Gattex: Dosage, side effects, uses, and more

Key takeaways

• Gattex (teduglutide) is a brand-name medication that is used to treat short bowel syndrome in adults and children ages 1 year and older who require intravenous fluids and nutrients.
• Gattex is administered via injection under the skin and helps the intestines absorb fluids and nutrients, potentially decreasing the need for intravenous support.
• Gattex can cause side effects and interact with other medications. Discuss your health history and any current prescriptions, supplements, and alcohol consumption with your doctor before starting treatment.

Gattex is a brand-name subcutaneous injection prescribed for short bowel syndrome (SBS). It contains the active ingredient teduglutide. (An active ingredient is what makes a medication work.)

Specifically, the Food and Drug Administration (FDA) has approved Gattex to treat SBS in adults and children ages 1 year and older.

With short bowel syndrome, your intestines are physically or functionally shorter than usual. This means your body can’t absorb oral fluids and nutrients effectively. Gattex is approved for people needing intravenous (IV) fluids and nutrients.

Drug details

Here are some key facts about Gattex:

• Drug class: glucagon-like peptide-2 (GLP-2) analog
• Drug form: powder in a single-dose vial that’s mixed with sterile water to make a solution suitable for subcutaneous injection
• Active ingredient: teduglutide
• Generic available? no
• Prescription required? yes
• Controlled substance? no
• Year of FDA approval: 2012

Gattex generic

Gattex is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active ingredient in a brand-name medication. Generics usually cost less than brand-name drugs.

The Food and Drug Administration (FDA) approves prescription drugs, such as Gattex, to treat certain conditions. Gattex may also be used off-label for other conditions. Off-label drug use is when an FDA-approved drug is prescribed for a purpose other than what it’s approved for.

Gattex for short bowel syndrome

Gattex is FDA approved to treat short bowel syndrome in people needing intravenous (IV) fluids and/or parenteral nutrition (IV nutrition). It’s approved for this use in adults and children ages 1 year and older.

With short bowel syndrome, your intestine is physically or functionally shorter than usual. This may be because you’ve had surgery to remove all or part of your small and/or large intestine, for example, to treat severe inflammatory bowel disease (IBD). It could also be due to other factors, such as illness or damage to your intestine, or a condition present from birth. With short bowel syndrome, your body can’t absorb oral fluids, nutrients, vitamins, and minerals effectively.

Symptoms of short bowel syndrome can include:

• diarrhea
• dehydration, which can cause dark urine, infrequent urination, and thirst
• bloating
• fatigue (low energy)
• weight loss
• malnutrition, which can cause dry skin and hair, muscle weakness and wasting, and untypical growth in children

Gattex helps your intestine absorb fluids and nutrients. This can reduce the amount of IV fluids and nutrition you need. For this purpose, your doctor may prescribe Gattex by itself or with other drugs.

Other drugs that may be used with Gattex include antidiarrheals, such as loperamide (Imodium), proton pump inhibitors, such as omeprazole (Prilosec), and oral rehydration solutions, such as Pedialyte.

Gattex and children

Gattex is FDA approved to treat short bowel syndrome in children ages 1 year and older who need to receive intravenous (IV) nutrients and fluids.

Gattex is not recommended for children who weigh less than 10 kg (about 22 lb).

The following information describes Gattex dosages that are commonly used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Gattex is administered by subcutaneous injection (injection under the skin). The medication comes in a kit that contains the components required to prepare and administer your Gattex injection. Your doctor or another healthcare professional will teach you or a caregiver how to do this at home.

The Gattex kit contains the following supplies:

• a single-dose vial containing 5 milligrams (mg) of Gattex powder
• a prefilled, single-dose diluent syringe containing 0.5 milliliters (mL) of sterile water for injection
• a separate needle to attach to the diluent syringe
• a dosing syringe with an attached needle for administering Gattex
• alcohol swabs

To prepare Gattex, first attach the separate needle to the diluent syringe. Then, inject the water from the diluent syringe into the vial to dissolve the powder. This makes a solution of Gattex with a strength of 5 mg per 0.5 mL (10 mg/mL).

To administer Gattex, you’ll use the dosing syringe to withdraw the prescribed dose of Gattex from the prepared vial and give the injection.

Dosage for short bowel syndrome

Gattex treats short bowel syndrome in adults and children ages 1 year and older.

The recommended dosage is 0.05 mg of Gattex per 1 kilogram (kg) of body weight, injected once per day. (1 kg is about 2.2. pounds [lb].)

Here are some example dosages:

• for an adult weighing 70 kg (about 154 lb), a usual dosage would be 3.5 mg (0.35 mL) injected once per day
• for a young child weighing 20 kg (about 44 lb), a usual dosage would be 1 mg (0.1 mL) injected once per day

Note that if your prescribed dose is more than 3.8 mg per day, you will need to use more than one vial of Gattex for your dose.

Children’s dosage

Gattex treats short bowel syndrome in children ages 1 year and older. The recommended dosage for children is the same as for adults.

Gattex is not recommended for children who weigh less than 10 kg (about 22 lb).

Dosage adjustment for kidney problems

If you have kidney problems, your doctor may prescribe a lower daily dose (half the usual dose) because Gattex can stay in your body longer.

Gattex should be administered by subcutaneous injection (injection under the skin). The injection should be given in the abdomen, front of the thigh, or upper arm.

Your doctor or another healthcare professional will teach you how to prepare and self-inject Gattex. Or they can teach your caregiver how to do this. Note that children should not self-inject Gattex. Instead, a nurse, other healthcare professional, or a trained adult (parent or caregiver) should give the injections.

The Gattex injection kit comes with detailed instructions for use. You can also find step-by-step preparation and administration instructions in a video on the manufacturer’s website.

You should inject Gattex in a different place each day. This is called rotating your injection site. It helps prevent injection site reactions. Avoid injecting Gattex into areas of skin that are sore, bruised, damaged, discolored, hard, or have moles or scars.

About using Gattex

The following information highlights key dosage issues.

• When to administer: You should administer Gattex once per day. Using the medication around the same time of day helps keep a steady level of the drug in your body. This helps Gattex work effectively.
• If you miss a dose: If you miss a dose, inject the missed dose as soon as possible that day. If you don’t remember until the next day, skip the missed dose and administer your next dose as usual. Don’t administer two doses on the same day.
• Length of use: Gattex is meant to be a long-term treatment. If you and your doctor determine that Gattex is safe and effective for you, you’ll likely take it long term.
• Length of time to work: Gattex starts working soon after you inject it.

Gattex can cause mild or serious side effects. The following lists contain some of the key side effects that may occur during Gattex treatment. These lists do not include all possible side effects.

For more information about the possible side effects of Gattex, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may concern or bother you.

Note: After the FDA approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medications safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while using Gattex and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Mild side effects

The following list highlights some mild side effects of Gattex. To learn about other mild side effects, talk with your doctor or pharmacist or view Gattex’s prescribing information.

Mild side effects of Gattex can include:

• abdominal pain
• nausea and vomiting
• bloating
• flatulence (gas)
• upper respiratory infection, such as the common cold or flu
• injection site reactions, such as pain, swelling, discoloration, or rash
• reduced appetite

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Gattex aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening, or you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• cholecystitis (gallbladder inflammation), gallstones, or pancreatitis (pancreas inflammation), which may cause symptoms such as: abdominal pain or swelling nausea and vomiting sweating loss of appetite fever or chills
• abdominal pain or swelling
• nausea and vomiting
• sweating
• loss of appetite
• fever or chills
• blockage in the intestine, which may cause symptoms such as: nausea and vomiting abdominal pain or swelling trouble passing gas or stool
• nausea and vomiting
• abdominal pain or swelling
• trouble passing gas or stool
• fluid overload, which may cause symptoms such as: swelling of the lower legs, feet, arms, or hands shortness of breath sudden weight gain
• swelling of the lower legs, feet, arms, or hands
• shortness of breath
• sudden weight gain
• polyps (growths) in the stomach or intestine, which may cause symptoms such as: blood in the stool, which may be red or black bleeding from the rectum abdominal cramps or pain
• blood in the stool, which may be red or black
• bleeding from the rectum
• abdominal cramps or pain
• increased growth of abnormal cells, which can raise your risk of developing cancer

ALLERGIC REACTION For some people, Gattex injection can cause an allergic reaction. In general, symptoms of allergic reaction can be mild or serious. Ways to manage For mild allergic reaction symptoms, such as a mild rash, call your doctor right away. They may recommend treatments to help manage your symptoms. They’ll also let you know whether you should keep taking the medication. For severe allergic reaction symptoms, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms require immediate medical care because they can become life threatening. If you’ve had a serious allergic reaction to Gattex, your doctor may recommend taking a different medication instead.

Gattex can interact with several other medications.

Before starting Gattex treatment, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

Interactions with medications

The table below indicates the medications that can interact with Gattex. This list does not contain all drugs that may interact with Gattex. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Medications that can interact with Gattex oral medications that have a small margin between an effective dose and a toxic dose, for example, benzodiazepines such as alprazolam (Xanax) or diazepam (Valium)

Alcohol interaction

It may not be safe to consume alcohol during Gattex treatment. Gattex may increase the amount of alcohol your body absorbs, which could increase its effects. Drinking alcohol can also worsen symptoms of short bowel syndrome, which Gattex treats.

If you have questions about the safety of drinking alcohol while taking Gattex, talk with your doctor or pharmacist.

As with all medications, the cost of Gattex can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Here are a few things to consider regarding Gattex and cost:

• Comparing pharmacies: The price of Gattex may vary depending on which pharmacy you use, so it can help to compare prices across pharmacies to find the lowest cost.
• Drug coupons: You may be able to find drug coupons on prescription discount websites that can reduce the cost of your medication. These coupons cannot be used with insurance copays or benefits, but the discounted price may be lower than what you would pay through insurance.
• Financial assistance: Some websites provide details about drug assistance programs, ways to make the most of your insurance coverage, and links to savings cards and other services. Two such websites are:

Also, the manufacturer of Gattex offers a cost savings program called Takeda Patient Support. For more information and to find out if you’re eligible for this program, call 866-888-0660 or visit the program website.

Optum Perks is owned by RVO Health. By clicking on this link, we may receive a commission. Learn more.

Other drugs are available that can treat short bowel syndrome (SBS). Some may be a better fit for you than others. If you’re interested in finding an alternative to Gattex, talk with your doctor. They can tell you about other medications that may work well for you.

The following drugs may be alternatives to Gattex:

• somatropin (Zorbtive)
• octreotide (Sandostatin)
• antidiarrheal medications, such as loperamide (Imodium) or codeine
• proton pump inhibitors, such as omeprazole (Prilosec) or lansoprazole (Prevacid)
• H2 blockers, such as ranitidine or famotidine
• bile-acid resins, such as cholestyramine (Prevalite, Locholest)
• pancreatic enzymes, such as pancrelipase (Creon, Pancrease, others)

If you can become pregnant, consider the following information about pregnancy, fertility, birth control, and breastfeeding.

Gattex and pregnancy

It is unknown whether Gattex should be taken during pregnancy. In animal studies, the drug didn’t cause fetal harm when given to pregnant females. However, studies in animals don’t always predict what will happen in humans.

There are risks with having unmanaged short bowel syndrome while pregnant. If you’re planning a pregnancy or can become pregnant, talk with your doctor about potential treatments for short bowel syndrome during pregnancy.

Together, you and your doctor can consider the risks and benefits of your treatment options and decide whether or not you should use Gattex during pregnancy.

Gattex and birth control

It is unknown if Gattex is safe to use during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Gattex.

Gattex and breastfeeding

Breastfeeding is not recommended while using Gattex. It is unknown if the drug passes into breast milk, but if it does, it could cause serious side effects in a child who’s breastfed. If you’re currently breastfeeding or planning to do so, talk with your doctor before using this medication. Your doctor may recommend other ways to feed a child who is breastfed during treatment with Gattex.

Gattex treats short bowel syndrome in people needing intravenous (IV) fluids and/or parenteral nutrition (IV nutrition).

What happens with short bowel syndrome

With short bowel syndrome, all or part of your small and/or large intestine has been surgically removed or is not working due to damage or disease.

When you eat or drink, your small intestine usually produces a hormone called glucagon-like peptide-2 (GLP-2). GLP-2 helps your intestine to absorb the fluids and nutrients you have consumed.

Without enough functioning small intestine, you may not make enough GLP-2. This can stop the rest of your intestine from effectively absorbing oral fluids, nutrients, vitamins, and minerals. As a result, you may have diarrhea, dehydration, malnutrition, and weight loss.

To help prevent these problems, your doctor may prescribe IV fluids and nutrition that are administered directly into your bloodstream. However, these treatments can cause certain complications, such as infections and kidney or liver problems.

What Gattex does

Gattex is a type of drug called a GLP-2 analogue. It mimics the action of GLP-2 in your body. This helps your intestine to absorb fluids and nutrients. In turn, this can reduce the amount of IV fluids and nutrients that you need.

The way a drug works is called its mechanism of action.

Before starting Gattex treatment, discuss your health history with your doctor. Gattex may not be right for you if you have certain medical conditions or other factors affecting your health. Be sure to talk with your doctor if any of the following apply to you:

• history or risk of cancer
• polyps (growths) in your stomach or intestine
• heart problems
• high blood pressure
• pancreas or gallbladder problems
• kidney problems
• previous allergic reaction to this or a similar drug
• pregnancy
• breastfeeding

Do not use more Gattex than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Gattex

If you think you’ve injected too much Gattex, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number or go to the nearest emergency room right away.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.