Teduglutide (GLP-2)
GLP-2 Receptor Agonist / Intestinotrophic FactorapprovedAlso known as: Gattex, Revestive, GLP-2 Analog, ALX-0600
A GLP-2 analog that promotes intestinal mucosal growth and adaptation, FDA-approved for short bowel syndrome to reduce dependence on parenteral nutrition.
Overview
Teduglutide is a recombinant analog of human glucagon-like peptide-2 (GLP-2) with a single amino acid substitution (Ala→Gly at position 2) that confers resistance to DPP-4 degradation, extending its half-life from 7 minutes to approximately 2 hours. GLP-2 is a 33-amino acid peptide produced by intestinal L-cells that specifically promotes intestinal mucosal growth, increases villus height, crypt depth, and mesenteric blood flow. Teduglutide (brand names Gattex/Revestive) was FDA-approved in 2012 for adults with short bowel syndrome (SBS) dependent on parenteral nutrition. It represents a targeted intestinotrophic therapy that can reduce or eliminate the need for IV nutrition in SBS patients.
Mechanism of Action
Teduglutide activates GLP-2 receptors on intestinal subepithelial myofibroblasts: (1) Stimulates crypt cell proliferation and inhibits apoptosis, increasing villus height and absorptive surface area; (2) Enhances intestinal blood flow through mesenteric vasodilation; (3) Slows gastric emptying and intestinal transit; (4) Increases expression of nutrient transporters on enterocytes; (5) Reduces gastric acid secretion; (6) Promotes intestinal barrier function; (7) The DPP-4 resistant modification extends half-life, allowing once-daily dosing.
Molecular Formula
C164H252N44O55S
Molecular Weight
3752.13 g/mol
Sequence
His-Gly-Asp-Gly-Ser-Phe-Ser-Asp-Glu-Met-Asn-Thr-Ile-Leu-Asp-Asn-Leu-Ala-Ala-Arg-Asp-Phe-Ile-Asn-Trp-Leu-Ile-Gln-Thr-Lys-Ile-Thr-Asp
Dosage Protocols
Dose Range
0.05 mg/kg – 0.05 mg/kg
Frequency
Once daily
Route
subcutaneous
Cycle Length
Ongoing (with periodic reassessment)
Fixed weight-based dose of 0.05 mg/kg daily. Reduce parenteral nutrition gradually as intestinal absorption improves. Colonoscopy required within 6 months before starting and at least every 2 years. Reduce dose by 50% in moderate-to-severe renal impairment.
Source: FDA prescribing information (Gattex)
🧮 Personalized Dosage Calculator
💰 Estimated Pricing
Typical Supply
3.8mg vials (daily injection)
Last Updated
2026-02
Brand Gattex. For short bowel syndrome. Extremely expensive orphan drug. ~$300,000/year. Insurance/specialty pharmacy required.
⚠️ Prices are estimates based on publicly available data and may vary significantly by vendor, location, and prescription status. This is not medical or financial advice.
Side Effects
| Effect | Severity |
|---|---|
| Abdominal pain | moderate |
| Injection site reactions | mild |
| Nausea | mild |
| Intestinal polyps | severe |
| Fluid overload | moderate |
Pros & Cons
Can reduce or eliminate dependence on parenteral nutrition in short bowel syndrome
Specifically promotes intestinal mucosal growth — the only approved intestinotrophic therapy
Clinically meaningful improvements in quality of life and reduced PN-related complications
Requires colonoscopy surveillance due to theoretical risk of intestinal neoplasia
Extremely expensive (~$300,000/year)
Indication limited to short bowel syndrome — not available for general gut health
Research Studies
🩸 Blood Work
No specific bloodwork requirements reported for this peptide. General health panels are always recommended before starting any peptide protocol.
Legal Status
FDA-approved as Gattex for short bowel syndrome (2012). EMA-approved as Revestive. Prescription-only. REMS program requires colonoscopy before and during treatment.
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