Teduglutide
Also known as: Gattex, Revestive, ALX-0600, [Gly2]-GLP-2, GLP-2 analog
Key Facts: Teduglutide
- Category
- Healing
- FDA Status
- FDA Approved
- Clinical Status
- FDA Approved (Gattex, December 2012; pediatric 1 year and older added May 2019) and approved in the EU as Revestive. Indicated for SBS patients dependent on parenteral support.
- Banned in Sport (WADA)
- Not on the WADA Prohibited List (2026).
- Administration
- Subcutaneous injection, rotating between abdominal quadrants, thighs, or arms
- Typical Dose
- 0.05 mg/kg once daily (labeled dose)
- Frequency
- Once daily
- Duration
- Long-term, with assessment of benefit and ongoing monitoring; IV support is weaned as absorption improves
How does Teduglutide work?
Teduglutide differs from natural GLP-2 by one amino acid (glycine swapped in at position 2), which shields it from DPP-4 breakdown and stretches its half-life from minutes to roughly 2 hours in healthy people (1.3 hours in SBS). It binds GLP-2 receptors on cells in the intestinal wall, which release local growth factors that increase villus height and crypt depth, improve blood flow to the gut, and slow gastric emptying and secretions. Net result: more absorptive surface and more time to absorb. The same growth signal is the reason for its main safety concern, because it can also speed the growth of polyps or existing tumors in the gut, so the label requires colonoscopy before and during treatment.
What does the research show?
In the pivotal adult trial (Study 1, NCT00798967), 86 adults with SBS were randomized to teduglutide 0.05 mg/kg daily or placebo for 24 weeks. 63% on teduglutide versus 30% on placebo were responders (at least a 20% cut in weekly IV support at weeks 20 and 24), and weekly IV volume fell 4.4 L versus 2.3 L. In the 2-year open-label extension, 93% of the 30 patients who completed 30 months reached at least a 20% reduction, and a minority came off IV support entirely. An earlier trial (Study 3) used a different primary endpoint that missed at the higher dose, though responder rates at 0.05 mg/kg were 46% versus 6%. A 24-week pediatric study of 59 children aged 1 to 17 led to the 2019 approval: 69% on 0.05 mg/kg cut IV support by at least 20%, and 3 of 26 weaned off. Honest caveats: it is a lifelong therapy for most, benefits fade if stopped, and colon-in-continuity patients often respond less dramatically than those with a stoma. Longer-acting GLP-2 drugs (glepaglutide, apraglutide) are trying to replace the daily shot.
FDA Approval Studies
This peptide is FDA approved. Below are the key clinical trials that supported its approval.
Study 1 / STEPS (NCT00798967)
NPS Pharmaceuticals • Phase 3
86
24 weeks
Responders with at least 20% reduction in weekly parenteral support at weeks 20 and 24
- ✓63% responders vs 30% on placebo (p=0.002)
- ✓Weekly IV volume down 4.4 L vs 2.3 L
- ✓54% vs 23% gained at least one day off IV support
Pediatric study (Study 5)
Shire • Phase 3
59
24 weeks
Reduction in parenteral support volume
- ✓69% on 0.05 mg/kg cut IV support by at least 20%
- ✓Mean 42% reduction in IV volume
- ✓3 of 26 weaned off IV support
What doses have been studied?
Typical Dosingⓘ
Community experience
0.05 mg/kg once daily (labeled dose)
0.025-0.05 mg/kg once daily depending on kidney function
Once daily
Before starting, adults need a colonoscopy with polyp removal and baseline bilirubin, alkaline phosphatase, lipase, and amylase. Colonoscopy is repeated after 1 year, then at least every 5 years. When stopping, fluid and electrolytes need close watching because absorption falls back.
Research Dosingⓘ
Scientific studies
FDA-approved labeled dosing (prescription only)
Doses from Studies
0.05 mg/kg once daily
FDA Approved Labeling - Gattex prescribing information, section 2.2 ↗
0.025 mg/kg once daily (renal impairment)
FDA Approved Labeling - Gattex prescribing information, section 2.3 ↗
Duration
Long-term, with assessment of benefit and ongoing monitoring; IV support is weaned as absorption improves
Administration
Subcutaneous injection, rotating between abdominal quadrants, thighs, or arms
When and how is Teduglutide taken?
Best Time to Take
Same time each day, any time of day
Once daily subcutaneous injection
Food Recommendation
With or without food
Why This Timing?
The label sets once-daily dosing without a fixed clock time. Consistency matters more than morning versus evening.
What are the side effects of Teduglutide?
Not everyone experiences these effects. Individual responses vary based on dosage, duration, and personal factors.
- ●Abdominal pain (30% vs 22% placebo)
- ●Nausea
- ●Upper respiratory infections
- ●Abdominal distension
- ●Injection site reactions
- ●Vomiting
- ●Fluid overload, including heart failure
- ●Hypersensitivity
- ●Swelling or changes of the stoma
- ●Acceleration of polyps or intestinal tumors (colonoscopy required)
- ●Intestinal obstruction
- ●Gallbladder and pancreatic problems (labs every 6 months)
- ●Increased absorption of other oral drugs (for example benzodiazepines)
References
- https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/203441s018lbl.pdf
- https://www.accessdata.fda.gov/drugsatfda_docs/nda/2012/203441Orig1s000Approv.pdf
- https://www.takeda.com/en-us/newsroom/news-releases/2019/us-fda-approves-gattex-teduglutide-for-children-1-year-of-age-and-older-with-short-bowel-syndrome-sbs/
- https://www.hcplive.com/view/fda-approves-teduglutide-for-pediatric-use
Research This Peptide Further
Frequently Asked Questions
What does Teduglutide do?
Teduglutide is a 33-amino-acid GLP-2 analog approved for short bowel syndrome (SBS) in people who depend on IV nutrition or fluids. GLP-2 is the gut's own growth signal, and teduglutide makes the remaining intestine grow taller villi and absorb more, so some patients can cut back the hours they spend hooked to a drip. The FDA approved it as Gattex in December 2012 (children 1 year and older were added in 2019), and in Europe it is sold as Revestive. It works, but it is a serious daily injection with real monitoring requirements, not a gut-health supplement.
How does Teduglutide work?
Teduglutide differs from natural GLP-2 by one amino acid (glycine swapped in at position 2), which shields it from DPP-4 breakdown and stretches its half-life from minutes to roughly 2 hours in healthy people (1.3 hours in SBS). It binds GLP-2 receptors on cells in the intestinal wall, which release local growth factors that increase villus height and crypt depth, improve blood flow to the gut, and slow gastric emptying and secretions. Net result: more absorptive surface and more time to absorb. The same growth signal is the reason for its main safety concern, because it can also speed the growth of polyps or existing tumors in the gut, so the label requires colonoscopy before and during treatment.
Is Teduglutide FDA approved?
Yes, Teduglutide is FDA approved. FDA Approved (Gattex, December 2012; pediatric 1 year and older added May 2019) and approved in the EU as Revestive. Indicated for SBS patients dependent on parenteral support.
Is Teduglutide banned in sport?
Not on the WADA Prohibited List (2026).
What are the side effects of Teduglutide?
Reported side effects include: Abdominal pain (30% vs 22% placebo), Nausea, Upper respiratory infections, Abdominal distension, Injection site reactions. Individual responses vary based on dosage, duration, and personal health factors.
What is the typical dose of Teduglutide?
Community-reported common dose: 0.05 mg/kg once daily (labeled dose) (Once daily). Range: 0.025-0.05 mg/kg once daily depending on kidney function. Administration: Subcutaneous injection, rotating between abdominal quadrants, thighs, or arms. Prescription drug. Dose set by prescriber per label. Not medical advice.
Related Peptides
Peptides commonly compared with Teduglutide or used in similar applications.
Ziconotide
FDAZiconotide is a real, FDA-approved painkiller pulled from the venom of a marine cone snail. It is not an opioid, and unlike morphine, people do not build tolerance to it over time. The catch: it only works delivered directly into the spinal fluid through an implanted pump, and its side effect profile is rough enough that it carries a black box warning.
HealingBPC-157
PreclinicalBPC-157 is a synthetic 15-amino-acid peptide (sequence Gly-Glu-Pro-Pro-Pro-Gly-Lys-Pro-Ala-Asp-Asp-Ala-Gly-Leu-Val) based on a fragment of a protective protein found in human gastric juice. It is studied almost entirely in animals for tendon, ligament, gut, and tissue healing, and it has racked up hundreds of preclinical papers. The catch: it is not approved by any regulator for any use, and the human evidence is a handful of small pilot studies, not real clinical proof.
HealingTB-500
PreclinicalTB-500 is a synthetic peptide that copies the active region of thymosin beta-4, a natural protein that controls how cells build and move their internal skeleton. Most TB-500 products reproduce the short LKKTETQ sequence (residues 17 to 23) responsible for binding actin and driving cell migration, which is why it gets marketed for tendon, muscle, and wound repair. Here is the honest part: there are essentially no completed human trials of the TB-500 fragment itself, and almost all the human clinical data is for the full-length thymosin beta-4 molecule, which is related but not the same thing.
HealingPentadecapeptide
PreclinicalPentadecapeptide almost always means BPC-157, a synthetic 15-amino-acid chain (Gly-Glu-Pro-Pro-Pro-Gly-Lys-Pro-Ala-Asp-Asp-Ala-Gly-Leu-Val) derived from a protein found in human gastric juice. It is one of the most hyped 'healing' peptides online, marketed for tendon, gut, and muscle repair, but here is the catch: essentially all of the supporting evidence is from rats and mice. There is no FDA approval and no completed human clinical trial proving it does any of this.
HealingThymosin Beta-4
Clinical TrialsThymosin beta-4 (Tbeta4) is a small 43 amino acid peptide found in nearly every cell in the body, originally isolated from the thymus. Its main job is binding and sequestering G-actin, the building block of the cell's internal scaffolding, which lets it influence cell movement, wound repair, and tissue regeneration. It is researched heavily for healing of skin, cornea, and heart tissue, but it is not an FDA-approved drug. (The injectable sold as TB-500 is a synthetic fragment marketed as related to Tbeta4, not the full natural peptide.)
HealingB7-33
PreclinicalB7-33 is a 27-amino-acid, single-chain peptide cut down from the B-chain of human relaxin-2, the hormone that loosens tissue during pregnancy. Relaxin itself has strong anti-scarring effects but is a complex two-chain molecule that is hard and expensive to make, so an Australian group (Hossain and colleagues, 2016) designed B7-33 as a simpler version. In rodent models it reduced heart and lung fibrosis about as well as full relaxin. It has never been tested in humans.
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