GLP-2 analogue Pregnancy: Available data from case reports in pregnant women have not identified a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes. No effects on embryo-fetal development in rats or rabbits at exposures up to 686 and 657 times the clinical exposure at the recommended human dose. Pregnant women with short bowel syndrome are at risk for malnutrition, which is associated with adverse maternal and fetal outcomes.

Teduglutide

Brand names: Revestive

Teduglutide is a glucagon-like peptide-2 analogue used to treat short bowel syndrome in patients dependent on parenteral support, under specialist supervision.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 0.05 mg/kg once daily

Route: Subcutaneous injection only (not for intravenous or intramuscular administration)

Frequency: Once daily

Max: No maximum dose stated

The recommended dosage is the same for adults and paediatric patients 1 year of age and older. Alternate injection sites between one of the 4 quadrants of the abdomen, or into alternating thighs or alternating arms. If a dose is missed, take it as soon as possible on that day; do not take 2 doses on the same day. Pre-treatment (within 6 months of starting): adults — colonoscopy and upper GI endoscopy with removal of polyps; paediatrics — faecal occult blood testing (and colonoscopy/sigmoidoscopy plus upper GI endoscopy if new or unexplained blood in stool); all patients — baseline bilirubin, alkaline phosphatase, lipase and amylase. Monitoring: laboratory assessments every 6 months; follow-up colonoscopy and upper GI endoscopy (or alternate imaging) at the end of 1 year, then no less frequently than every 5 years if no polyp found. On discontinuation, monitor for fluid and electrolyte imbalance. Reconstitution: each 5 mg vial with the supplied 0.5 mL preservative-free Sterile Water for Injection gives a 10 mg/mL solution; a maximum of 0.38 mL of reconstituted solution (3.8 mg teduglutide) can be withdrawn from the vial for dosing. SOURCE CAVEAT: no UK SPC was fetched; the above is US labelling (GATTEX, Takeda, 2025-09-05) and must be verified against the UK SPC before publication.

Paediatric dose

Dose: 0.05 mg/kg

Route: Subcutaneous injection only

Frequency: Once daily

Max: No maximum dose stated; a maximum of 0.38 mL of reconstituted solution (3.8 mg teduglutide) can be withdrawn from a vial for dosing

US label: recommended dosage for adults and paediatric patients 1 year of age and older is 0.05 mg/kg once daily. Safety and effectiveness below 1 year of age have not been established. Use of the 5 mg kit is not recommended in paediatric patients weighing less than 10 kg. Self-administration in paediatric patients has not been tested. Renal impairment (eGFR less than 60 mL/min/1.73 m2, including end-stage renal disease): 0.025 mg/kg once daily. US labelling — verify against the UK SPC and a children's formulary before use.

Dose adjustments

Renal

Adults and paediatric patients with moderate and severe renal impairment and end-stage renal disease (eGFR less than 60 mL/min/1.73 m2): 0.025 mg/kg once daily

Dose auto-extracted from US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Paediatric weight-based calculator

Patient weight (kg)

Verify in a children's formulary

Contraindications

None stated (US label section 4: 'None')

Side effects

Abdominal pain
Nausea and vomiting
Abdominal distension
Injection site reaction
Upper respiratory tract infection
Fluid overload; hypersensitivity

Interactions

Potential for increased absorption of concomitant oral medications — monitor patients on oral drugs requiring titration or with a narrow therapeutic index; the concomitant drug may require a dose reduction
Benzodiazepines — altered mental status observed in patients taking teduglutide with benzodiazepines in adult clinical studies

Clinical monograph

How it works

As a GLP-2 analogue it promotes growth and improves the absorptive function of the intestinal mucosa, increasing fluid and nutrient absorption.

Prescribing in practice

Because it is trophic to intestinal tissue, colonoscopy to exclude colonic polyps or neoplasia is required before starting and periodically during treatment.
It can cause intestinal obstruction and worsen fluid overload, and may increase the absorption of concomitant oral medicines, requiring their review.
Treatment should be initiated and monitored within a specialist intestinal failure service.

Monitoring

Perform colonoscopic surveillance per the SPC and monitor fluid balance, nutritional status, and parenteral support requirements.

Counselling the patient

Attend all scheduled colonoscopies and monitoring appointments.
Report abdominal swelling, persistent vomiting, or marked changes in your stoma or bowel output.

Evidence & guidelines

Teduglutide is recommended for short bowel syndrome to reduce dependence on parenteral nutrition in selected patients.

Reference: NICE HST12; SmPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Pathways