Teduglutide

Teduglutide (brand names Gattex and Revestive) is a prescription medicine for people with short bowel syndrome — a serious condition, usually following major intestinal surgery, where too little intestine remains to absorb enough food and water, so patients depend on IV nutrition to stay alive. It is a lab-made version of a natural gut hormone that tells the intestinal lining to grow, which helps the remaining intestine absorb more. It is FDA-approved for that specific condition. It is not a general gut-health or gut-repair product.

Teduglutide has been studied in people with short bowel syndrome who rely on IV nutrition, and the goal was to reduce how much of that IV support they need. In the main trial, 63% of people on teduglutide cut their IV support by more than a fifth, compared with 30% on placebo — a real difference, but one where a notable share of the placebo group improved too. It works by prompting the intestinal lining to grow, which the trial confirmed with a blood marker. The honest part: this reduces IV support, it does not cure the condition, and because the drug's whole mechanism is telling gut tissue to grow, ongoing monitoring is part of how it is prescribed. It has not been studied as a general gut-repair compound in healthy people.

FDA-approved prescription drug (Gattex in the US; Revestive in the EU). Indicated for short bowel syndrome with intestinal failure in patients dependent on parenteral (intravenous) nutritional support. This is a genuine prescription medicine used under specialist care, distinct from the research-supply peptides elsewhere in this library. Approved age range and full indication wording are set by current labeling and should be read there. WADA status: teduglutide is not named on the 2026 WADA Prohibited List. Because it holds regulatory approval for human therapeutic use, S0 (Non-Approved Substances) does not capture it. The S2.3 growth-factor catch-all also does not capture it: that clause is limited by its own wording to growth factors "affecting muscle, tendon or ligament protein synthesis/degradation, vascularisation, energy utilization, regenerative capacity or fibre type switching" (verified verbatim against the 2026 list text, 2026-08-04) — teduglutide's trophic action is on intestinal mucosa, none of which are in that list. Athletes should still verify with their anti-doping organization. Not DEA-scheduled (prescription, non-controlled).

Teduglutide is a prescription drug used under specialist supervision for a serious condition. Its mechanism is deliberately growth-promoting in the intestine, and for that reason gastrointestinal monitoring forms part of how it is prescribed — consult current labeling and your prescriber for what that involves. It is not named on the WADA Prohibited List, is not captured by S0 because it is an approved medicine, and is not captured by the S2.3 growth-factor clause because that clause is limited to muscle, tendon, and ligament effects — but athletes should verify with their anti-doping organization. VialWise is a research and educational reference, not medical advice — consult a licensed professional.

⚠️ This is an approved prescription medicine, not a research peptide. Teduglutide is dispensed by a pharmacy and used under specialist gastroenterology or nutrition-support care for a life-altering condition. The reconstitution and self-dosing workflows used elsewhere in this library do not apply. Information here is informational, not medical advice.

⚠️ It is not a general "gut healing" peptide. This is the most important framing point for this entry. Teduglutide's entire evidence base is in short bowel syndrome with intestinal failure — patients who depend on intravenous nutrition to survive. It has not been studied as a gut-repair or gut-lining compound in healthy people, in IBS, in leaky gut, or in any of the settings where gut-focused research peptides are discussed. Reading "GLP-2 analog that grows the intestinal lining" as a general gut-repair claim goes well past what the evidence supports.

⚠️ A growth-promoting mechanism cuts both ways. Teduglutide works by telling intestinal tissue to grow, confirmed in the pivotal trial by a rise in plasma citrulline, a biomarker of mucosal mass.[¹] That is the therapeutic effect. It is also the reason gastrointestinal monitoring is built into how the drug is prescribed. A compound whose purpose is stimulating tissue growth deserves that scrutiny.

Teduglutide is a recombinant analogue of glucagon-like peptide-2 (GLP-2), marketed as Gattex (US) and Revestive (EU).

Mechanism. GLP-2 is a hormone released by the gut after eating that promotes growth of the intestinal mucosa and slows gastric emptying and secretion.[¹][²] Native GLP-2 is degraded almost immediately by the enzyme DPP-4; teduglutide is modified to resist that degradation, giving it a clinically useful duration.[²] The intended result in short bowel syndrome is a remaining intestine with more absorptive surface, which absorbs more fluid and nutrients and therefore requires less intravenous replacement.[¹][²] The pivotal trial confirmed the mechanism biologically: teduglutide raised plasma citrulline, a biomarker of intestinal mucosal mass.[¹]

Note the family relationship — GLP-1 and GLP-2 are sibling hormones from the same precursor. The GLP-1 receptor agonists elsewhere in this library act on appetite and glucose; GLP-2 acts on the intestinal lining. They are not interchangeable and share no indication.

Evidence quality. The human evidence base is stronger in design than most entries in this library, though narrow in scope:

- The pivotal trial was a 24-week randomized, double-blind, placebo-controlled study in patients with short bowel syndrome with intestinal failure, comparing subcutaneous teduglutide/day (n=43) against placebo (n=43).[¹] The primary endpoint — more than 20% reduction in parenteral support volume at weeks 20 and 24 — was met by 27 of 43 (63%) on teduglutide versus 13 of 43 (30%) on placebo (P =.002).[¹] Mean reduction in parenteral support volume was 4.4 ± 3.8 L/week on teduglutide (from a baseline of 12.9 ± 7.8 L/week) versus 2.3 ± 2.7 L/week on placebo (from 13.2 ± 7.4 L/week), P <.001.[¹] A clinically meaningful secondary result: 21 of 39 (54%) teduglutide patients gained at least one full day per week free of parenteral support, versus 9 of 39 (23%) on placebo (P =.005).[¹] - A clinical review by Nørholk, Holst, and Jeppesen summarized the mechanism and the earlier Phase 2 balance study, which reported teduglutide reduced diarrhea by roughly 700 g/day and faecal energy losses by roughly 0.8 MJ/day.[²] Jens Juul Holst is the co-discoverer of the GLP peptides, which makes this a strong mechanistic source.

Read the placebo arm. 30% of placebo patients also met the primary endpoint, and the placebo group's parenteral support fell by 2.3 L/week.[¹] Structured fluid management and protocolised care produce real improvement on their own in this population. Teduglutide's benefit is the difference between the arms, not the full 4.4 L/week figure.

Regulatory status (US). FDA-approved as Gattex "for the treatment of adults and pediatric patients 1 year of age and older with Short Bowel Syndrome (SBS) who are dependent on parenteral support." That single indication covers both adults and children from 1 year; safety and effectiveness below 1 year of age are not established. Not DEA-scheduled.

Regulatory status (sport — WADA). Teduglutide is not named on the 2026 WADA Prohibited List (checked directly against the list text, 2026-08-04). Two class-level questions were checked rather than assumed: - S0 (Non-Approved Substances) applies only to substances with no current approval by any governmental regulatory health authority for human therapeutic use. Teduglutide holds approval, so S0 does not capture it. - S2.3 (Growth Factors and Growth Factor Modulators) is a real question for an intestinotrophic drug, so the clause was read verbatim. Its catch-all is limited to "other growth factors or growth factor modulators affecting muscle, tendon or ligament protein synthesis/degradation, vascularisation, energy utilization, regenerative capacity or fibre type switching." Teduglutide's trophic action is on intestinal mucosa, which is not among those tissues, and it is not in the S2.3 named list. It is therefore not captured.

Athletes should verify current status with their National Anti-Doping Organization.

Common research interests. Teduglutide is discussed mainly as (a) proof that a gut hormone analogue can measurably rebuild absorptive capacity in humans, and (b) the GLP-2 counterpart to the GLP-1 drugs. Neither of those extends to use as a general gut-repair compound, which has not been studied.

Commonly reported

• The distribution of treatment-emergent adverse events leading to study discontinuation was similar between groups — 2 patients on teduglutide versus 3 on placebo.[¹]
• The trial's overall conclusion was that 24 weeks of treatment was generally well tolerated.[¹]
• Gastrointestinal effects consistent with a drug acting on the gut — the review describes reduced diarrhea as part of the therapeutic effect.[²]
• Growth-related monitoring. Because the drug's mechanism is stimulating mucosal growth, gastrointestinal surveillance is part of how it is prescribed. This entry does not enumerate that monitoring; consult labeling and your prescriber.

This is a prescription medicine used for a serious condition under specialist supervision. Use outside that context is outside everything the evidence base covers.

Active or suspected gastrointestinal malignancy — a growth-promoting mechanism makes this the central caution; consult current labeling for the specific contraindications and screening requirements.

General gut-health, IBS, or "leaky gut" use — not studied, not approved, and not supported by any source in this entry.

Pregnancy and lactation — refer to current labeling; not addressed by the trials cited here.

Pediatric use — the pivotal trial cited here enrolled adults and adolescents, but the approved age range is broader: the label covers pediatric patients 1 year of age and older. Safety and effectiveness in children under 1 year are not established.

Regulatory note (sport): not named on the 2026 WADA Prohibited List, not captured by S0 (approved medicine), and not captured by S2.3 (that clause covers muscle, tendon, and ligament effects only). Verify with your anti-doping organization.

Not DEA-scheduled.

Peptide

A short chain of amino acids, the building blocks of proteins. Many compounds in this library are peptides.

GLP-2 (glucagon-like peptide-2)

A natural hormone released by the gut after eating that signals the intestinal lining to grow and absorb more. It is a close relative of GLP-1, the hormone behind the weight-management medicines.

Short bowel syndrome

A condition where so much intestine has been removed or is not working that the body cannot absorb enough nutrients and fluid from food alone.

Parenteral support

Nutrition and fluid delivered directly into a vein rather than through the digestive system. Life-sustaining, but burdensome and carrying real risks of infection and liver problems over time.

Intestinotrophic

Causing the intestinal lining to grow. That is teduglutide's intended effect — and also the reason its safety monitoring focuses on the gut.

1. Jeppesen PB, Pertkiewicz M, Messing B, Iyer K, Seidner DL, O'Keefe SJD, Forbes A, Heinze H, Joelsson B. (2012). Teduglutide reduces need for parenteral support among patients with short bowel syndrome with intestinal failure. Gastroenterology, 143(6):1473–1481.e3.(PMID 22982184 · NCT00798967)
2. Nørholk LM, Holst JJ, Jeppesen PB. (2012). Treatment of adult short bowel syndrome patients with teduglutide. Expert Opinion on Pharmacotherapy, 13(2):235–243.(PMID 22224470)

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• BPC-157 — shared research area
• GHK-Cu — shared research area
• GLOW — shared research area