Chirhostim 16mcg Inj, 1 Vial
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.
Drug Class
Diagnostic agent
Pharmacologic Class
Gastrointestinal hormone; Pancreatic function diagnostic
Pregnancy Category
Category C
FDA Approved
Mar 2004
DEA Schedule
Not Controlled
Overview
What is this medicine?
Secretin is a natural hormone that helps your body digest food. When given as an injection, it helps doctors check how well your pancreas is working or to diagnose certain stomach conditions by stimulating the release of digestive fluids or other hormones.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and carefully read all accompanying information. Adhere to the dosage instructions provided by your healthcare team. This medication is administered via intravenous injection.
For proper storage and disposal, consult with your doctor, nurse, or pharmacist to determine the best approach if you need to store this medication at home.
If you miss a dose, contact your doctor promptly to receive guidance on the next steps to take.
For proper storage and disposal, consult with your doctor, nurse, or pharmacist to determine the best approach if you need to store this medication at home.
If you miss a dose, contact your doctor promptly to receive guidance on the next steps to take.
Lifestyle & Tips
- No specific lifestyle modifications are required for this diagnostic agent.
- Follow your doctor's instructions regarding fasting or medication adjustments before the test.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
0.2 mcg/kg administered as an intravenous bolus injection over 1 minute
Dose Range:
0.2 - 0.2 mg
Condition-Specific Dosing:
pancreaticfunction_diagnosis:
0.2 mcg/kg IV bolus
gastrinoma_diagnosis:
0.2 mcg/kg IV bolus
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
0.2 mcg/kg administered as an intravenous bolus injection over 1 minute
Adolescent:
0.2 mcg/kg administered as an intravenous bolus injection over 1 minute
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment recommended
Moderate:
No specific adjustment recommended
Severe:
No specific adjustment recommended, use with caution due to limited data
Dialysis:
No specific adjustment recommended, use with caution
Hepatic Impairment:
Mild:
No specific adjustment recommended
Moderate:
No specific adjustment recommended
Severe:
No specific adjustment recommended, use with caution due to limited data
Confidence:
Medium
Pharmacology
Mechanism of Action
Secretin is a naturally occurring hormone that stimulates the pancreas to secrete bicarbonate-rich fluid. In diagnostic testing, it is used to assess pancreatic exocrine function by measuring bicarbonate secretion in duodenal aspirates. In gastrinoma (Zollinger-Ellison Syndrome), secretin stimulates gastrin release, which is an abnormal response used diagnostically.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Immediate (IV bolus)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Not widely reported, rapidly distributed to extracellular fluid
ProteinBinding:
Not extensively protein bound
CnssPenetration:
Limited
Elimination:
HalfLife:
2 to 8 minutes
Clearance:
High, rapid clearance from plasma
ExcretionRoute:
Renal (as inactive metabolites)
Unchanged:
<5%
Pharmacodynamics
OnsetOfAction:
Within 1-2 minutes (pancreatic secretion)
PeakEffect:
10-20 minutes (pancreatic secretion)
DurationOfAction:
Approximately 60-90 minutes (effects dissipate)
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
If you experience any of the following symptoms, call your doctor or seek medical attention immediately, as they may be signs of a severe and potentially life-threatening reaction:
- Signs of an allergic reaction, such as 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.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
- Stomach pain
- Flushing
- Upset stomach or vomiting
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
If you experience any of the following symptoms, call your doctor or seek medical attention immediately, as they may be signs of a severe and potentially life-threatening reaction:
- Signs of an allergic reaction, such as 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.
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. Contact your doctor or seek medical help if you experience any of the following side effects or if they persist or bother you:
- Stomach pain
- Flushing
- Upset stomach or vomiting
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, consult your doctor. For medical advice about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Difficulty breathing or wheezing
- Hives, rash, or itching
- Swelling of the face, lips, tongue, or throat
- Dizziness or lightheadedness
- Severe abdominal pain
- Nausea or vomiting
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current medications and health conditions. Never start, stop, or adjust the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Certain medications, such as those used to reduce stomach acid, may need to be discontinued before starting this drug; consult with your doctor to discuss potential interactions. If you consume alcohol regularly or have a history of liver disease, notify your doctor, as this may impact the accuracy of test results. Additionally, if you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss the potential benefits and risks of this medication with your doctor to ensure the well-being of both you and your baby.
Overdose Information
Overdose Symptoms:
- Exaggerated pharmacological effects (e.g., increased pancreatic secretion, transient hypotension)
- Severe hypersensitivity reaction (anaphylaxis)
What to Do:
Overdose is unlikely given the single-dose diagnostic use. Management is supportive, focusing on maintaining vital signs and treating any severe hypersensitivity reactions. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.
Drug Interactions
Moderate Interactions
- Anticholinergics (e.g., atropine, scopolamine): May inhibit pancreatic secretion, potentially leading to false-negative results in pancreatic function tests. Discontinue prior to test.
- Proton Pump Inhibitors (PPIs) / H2-receptor antagonists: May affect baseline gastrin levels or pancreatic bicarbonate output, potentially interfering with diagnostic accuracy. Consider discontinuation prior to test if clinically appropriate.
Monitoring
Baseline Monitoring
Patient history and physical exam
Rationale: To assess overall health, identify contraindications, and establish baseline for diagnostic interpretation.
Timing: Prior to administration
Baseline serum gastrin levels (for gastrinoma diagnosis)
Rationale: Essential for comparison with post-secretin levels to diagnose gastrinoma.
Timing: Prior to secretin administration
Baseline duodenal aspirate (for pancreatic function diagnosis)
Rationale: To establish baseline bicarbonate and fluid output before secretin stimulation.
Timing: Prior to secretin administration
Routine Monitoring
Vital signs (blood pressure, heart rate, respiratory rate)
Frequency: Every 5-15 minutes during and immediately after administration
Target: Within patient's normal limits
Action Threshold: Significant deviations (e.g., hypotension, tachycardia) warrant immediate assessment and intervention.
Signs/symptoms of hypersensitivity reaction
Frequency: Continuously during and for at least 30 minutes after administration
Target: Absence of rash, urticaria, dyspnea, angioedema, hypotension
Action Threshold: Any signs of allergic reaction require immediate cessation of infusion and emergency management.
Serum gastrin levels (for gastrinoma diagnosis)
Frequency: At 2, 5, 10, and 30 minutes post-injection
Target: Interpretation based on diagnostic criteria (e.g., increase >200 pg/mL over baseline)
Action Threshold: Not applicable for action, but for diagnostic interpretation.
Duodenal aspirate collection (for pancreatic function diagnosis)
Frequency: Collected in 15-minute intervals for 60 minutes post-injection
Target: Interpretation based on bicarbonate concentration and volume
Action Threshold: Not applicable for action, but for diagnostic interpretation.
Symptom Monitoring
- Rash
- Urticaria
- Pruritus
- Dyspnea
- Wheezing
- Angioedema
- Hypotension
- Dizziness
- Abdominal discomfort
- Nausea
Special Patient Groups
Pregnancy
Secretin is classified as Pregnancy Category C. There are no adequate and well-controlled studies in pregnant women. Use during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Trimester-Specific Risks:
First Trimester:
Risk cannot be ruled out; use only if clearly needed.
Second Trimester:
Risk cannot be ruled out; use only if clearly needed.
Third Trimester:
Risk cannot be ruled out; use only if clearly needed.
Lactation
It is not known whether secretin is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when secretin is administered to a nursing woman. Consider the developmental and health benefits of breastfeeding along with the mother’s clinical need for secretin and any potential adverse effects on the breastfed infant from secretin or from the underlying maternal condition.
Infant Risk:
L3 (Moderate risk; unknown human data, but a peptide with short half-life, likely low oral bioavailability for infant).
Pediatric Use
Secretin has been used in pediatric patients for diagnostic purposes, with dosing based on weight (0.2 mcg/kg). Safety and efficacy in pediatric patients are generally considered similar to adults, but specific data in very young infants are limited.
Geriatric Use
No specific dose adjustments are recommended for geriatric patients. However, elderly patients may have reduced physiological reserve or comorbidities, so monitoring for adverse reactions should be vigilant. Renal function should be considered, though secretin is primarily degraded enzymatically.
Clinical Information
Clinical Pearls
- Secretin is a diagnostic agent, not a therapeutic one. Its use is limited to specific diagnostic procedures for pancreatic exocrine function and gastrinoma.
- Administer as a rapid IV bolus over 1 minute. Do not infuse slowly.
- Patients should be fasting for at least 12-15 hours prior to the test for optimal results.
- Be prepared for potential hypersensitivity reactions, including anaphylaxis, as secretin is a peptide hormone. Have resuscitation equipment and medications readily available.
- Ensure proper collection of duodenal aspirates or blood samples at precise time points for accurate diagnostic interpretation.
- Medications that affect pancreatic secretion (e.g., anticholinergics) or gastrin levels (e.g., PPIs) should ideally be discontinued prior to the test, if clinically feasible, to avoid interference with results.
Alternative Therapies
- For pancreatic exocrine insufficiency: Fecal elastase-1 test, direct pancreatic function tests (e.g., endoscopic pancreatic function test with cholecystokinin), imaging studies (e.g., CT, MRI, EUS).
- For gastrinoma (Zollinger-Ellison Syndrome): Fasting serum gastrin, gastric pH measurement, somatostatin receptor scintigraphy (SRS), endoscopic ultrasound (EUS), cross-sectional imaging (CT/MRI).
Cost & Coverage
Average Cost:
High (e.g., $1,000 - $2,000+) per 16 mcg vial
Insurance Coverage:
Generally covered by most insurance plans for FDA-approved diagnostic indications, often requiring prior authorization.
General Drug Facts
If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance. To ensure safe and effective treatment, never share your medication with others, and do not take medication prescribed to someone else.
Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion or exposure. Properly dispose of unused or expired medications by checking with your pharmacist for guidance on the best disposal method. Unless instructed to do so by a healthcare professional or pharmacist, avoid flushing medications down the toilet or pouring them down the drain, as this can harm the environment. Many communities have drug take-back programs that provide a safe and responsible way to dispose of unwanted medications.
Some medications may come with an additional patient information leaflet, which can be obtained by consulting with your pharmacist. If you have any questions or concerns about your medication, it is crucial to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken, as this will help healthcare professionals provide the most effective treatment.
Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion or exposure. Properly dispose of unused or expired medications by checking with your pharmacist for guidance on the best disposal method. Unless instructed to do so by a healthcare professional or pharmacist, avoid flushing medications down the toilet or pouring them down the drain, as this can harm the environment. Many communities have drug take-back programs that provide a safe and responsible way to dispose of unwanted medications.
Some medications may come with an additional patient information leaflet, which can be obtained by consulting with your pharmacist. If you have any questions or concerns about your medication, it is crucial to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken, as this will help healthcare professionals provide the most effective treatment.