Xphozah
Xphozah (tenapanor) is a prescription medication used to lower phosphate levels in adults with chronic kidney disease (CKD) on dialysis. It's approved to take alone or with phosphate binders. But unlike traditional phosphate binders, Xphozah (tenapanor) works by blocking phosphate from being absorbed in your intestines instead of binding it in your gut. The usual dose is one tablet by mouth twice a day, typically before breakfast and dinner. The most common side effect is diarrhea.
What is Xphozah (tenapanor)?
What is Xphozah (tenapanor) used for?
- Lower phosphate levels in adults with chronic kidney disease (CKD) on dialysis who haven't responded well to or can't take phosphate binders
How Xphozah (tenapanor) works
Xphozah (tenapanor) is a sodium/hydrogen exchanger 3 (NHE3) inhibitor. It works by blocking a protein in your intestines called NHE3, which usually helps your body absorb phosphate from food.
By blocking NHE3, Xphozah (tenapanor) keeps some phosphate from being absorbed, which lowers the phosphate levels in your blood. This helps protect your kidneys and bones from damage due to phosphate buildup in CKD.
Drug facts
Side effects of Xphozah (tenapanor)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Diarrhea (43-53%)
Xphozah (tenapanor) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe diarrhea: diarrhea that doesn't improve, severe stomach pain, bloody stool
The following Xphozah (tenapanor) 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
- Dehydration—increased thirst, dry mouth, feeling faint or lightheaded, headache, dark yellow or brown urine
- Severe or prolonged diarrhea
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Xphozah (tenapanor)
Pros
- Tablet taken by mouth
- Helpful when phosphate binders alone aren't enough
- Starts working within the first week
Cons
- Must take before breakfast and dinner
- Diarrhea is a very common side effect
- Only available through specialty pharmacies
Pharmacist tips for Xphozah (tenapanor)
- Take Xphozah (tenapanor) 5 to 10 minutes before breakfast and dinner. This timing helps the medication work best.
- Don’t take Xphozah (tenapanor) right before dialysis since it can cause diarrhea. Instead, take it right before your next meal.
- If you miss a dose of Xphozah (tenapanor), skip it and take your next dose at the regular time. Don't take two doses at the same time.
- Avoid taking Xphozah (tenapanor) within 3 hours of sodium polystyrene sulfonate (SPS). SPS can make Xphozah (tenapanor) work less well.
- Don't take Xphozah (tenapanor) with stool softeners or laxatives. That's because Xphozah (tenapanor) can sometimes cause diarrhea, and these medications might make it worse.
- Store Xphozah (tenapanor) in a dry place in its original bottle. Keep the bottle tightly closed and don't remove the desiccant inside.
Common questions about Xphozah (tenapanor)
Yes, Xphozah (tenapanor) is approved by the FDA. It was approved in October 2023.
Yes, Xphozah (tenapanor) is a specialty drug. This means you can only get it from a specialty pharmacy, not a regular retail pharmacy. Ask your prescriber for help with filling your prescription.
Yes, Xphozah (tenapanor) often causes diarrhea. In studies, about half of people taking it had diarrhea, usually mild to moderate. Diarrhea typically starts soon after you begin treatment, but it should get better over time. If you keep having several watery bowel movements each day, tell your prescriber. They might lower your dose or recommend other ways to manage it.
In studies, Xphozah (tenapanor) started lowering phosphate levels within the first week of treatment. Your prescriber will order lab tests so they can check your phosphate level and make sure the medication is working for you.
No. Xphozah (tenapanor) isn't a phosphate binder like Renvela or PhosLo. Both lower blood phosphate levels in people with CKD on dialysis, but they work differently. Xphozah (tenapanor) is a phosphate blocker that stops certain proteins in your intestine from absorbing phosphate from food. On the other hand, phosphate binders attach directly to phosphate in food so your body can’t absorb it. You usually take Xphozah (tenapanor) before breakfast and dinner, while phosphate binders are taken with every meal. Talk with your prescriber to learn which treatment is right for you.
No. Take Xphozah (tenapanor) right before your morning and evening meals so it works best. Studies show it lowers phosphate levels more when taken 5 to 10 minutes before breakfast and dinner. The medication works by blocking proteins in your intestine from absorbing the phosphate that's in the food you just ate. Xphozah (tenapanor) won't work as well if you take it on an empty stomach because there's no phosphate from food to block.
Studies showed that people who took Xphozah (tenapanor) had lower blood phosphate levels over 6 months compared to those who took a placebo. In addition, Xphozah (tenapanor) can also help if phosphate binders alone haven't worked well. A 4-week study showed that adding Xphozah (tenapanor) to a phosphate binder dropped phosphate levels more than a phosphate binder by itself.
Both Xphozah (tenapanor) and Ibsrela (tenapanor) have the same active ingredient, but they treat different conditions. Xphozah (tenapanor) is used to lower phosphate levels in adults with CKD on dialysis. Ibsrela (tenapanor) is used to treat adults with irritable bowel syndrome with constipation (IBS-C). Talk to your prescriber if you have questions about comparing the two.
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Risks and warnings for Xphozah (tenapanor)
Xphozah (tenapanor) 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.
Diarrhea
- Risk factors: People under 6 years of age
Diarrhea is the most common side effect of Xphozah (tenapanor). In studies, more than half of people taking it had diarrhea. It typically started soon after treatment began but could happen at any time. Most cases were mild to moderate and got better as treatment continued or after the dose was lowered.
Some people had severe diarrhea, which can cause dehydration or low sodium levels. Let your prescriber know right away if your diarrhea doesn't improve after 2 days, if you have severe stomach pain, or notice blood in your stool. You might have to stop taking Xphozah (tenapanor).
Xphozah (tenapanor) dosage
Typical dosage for Xphozah (tenapanor)
The typical dose is 30 mg by mouth twice a day, before morning and evening meals.
Xphozah (tenapanor) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Xphozah (tenapanor) will not be safe for you to take.
- Children under 6 years old because of the risk of diarrhea and serious dehydration
- Blockage in the gut
What are alternatives to Xphozah (tenapanor)?
Xphozah (tenapanor) images
