Identification

Logo pink
Are you a
new drug developer?
Contact us to learn more about our customized products and solutions.
Logo pink
Stay in the know!
As part of our commitment to providing the most up-to-date drug information, we will be releasing #DrugBankUpdates with our newly added curated drug pages.
#DrugBankUpdates
Name
Teduglutide
Accession Number
DB08900
Type
Biotech
Groups
Approved
Biologic Classification
Protein Based Therapies
Other protein based therapies
Description

Teduglutide is a glucagon-like peptide-2 (GLP-2) analogue. It is made up of 33 amino acids and is manufactured using a strain of Escherichia coli modified by recombinant DNA technology. Teduglutide differs from GLP-2 by one amino acid (alanine is substituted by glycine). The significance of this substitution is that teduglutide is longer acting than endogenous GLP-2 as it is more resistant to proteolysis from dipeptidyl peptidase-4. FDA approved on December 21, 2012.

Protein chemical formula
C164H252N44O55S
Protein average weight
3752.0 Da
Sequences
>Protein sequence for teduglutide
HGDGSFSDEMNTILDNLAARDFINWLIQTKITD
Download FASTA Format
Synonyms
  • (Gly2)GLP-2
  • Glucagon-like peptide II (2-glycine) (human)
  • Gly(2)-GLP-2
  • Teduglutida
  • Teduglutide
  • Teduglutide [rDNA origin]
  • Teduglutide Recombinant
External IDs
ALX 0600 / ALX-0600
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
GattexInjection, powder, lyophilized, for solution5 mg/0.5mLSubcutaneousShire-NPS Pharmaceuticals, Inc.2012-12-21Not applicableUs
RevestiveKit; Powder, for solutionSubcutaneousShire Pharmaceuticals Ireland Limited2015-10-28Not applicableCanada
RevestiveInjection, powder, for solution5 mgSubcutaneousShire2012-08-30Not applicableEu
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

    Learn more
  • Product Code
    Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

    Learn more
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
GattexTeduglutide (5 mg/0.5mL) + Ethanol (0.7 mL/1mL)KitTopicalShire-NPS Pharmaceuticals, Inc.2012-12-21Not applicableUs
GattexTeduglutide (5 mg/0.5mL) + Ethanol (0.7 mL/1mL)KitTopicalShire-NPS Pharmaceuticals, Inc.2012-12-21Not applicableUs
Categories
UNII
7M19191IKG
CAS number
197922-42-2

Pharmacology

Indication

Treatment of short bowel syndrome (SBS), malabsorption associated with the removal of the intestine, in adults patients who are dependent on parenteral support.

Associated Conditions
Pharmacodynamics

An enhancement of gastrointestinal fluid absorption (750-1000 mL/day) was observed following daily administrations of teduglutide. An increase in villus height and crypt depth of the intestinal mucosa was also noted. A decrease in fecal weight has also been observed. Teduglutide does not prolong the QTc interval.

Mechanism of action

Teduglutide is an analog of naturally occurring human glucagon-like peptide-2 (GLP-2), a peptide secreted by L-cells of the distal intestine in response to meals. GLP-2 increases intestinal and portal blood flow and inhibit gastric acid secretion. Teduglutide binds to the glucagon-like peptide-2 receptors located in enteroendocrine cells, subepithelial myofibroblasts and enteric neurons of the submucosal and myenteric plexus. This causes the release of insulin-like growth factor (IGF)-1, nitric oxide and keratinocyte growth factor (KGF). These growth factors may contribute to the increase in crypt cell growth and surface area of the gastric mucosa. Ultimately, absorption through the intestine is enhanced.

TargetActionsOrganism
AGlucagon-like peptide 2 receptor
agonist
Humans
Additional Data Available
Adverse Effects

Comprehensive structured data on known drug adverse effects with statistical prevalence. MedDRA and ICD10 ids are provided for adverse effect conditions and symptoms.

Learn more
Additional Data Available
Contraindications

Structured data covering drug contraindications. Each contraindication describes a scenario in which the drug is not to be used. Includes restrictions on co-administration, contraindicated populations, and more.

Learn more
Additional Data Available
Blackbox Warnings

Structured data representing warnings from the black box section of drug labels. These warnings cover important and dangerous risks, contraindications, or adverse effects.

Learn more
Absorption

The pharmacokinetic profile of teduglutide (when administered subcutaneously) is described by a one-compartment model with first order absorption in the abdomen, arm, and thigh. With escalating doses, teduglutide demonstrates linear pharmacokinetics. Absolute bioavailability, SubQ = 88%; Tmax, SubQ = 3-5 hours;
Cmax, 0.05 mg/kg SubQ, SBS patients = 36 ng/mL; AUC, 0.05 mg/kg SubQ, SBS patients = 0.15 µg•hr/mL; Teduglutide does not accumulate following multiple subcutaneous administrations.

Volume of distribution

Vd, healthy subjects = 103 mL/kg

Protein binding
Not Available
Metabolism

Although a formal investigation has not been conducted, it is expected because teduglutide is a peptide-based drug, it will be degraded into smaller peptides and amino acids via catabolic pathways. The cytochrome P450 enzyme system is not involved in the metabolism of this drug.

Route of elimination

Urine

Half life

Terminal half-life, healthy subjects = 2 hours; Terminal half-life, SBS patients = 1.3 hours

Clearance

Plasma clearance, healthy subjects = 123 mL/hr/kg; This value indicates that teduglutide is primarily cleared by the kidney.

Toxicity

The most common adverse reactions (≥ 10%) across all studies with GATTEX are abdominal pain, injection site reactions, nausea, headaches, abdominal distension, upper respiratory tract infection. In addition, vomiting and fluid overload were reported in the SBS studies (1 and 3) at rates ≥ 10%.

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Teduglutide which could result in a higher serum level.
AcarboseAcarbose may decrease the excretion rate of Teduglutide which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Teduglutide which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Teduglutide which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Teduglutide which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Teduglutide which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Teduglutide which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Teduglutide which could result in a higher serum level.
AcrivastineTeduglutide may decrease the excretion rate of Acrivastine which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Teduglutide which could result in a higher serum level.
Additional Data Available
  • Extended Description
    Extended Description

    Extended description of the mechanism of action and particular properties of each drug interaction.

    Learn more
  • Severity
    Severity

    A severity rating for each drug interaction, from minor to major.

    Learn more
  • Evidence Level
    Evidence Level

    A rating for the strength of the evidence supporting each drug interaction.

    Learn more
  • Action
    Action

    An effect category for each drug interaction. Know how this interaction affects the subject drug.

    Learn more
Food Interactions
Not Available

References

General References
  1. Burness CB, McCormack PL: Teduglutide: a review of its use in the treatment of patients with short bowel syndrome. Drugs. 2013 Jun;73(9):935-47. doi: 10.1007/s40265-013-0070-y. [PubMed:23729002]
  2. Semrad CE: The long road to a new short-bowel therapy: teduglutide for clinical use. Clin Gastroenterol Hepatol. 2013 Jul;11(7):824-5. doi: 10.1016/j.cgh.2013.03.030. Epub 2013 Apr 13. [PubMed:23591284]
  3. Jeppesen PB: Teduglutide, a novel glucagon-like peptide 2 analog, in the treatment of patients with short bowel syndrome. Therap Adv Gastroenterol. 2012 May;5(3):159-71. doi: 10.1177/1756283X11436318. [PubMed:22570676]
External Links
KEGG Drug
D06053
KEGG Compound
C16049
PubChem Substance
347910383
ChEBI
72305
ChEMBL
CHEMBL2104987
RxList
RxList Drug Page
Drugs.com
Drugs.com Drug Page
Wikipedia
Teduglutide
ATC Codes
A16AX08 — Teduglutide
AHFS Codes
  • 56:92.00 — Miscellaneous GI Drugs
FDA label
Download (410 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1CompletedNot AvailableHealthy Volunteers1
1CompletedNot AvailablePharmacokinetics and Safety of Elevated Doses1
1CompletedNot AvailableImpaired kidney function1
1CompletedOtherHepatic Impairment1
1CompletedTreatmentHealthy Volunteers1
1RecruitingTreatmentPostoperative Fistula1
2CompletedTreatmentCrohn's Disease (CD)2
2Not Yet RecruitingTreatmentSevere Acute Malnutrition1
2RecruitingTreatmentHuman Immunodeficiency Virus (HIV)1
2, 3Not Yet RecruitingBasic ScienceHyperlipidemias1
2, 3RecruitingBasic ScienceHyperlipidemias3
3Active Not RecruitingTreatmentShort Bowel Syndrome (SBS)4
3CompletedTreatmentShort Bowel Syndrome (SBS)9
3Enrolling by InvitationTreatmentShort Bowel Syndrome (SBS)1
3Not Yet RecruitingTreatmentIleostomy - Stoma1
3RecruitingTreatmentShort Bowel Syndrome (SBS)1
4CompletedTreatmentShort Bowel Syndrome (SBS)1
4RecruitingTreatmentShort Bowel Syndrome (SBS)1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
Injection, powder, lyophilized, for solutionSubcutaneous5 mg/0.5mL
KitTopical
Injection, powder, for solutionSubcutaneous5 mg
Kit; powder, for solutionSubcutaneous
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)
US5789379Yes1998-08-042020-10-14Us
US7056886Yes2006-06-062023-03-18Us
US7847061Yes2010-12-072026-05-01Us
US9060992Yes2015-06-232026-05-01Us
US9555079Yes2017-01-312026-05-01Us
US9545434Yes2017-01-172026-05-01Us
US9539310Yes2017-01-102026-05-01Us
US9545435Yes2017-01-172026-05-01Us
US9592273Yes2017-03-142026-05-01Us
US9592274Yes2017-03-142026-05-01Us
US9572867Yes2017-02-212026-05-01Us
US9987334Yes2018-06-052026-05-01Us
US9968658Yes2018-05-152026-05-01Us
US9981016Yes2018-05-292026-05-01Us
US9974837Yes2018-05-222026-05-01Us
US9974835Yes2018-05-222026-05-01Us
US9981014Yes2018-05-292026-05-01Us
US9968656Yes2018-05-152026-05-01Us
US9968655Yes2018-05-152026-05-01Us
US9987335Yes2018-06-052026-05-01Us
US9993528Yes2018-06-122026-05-01Us
Additional Data Available
  • Filed On
    Filed On

    The date on which a patent was filed with the relevant government.

    Learn more

Properties

State
Liquid
Experimental Properties
Not Available

Taxonomy

Description
Not Available
Kingdom
Organic Compounds
Super Class
Organic Acids
Class
Carboxylic Acids and Derivatives
Sub Class
Amino Acids, Peptides, and Analogues
Direct Parent
Peptides
Alternative Parents
Not Available
Substituents
Not Available
Molecular Framework
Not Available
External Descriptors
Not Available

Targets

Kind
Protein
Organism
Humans
Pharmacological action
Yes
Actions
Agonist
General Function
Glucagon receptor activity
Specific Function
This is a receptor for glucagon-like peptide 2. The activity of this receptor is mediated by G proteins which activate adenylyl cyclase.
Gene Name
GLP2R
Uniprot ID
O95838
Uniprot Name
Glucagon-like peptide 2 receptor
Molecular Weight
63000.84 Da
References
  1. Burness CB, McCormack PL: Teduglutide: a review of its use in the treatment of patients with short bowel syndrome. Drugs. 2013 Jun;73(9):935-47. doi: 10.1007/s40265-013-0070-y. [PubMed:23729002]

Drug created on June 05, 2013 23:11 / Updated on December 08, 2019 20:10