Gattex
Gattex (teduglutide) is an injectable medication used by people with short bowel syndrome (SBS) to help lower the amount of nutrition they need to get intravenously (IV), meaning through the veins. It's injected under the skin, but it can be difficult to use for some people because the injection requires a lot of steps. Some people might see results in as early as 1 month, but it can take over a year for others. It's only available as a brand medication, so it can be expensive.
What is Gattex (teduglutide)?
What is Gattex (teduglutide) used for?
Treatment of adults and children ages 1 year and older (and weighing at least 22 lbs) with SBS who are dependent on IV nutrition
How Gattex (teduglutide) works
Gattex (teduglutide) is a glucagon-like peptide-2 (GLP-2) analog. This means it acts like GLP-2, a chemical made by your body. GLP-2 helps more blood to flow to your intestines. It also helps your body absorb nutrients when you eat.
People with SBS have damage to their intestines that prevents them from absorbing enough nutrients from the food they eat. This means that many people with SBS have to get their nutrients from a tube placed in their vein (known as IV nutrition). Gattex (teduglutide) helps people with SBS absorb more nutrients through the food they eat and can help lower the amount of IV nutrition they require.
Drug Facts
What are the side effects of Gattex (teduglutide)?
Common Side Effects
- Stomach pain (30%)
- Nausea (23%)
- Sore throat, stuffy nose, or cough (21%)
- Stomach swelling (20%)
- Pain, swelling, or redness at injection site (13%)
Other Side Effects
- Vomiting
- Fluid buildup
- Allergic reactions (e.g. rash, itching, swelling)
- Gas
- Lower appetite
- Cough
- Sleep problems
Serious Side Effects
- Blockage of the intestines: trouble going to the bathroom or passing gas, stomach pain or swelling, nausea, vomiting
- Blockage of the gallbladder or pancreas: stomach pain and tenderness,
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Bowel blockage—stomach cramping, unable to have a bowel movement or pass gas, loss of appetite, vomiting
- Gallbladder problems—severe stomach pain, nausea, vomiting, fever
- Pancreatitis—severe stomach pain that spreads to your back or gets worse after eating or when touched, fever, nausea, vomiting
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Bloating
- Nausea
- Pain, redness, or irritation at injection site
- Runny or stuffy nose
- Stomach pain
- Swelling of the ankles, hands, or feet
- Vomiting
Pros and cons of Gattex (teduglutide)
Pros
Can help people with SBS lower their dependency on IV nutrition
Can be given to children as young as 1 year old
Support program can help set up a training with a nurse to learn how to properly give the injection
Cons
Needs to be injected
Can cause abnormal growths in the colon, which can lead to cancer
Only available as a brand medication, so it can be expensive
Can take several months to see results
Pharmacist tips for Gattex (teduglutide)
Gattex (teduglutide) vials are stored in the refrigerator at the pharmacy but should be stored at room temperature once you receive them. They'll expire after 3 months at room temperature. The pharmacy should put a date on the vials to remind you when they should be used by. Throw away any vials that haven't been used by this date.
Be sure to watch the Gattex instructional video or read the instructions on how to prepare and inject this medication before you start. Gattex (teduglutide) comes as a powder for injection in a vial that should only be used once (single dose vial). The powder must be mixed with sterile water. All the supplies needed to mix and inject it should be provided in the medication kit.
Gattex (teduglutide) expires a short time after it's mixed, so use it within 3 hours after mixing. Throw away any unused medication that's been mixed, even if there's some left in the vial. Don't store any Gattex (teduglutide) you have mixed for later use.
Inject Gattex (teduglutide) once a day, at the same time each day. The medication should be injected under the skin in your stomach area, upper legs (thighs), or upper arms. Rotate between a few injection sites and choose a different site each day to prevent bruising, pain, or irritation. You can write down the location of each daily injection to help you keep track of where your next injection should be.
Wash your hands with soap and water, and dry with a clean towel before every Gattex (teduglutide) injection. Always wipe the injection site you choose with a new alcohol swab, and always use a new syringe and needle for each injection. Doing these things will help prevent an infection.
You can give yourself your own injection of Gattex (teduglutide). If your child is taking the medication, the injection should be given by you or another caregiver to ensure that it's given correctly.
Frequently asked questions about Gattex (teduglutide)
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What are the risks and warnings for Gattex (teduglutide)?
Gattex (teduglutide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Making abnormal cells grow faster
Gattex (teduglutide) can make cells in your body grow faster than normal. If you happen to have abnormal cells in your body, this means that there’s a higher chance that they can turn into cancer. If you find out that you have cancer of the intestines, liver, gallbladder or pancreas, your provider will stop Gattex (teduglutide). If you get other types of cancers, talk to your healthcare provider about whether or not it's safe to continue taking Gattex (teduglutide).
Gattex (teduglutide) can also cause polyps in the colon (large intestine), which can develop into cancer if they're not removed. Your provider will check for and remove any polyps before you start this medication. You’ll also need to have regular colonoscopies while you’re taking Gattex (teduglutide) to check for polyps.
Blockage of the intestines or stoma
Gattex (teduglutide) can raise your risk of getting a blockage in your intestines. This can prevent food, liquids, and gas from moving normally through your intestines. Tell your healthcare provider right away if you have trouble going to the bathroom or passing gas, pain or swelling in your stomach, nausea, or vomiting, because these could be signs of a blockage.
If you have a stoma, Gattex (teduglutide) can also cause swelling and blockage of your stoma opening. You'll need to stop taking the medication if a blockage occurs. But, your provider might advise you to restart it once the blockage goes away.
Gallbladder, bile duct, or pancreas problems
Gattex (teduglutide) can raise your risk of problems such as swelling or a blockage of your gallbladder or pancreas. Your healthcare provider will do tests to check your gallbladder and pancreas within 6 months before starting the medication and at least every 6 months while you're taking it. Tell your provider right away if you have stomach pain, chills, fever, nausea, vomiting, changes in your stool, or dark urine, because these could be signs that you have a blockage.
Too much fluid
Risk factors: Heart problems
Using Gattex (teduglutide) can raise the amount of fluid your body absorbs. This can cause your heart to have to work harder, which can lead to heart problems. Your provider might need to adjust the amount of IV nutrition you're getting to prevent too much fluid buildup in your body. Let your provider know if you experience symptoms of too much body fluid, such as trouble breathing or swelling of your arms or legs while taking Gattex (teduglutide).
Medication interactions (higher levels of some oral medications)
Risk factors: Taking medications that are sensitive to dose changes
Studies show that taking some benzodiazepines by mouth (orally) along with Gattex (teduglutide) can sometimes cause you to absorb more of the benzodiazepine, which can lead to problems such as confusion or even coma. Be careful taking Gattex (teduglutide) along with other medications (e.g. benzodiazepines) where small differences in dose can cause serious side effects. Talk to your provider about any other medications you take, especially if you feel more side effects from the medication than usual.
Gattex (teduglutide) dosage forms
Typical dosing for Gattex (teduglutide)
The dose of Gattex (teduglutide) depends on your weight. The typical dose is 0.05 mg/kg injected under the skin once daily.
Your dose might be lower if you have kidney problems.
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