SECRETIN-FERRING
Clinical safety rating: caution
Comprehensive clinical and safety monograph for SECRETIN-FERRING (SECRETIN-FERRING).
Secretin is a gastrointestinal peptide hormone that stimulates the secretion of bicarbonate and water from the pancreas, and also increases bile secretion. It acts on secretin receptors (SCTR) in the pancreas, bile duct, and stomach, leading to activation of adenylate cyclase and increased cyclic AMP levels.
| Metabolism | Secretin is metabolized by proteolytic enzymes in plasma and tissues, with a half-life of approximately 4 minutes. No specific cytochrome P450 involvement. |
| Excretion | Secretin is rapidly eliminated from plasma primarily via renal excretion (approximately 90%) with minimal biliary/fecal excretion (<10%). |
| Half-life | The terminal elimination half-life is approximately 4 to 5 minutes in healthy adults, reflecting rapid enzymatic degradation and renal clearance. This short half-life necessitates continuous intravenous infusion for sustained effect during diagnostic procedures. |
| Protein binding | Negligible protein binding (<5%); binding proteins not clinically relevant (albumin). |
| Volume of Distribution | Approximately 0.3 L/kg, suggesting distribution primarily in extracellular fluid. |
| Bioavailability | Intravenous: 100% (only route used clinically). Not administered orally due to peptide degradation in the GI tract. |
| Onset of Action | Intravenous administration: Onset of pancreatic secretion occurs within 1 minute of injection. Peak effect is observed at 2-4 minutes. |
| Duration of Action | Intravenous: Duration of action is short, lasting approximately 30-60 minutes for stimulation of pancreatic bicarbonate secretion. Clinical effects (e.g., during secretin test) are monitored over 60-90 minutes post-infusion. |
0.2 mcg/kg IV bolus over 1 minute, or 0.4 mcg/kg IV bolus, for stimulation of pancreatic secretions during diagnostic testing; maximum single dose: 0.4 mcg/kg.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustments established for renal impairment; use caution in severe renal dysfunction (GFR <30 mL/min) due to potential accumulation of inactive metabolites. |
| Liver impairment | No specific dose adjustments established for hepatic impairment; use standard dosing as hepatic metabolism is minimal. |
| Pediatric use | 0.2 mcg/kg IV bolus over 1 minute; weight-based dosing per adult protocol; safety and efficacy not established in neonates. |
| Geriatric use | No specific adjustment; consider lower initial dose (0.2 mcg/kg) due to age-related physiologic changes and increased sensitivity to gastrointestinal side effects. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for SECRETIN-FERRING (SECRETIN-FERRING).
| Breastfeeding | No data on excretion into breast milk. Due to large molecular weight and poor oral bioavailability, systemic absorption in infant is unlikely. Use with caution in breastfeeding mothers; risk considered low. |
| Teratogenic Risk | Category B: No evidence of risk in humans. Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities despite possible risks in animal studies. No known teratogenic effects in first trimester; minimal systemic absorption limits fetal exposure. |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
Hypersensitivity to secretin or any component of the formulation.
| Precautions | Hypersensitivity reactions may occur. Use with caution in patients with a history of asthma or allergies. Resuscitative equipment should be available during administration. |
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| Fetal Monitoring |
| No specific monitoring required. Observe for hypersensitivity reactions; fetal monitoring not indicated due to minimal systemic absorption. |
| Fertility Effects | No known effects on fertility. Animal studies show no impairment of fertility at clinically relevant doses. |