Teduglutide: Medicine Overview
Teduglutide (Gattex in the US, Revestive in the EU) is a GLP-2 analogue approved for short bowel syndrome; this page covers label indications, trial results, growth-related warnings and monitoring.
Content last updated . This page has not been medically reviewed.
Quick overview
Teduglutide is an injectable GLP-2 analogue: a lab-made version of glucagon-like peptide-2, a natural gut peptide. It is approved for short bowel syndrome (SBS), a condition in which nutrients and fluids are not properly absorbed, usually because a large part of the intestine was surgically removed. [1] This page explains the official labels. It is education only; it is not dosing guidance and not advice about starting, changing or stopping care.Evidence label used here: approved medicine. For related gut peptide medicines see Gastrointestinal Peptide Medicines. GLP-2 is a different signal from the GLP-1 used in diabetes and weight medicines; compare with GLP-1 and GIP Biology.
Molecule, brand and product
- Active ingredient: teduglutide. Brands as labeled: Gattex (US, Takeda) and Revestive (EU). [2][1]
- Natural counterpart: the US label says teduglutide is an analogue of human GLP-2, a peptide secreted by L-cells of the distal intestine. [2]
How it is thought to work
Per the US label, GLP-2 increases blood flow in the intestine and inhibits gastric acid secretion. Teduglutide binds GLP-2 receptors on certain gut cells, causing local release of mediators including IGF-1, nitric oxide and keratinocyte growth factor. [2] The label does not describe it as a general digestive aid.What the trials showed
In the main US randomized, placebo-controlled study, adults with SBS who needed parenteral nutrition at least 3 times a week were treated for 24 weeks (43 on teduglutide, 43 on placebo). The primary measure was a clinical response, defined as at least a 20% reduction in weekly parenteral volume at weeks 20 and 24. [2]| Result at week 24 | Teduglutide | Placebo |
|---|---|---|
| Responders | 63% (27 of 43) | 30% (13 of 43) |
| Average weekly parenteral volume reduction | 4.4 liters | 2.3 liters |
| At least one day less parenteral support | 54% | 23% |
[2] In the 2-year open-label extension, 96% (21 of 22) of responders who continued sustained their response. [2] Extension studies without a placebo group are less reliable than the randomized phase. Funding and registration details were not reviewed for this page.
Monitoring and professional care
This is a specialist-managed medicine. The label calls for a colonoscopy and upper GI endoscopy with polyp removal within 6 months before starting in adults, follow-up colonoscopy after 1 year and then at least every 5 years, and blood tests of bilirubin, alkaline phosphatase, lipase and amylase every 6 months. In children it calls for annual fecal occult blood testing. [2] These are label monitoring expectations for clinicians, not a checklist for self-management. See Other Specialized Peptide Medicines for related approved products.Off-label and investigational questions
Uses outside short bowel syndrome, such as general digestive health or inflammatory bowel disease, are not in the labels read. Proper evidence not found in the FDA label and EMA page checked (other trial literature was not reviewed). Do not treat the SBS result as evidence for other gut conditions.Frequently asked questions
Is teduglutide the same as GLP-1 medicines for diabetes?
No. It copies GLP-2, a different gut peptide, and is approved for short bowel syndrome. [2]
Why is a colonoscopy part of the label?
Because polyps were found in studies and growth-related risks are a labeled warning. [2]
Is it approved in the EU?
Yes, as Revestive for short bowel syndrome, per the EMA page. [1]
Does it cure short bowel syndrome?
The trials measured how much intravenous support was reduced, not cure. [2]
Should I change my care?
This page cannot advise that. Please speak with your care team, and see Approved, Investigational and Unapproved Peptides.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
Approved uses by jurisdiction
| Jurisdiction | Indication as written in the source |
|---|---|
| United States (FDA label, DailyMed version dated 2025-09-05) | Treatment of adults and pediatric patients 1 year and older with short bowel syndrome who are dependent on parenteral support (nutrition or fluids given into a vein). [2] |
| European Union (EMA page for Revestive) | Treatment of patients aged 1 year and above with SBS, who should be stable after a period of intestinal adaptation following surgery. The EMA overview text separately says 4 months and above, which differs from its indication field, so check the current product information. [1] |
The EMA page also records an orphan medicine designation on 11 December 2001. [1] Other countries were not verified.
Major safety information
- Possible acceleration of abnormal growth. The label says teduglutide has the potential to cause hyperplastic (excess cell growth) changes including neoplasia, based on its activity and on rodent studies. Intestinal polyps were found in clinical studies and after marketing. If a gut cancer occurs, treatment should be discontinued. [2]
- Intestinal obstruction, gallbladder, bile and pancreas problems, and fluid overload including congestive heart failure are listed warnings. [2]
- Absorption of other medicines. Because it improves gut absorption, oral medicines such as benzodiazepines may need monitoring. [2]
- Contraindications: the label lists none. [2]
- Most common reactions (10% or more): abdominal pain, nausea, upper respiratory infection, abdominal distension, injection-site reaction, vomiting, fluid overload and hypersensitivity. [2]