Sincalide (Kinevac) - Indications, Dose, Side effects

Sincalide (Kinevac) is a cholecystokinin drug (an 8-aminoacid C-terminal of cholecystokinin, CCK-8) that is used to diagnose pancreatic and biliary disorders.

Sincalide Uses:

  • Barium meal transit time acceleration:

    • to speed up the passage of a barium meal through the small intestine, cutting down on the amount of time and radiation needed to examine the intestinal tract using fluoroscopy and x-rays.
  • Pancreatic secretion stimulation:

    • before taking a duodenal aspirate to examine the cytology, content, and activity of the enzymes, to promote pancreatic secretion (particularly in combination with secretin).
  • Gallbladder contraction stimulation:

    • to induce gallbladder contraction, as determined by various diagnostic imaging techniques, or to collect a sample of concentrated bile via duodenal aspiration for lipid, salt, phospholipid, and crystal analysis.

Sincalide Dose in Adults

Sincalide Dose in the treatment of Barium meal transit time acceleration:

  • Once the barium meal has passed the proximal jejunum, administer 0.04 mcg/kg intravenously over 30 to 60 seconds.
  • If the barium has not moved after 30 minutes, a second dose of 0.04 mcg/kg may be given.
  • 0.12 mcg/kg IV infusion over a 30-minute period.

Sincalide Dose for Gallbladder contraction stimulation:

  • If an adequate contraction does not occur after 15 minutes, the second dosage of 0.04 mcg/kg may be administered intravenously.
  • IM:
    • 0.1 mcg per kg
  • IV infusion:
    • 0.12 mcg per kg; administered over 50 minutes

Sincalide Dose in the treatment of Pancreatic secretion stimulation:

  • 30 minutes after the start of the secretin infusion, 0.02 mcg/kg IV over a 30-minute period.

Sincalide Dose in Children

Not studied.

Pregnancy Risk Category: B

  • Based on limited human data (Silberstein, 1994), and its effects on smooth muscle, it should not be used during pregnancy. It may cause spontaneous abortions or premature labour.

Sincalide use during breastfeeding:

  • It is unknown if breast milk contains sincalide.
  • According to the manufacturer breastfeeding during therapy is a decision that should be made after considering the risks to infants and the benefits to mothers.

Sincalide Dose in Kidney Disease:

There are no dosage adjustments provided in the manufacturer’s labeling.

Sincalide Dose in Liver disease:

There are no dosage adjustments provided in the manufacturer’s labeling.

Common Side Effects of Sincalide (Kinevac):

  • Gastrointestinal:

    • Abdominal Distress
    • Abdominal Pain
    • Nausea

Contraindication to Sincalide Include:

  • intestinal blockage hypersensitivity to sincalide and any ingredient in the formulation
  • Labeling in Canada: Additional warnings not included in US labelling: Patients who should not consume a fatty meal:
    • Acute abdomen
    • Acute pancreatitis
    • Cholecystitis acute
    • appendicitis
    • Bleeding
    • peptic ulcers that are perforating or penetrating
    • common bile duct obstruction
    • Cystic duct obstruction
    • Gallbladder infection or empyema
    • Perforation of hollow viscous
    • peritonitis
    • pyloric Stenosis
    • Small gallbladder stones

Warnings and precautions

  • Gastrointestinal:

    • IV injections can cause transient GI adverse reactions (eg, nausea and vomiting, abdominal pain/crampings, dizziness, flushing)
    • Infusions via IV may reduce the risk of adverse GI effects.
  • Hypersensitivity

    • Within an hour of the administration of sincalide, reports of anaphylaxis and other severe responses have been made. observe both during and following the infusion.
    • Stop using any medication immediately and seek appropriate treatment for hypersensitivity reactions.
  • Obstruction

    • There is a greater risk of small gallstones forming cystic ducts or common bile conduits and obstructing flow.

Sincalide: Drug Interaction

Risk Factor D (Consider therapy modification)

Drugs that Affect Gallbladder Function

May reduce Sincalide's therapeutic impact. Prior to using sincalide to induce gallbladder contraction, you should think about stopping any medications that can impair gallbladder motility.

Monitoring parameters:

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

How to administer Sincalide?

  • IV: Administration via infusion may help manage some adverse events or increase GI tolerance.
  • Contraction of the gallbladder:

    • Use an IV push over a 30- to 60-second period or an IV infusion of 100 mL of NS mixed at a rate of 2 mL per minute.
  • Pancreatic function:

    • 30 minutes after the start of the secretin infusion, start the administration.
  • Accelerate barium transit through the small bowel:

    • Give as an IV push over 30 to 60 seconds or as a 30-minute IV infusion that includes 100 mL of NS. After the barium meal has passed the proximal jejunum, provide the dosage.

Mechanism of action of Sincalide (kinevac):

  • It stimulates the contraction of your gallbladder
  • By causing pyloric contract, it inhibits gastric emptying
  • It increases intestinal motility.
  • stimulates pancreatic secretion;
  • Smooth muscle contraction

Start of action: Gallbladder contraction: 5-15 minutes

International Brands of Sincalide:

  • Kinevac

Sincalide Brand Names in Pakistan:

No Brands Available in Pakistan.