Peptides›Cognitive, Metabolic›Sincalide

Sincalide

/ Synthetic CCK-8 octapeptide; CCK-A and CCK-B receptor agonist

TIER 1 · ClinicalN = 0 · TESTING PENDINGMW 1143.00 g·mol⁻¹

ALIAS · CCK-8 · Cholecystokinin octapeptide · Kinevac (trade)

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Research use onlyAny dose figures below describe what specific cited studies used, reported factually. Nothing on this page is guidance for human use.READ FIRST →

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§ A · Identity

Primary sequenceDY(SO3H)MGWMDF-NH2

MW · 1143.00CLASS · Synthetic CCK-8 octapeptide; CCK-A and CCK-B receptor agonistCATEGORY · Cognitive, Metabolic

Tier 1. Sincalide (synthetic sulfated CCK-8 octapeptide) is FDA-approved as Kinevac for diagnostic stimulation of gallbladder contraction during cholescintigraphy (gallbladder ejection fraction measurement) and for accelerating small-bowel transit during barium contrast studies. Approved 1976.

§ B · Mechanism of action

Sincalide is the synthetic carboxy-terminal octapeptide of cholecystokinin (CCK-8), with sulfation on the tyrosine residue (position 7 of CCK-8 / position 27 of the parent CCK-33). The sulfation is essential for full agonist potency at the CCK-A (CCK1) receptor. CCK-8 binds both CCK-A and CCK-B (CCK2) receptors but with much higher affinity at CCK-A, which is the relevant receptor for the gallbladder and gastrointestinal indications.

CCK-A receptor activation on gallbladder smooth muscle drives strong, coordinated gallbladder contraction with concurrent relaxation of the sphincter of Oddi, expelling bile into the duodenum. The same receptor on small-bowel smooth muscle accelerates intestinal transit. CCK-A signalling on pancreatic acinar cells stimulates digestive enzyme release.

In diagnostic cholescintigraphy, sincalide infusion after intravenous Tc-99m HIDA produces measurable gallbladder ejection fraction over 30-60 minutes. The threshold for normal vs abnormal varies by protocol; the test supports the diagnosis of functional gallbladder disorder when ejection fraction is reduced in the absence of stones.

§ C · Human clinical evidence

Tier 1 for diagnostic indications. Sincalide (Kinevac) holds FDA approval for stimulation of gallbladder contraction in cholescintigraphy, stimulation of pancreatic secretion in conjunction with secretin during pancreatic function testing, and acceleration of barium small-bowel transit. Standardised infusion protocols (e.g. 0.02 microg/kg over 60 minutes) for cholescintigraphy are widely used.

§ D · Primary literature

PubMed1860640Yap L et al. — Acalculous biliary pain: cholecystectomy alleviates symptoms in patients with abnormal cholescintigraphy · Gastroenterology · human-observationalPatients with acalculous biliary pain and reduced gallbladder ejection fraction on CCK-cholescintigraphy showed symptom relief after cholecystectomy; supports diagnostic utility of sincalide-stimulated GBEF for functional gallbladder disorder.Limitations: Small single-centre observational cohort; no randomisation.1991

PubMed22293163Ziessman HA et al. — Sincalide cholescintigraphy - 32 years later: evidence-based data on its clinical utility and infusion methodology · Seminars in Nuclear Medicine · reviewComprehensive review of sincalide cholescintigraphy methodology and clinical utility; supports the standardised 60-minute infusion protocol and discusses interpretation thresholds.Limitations: Narrative review.2012

§ F · Safety signal

Intravenous sincalide produces dose-dependent abdominal cramping, nausea, and an urge to defecate during the brief infusion. Adverse effects are typically transient. Standard slow-infusion protocols (over 30-60 minutes) reduce cramping severity compared with rapid bolus administration.

§ H · Regulatory status

Regulatory status

FDA status:: FDA-approved
Compounding:: Not eligible for compounding (approved, not in shortage)

§ I · Notable gaps and controversies

The diagnostic threshold for 'abnormal' gallbladder ejection fraction has been debated in the imaging literature - cut-offs of 35-40% are commonly used but inter-protocol variability is substantial.

Compounding eligibility is 'not eligible' as sincalide is a marketed FDA-approved product. Vendor-sold 'CCK-8' research peptide does not interchange with the licensed Kinevac product.