Teduglutide
Metabolic
ABOUT
Teduglutide is a GLP-2 analogue approved as Gattex for short bowel syndrome in patients dependent on parenteral support. It is the only approved GLP-2 receptor agonist.
EVIDENCE OVERVIEW
Supported by controlled human trials
WHAT THIS MEANS
Established. Review the research and limitations before relying on this record.
IDENTITY
HALF-LIFE
HOW IT IS THOUGHT TO WORK
A recombinant 33-amino-acid analogue of human GLP-2 differing by a single glycine-for-alanine substitution at position 2. That substitution resists DPP-4 degradation, extending half-life from roughly 7 minutes for native GLP-2 to about 2 hours. It increases villus height and crypt depth in the intestinal epithelium, enlarging absorptive surface area.
PHARMACOKINETICS
Elimination half-life approximately 2 hours in healthy subjects and about 1.3 hours in adults with short bowel syndrome. Given once daily by subcutaneous injection at 0.05 mg/kg.
REVIEW
PUBLISHED PAIR RECORDS
with Liraglutide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Liraglutide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Exenatide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Exenatide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Dulaglutide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Dulaglutide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Pramlintide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Pramlintide works in the opposite direction on the same variable - amylin-analogue labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Semaglutide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Semaglutide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Tirzepatide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Tirzepatide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Retatrutide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Retatrutide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. The metabolic agent in this pair is investigational, so no labelled combination guidance exists for it. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Survodutide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Survodutide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. The metabolic agent in this pair is investigational, so no labelled combination guidance exists for it. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Mazdutide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Mazdutide works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. The metabolic agent in this pair is investigational, so no labelled combination guidance exists for it. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Cagrilintide
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Cagrilintide works in the opposite direction on the same variable - amylin-analogue labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. The metabolic agent in this pair is investigational, so no labelled combination guidance exists for it. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Native GIP
Opposing effects on intestinal absorptionTeduglutide is a GLP-2 analogue that increases villus height and crypt depth, enlarging absorptive surface area; its labelling records a potential for increased absorption of concomitant oral medicines and advises monitoring where a drug is titrated or has a narrow therapeutic index, since the oral drug may need its dose reduced. Native GIP works in the opposite direction on the same variable - incretin-pathway labelling and pharmacology describe delayed gastric emptying, which slows the rate at which an oral medicine reaches the small intestine. One agent is enlarging the absorptive surface while the other is changing the timing of delivery to it, so the net effect on any co-administered oral medicine is not predictable from either alone. The metabolic agent in this pair is investigational, so no labelled combination guidance exists for it. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with MK-677
Increased absorption of an orally dosed compoundTeduglutide labelling states that, because it enlarges intestinal absorptive capacity, there is a potential for increased absorption of concomitant oral medicines, and directs prescribers to monitor any oral drug that is titrated or has a narrow therapeutic index because it may need a dose reduction. MK-677 is taken orally, so it falls inside that statement. MK-677 is orally active with sustained once-daily dosing, so a change in absorbed fraction shifts exposure across the whole dosing interval rather than producing a single altered peak. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with noopept
Increased absorption of an orally dosed compoundTeduglutide labelling states that, because it enlarges intestinal absorptive capacity, there is a potential for increased absorption of concomitant oral medicines, and directs prescribers to monitor any oral drug that is titrated or has a narrow therapeutic index because it may need a dose reduction. Noopept is taken orally, so it falls inside that statement. No human oral pharmacokinetic profile has been established for this compound, so the size of any change in absorbed amount is uncharacterised rather than known to be small. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Larazotide acetate
Increased absorption of an orally dosed compoundTeduglutide labelling states that, because it enlarges intestinal absorptive capacity, there is a potential for increased absorption of concomitant oral medicines, and directs prescribers to monitor any oral drug that is titrated or has a narrow therapeutic index because it may need a dose reduction. Larazotide acetate is taken orally, so it falls inside that statement. Larazotide is the sharpest case in this catalogue: it is an enteric-coated oral peptide whose whole design assumes release at a particular point in the small intestine and minimal systemic absorption, and it acts on the same intestinal barrier teduglutide remodels. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with 5-amino-1mq
Increased absorption of an orally dosed compoundTeduglutide labelling states that, because it enlarges intestinal absorptive capacity, there is a potential for increased absorption of concomitant oral medicines, and directs prescribers to monitor any oral drug that is titrated or has a narrow therapeutic index because it may need a dose reduction. 5-Amino-1MQ is taken orally, so it falls inside that statement. No human oral pharmacokinetic profile has been established for this compound, so the size of any change in absorbed amount is uncharacterised rather than known to be small. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 21 Aug 2026with Kyinsu
Inherited from a component of this blendKyinsu contains Semaglutide, and the catalogue holds a curated pair record between that component and Teduglutide: Semaglutide (opposing effects on intestinal absorption). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with CagriSema
Inherited from a component of this blendCagriSema contains Semaglutide and Cagrilintide, and the catalogue holds a curated pair record between those components and Teduglutide: Semaglutide (opposing effects on intestinal absorption); Cagrilintide (opposing effects on intestinal absorption). Taking the blend therefore carries the same consideration as taking that component on its own, with the difference that a fixed-ratio vial cannot be adjusted independently of the rest of its contents. The evidence and citations here are the component record's; nothing has been studied about the blend itself. Peppy reports curated pharmacology, not a safety verdict. A prescriber or pharmacist should review any intended combination.
Reviewed 25 Aug 2026with Glepaglutide
Overlapping GLP-2 analogue activityGlepaglutide and teduglutide are GLP-2 analogues studied for short-bowel syndrome. Their clinical trials establish the shared target class, but Peppy did not identify a direct coadministration study. This is a meaningful class overlap, not evidence for combining the products.
Reviewed 8 Oct 2026HUMAN EVIDENCE
FDA-approved in December 2012 for adults with short bowel syndrome dependent on parenteral support, following the pivotal phase 3 STEPS trial in 86 adults, with the indication later extended to paediatric patients aged 1 year and older. It is approved in more than 30 countries. Longer-acting GLP-2 analogues (apraglutide, glepaglutide) are in development.
REPORTED EFFECTS
The central labelled risk follows directly from the mechanism: because it promotes intestinal mucosal growth, there is potential for acceleration of neoplastic growth, and colonoscopy with removal of polyps is required before starting and periodically thereafter. Other labelled warnings include intestinal obstruction, biliary and pancreatic disease requiring laboratory monitoring, and fluid overload. Abdominal pain, nausea, injection-site reactions and stoma complications are common.
RESEARCH LIMITATIONS
This is a source-backed summary, not a recommendation. Read the mechanism, pharmacokinetic, human-evidence and reported-effect fields separately: a mechanism is not an outcome. Availability, legal status and product quality differ by jurisdiction; consult a qualified clinician.
CURATED SOURCES · 2