Version October 2024
Note: Prior to injection, administer an IV dose of 0.2 mcg to test for possible allergy; if no sign of allergy after 1 minute, may administer the full diagnostic dose.
Diagnostic aid, gastrinoma (Zollinger-Ellison syndrome): IV: 0.4 mcg/kg as a single dose.
Diagnostic aid, pancreatic exocrine dysfunction or endoscopic retrograde cholangiopancreatography: IV: 0.2 mcg/kg as a single dose.
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Secretin: Pediatric drug information")
Diagnostic agent for gastrinoma (Zollinger-Ellison): Limited data available: Adolescents ≥15 years: IV: 0.4 mcg/kg as single dose over 1 minute (Ref). 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.
Diagnostic agent for pancreatic function: Limited data available: Infants, Children, and Adolescents: IV: 0.2 mcg/kg as single dose over 1 minute; maximum dose: 16 mcg/dose (Ref).
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 (Ref).
Dosage adjustment for concomitant therapy: Significant drug interactions exist, requiring dose/frequency adjustment or avoidance. Consult drug interactions database for more information.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%: Gastrointestinal: Nausea (≤2%)
<1%:
Cardiovascular: Bradycardia, decreased blood pressure, flushing, weak pulse
Dermatologic: Diaphoresis, pallor, skin rash
Endocrine & metabolic: Hot flash
Gastrointestinal: Abdominal cramps, abdominal distress, bloating, burning sensation of gastrointestinal tract, diarrhea, hunger, vomiting
Hypersensitivity: Hypersensitivity angiitis
Nervous system: Dizziness, fatigue, headache, numbness of extremities, seizure-like activity, tingling of extremities
Respiratory: Oxygen saturation decreased, respiratory distress
Miscellaneous: Fever
Use during episodes of acute pancreatitis.
Disease-related concerns:
• Allergic reactions: A test dose is recommended prior to administering the full diagnostic dose due to the potential for allergic reactions, particularly in patients with a history of atopic allergy and/or asthma.
• Hepatic impairment: Patients with hepatic impairment may be hyperresponsive to secretin stimulation, which may 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; secretin test may falsely suggest pancreatic disease. Consider additional testing and clinical assessments to aid in diagnosis.
Other warnings/precautions:
• Vagotomy: Patients who have undergone vagotomy may be hyporesponsive to secretin stimulation; secretin test may falsely suggest pancreatic disease. Consider additional testing and clinical assessments to aid in diagnosis.
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)
No
Solution (reconstituted) (ChiRhoStim Intravenous)
16 mcg (per each): $756.00
Solution (reconstituted) (SecreFlo Intravenous)
16 mcg (per each): $510.00
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
IV: Administer by IV injection over 1 minute. A test dose is recommended prior to administering the full diagnostic dose.
Parenteral: Administer by direct IV injection slowly over 1 minute.
Diagnostic aid, endoscopic retrograde cholangiopancreatography: Stimulation of pancreatic secretions to facilitate in the identification of the ampulla of Vater and accessory papilla during endoscopic retrograde cholangiopancreatography.
Diagnostic aid, gastrinoma (Zollinger-Ellison syndrome): Stimulation of gastrin secretion to aid in the diagnosis of gastrinoma (Zollinger-Ellison syndrome).
Diagnostic aid, pancreatic exocrine dysfunction: Stimulation of pancreatic secretions, including bicarbonate, to aid in the diagnosis of pancreatic exocrine dysfunction.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the drug interactions program by clicking on the “Launch drug interactions program” link above.
Agents with Clinically Relevant Anticholinergic Effects: 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. Risk D: 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. Risk D: Consider therapy modification
Inhibitors of the Proton Pump (PPIs and PCABs): 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 PPIs or PCABs and secretin, and discontinue PPI or PCAB several weeks prior to secretin administration, with the duration of separation determined by the specific acid suppressant. See full monograph for details. Risk D: Consider therapy modification
Animal reproduction studies have not been conducted.
It is not known if secretin is present in breast milk. According to the manufacturer, the decision to continue or discontinue breastfeeding during therapy should take into account the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.
Patients should fast 12 to 15 hours prior to beginning the test.
Refer to protocols for collection of pancreatic secretion and/or serum gastrin.
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
Half-life elimination: 45 minutes
Clearance: 580.9 ± 51.3 mL/minute
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