Kinevac

Cholecystography and Cholangiography

Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.

Reconstitution:
Add 5 mL of Sterile Water for Injection aseptically to vial.
Storage: Reconstituted sincalide injection may be kept at room temperature; use within 8 hours of reconstitution. Discard any unused portion.
 
Direct IV injection:
Inject IV over 30 to 60 seconds. Rapid injection may result in contraction of the neck of the gallbladder and thus delay gallbladder expulsion. The Society of Nuclear Medicine recommends administering sincalide over 3 to 5 minutes to prevent biliary spasm and gastrointestinal adverse events.
For barium meal small bowel transit acceleration: Administer sincalide after the barium meal has passed the proximal jejunum.
 
Intermittent IV infusion:
For gallbladder contraction: To reduce side effects, may dilute sincalide dose in 100 mL of Sodium Chloride Injection. Administer at rate of 2 mL/minute IV.
For pancreatic secretion stimulation: Dilute sincalide dose to 30 mL with Sodium Chloride Injection. Begin sincalide 30 minutes after the start of the secretin infusion, which is given over 60 minutes. Administer sincalide at a rate of 1 mL/minute IV.
For barium meal small bowel transit acceleration: To reduce side effects, may dilute sincalide dose to approximately 100 mL with Sodium Chloride Injection. Administer over 30 minutes IV and after the barium meal has passed the proximal jejunum.
Storage: Sodium Chloride Injection dilutions may be kept at room temperature; use within 1 hour of dilution.

seizures / Delayed / Incidence not known
anaphylactic shock / Rapid / Incidence not known
bradycardia / Rapid / Incidence not known

hypertension / Early / Incidence not known
dyspnea / Early / Incidence not known
hypotension / Rapid / Incidence not known

nausea / Early / 20.0
abdominal pain / Early / 20.0
vomiting / Early / Incidence not known
fecal urgency / Early / Incidence not known
diarrhea / Early / Incidence not known
headache / Early / Incidence not known
dizziness / Early / Incidence not known
syncope / Early / Incidence not known
flushing / Rapid / Incidence not known
sneezing / Early / Incidence not known
pruritus / Rapid / Incidence not known
rash / Early / Incidence not known
throat irritation / Early / Incidence not known
diaphoresis / Early / Incidence not known

Kinevac

Rx

Synthetic C-terminal octapeptide of cholecystokinin; stimulates gallbladder contraction, pancreas secretion, and intestinal motility; used as a diagnostic aid in assessment of hepatobiliary system and pancreatic function, and to accelerate the transit of a barium meal through the small bowel.

0.02 mcg/kg IV as a single dose. Start sincalide 30 minutes after the start of the secretin infusion.

0.02 mcg/kg IV; after 15 minutes, if gallbladder contraction is unsatisfactory, a second dose of 0.04 mcg/kg IV may be administered. Alternatively, 0.12 mcg/kg IV infusion may be given to reduce intestinal side effects.

0.04 mcg/kg IV; after 30 minutes, if the transit of the barium meal is unsatisfactory, may repeat dose. Alternatively, 0.12 mcg/kg IV infusion may be given to reduce intestinal side effects.

The serum half-life of sincalide is prolonged in patients with hepatic cirrhosis (see Pharmacokinetics); however the clinical significance, if any, of these findings is unknown. Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.

The serum half-life of sincalide is prolonged in patients with renal impairment (see Pharmacokinetics); however the clinical significance, if any, of these findings is unknown. Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.

Acetaminophen; Aspirin; Diphenhydramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Caffeine; Pyrilamine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Chlorpheniramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Chlorpheniramine; Dextromethorphan: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Chlorpheniramine; Phenylephrine : (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Dextromethorphan; Doxylamine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Diphenhydramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acetaminophen; Pamabrom; Pyrilamine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Acrivastine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Anticholinergics: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by anticholinergics. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Benzodiazepines: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by benzodiazepines. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Bethanechol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by bethanechol. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of results.
Brompheniramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Brompheniramine; Dextromethorphan; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Brompheniramine; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Brompheniramine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Brompheniramine; Pseudoephedrine; Dextromethorphan: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Calcium-channel blockers: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by calcium-channel blockers. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of results.
Carbinoxamine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Cetirizine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Cetirizine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlophedianol; Dexbrompheniramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlophedianol; Dexchlorpheniramine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorcyclizine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Codeine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Dextromethorphan: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Dextromethorphan; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Dihydrocodeine; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Hydrocodone: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Ibuprofen; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Chlorpheniramine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Clemastine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Cyclizine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Cyproheptadine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Desloratadine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Desloratadine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Desogestrel; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Dexbrompheniramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Dexbrompheniramine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Dexchlorpheniramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Dextromethorphan; Diphenhydramine; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Dimenhydrinate: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Diphenhydramine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Diphenhydramine; Ibuprofen: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Diphenhydramine; Naproxen: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Diphenhydramine; Phenylephrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Doxylamine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Doxylamine; Pyridoxine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Drospirenone; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Drospirenone; Ethinyl Estradiol; Levomefolate: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Erythromycin: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by erythromycin. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of results.
Estradiol; Progesterone: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent progesterone. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Ethinyl Estradiol; Norelgestromin: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Ethinyl Estradiol; Norethindrone Acetate: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Ethinyl Estradiol; Norgestrel: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Ethynodiol Diacetate; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Etonogestrel; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Fexofenadine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Fexofenadine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Food: (Moderate) Consumption of food, especially food with high fatty content, results in the release of endogenous cholecystokinin. Sincalide is a synthetic C-terminal octapeptide of cholecystokinin used in diagnostic imaging of the gallbladder and biliary system. False positives (non-visualization) may result if the gallbladder has been emptied by ingestion of food prior to imaging. Advise patients of the appropriate fasting time, usually at least 2 to 4 hours or overnight.
Hydroxyzine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Indomethacin: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by indomethacin. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of results.
Levocetirizine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Levonorgestrel; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Levonorgestrel; Ethinyl Estradiol; Ferrous Bisglycinate: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Levonorgestrel; Ethinyl Estradiol; Ferrous Fumarate: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Loratadine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Loratadine; Pseudoephedrine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Meclizine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Morphine: (Moderate) As morphine may cause constriction of the sphincter of Oddi, a direct counteraction to sincalide, concomitant therapy is usually not advisable. However, morphine augmentation may be desirable in place of delayed imaging in cases when acute cholecystitis is suspected. Withhold opioids for 4 hours prior to radiographic study of the hepatobiliary system with sincalide.
Morphine; Naltrexone: (Moderate) As morphine may cause constriction of the sphincter of Oddi, a direct counteraction to sincalide, concomitant therapy is usually not advisable. However, morphine augmentation may be desirable in place of delayed imaging in cases when acute cholecystitis is suspected. Withhold opioids for 4 hours prior to radiographic study of the hepatobiliary system with sincalide.
Nitrates: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent nitrates. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Norethindrone Acetate; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Norethindrone; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Norethindrone; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Norgestimate; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Octreotide: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent octreotide. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Phentolamine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent phentolamine. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Progesterone: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent progesterone. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Pseudoephedrine; Triprolidine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Pyrilamine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Secretin: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent secretin. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Sedating H1-blockers: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.
Segesterone Acetate; Ethinyl Estradiol: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent oral contraceptives. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Theophylline, Aminophylline: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent aminophylline. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results. (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent theophylline. False study results are possible in patients with drug-induced hyper- or hypo-responsiveness; thorough patient history is important in the interpretation of procedure results.
Triprolidine: (Moderate) Sincalide-induced gallbladder ejection fraction may be affected by concurrent medications, including H1-blockers. False study results are possible; thorough patient history is important in the interpretation of procedure results.

Kinevac/Sincalide Intravenous Inj Pwd F/Sol: 5mcg

Maximum dosage limits are not available.

Maximum dosage limits are not available.

Safety and efficacy have not been established.

Safety and efficacy have not been established.

Mechanism of Action: Sincalide is a synthetically prepared C-terminal octapeptide of cholecystokinin, an endogenous cholecystotopancreatic-gastrointestinal hormone that is released from the duodenal mucosa in response to fat and amino acid ingestion. Endogenous cholecystokinin is known to stimulate gallbladder contraction, relax the sphincter of Oddi, inhibit gastric emptying, and increase intestinal motility ; impacts on other systems are not fully elicited. At therapeutic doses, sincalide causes reversible pharmacological effects on the gallbladder, pancreas, and intestinal smooth muscle similar to those of endogenous cholecystokinin.When injected, sincalide produces gallbladder contraction thereby resulting in a substantial reduction in gallbladder size. The evacuation of bile that results is similar to that which occurs physiologically in response to endogenous cholecystokinin. The intravenous bolus administration of sincalide causes a prompt contraction of the gallbladder that becomes maximal in 5 to 15 minutes, as compared with the stimulus of a fatty meal, which causes a progressive contraction that becomes maximal after approximately 40 minutes. As such, sincalide provides a prompt and predictable action for duodenal aspiration of concentrated bile for analysis, and in hepatobiliary imaging, for the study of gallbladder and biliary system function. Generally, a 40 percent reduction in radiographic area of the gallbladder is considered satisfactory contraction, although some patients will show area reduction of 60 to 70 percent.Like endogenous cholecystokinin, sincalide stimulates pancreatic secretion; concurrent administration with secretin increases both the volume of pancreatic secretion and the output of bicarbonate and enzymes by the gland. This combined effect of secretin and sincalide permits the assessment of specific pancreatic function through duodenal aspirate measurement and analysis of composition.Sincalide stimulates smooth muscle which increases intestinal motility, and may cause pyloric contraction, which retards gastric emptying. Correctly timed sincalide administration following the ingestion of a barium meal will accelerate the transit of the contrast agent through the small bowel, thereby decreasing the time and extent of radiation associated with fluoroscopy and x-ray examination of the intestinal tract.

Sincalide is administered intravenously or intramuscularly. Pharmacokinetic studies have not been undertaken by the manufacturer; however, data from a study conducted in rats indicate that sincalide is widely distributed in the body and concentrates in the liver, pancreas, pyloric sections of the stomach, intestines, and thyroid following administration. Sincalide is not found in the lung tissue, nor does it penetrate the blood-brain barrier.  The serum half-life, as calculated from 8 healthy volunteers, is 1.30 +/- 0.07 minutes; both renal and hepatic elimination pathways are thought to exist in humans.

Maximal gallbladder contraction occurs at 5 to 15 minutes post intravenous bolus administration of sincalide.

Available data with sincalide use in pregnancy are insufficient to establish a drug-associated risk of adverse developmental outcomes. Based on limited human data and its mechanism of action, sincalide may cause preterm labor or spontaneous abortion. In animal embryofetal development studies, no effects were seen at doses comparable to the maximum recommended human dose (MRHD) on a mg/kg basis when sincalide was administered to hamsters and rats during organogenesis. However, in a prenatal development study in rats given sincalide during organogenesis through parturition, decreased weight gain and developmental delays were observed at a dose 122-times higher than the MRHD based on body surface area.[32504]

There are no data on the presence of sincalide in human or animal milk, the effects on the breast-fed infant, or the effects on milk production. Consider the developmental and health benefits of breast-feeding along with the mother's clinical need for sincalide and any potential adverse effects on the breast-fed infant from sincalide or the underlying maternal condition.