teduglutide teduglutide teduglutide (brand names gattex in the us and revestive in europe) is a 33-membered polypeptide and glucagon-like peptide-2 (glp-2) analog that is used for the treatment of short bowel syndrome. it works by promoting mucosal growth and possibly restoring gastric emptying and secretion. in europe it has been granted orphan drug status and is marketed under the brand revestive by nycomed. it was approved by the united states under the name gattex on 21 december 2012, where it was given status as an orphan drug. teduglutideclinical datatrade namesgattex, revestiveahfs/drugs.comgattexlicense data eu ema: by inn us dailymed: teduglutide routes ofadministrationsubcutaneous injectionatc codea16ax08 (who) legal statuslegal status au: s4 (prescription only) us: ℞-only pharmacokinetic databioavailability88%metabolismproteolysiselimination half-life2 hidentifiers iupac name l-histidylglycyl-l-α-aspartylglycyl-l-seryl-l-phenylalanyl-l-seryl-l-α-aspartyl-l-α-glutamyl-l-methionyl-l-asparaginyl-l-threonyl-l-isoleucyl-l-leucyl-l-α-aspartyl-l-asparaginyl-l-leucyl-l-alanyl-l-alanyl-l-arginyl-l-α-aspartyl-l-phenylalanyl-l-isoleucyl-l-asparaginyl-l-tryptophyl-l-leucyl-l-isoleucyl-l-glutaminyl-l-threonyl-l-lysyl-l-isoleucyl-l-threonyl-l-aspartic acid cas number197922-42-2pubchem cid16139605iuphar/bps7049chemspider17296109unii7m19191ikgkeggd06053 ychebichebi:72305 ychemical and physical dataformulac164h252n44o55smolar mass3752.13 g·mol−13d model (jsmol)interactive image smiles cc(c)(nc(=o)(cc(c)c)nc(=o)(cc1cc2ccccc12)nc(=o)(cc(n)=o)nc(=o)(nc(=o)(cc1ccccc1)nc(=o)(cc(o)=o)nc(=o)(cccnc(n)=n)nc(=o)(c)nc(=o)(c)nc(=o)(cc(c)c)nc(=o)(cc(n)=o)nc(=o)(cc(o)=o)nc(=o)(cc(c)c)nc(=o)(nc(=o)(nc(=o)(cc(n)=o)nc(=o)(ccsc)nc(=o)(ccc(o)=o)nc(=o)(cc(o)=o)nc(=o)(co)nc(=o)(cc1ccccc1)nc(=o)(co)nc(=o)cnc(=o)(cc(o)=o)nc(=o)cnc(=o)(n)cc1cnc1)(c)o)(c)cc)(c)cc)c(=o)n(ccc(n)=o)c(=o)n((c)o)c(=o)n(ccccn)c(=o)n((c)cc)c(=o)n((c)o)c(=o)n(cc(o)=o)c(o)=o inchi inchi=1s/c164h252n44o55s/c1-21-77(11)126(156(255)187-95(44-46-114(167)214)141(240)206-130(83(17)211)160(259)186-93(42-33-34-49-165)140(239)202-129(80(14)24-4)159(258)208-131(84(18)212)161(260)200-111(163(262)263)66-125(230)231)203-151(250)100(54-76(9)10)189-145(244)103(57-88-67-175-92-41-32-31-40-90(88)92)192-147(246)105(60-116(169)216)199-157(256)127(78(12)22-2)204-152(251)102(56-87-38-29-26-30-39-87)190-149(248)109(64-123(226)227)195-137(236)94(43-35-50-174-164(171)172)183-134(233)82(16)179-133(232)81(15)180-142(241)98(52-74(5)6)188-146(245)104(59-115(168)215)194-150(249)110(65-124(228)229)196-143(242)99(53-75(7)8)198-158(257)128(79(13)23-3)205-162(261)132(85(19)213)207-153(252)106(61-117(170)217)193-139(238)97(48-51-264-20)185-138(237)96(45-47-120(220)221)184-148(247)108(63-122(224)225)197-155(254)113(72-210)201-144(243)101(55-86-36-27-25-28-37-86)191-154(253)112(71-209)182-119(219)70-177-136(235)107(62-121(222)223)181-118(218)69-176-135(234)91(166)58-89-68-173-73-178-89/h25-32,36-41,67-68,73-85,91,93-113,126-132,175,209-213h,21-24,33-35,42-66,69-72,165-166h2,1-20h3,(h2,167,214)(h2,168,215)(h2,169,216)(h2,170,217)(h,173,178)(h,176,234)(h,177,235)(h,179,232)(h,180,241)(h,181,218)(h,182,219)(h,183,233)(h,184,247)(h,185,237)(h,186,259)(h,187,255)(h,188,245)(h,189,244)(h,190,248)(h,191,253)(h,192,246)(h,193,238)(h,194,249)(h,195,236)(h,196,242)(h,197,254)(h,198,257)(h,199,256)(h,200,260)(h,201,243)(h,202,239)(h,203,250)(h,204,251)(h,205,261)(h,206,240)(h,207,252)(h,208,258)(h,220,221)(h,222,223)(h,224,225)(h,226,227)(h,228,229)(h,230,231)(h,262,263)(h4,171,172,174)/t77-,78-,79-,80-,81-,82-,83+,84+,85+,91-,93-,94-,95-,96-,97-,98-,99-,100-,101-,102-,103-,104-,105-,106-,107-,108-,109-,110-,111-,112-,113-,126-,127-,128-,129-,130-,131-,132-/m0/s1 ykey:cilixqojundidu-asqigdhwsa-n y (verify) medical uses up to a certain point, the gut can adapt to partial resections that result in short bowel syndrome. still, parenteral substitution of water, minerals and vitamins (depending on which part of the gut has been removed) is often necessary. teduglutide may reduce or shorten the necessity of such infusions by improving the intestinal mucosa and possibly by other mechanisms. adverse effects common adverse effects in clinical studies included abdominal discomfort (49% of patients), respiratory infections (28%), nausea (27%) and vomiting (14%), local reactions at the injection site (21%), and headache (17%). chemistry and mechanism of action teduglutide differs from natural glp-2 by a single amino acid: an alanine is replaced with a glycine. this blocks breaking down of the molecule by dipeptidyl peptidase and increases its half-life from seven minutes (glp-2) to about two hours, while retaining its biological actions. these include maintenance of the intestinal mucosa, increasing intestinal blood flow, reducing gastrointestinal motility and secretion of gastric acid.