Ibsrela (tenapanor) is a prescription drug used to treat irritable bowel syndrome with constipation (IBS-C) in adults. Ibsrela comes as an oral tablet.

To learn more about Ibsrela’s uses, see the “What is Ibsrela used for?” section below.

Ibsrela basics

Ibsrela contains the active ingredient tenapanor. (An active ingredient is what makes a drug work.) It belongs to a group of drugs called sodium/hydrogen exchanger 3 inhibitors.

Ibsrela is a brand-name medication. A generic version of the drug isn’t currently available.

Like most drugs, Ibsrela may cause mild to serious side effects. The lists below contain some of the more common side effects the drug may cause but don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Ibsrela. They can also suggest ways to help reduce them.

Mild side effects

Below is a list of some of the mild side effects Ibsrela may cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the drug’s prescribing information.

Mild side effects of Ibsrela that have been reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Ibsrela can occur, but they aren’t common. If you have serious side effects from this medication, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Serious side effects of Ibsrela that have been reported include:

* For more information, see the “What should be considered before taking Ibsrela?” section.
† To learn more about this side effect, see the “Allergic reaction” section just below.

Allergic reaction

While allergic reaction wasn’t reported in studies of Ibsrela, it can still happen.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Ibsrela. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Find answers to some commonly asked questions about Ibsrela.

Can Ibsrela cause weight gain or weight loss?

Weight changes weren’t reported as a side effect in studies of Ibsrela. However, diarrhea is a common side effect. If you experience prolonged or excessive diarrhea, you may become dehydrated. Dehydration means you’ve lost an unhealthy amount of fluid, and this fluid loss can cause you to temporarily weigh less.

How does Ibsrela compare with Linzess?

Ibsrela and Linzess are both used to treat IBS-C in adults. Linzess is also used to treat other types of constipation. (Ibsrela is only prescribed for IBS-C.)

Ibsrela and Linzess belong to different groups of drugs and contain different active ingredients. Ibsrela contains tenapanor, while Linzess contains linaclotide.

Another difference is that Linzess can be prescribed for certain children ages 6–17 years old with chronic constipation from an unclear cause. Ibsrela isn’t recommended for anyone under the age of 18 years.

Ibsrela comes as an oral tablet, while Linzess is available as an oral capsule.

If you have other questions about how Ibsrela and Linzess compare, talk with your doctor. They can help you find the best treatment for your condition.

How does Ibsrela work?

If you have IBS-C, you may have bowel movements that are less frequent than normal or that are harder to pass.

Ibsrela blocks a certain protein in the small intestine and colon called sodium/hydrogen exchanger 3 (NHE3). Your body absorbs less sodium from the food you eat when NHE3 is blocked. When your body absorbs less sodium, more water is able to flow into your digestive system. This may soften your stool, making it easier to pass. It may also increase the frequency of the bowel movements you have.

Below is the commonly used dosage of Ibsrela, but always take the dosage your doctor prescribes. They’ll recommend the correct dosage for you.

Form and strength

Ibsrela is available as an oral tablet in one strength of 50 milligrams (mg).

Recommended dosage

For the treatment of IBS-C, your doctor will likely prescribe a dosage of 50 mg taken two times per day. You’ll take one dose just before breakfast or your first meal of the day. You’ll take the other dose just before dinner.

Questions about taking Ibsrela

Below are some common questions about taking Ibsrela.

  • Can Ibsrela be chewed, crushed, or split? The manufacturer of Ibsrela hasn’t studied how chewing, crushing, or splitting the drug may affect how it works. It’s best to swallow the tablets whole. If you have trouble swallowing pills, check out this article or ask your doctor or pharmacist for advice.
  • Should I take Ibsrela with food? Ibsrela should be taken just before eating breakfast (or your first meal of the day) and dinner. This helps Ibsrela work effectively.
  • Is there a best time of day to take Ibsrela? Ibsrela should be taken twice daily, just before you eat breakfast and dinner.
  • What if I miss a dose of Ibsrela? If you miss a dose of Ibsrela, skip the missed dose and take the next dose at its usual time. You should not take two doses at once to make up for a missed dose. Doing so could increase your risk of side effects.
  • Will I need to take Ibsrela long term? Ibsrela is typically a long-term treatment. If you and your doctor determine that it’s safe and effective for your condition, you’ll likely take it long term.
  • How long does Ibsrela take to work? Ibsrela starts to work after you take your first dose. According to studies, people taking Ibsrela had more frequent bowel movements with less abdominal pain by the first week of treatment.


Do not take more Ibsrela than your doctor prescribes as this can lead to harmful effects.

Symptoms of overdose

Symptoms caused by an overdose may include diarrhea. If severe or long lasting, diarrhea could lead to dehydration.

What to do in case you take too much Ibsrela

Call your doctor if you think you’ve taken too much Ibsrela. You can also call 800-222-1222 to reach America’s Poison Centers or use its online resource. If you have severe symptoms, immediately call 911 or your local emergency number, or go to the nearest emergency room.

Whether you have health insurance or not, cost may be a factor when you’re considering Ibsrela. What you’ll pay for Ibsrela may depend on several things, such as your treatment plan and the pharmacy you use.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for Ibsrela when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
  • Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called ArdelyxAssist may also be available.

You can also check out this article to learn more about saving money on prescriptions.

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50mg ibsrela (60 Tablets)

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Simply show the Optum Perks coupon at your preferred pharmacy or order online and instantly save up to 80% without using insurance. The coupon doesn’t expire, so be sure to save it for refills.

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Other drugs are available that can treat your condition. If you’d like to explore an alternative to Ibsrela, talk with your doctor. They can tell you about other medications that might work well for you.

The following drugs are also used to treat IBS-C in adults:

Ibsrela is prescribed to treat IBS-C in adults. IBS-C may cause symptoms such as abdominal pain and bloating. You may also notice you have bowel movements less often or that when you do, they’re more difficult to pass.

The exact cause of IBS-C is unknown but may be linked to having a more sensitive colon or immune system. Stress and anxiety commonly strain the immune system, which can also trigger an IBS-C flare-up.

Ibsrela works directly in the digestive tract to treat IBS-C. By blocking the absorption of sodium from the foods you eat, more water flows into the small intestine and colon. This water softens stool, making it easier to pass and helping it to pass more often.

Below is important information you should consider before taking Ibsrela.


Taking a drug with certain medications, vaccines, foods, and other things can affect how the drug works. These effects are called interactions.

Before starting Ibsrela 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 take. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Drug interactions

Ibsrela may decrease the effects of enalapril (Vasotec, Epaned). This is not the only drug that may interact with Ibsrela. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Ibsrela and alcohol

It’s likely safe to consume alcohol while taking Ibsrela, as alcohol is not known to interact with this drug.

Pregnancy and breastfeeding

It’s not known whether it’s safe to take Ibsrela during pregnancy or while breastfeeding.

Ibsrela targets your digestive tract and circulates through the rest of your body in extremely low amounts. How much Ibsrela passes into breast milk and the drug’s effects on a child who’s breastfed have not been studied.

If you’re pregnant or breastfeeding, or planning to be either, talk with your doctor before starting Ibsrela treatment.

Boxed warning

Ibsrela has a boxed warning about the risk of serious dehydration when used in certain children. A boxed warning is the most serious warning from the FDA. It alerts doctors and patients about drug effects that may be dangerous.

Ibsrela may cause diarrhea in adults, which can cause dehydration if prolonged or severe. But dehydration can become a more serious, even fatal, condition in children. Due to this risk, only people over the age of 18 years should take this medication.

If your child has constipation, talk with your doctor about their treatment options.

Other warnings

Ibsrela can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether this medication is a good treatment option for you.

Talk with your doctor about your health history before starting Ibsrela. Be sure to tell them if any of the following factors apply to you:

If you have questions about Ibsrela treatment, talk with your doctor or pharmacist. Questions you may want to ask include:

  • Can I take Ibsrela only when I feel I need it?
  • Can I take Ibsrela with other medications I’m taking for IBS-C?
  • Will Ibsrela become less effective the longer I take it?

To learn more about side effects of Ibsrela, see this article.

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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.