Teduglutide

Written by The Peptide Record editorialClinical review not yet completedLast reviewed 12 September 2026

Teduglutide (Gattex/Revestive) is a real, FDA-approved GLP-2 analog for short bowel syndrome — a genuinely different peptide family from the GLP-1 drugs covered elsewhere on this site, working by promoting intestinal growth and absorption rather than suppressing appetite.

In brief

Should you care? Only if short bowel syndrome is relevant to you or someone you know — this isn't a wellness or weight-loss peptide, and has no grey-market presence.

The short version

GLP-2, not GLP-1 — a one-amino-acid-modified analog of glucagon-like peptide-2, mechanistically distinct from semaglutide/tirzepatide/retatrutide.
Approved December 2012 for adults with SBS-associated intestinal failure; expanded to children 1 year and older in 2019.
Requires a colonoscopy before starting and periodic monitoring after, due to a neoplastic-growth signal seen in animal studies.

What it is, and how it differs from GLP-1 drugs

Teduglutide is a recombinant analog of human glucagon-like peptide-2 (GLP-2), a 33-amino-acid peptide differing from the native hormone by a single substitution (glycine for alanine at position 2) that resists DPP-4 enzyme degradation and extends its half-life from around 7 minutes to roughly 2 hours. It acts on intestinal GLP-2 receptors to promote mucosal growth, increase villus height, slow gastric emptying, and improve fluid and nutrient absorption — the therapeutic opposite of what this site's GLP-1 pages (semaglutide, tirzepatide, retatrutide) are used for. It has no appetite-suppressing or weight-loss effect and no grey-market or bodybuilding-adjacent use.

The approval and pivotal trial

The FDA approved teduglutide (as Gattex) on 21 December 2012 for adults with short bowel syndrome who depend on parenteral nutrition or IV fluids, based on the STEPS trial (Jeppesen et al., Gastroenterology 2012, PMID 22982184): a 24-week, placebo-controlled trial in 169 patients that found a clinically meaningful reduction (20-100%) in weekly parenteral support volume, sustained from week 20 to 24, in significantly more teduglutide patients than placebo — with mean reductions of 2.5 to 4.4 liters per week. The FDA extended the approval to children aged 1 year and older on 17 May 2019.

Safety: the monitoring requirement that comes with it

Teduglutide's label carries a Warnings and Precautions section (not a boxed warning) about a neoplastic-growth signal seen in animal carcinogenicity studies: patients need a colonoscopy within 6 months before starting treatment, with follow-up at 1 year and periodically after, and must stop the drug if colorectal or small-bowel cancer is diagnosed. Other documented effects include GI symptoms, fluid overload (relevant given many SBS patients already have central venous lines and a heart-failure risk), gallbladder/biliary disease, pancreatitis, and injection-site reactions. A REMS program requires this monitoring to be built into prescribing.

Current status

Still marketed by Takeda under the Gattex (US) and Revestive (EU) brand names. Patent protection was expected to lapse around 2025-2026, so a generic entry may be recent or imminent by the time you're reading this — worth checking current availability directly. We found no FDA warning letter naming teduglutide or GLP-2 sold as a "research peptide" — unlike the GLP-1 drugs, it does not appear to have any grey-market presence, consistent with having no cosmetic, performance, or weight-loss appeal.

References

Jeppesen PB, Pertkiewicz M, Messing B, et al., "Teduglutide Reduces Need for Parenteral Support Among Patients With Short Bowel Syndrome With Intestinal Failure," Gastroenterology 2012;143(6):1473-1481, PMID 22982184, DOI: 10.1053/j.gastro.2012.09.007.
FDA approval history for Gattex (teduglutide), initial approval 21 December 2012; pediatric expansion 17 May 2019.