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 facilitate the transit of a barium meal through the small bowel, thereby reducing 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) before obtaining a duodenal aspirate for analysis of enzyme activity, composition, and cytology.

Sincalide Dose in Adults

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

• IV: 0.04 mcg/kg over 30 to 60 seconds initiated once the barium meal is beyond the proximal jejunum;
• The second dose of 0.04 mcg/kg may be administered, if the movement of barium has not occurred in 30 minutes,
• IV infusion: 0.12 mcg/kg; administered over 30 minutes

Sincalide Dose for Gallbladder contraction stimulation:

• IV: 0.02 mcg/kg over 30 to 60 seconds; the second dose of 0.04 mcg/kg may be given, if satisfactory contraction does not occur in 15 minutes,
• IV infusion:
  • 0.12 mcg/kg; administered over 50 minutes
• IM:
  • 0.1 mcg/kg

Sincalide Dose in the treatment of Pancreatic secretion stimulation:

• IV: 0.02 mcg/kg; administered over 30 minutes; 30 minutes after the start of the secretin infusion

Sincalide Dose in Childrens

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 labor.

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:

• Hypersensitivity to sincalide and any component of the formulation
• intestinal obstruction
• Canadian labeling: Additional contraindications not in US labeling: For patients for whom a fatty meal is contraindicated:
  • 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

  • Anaphylaxis and other serious reactions have been reported within one hour of sincalide administration. Monitor during and after 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

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:

  • Administer as an IV push over 30 to 60 seconds, or as an IV infusion mixed in 100 mL of NS at a rate of 2 mL/minute.

• Pancreatic function:

  • Administer over 30 minutes 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.

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.