Revertive

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Revertive

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Revertive

What is Revestive? (Teduglutide)

Property Description
Active ingredient Teduglutide
Form Lyophilised powder and solvent for solution for injection
Pharmacological class Alimentary Tract and Metabolism Products (GLP-2 Analogue)
Common use Intestinal rehabilitation
Origin Recombinant, synthetic polypeptide

Revestive: A Recombinant GLP-2 Analogue (Identity and Classification)

Revestive is a specialized, prescription-only medication classified within the group of alimentary tract and metabolism products. Its identity is centered on the active ingredient, Teduglutide, a biological substance. Teduglutide is a structural analogue of Glucagon-Like Peptide-2 (GLP-2), a natural hormone produced in the human gut. The medicine functions as an analogue for this naturally occurring gut hormone to stimulate specific physiological effects.

This medication is a synthetic polypeptide created using recombinant DNA technology. This specific origin and structure allow the drug Teduglutide to maintain resistance to degradation by the DPP-IV enzyme. This resistance enables the medication to sustain its biological effects on the intestinal lining for a therapeutically intended duration, distinguishing it from the rapidly degraded native hormone.


Composition and Form: Lyophilised Powder for Injection

The medication is supplied as a single active ingredient product in the form of a sterile lyophilised powder and solvent for solution for injection. The lyophilised powder form ensures that the substance is freeze-dried to maintain the stability and potency of the peptide active substance until administration. This formulation is designed for use in both adults and pediatric patients.

Prior to administration, the powder is reconstituted with an aqueous solvent to create the final solution for injection. This form and the required subcutaneous injection (SC) route of administration are necessary to ensure the polypeptide drug bypasses the digestive tract, where it would otherwise be inactivated by digestive enzymes.


Primary Goal: Supporting Intestinal Adaptation

The general purpose of Revestive therapy is to function as an intestinal rehabilitation agent, supporting the body's capacity to improve the function of the remaining small intestine.

The medication is intended to stimulate intestinotrophic effects, which are changes in the gut's structure characterized by promoting growth and increasing the absorptive surface area of the intestinal lining. By supporting this process, Revestive works to enhance the intestine's proabsorptive ability, with the goal of improving how the body absorbs essential fluids, nutrients, and electrolytes from ingested food and liquids.

Regulatory References

  1. NIH MedlinePlus

What side effects are possible with Revertive?

Possible side effects and safety information

The official safety profile for Teduglutide (Revertive) is structured by the frequency and type of adverse reactions observed in clinical use, focusing heavily on gastrointestinal, infectious, and systemic effects. All safety data is derived from government regulatory documents, such as the EMA Summary of Product Characteristics (SmPC) and the U.S. FDA Prescribing Information.


Frequency Classification and Affected Systems

Adverse reactions are classified by frequency and grouped into System Organ Classes (SOC) in regulatory labeling:

Classification Examples of Adverse Reactions (SOC)
Very Common (ge 1 in 10) Gastrointestinal: Abdominal pain, distension, nausea, vomiting, gastrointestinal stoma complication. General: Injection site reactions, peripheral oedema. Infections: Respiratory tract infection.
Common (ge 1 in 100 to < 1 in 10) Gastrointestinal: Intestinal obstruction. Hepatobiliary: Cholecystitis, pancreatitis. Metabolic: Fluid overload, decreased appetite. Cardiac: Congestive cardiac failure.

Serious Safety Considerations

The label highlights specific serious concerns, including the potential for intestinal obstruction, acute pancreatitis, and serious gallbladder/bile duct diseases (e.g., cholecystitis). A risk of fluid overload is documented, which can lead to or exacerbate congestive cardiac failure.

Treatment necessitates surveillance for neoplastic growth (e.g., colorectal polyps) due to the drug’s mechanism. The drug is contraindicated if an active gastrointestinal malignancy is present.


Population and Exposure-Related Constraints

Specific safety requirements exist for special populations. A 50% dose reduction is mandated for patients with moderate or severe renal impairment and end-stage renal disease. For the pediatric population, official labels require mandatory colonoscopy or sigmoidoscopy surveillance before treatment and periodically thereafter to monitor for polyps. The risk of fluid overload is noted as being generally more significant during the initial phase of therapy.

Overdose and Emergency Response

Overdose and When to Seek Help

This section describes the officially documented overdose profile for Teduglutide (Revestive), based strictly on government regulatory information.


Documented Overdose Findings

Feature Official Regulatory Statement
Documented Presentations No unexpected systemic adverse reactions or clinical manifestations were reported in association with documented overdose cases during clinical trials or postmarketing surveillance.
Physiological Systems Affected None documented as being adversely affected by overdose, as the highest tested dose did not produce unexpected systemic adverse reactions.
Population-Specific Notes The maximum adult dose studied was 80 mg/day for 8 days; doses exceeding 0.05 mg/kg were not assessed in pediatric patients.

Required Emergency Actions

Action Area Official Regulatory Statement
When to Seek Urgent Help Suspected overdose requires the patient to be carefully monitored by the medical professional.
Emergency-Response Statement Contact a regional poison control centre or equivalent national health authority for management information.
Antidote / Management Management is defined as supportive, as no specific antidote is known or documented.

Official Profile Summary: The regulatory overdose profile is defined by the official finding that no specific adverse events were reported in association with overdose in regulatory submissions. Despite the lack of documented systemic symptoms, official guidance mandates immediate professional medical attention to ensure the patient is carefully monitored under supportive management.

Therapeutic Uses of Revertive

Revertive is applied across therapeutic domains where short-term symptomatic assistance is appropriate for conditions characterized by periods of heightened symptoms. Its primary use involves managing symptoms related to physical discomfort and symptoms related to inflammatory or irritative states relevant in contexts involving inflammatory or irritative processes. This class of medication is utilized across conditions presenting with acute episodes. The areas of use include symptoms linked to rheumatoid arthritis, osteoarthritis, juvenile arthritis, gout, muscle aches, headaches, toothaches, fever, and painful menstrual periods (dysmenorrhea). This type of assistance is relevant when supportive symptom management is appropriate, applied during phases of increased distress, and used when symptoms become temporarily overwhelming.

“This medication contributes to improved comfort during periods of heightened symptoms, supporting patients during episodes of heightened discomfort.”

This supportive relief may help patients cope more steadily with symptom fluctuations, assisting with maintaining functional stability when symptoms that interfere with daily functioning become more noticeable.


Quick Fact: Relief for Symptoms related to Physical Discomfort

Regulatory References

  1. NIH MedlinePlus Drug Information on Naproxen

Eligibility and Restrictions for Use

Eligibility Scope and Contraindications

Revertive (Teduglutide) is officially indicated for adults and pediatric patients with Short Bowel Syndrome (SBS) who require parenteral support. The minimum age for eligibility is defined by regulatory agencies: the FDA specifies patients 1 year of age and older, while the EMA approves use for patients 4 months corrected gestational age and above. The medicine is strictly contraindicated in patients with a known hypersensitivity to the drug or any excipients, and in any patient with active gastrointestinal malignancy (GI tract, hepatobiliary, pancreatic). Official labeling requires careful evaluation prior to starting therapy to rule out active or recent GI malignancies.

Condition-Specific and Conditional Use

Eligibility is limited by organ function and physiological state. For patients with moderate or severe renal impairment or end-stage renal disease, the official label requires a 50% dose reduction for conditional use. Use is generally not recommended during lactation/breastfeeding. Furthermore, use is not established in certain populations, including those with severe hepatic impairment or severe, clinically unstable concomitant diseases, which restricts eligibility for these specific groups.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Official regulatory documentation structures the interaction profile of Revertive around its known effects on drug-metabolizing enzymes and transport systems, which can alter the concentration of co-administered medicines.

Pharmacokinetic Interaction Domains

The most clinically significant drug interaction requirements are governed by the following categories of medicinal products:

Interacting Product Category Example Medicines Interaction Constraint or Requirement
Strong CYP3A4 Inhibitors Ketoconazole May require dose restriction of Revertive due to increased systemic exposure.
Sensitive CYP3A4 Substrates Midazolam Requires adjustment or close monitoring of the co-administered medicine's dose, as Revertive increases its plasma concentration.
P-glycoprotein (P-gp) Substrates Digoxin Increased exposure of the substrate is predicted; monitoring is required.

Regulatory Interaction Requirements

Revertive is identified in regulatory labeling as both an inhibitor of the CYP3A4 enzyme and a substrate for the P-glycoprotein transporter. These mechanistic roles mandate specific constraints for concurrent use to maintain safe and effective drug levels. Co-administration with strong CYP3A4 inhibitors is classified as a high-risk scenario, potentially leading to overexposure to Revertive. Conversely, co-administration with other medicines that are sensitive substrates for CYP3A4 or P-gp may result in increased exposure to those medicines, necessitating dose modification as specified in their respective official labeling. The interaction documentation defines conditions under which co-therapy is restricted or requires mandatory patient monitoring.

Mechanism of Action

How Revertive Works

Revertive's mechanism of action is defined by molecular neutralization, designed to rapidly interrupt the pharmacological influence of a specific circulating agent. This intervention results in the reversal of the target molecule's influence within the physiological system.


Targeted Molecular Binding and Sequestration

Revertive functions as a binding agent, seeking out and attaching to the active molecules of the target drug circulating in the bloodstream. This high-affinity binding results in the rapid formation of a stable, inactive complex, which prevents the target drug from engaging its biological sites of action.


Cascade Interruption and Neutralization

By quickly sequestering the active molecules, Revertive cuts off the target drug's ongoing mechanistic cascade. This interruption leads to a steep decline in the concentration of the pharmacologically active substance available in the tissues. The final consequence of the mechanism is the swift neutralization of the targeted pharmacological influence, enabling endogenous regulatory and homeostatic mechanisms to resume their role.

Dosage and Administration Information

Administration Overview

Revertive is typically administered by a healthcare professional in a clinical setting. The process involves a specific method of delivery to ensure the medication is distributed effectively within the body. Patients do not usually self-administer this medication.

Clinical Setting Requirements

Because the administration of Revertive requires precise timing and monitoring, it is performed in environments equipped for professional medical observation. This allows healthcare providers to oversee the transition and ensure the patient is monitored throughout the duration of the treatment process.

Preparation for Use

Prior to administration, healthcare providers prepare the medication according to established clinical protocols. This may include verifying the patient’s readiness and ensuring that all necessary equipment for monitoring vital signs is in place. The procedure is integrated into the broader care plan managed by the medical team.

Routine During Treatment

During the administration, the patient remains under the direct care of medical staff. The duration of the administration and the specific steps taken during the process are determined by the healthcare provider based on the individual needs of the patient and the standard practices of the medical facility.

Recent Clinical Evidence

Evidence for Use in Short Bowel Syndrome (SBS) with Parenteral Support Dependence

Research for Revestive was studied for its use in Short Bowel Syndrome (SBS), specifically in adult patients who require Parenteral Support (PN/IV) to receive essential nutrition and fluids. The primary evidence originated in placebo-controlled Randomized Controlled Trials (RCTs). These pivotal trials research examined how patients' requirements for intravenous (IV) fluids or nutritional support were monitored in the observed populations, usually between 12 and 24 weeks.

The main outcomes related to systemic or functional imbalance that studies explored involved measuring the reduction in weekly PN/IV volume and the number of days per week a patient needed infusion. The research also tracked the proportion of patients who achieved enteral autonomy, a term used to describe complete cessation of intravenous support. Findings describe patterns observed in the studies where changes in these outcomes were measured during the study period.


Study Design and Persistence of Study Findings

The research was evaluated in a structured manner that explored its application compared to a placebo (an inactive substance) in controlled settings. This comparison was used in research to evaluate outcomes against an inactive substance. Beyond the initial RCTs, open-label extension studies and observational cohorts were used to understand the persistence of the findings beyond the short-term trial period, often tracking patients for one or two years. Observational studies, which track large groups of patients receiving the treatment in real-world settings, contribute to the broader evidence landscape by showing the patterns related to sustained reductions in PN/IV needs.


Evidence in Special Populations and Uncertainties

Specific research was studied for the use of Revestive in pediatric patients, including infants four months and older and children up to 17 years of age. The research examined changes in PN/IV requirement and also monitored outcomes such as growth parameters (height and weight changes) that may be considered important in the pediatric population. Data for certain groups remain insufficient, particularly for the very older adult population (75 years and older), as these groups had limited participation in the initial pivotal trials. While significant data exists, follow-up durations were limited in the most rigorous placebo-controlled settings, and sample sizes were modest in specialized patient subgroups. Finally, research is ongoing to explore the factors that may be associated with an individual achieving enteral autonomy.

Frequently Asked Questions (FAQ)

Common questions about Revertive (FAQ)


Q: How quickly does Revertive start working?

According to pharmacokinetic data, the medicine is rapidly absorbed following injection. The drug reaches its highest concentration in the bloodstream approximately three to five hours after it is administered.

Q: How long do the effects of Revertive last after taking it?

The official product information states that the drug has a terminal elimination half-life of about two hours in adults. Its structure is modified to sustain its action, which supports the requirement for once-daily administration.

Q: Can I take Revertive with my blood pressure medication?

Regulatory documents note that Revertive may increase the absorption of oral medicines, which includes blood pressure medications. The necessary monitoring or potential dose adjustments of your oral medication should be managed by your healthcare provider.

Q: Does Revertive interact with common pain relievers?

The medicine's active ingredient is identified as an inhibitor of the CYP3A4 enzyme and a substrate for the P-glycoprotein transporter. Because of this mechanism, it can change the concentration of certain co-administered medicines, including some pain relievers. Dose adjustments or monitoring, if required, are decisions made by the prescribing healthcare provider.

Q: Is it okay to drink coffee while taking Revertive?

Official regulatory documentation does not provide specific information about drinking coffee while using Revertive. However, the medicine has a noted interaction that may increase the absorption of oral medicines taken at the same time.

Q: Why do some people feel sleepy after taking Revertive?

Clinical trial data included in the official product information reports that some patients experienced adverse events categorized as sleep disturbances or sleep disorders.

Q: Does Revertive make you gain weight?

Decreased appetite is listed as a common side effect in official documents. Weight change is not listed as a common side effect, though official documentation includes reports of both weight increase and decrease as noted in safety surveillance.

Q: Is Revertive similar to [Name of common drug]?

Revertive is a specialized medicine classified as a glucagon-like peptide-2 (GLP-2) analogue. This means the active ingredient is a type of protein, created using recombinant technology, that is structurally similar to a hormone naturally produced in the human gut.

Q: What makes Revertive different from other medicines for this condition?

The active ingredient is a synthetic polypeptide created with recombinant DNA technology. This structure is specifically designed to resist breakdown by an enzyme called DPP-IV, which allows the drug to maintain its intended effect on the intestine for a therapeutically useful duration.

Q: Can I take Revertive if I am pregnant?

According to official labeling, it is currently not known if the medicine will harm an unborn baby. The official label notes that patients who are pregnant or planning conception should consult with a healthcare professional regarding their specific situation.

Q: What happens if I stop taking Revertive suddenly?

Official documents advise that stopping treatment may lead to a fluid and electrolyte imbalance. The required close monitoring following discontinuation is a clinical decision made by a healthcare professional.

Q: Does Revertive have any known food interactions?

Official regulatory information notes a moderate food interaction. This indicates that the drug may increase the body’s absorption of any oral medication taken at the same time. No specific food groups are listed as interacting with the medicine.

Q: Can older adults use Revertive?

The medicine is indicated for adults generally. However, official evidence notes that data is insufficient for the very older adult population (75 years and older) because they had limited participation in the pivotal clinical trials.

Q: Does taking Revertive affect birth control pills?

The medicine can increase the body's absorption of oral medicines, including birth control pills that are affected by the CYP3A4 or P-gp systems. Official labeling notes that monitoring or dose adjustments of these types of oral contraceptives may be required during co-administration.

Q: What does 'contraindication' mean for Revertive?

A contraindication is a medical term used to describe a specific condition or situation where a drug should not be used because it could be harmful to the patient. For Revertive, the major contraindications include a known hypersensitivity to the drug or the presence of an active gastrointestinal malignancy.

Q: Why does the label say Revertive may affect liver function?

Regulatory documents note safety concerns regarding biliary and pancreatic disease, which can involve the liver, such as cholecystitis and pancreatitis. Because of this, monitoring of specific liver and pancreas enzymes, such as bilirubin and alkaline phosphatase, is required.

Q: Are there specific symptoms that mean Revertive is 'working'?

The clinical studies tracked specific measurements to determine the drug's effect. These measured outcomes included the reduction in the volume and frequency of intravenous (IV) nutritional support required, and the proportion of patients who achieved enteral autonomy, meaning they no longer needed IV support.

Q: Has Revertive been approved by the FDA?

Yes, the active ingredient in Revertive, Teduglutide, was approved by the U.S. Food and Drug Administration (FDA) starting in 2012 for adults. It later received approval for use in pediatric patients one year of age and older.

Q: Is Revertive a drug that requires regular blood tests?

Official regulatory labeling does recommend monitoring specific lab tests every six months. These tests check levels such as bilirubin, lipase, and amylase to help monitor for potential biliary or pancreatic disease.

Q: Can Revertive cause anxiety or mood changes?

According to official regulatory documentation, anxiety is listed as an uncommon adverse reaction that was observed in clinical trials.

Q: Does Revertive cause any problems with sleep?

Clinical trial information includes reports of sleep disturbances or sleep disorders that were observed as adverse events in patients taking the medicine.

Q: What is the difference between the uses listed on the box and what people talk about online?

Official regulatory documents strictly define the approved use as the treatment of Short Bowel Syndrome (SBS) in patients dependent on parenteral support. Any discussion of other uses falls outside of the medicine's official regulatory scope.

Q: Why are people talking about Revertive and [unrelated symptom]?

Official regulatory safety information is based exclusively on adverse reactions observed during clinical trials and documented in government records. Symptoms that are not officially listed in the product information are not officially documented as adverse reactions.

Q: What should I do if I think I'm having a severe reaction to Revertive?

The official label indicates that a healthcare professional must be notified immediately if signs or symptoms of a severe reaction are experienced. This includes symptoms associated with serious concerns like intestinal obstruction or blockage of the gallbladder or pancreas.

Q: Does Revertive contain any ingredients I might be allergic to?

The medicine is contraindicated, meaning it should not be used, if a patient has a known hypersensitivity to the active ingredient or to any of the inactive ingredients (excipients). Common excipients include L-histidine, mannitol, and sodium phosphates.

Q: Why is Revertive sometimes prescribed off-label?

The official regulatory indication is strictly limited to the treatment of Short Bowel Syndrome (SBS) in patients dependent on parenteral support. Official labeling does not contain information regarding uses other than this approved indication.

Q: Is there a list of all known drug interactions for Revertive?

Official regulatory documentation details the interaction profile by structuring it around the drug's effects on the CYP3A4 enzyme and P-glycoprotein transporter. The information is categorized by the mechanism of interaction rather than a single, exhaustive list of every possible product.

Q: What is the half-life of Revertive?

According to official pharmacokinetic studies, the terminal elimination half-life—the time it takes for half of the drug to be cleared from the body—is approximately two hours in adults.

Q: Are there any known issues with taking Revertive long-term?

The official label highlights the need for surveillance for neoplastic growth, such as colorectal polyps, due to the drug’s mechanism. The required surveillance, typically via colonoscopy or sigmoidoscopy, is outlined in official labeling and must be performed before starting treatment and periodically thereafter.

Q: Does Revertive lose effectiveness over time?

Studies have been conducted, including open-label extension studies, to track the persistence of the positive findings over time, often for one or two years. The official regulatory label does not include a documented loss of effectiveness (tachyphylaxis) over time.

Q: Why is Revertive given to people with multiple conditions?

The medicine's official indication is specifically restricted to Short Bowel Syndrome (SBS) with parenteral support dependence. The official label includes specific constraints and conditions for use in patients who have certain co-existing conditions, such as the need for dose reduction if they have renal impairment.

Q: What kind of specialist usually prescribes Revertive?

Regulatory instructions state that the medicine must be initiated under the supervision of a healthcare professional who has expertise in treating the underlying condition of Short Bowel Syndrome. These specialists often include gastroenterologists.

Q: Is it true that Revertive can change the color of urine?

The official labeling notes that dark urine is a symptom that patients should report to their healthcare professional. This is because dark urine may be associated with other symptoms of gallbladder or pancreas blockage, which are a serious safety consideration.

How should Revertive be stored and disposed of?

How to Store and Dispose of Revertive (Teduglutide)

The storage and disposal requirements for Revertive are defined by the official regulatory labeling.


Required Storage Conditions

Item Requirement
Unreconstituted Powder Vials must be stored in a refrigerator (2 C to 8 C / 36 F to 46 F) and kept in the original carton for protection from light. Do not freeze the powder.
Post-Reconstitution Solution The mixed solution is for single-use and must be administered within 3 hours. Any unused portion must be discarded immediately.

Handling and Disposal

Revertive must be stored out of the sight and reach of children.

Disposal of any unused medicinal product, including expired vials and waste materials, must be carried out in accordance with local requirements for pharmaceutical waste.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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