Version May 2024
Barium meal transit time acceleration:
IV: 0.04 mcg/kg 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 over 30 minutes.
Gallbladder contraction stimulation:
IV: 0.02 mcg/kg; 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 over 50 minutes.
Pancreatic secretion stimulation: IV infusion: 0.02 mcg/kg over 30 minutes; initiated 30 minutes after the start of the secretin infusion.
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.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
>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
Hypersensitivity to sincalide, sulfites, or any component of the formulation; intestinal obstruction.
Canadian labeling: Additional contraindications (not in US labeling): In patients where a fatty meal would be contraindicated, including: Acute abdomen; acute pancreatitis; acute cholecystitis; appendicitis; bleeding, penetrating, or perforating peptic ulcer; common bile duct obstruction; cystic duct obstruction; gallbladder empyema or infection; hollow viscous; mechanical GI tract obstruction; perforation; peritonitis; pyloric stenosis; small gallbladder stones.
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.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Injection:
Kinevac: 5 mcg (1 ea) [contains sodium metabisulfite]
Solution Reconstituted, Injection [preservative free]:
Generic: 5 mcg (1 ea)
Yes
Solution (reconstituted) (Kinevac Injection)
5 mcg (per each): $156.56
Solution (reconstituted) (Sincalide Injection)
5 mcg (per each): $148.96 - $163.96
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.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Injection:
Kinevac: 5 mcg (1 ea) [contains sodium metabisulfite]
Generic: 5 mcg (1 ea)
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 over 50 minutes (2 mL/minute).
Pancreatic function: Administer as an IV infusion mixed in 30 mL of NS over 30 minutes (1 mL/minute) 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.
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.
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 Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Drugs that Affect Gallbladder Function: May diminish the therapeutic effect of Sincalide. Management: Consider discontinuing drugs that may affect gallbladder motility prior to the use of sincalide to stimulate gallbladder contraction. Risk D: Consider therapy modification
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).
It is not known if sincalide is present in breast milk.
According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.
Hypersensitivity reaction (during and within 1 hour of administration).
Gallbladder size: ≥40% reduction considered a satisfactory contraction.
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
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