Precautions

Concerns related to adverse effects:

• Gastrointestinal: IV injection may cause transient GI adverse effects (eg, nausea, vomiting, abdominal pain/cramping, dizziness, flushing). Administration via IV infusion may lessen risks of developing adverse GI effects.

• Hypersensitivity: Serious reactions, including anaphylaxis, have been reported during or within 1 hour following sincalide administration; monitor during and after infusion. Immediately discontinue therapy and initiate appropriate treatment for hypersensitivity reactions.

• Obstruction: Increased risk (minimal) of evacuating small gallstones into cystic duct or common bile duct and obstructing flow.

Concurrent drug therapy issues:

• Gallbladder response: Drugs known to stimulate or inhibit gallbladder motility or contractile response may interfere with response to sincalide. Consider temporary discontinuation of these drugs prior to sincalide administration when used for gallbladder contraction.

Dosage form specific issues:

• Sodium metabisulfite: Solution for injection contains sodium metabisulfite, which may cause allergic reactions in some individuals.

Monitoring Parameters

Hypersensitivity reaction (during and within 1 hour of administration).

Pregnancy Considerations

Based on limited human data (Silberstein 1994) and its effect on smooth muscle, use during pregnancy, including near term, should be avoided (may cause spontaneous abortion or premature labor).

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 abdominal pain, nausea, vomiting, abdominal cramps, flushing, diarrhea, or sneezing. Have patient report immediately to prescriber severe headache, dizziness, passing out, vision changes, bradycardia, shortness of breath, sweating a lot, numbness or tingling of the face, seizures, or feeling of needing to have a bowel movement often (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 health care 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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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