teduglutide (rDNA origin)

(te-due-gloo-tide) ,


(trade name)


Therapeutic: temporary class
Pregnancy Category: B


Treatment of short bowel syndrome in adult patients who are dependent on parenteral nutrition.


Increases intestinal and portal blood flow, inhibits gastric acid secretion.
Binding to receptors causes release of insulin-like growth factor, nitric oxide and keratinocyte growth factor.

Therapeutic effects

Improved gastrointestinal absorption of fluids and nutrients with a decreased need for parenteral nutrition/IV support.


Absorption: 88% absorbed following subcutaneous administration.
Distribution: Unknown.
Metabolism and Excretion: Probably degraded into small peptides and amino acids; primarily renally eliminated.
Half-life: 2 hr.

Time/action profile (↓ in parenteral nutrition/IV volume need)

subcutwithin 1 mounknownunknown


Contraindicated in: Lactation: Breastfeeding should be avoided.
Use Cautiously in: Patients with history of or ↑ risk of gastrointestinal malignancy; Underlying cardiovascular disease (fluid overload may be problematic); CCr <50 mL/min (dose ↓ required); Biliary and pancreatic disease; Geriatric: Elderly patients may be ↑ sensitive to drug effects; Obstetric: Use during pregnancy only if clearly needed; Pediatric: Safety and effectiveness not established.

Adverse Reactions/Side Effects

Central nervous system

  • headache (most frequent)
  • sleep disturbances


  • cough


  • accelerated intestinal malignancy (life-threatening)
  • intestinal obstruction (life-threatening)
  • abdominal distention (most frequent)
  • abdominal pain (most frequent)
  • nausea (most frequent)
  • stoma complications (most frequent)
  • appetite disorders
  • cholangitis
  • cholecystitis
  • cholelithiasis
  • flatulence
  • pancreatitis

Fluid and Electrolyte

  • fluid overload (most frequent)


  • injection site reactions (most frequent)


  • hypersensitivity reactions


Drug-Drug interaction

May ↑absorption of orally administered medications; cautiously monitor drugs with narrow therapeutic indices or drugs requiring careful titration.


Subcutaneous (Adults) 0.05 mg/kg once daily.

Renal Impairment

Subcutaneous (Adults) CCr <50 mL/min—0.025 mg/kg once daily.


Lyophilized powder for reconstitution: 5 mg/vial with 0.5 mL Sterile Water for Injection in a pre-filled syringe

Nursing implications

Nursing assessment

  • Obtain a colonoscopy of entire colon with removal of polyps within 6 mo prior to starting teduglutide. Follow-up colonoscopy is recommended at end of 1 yr on teduglutide. If no polyps found, repeat at least every 5 yrs. If polyps found follow recommended guidelines.
  • Monitor for fluid overload, especially in patients with underlying cardiovascular disease; may require adjustment in parenteral support.
  • Lab Test Considerations: Monitor bilirubin, alkaline phosphatase, lipase, and amylase within 6 mo of starting and every 6 mo after starting therapy. If clinically meaningful ↑ occurs further diagnostic work-up is recommended.

Potential Nursing Diagnoses

Imbalanced nutrition: less than body requirements (Indications)


  • Reconstitute each vial with 0.5 mL of preservative-free Sterile Water for Injection slowly injected from pre-filled syringe. Allow vial to stand for 30 seconds, then gently roll between palms for 15 seconds; do not shake. Allow mixed contents to stand for 2 min. Inspect for undissolved powder and gently roll again until dissolved. If product remains undissolved after second attempt, do not use. Solution should be clear and colorless to light straw; do not administer solutions that are discolored or contain a precipitate. Vial contains 0.38 mL of reconstituted solution with up to 3.8 mg of teduglutide. Administer within 3 hrs of reconstitution. Store in refrigerator; do not freeze. Discard unused solution.
  • Subcutaneous: Inject subcut once daily in thighs, arms, and quadrants of the abdomen. Rotate sites daily. Do not inject IM or IV.
  • Discontinuation may result in fluid and electrolyte imbalance; monitor closely.

Patient/Family Teaching

  • Instruct patient in correct technique for injection and disposal of equipment. Take missed doses as soon as remembered in same day; do not take 2 doses in one day. Advise patient to read Medication Guide before starting and with each Rx refill in case of changes.
  • Advise patient that injection site reaction may occur, but if severe reaction or severe rash occurs, notify health care professional.
  • Inform patient of risk of accelerated neoplastic growth, colorectal polyps, and small bowel neoplasia. Advise patient to report signs and symptoms.
  • Advise patient to notify health care professional if signs and symptoms of intestinal obstruction (abdominal pain, swelling of stoma) occur. May require temporary discontinuation of teduglutide.
  • Instruct patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and consult health care professional before taking any new medications. Oral medications may be absorbed more completely and may require dose adjustment.
  • Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
  • Emphasize the importance of routine lab tests and colonoscopies to monitor for adverse effects.

Evaluation/Desired Outcomes

  • Improved gastrointestinal absorption of fluids and nutrients with a decreased need for parenteral nutrition/IV support.
Drug Guide, © 2015 Farlex and Partners
References in periodicals archive ?
Summary: [170 Pages Report] Peptide Based Gastrointestinal Disorders Therapeutics Market research report categorizes the global market By Drug (Teduglutide, Linaclotide), By Distribution Channel (Hospital Pharmacies, Retail Pharmacies, Online Pharmacies), & By Region (North America, Latin America, Europe, Japan, APEJ, MEA).
-- The Food and Drug Administration has approved extending the indication of Takeda Pharmaceuticals' Gattex (teduglutide) for injection to pediatric patients 1 year of age and older with short bowel syndrome (SBS) who need additional nutrition or fluids from intravenous (IV) feeding (parenteral support).
The United States Food and Drug Administration (FDA) has approved Japan-based Takeda Pharmaceuticals' extension of the indication of GATTEX (teduglutide) for injection to paediatric patients one year of age and older with Short Bowel Syndrome (SBS) who need additional nutrition or fluids from intravenous (IV) feeding, it was reported yesterday.
Global Banking News-May 20, 2019-Takeda Pharmaceuticals awarded US FDA approval for GATTEX (teduglutide) for children with short bowel syndrome
Teduglutide. In 2012, the FDA approved teduglutide (Gattex[R]), one of the most promising new therapies for SBS (Compher et al., 2016).
In medication, teduglutide was first approved by the FDA for short bowel syndrome disorder.
Treatment with the glucagon-like peptide 2 (GLP-2) analog teduglutide is generally associated with clinically significant reductions ([greater than or equal to]20% from baseline) in the parenteral nutrition (PN) volume in adult patients with short bowel syndrome (SBS) (1,2).
General medications to treat short bowel syndrome include antibiotics to prevent bacterial overgrowth, H2 blockers to treat too much gastric acid secretion, proton pump inhibitors to treat too much gastric acid secretion, choleretic agents to improve bile flow and prevent liver disease, bile-salt binders to decrease diarrhea, anti-secretin agents to reduce gastric acid in the intestine, hypomotility agents to increase the time it takes food to travel through the intestines, leading to increased nutrient absorption, growth hormones to improve intestinal absorption, teduglutide to improve intestinal absorption.
Recently, recombinant human glucagon-like peptide- (GLP-) 2 analog (teduglutide) has been shown to reduce the volume and the number of days of TPN support [26-28].
(2012) Teduglutide, a glucagon-like peptide 2 analogue: a novel protective agent with anti-apoptotic and anti-oxidant properties in mice with lung injury.
GLP-2 analogue (teduglutide) is approved for treatment of short bowel