What it is
Teduglutide is a GLP-2 receptor agonist, meaning it activates the receptor for glucagon-like peptide-2, a gut hormone. It is FDA-approved, as Gattex (also sold as Revestive), for short bowel syndrome. Gattex is FDA-approved for adults and pediatric patients 1 year of age and older with short bowel syndrome who are dependent on parenteral support, meaning nutrition or fluids given by infusion.
It promotes growth and repair of the intestinal mucosa, the lining of the gut, which is why it draws interest in gut-healing discussions. Its trophic (growth-promoting) action on intestinal tissue is also the source of its main safety considerations.
How it's thought to work
Teduglutide activates GLP-2 receptors in the gut, increasing villus height and crypt depth, and is described as improving mucosal integrity and nutrient absorption. The prescribing information reports that teduglutide increased villus height and crypt depth of the intestinal mucosa and enhanced intestinal fluid absorption in a dose-ranging study of 17 adults with short bowel syndrome.
It is a DPP-4-resistant GLP-2 analogue, a modification that extends its half-life over native GLP-2. DPP-4 is an enzyme that rapidly breaks down native GLP-2.
Teduglutide was hypothesized to slow gastric emptying, but a randomized, placebo-controlled trial in healthy subjects found no significant difference in gastric emptying of liquids.
What the research says
Multiple clinical trials support reduced parenteral support requirements in short bowel syndrome, and teduglutide is FDA-approved for that indication.
In a 24-week randomized, placebo-controlled trial of 86 people with short bowel syndrome and intestinal failure, 63% of those given teduglutide (27 of 43) had a greater than 20% reduction in parenteral support volume at weeks 20 and 24, compared with 30% on placebo (13 of 43).
Reported side effects
Its most common adverse reactions (10% or more of patients) are abdominal pain, nausea, upper respiratory tract infection, abdominal distension, injection site reaction, vomiting, fluid overload and hypersensitivity. Among 53 people with a stoma in the placebo-controlled studies, gastrointestinal stoma complications were reported in 42% (13 of 31) of those given teduglutide and 14% (3 of 22) of those given placebo.
The prescribing information describes intestinal polyps found during clinical studies, and a potential for hyperplastic changes including neoplasia (abnormal tissue growth), and calls for colonoscopy and upper GI endoscopy with removal of polyps before and during treatment.
Reconstitution
Teduglutide (GLP-2) is supplied as a lyophilized (freeze-dried) powder and is typically reconstituted with bacteriostatic (BAC) water before use. It commonly comes in 5 mg and 10 mg vials. The amount of peptide in the vial is fixed; the water added only changes how concentrated the solution is.
Worked example. A 10 mg vial is 10,000 mcg. Reconstituted with 2.5 mL of BAC water, that works out to 10,000 mcg ÷ 2.5 mL = 4,000 mcg/mL. On a U-100 insulin syringe, where each unit is 0.01 mL, each unit holds 4,000 × 0.01 = 40 mcg. A 5 mg vial with 0.5 mL comes out at 10,000 mcg/mL instead, or 100 mcg per unit. Use the peptide reconstitution calculator to work out the concentration and units for any vial size and water volume.
Important notes
Teduglutide is FDA-approved for a specific indication, with colonoscopy and endoscopy surveillance described in the prescribing information. Off-label use for general gut health is not FDA-approved and carries the same trophic tissue concerns.
Sources
- GATTEX (teduglutide) for injection, for subcutaneous use - Prescribing Information. U.S. Food and Drug Administration, 2025. Fda label
- Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure. Jeppesen PB et al. Gastroenterology, 2012. Human trial
- Teduglutide (ALX-0600), a dipeptidyl peptidase IV resistant glucagon-like peptide 2 analogue, improves intestinal function in short bowel syndrome patients. Jeppesen PB et al. Gut, 2005. Human trial
- A randomized, double-blind, placebo-controlled, multiple-dose, parallel-group clinical trial to assess the effects of teduglutide on gastric emptying of liquids in healthy subjects. Berg JK et al. BMC Gastroenterology, 2014. Human trial
Frequently asked questions
These questions cover the same ground as the sections above, in a shorter format.
What is teduglutide?
A GLP-2 receptor agonist FDA-approved as Gattex for short bowel syndrome, which promotes growth and repair of the intestinal lining.
How is teduglutide thought to work?
It activates GLP-2 receptors in the gut, increasing villus height and crypt depth and fluid absorption; it is a DPP-4-resistant GLP-2 analogue with a longer half-life than native GLP-2.
What does the research on teduglutide say?
Randomized trials in short bowel syndrome found more people reached a meaningful reduction in parenteral support on teduglutide than on placebo, and it is FDA-approved for that indication.
What are the reported side effects of teduglutide?
Abdominal pain and distension, nausea, injection site reactions, fluid overload and stoma complications, plus a concern about intestinal polyps and neoplasia that the label addresses with colonoscopy.
How much is one unit from a 10 mg Teduglutide (GLP-2) vial?
With 2.5 mL of BAC water, a 10 mg vial is 4,000 mcg/mL, so one unit on a U-100 syringe (0.01 mL) holds 40 mcg.
The full entry, plus the calculator
The PeptidesAI app has the complete encyclopedia entry for Teduglutide (GLP-2) — one of 70 compounds covered — plus the reconstitution calculator, a dose log and reminders. Free to download on iPhone.
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