secretin (Rx)

Brand and Other Names:ChiRhoStim
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injection, powder for reconstitution

  • 16mcg/vial
  • 40mcg/vial
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Pancreas Dysfunction

Indicated for stimulation of pancreatic secretions, including bicarbonate, to aid in the diagnosis of pancreatic exocrine dysfunction

0.2 mcg/kg IV infused over 1 minute

Gastrinoma

Indicated for stimulation of gastrin secretion to aid in the diagnosis of gastrinoma

0.4 mcg/kg IV infused over 1 minute

Ampulla of Vater & Accessory Papilla

Indicated for stimulation of pancreatic secretions to facilitate the identification of the ampulla of Vater and accessory papilla during endoscopic retrograde cholangiopancreatography (ERCP)

0.2 mcg/kg IV infused over 1 minute

Dosing Considerations

Discontinue interaction drugs

  • To avoid an incorrect stimulation test result, discontinue the following drugs prior to administration of secretin
  • Anticholinergics: Discontinue at least 5 half-lives before testing H2-receptor antagonists: Discontinue at least 2 days before testing Proton pump inhibitors (PPI): Consult prescribing information for specific PPI

Safety and efficacy not established

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Interactions

Interaction Checker

and secretin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            <1%

            Nausea

            Vomiting

            Flushing

            Upset stomach

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            Warnings

            Contraindications

            None

            Cautions

            Hyporesponse: Coadministration with anticholinergic drugs may cause a hyporesponse to stimulation testing (see Dosing Considerations)

            Hyperresponse: Coadministration of H2-receptor antagonists or PPIs may cause a hyperresponse in gastrin secretion in response to stimulation testing, falsely suggesting gastrinoma (see Dosing Considerations)

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            Pregnancy & Lactation

            Pregnancy

            There are no available data (either clinical studies or postmarketing reports) of use of synthetic human secretin in pregnant women

            Animal reproduction studies have not been conducted

            Lactation

            There are no data on the presence of synthetic human secretin in human or animal milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Mechanism of Action

            Stimulates pancreatic ductal cells to secrete pancreas fluid in large volumes that contain bicarbonate

            Secretin is a hormone that is normally released from the duodenum upon exposure of the proximal intestinal lumen to gastric acid, fatty acids, and amino acids

            Secretin is released from enterochromaffin cells in the intestinal mucosa

            Pharmacokinetics

            Half-Life: 45 min

            Vd: 2.7 L

            Total Body Clearance: 580±51.3 mL/min

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            Administration

            IV Preparation

            Determine number of vials needed for dose

            Reconstitute vial(s) with 0.9% NaCl (see below for amount per vial) and shake vigorously to ensure dissolution

            Once vial(s) reconstituted, visually inspect solution for particulate matter and discoloration prior to administration

            If particulate matter or discoloration is seen, discard

            Use immediately after reconstitution and discard any unused portion

            Reconstitution

            • 16-mcg vial
              • Dissolve contents of 16-mcg vial in 8 mL 0.9% NaCl
              • Resulting concentration: 2 mcg/mL
            • 40-mcg vial
              • Dissolve contents of 40-mcg vial in 10 mL 0.9% NaCl
              • Resulting concentration: 4 mcg/mL

            IV Administration

            Administer by slow IV injection over 1 min

            Fasting before test

            • Exocrine pancreas dysfunction: Instruct patient to fast for 12-15 hr before test
            • Gastrinoma: Instruct patient to fast for 12 hr before test

            Storage

            Store frozen at -20°C

            Protect from light

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            Formulary

            FormularyPatient Discounts

            Adding plans allows you to compare formulary status to other drugs in the same class.

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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