Tenapanor (Ibsrela) is an FDA-approved medication for irritable bowel syndrome with constipation (IBS-C). A doctor may prescribe it if other medications do not manage your symptoms.
There’s currently no cure for IBS-C, but the right treatment plan can help manage the symptoms. Treatments for IBS-C often include lifestyle changes and diet, but doctors may prescribe medication, such as tenapanor (Ibsrela), if other treatments haven’t helped to manage your symptoms. These symptoms can include:
- bloating
- discomfort
- abdominal pain
- changes in bowel movements
- hard stool
- infrequent bowel movements
Medications, including tenapanor (Ibsrela), may help manage your symptoms if other treatments have not worked.
Keep reading to learn about how tenapanor (Ibsrela) works, who doctors recommend it for, and the potential side effects.
Tenapanor (Ibsrela) works in the gut, particularly the small intestine and colon, to block the absorption of certain substances by turning off the sodium-hydrogen exchanger 3 (NHE3) receptor.
In people with IBS-C, it inhibits dietary sodium uptake, which increases intestine water secretion. This can stimulate bowel movements.
The FDA approved Tenapanor (Ibsrela) in September 2019 to treat IBS-C but it wasn’t launched in the United States until a couple of years later.
Ardelyx, the manufacturer, switched gears to target hyperphosphatemia, a condition that causes extra phosphorus in the blood, instead of IBS-C. Tenapanor (marketed as Xphozah) was intended to help adults with chronic kidney disease control the amount of phosphorus in their blood, especially those who didn’t respond to other therapies and were on dialysis.
The medication worked in the gut to prevent phosphate absorption, specifically blocking the sodium-hydrogen exchanger 3 (NHE3) receptor. One tablet taken twice daily by mouth was reportedly enough to decrease the passive absorption of phosphorus.
Researchers noted that diarrhea was the most common side effect of the medication. Elevated water secretion likely played a role in why people without constipation who were taking the medication for hyperphosphatemia experienced diarrhea.
After an FDA review in July 2021 of tenapanor for hyperphosphatemia, the medication was pivoted again and launched in April 2022 as the first and only NHE3 inhibitor for treating IBS-C.
Tenapanor triggers an increase in water secretion, which helps relieve the constipation of IBS-C.
More water in the stool elimination process can lead to softer and more frequent bowel movements. This can also help reduce bloating and abdominal pain.
Additionally, tenapanor positively affects visceral hypersensitivity. This condition occurs when the soft organs in the abdomen, pelvis, and chest, as well as the visceral organs, are more sensitive and produce feelings of pain and discomfort more easily.
Tenapanor decreases visceral hypersensitivity, reducing pain even if you don’t have a bowel movement.
The FDA mainly used two clinical trials when reviewing tenapanor for the treatment of IBS-C.
In a
During this time, they assessed symptoms related to:
- ease, timing, and frequency of bowel movements
- abdominal pain and discomfort
- the sensation of complete emptying
- the need to use rescue medication (such as a laxative)
Those who received tenapanor reported less abdominal pain and having bowel movements more often than the placebo group.
In a 2020 clinical trial, participants with IBS-C were either given 50 mg of tenapanor twice a day or a placebo for 12 weeks. After 12 weeks, some people took tenapanor for 4 weeks while others switched to a placebo to evaluate withdrawal symptoms. At the end of the study, more people who took tenapanor reported less constipation and reduced abdominal pain.
Over 1,200 patients participated in the clinical trials. Those who were given tenapanor reported a 30% or greater improvement in their frequency of spontaneous bowel movement and severity of abdominal pain compared to those given the placebo.
Some reported improvements as early as the first week after taking tenapanor twice daily. The most commonly reported symptom was
Tenapanor is only for adults. Doctors recommend it for those with IBS-C who regularly experience two or more symptoms over at least 3 months, including:
- the sensation of blockage or failure to completely empty the bowels
- straining during 25% or more of bowel movements
- required manual maneuvers to facilitate at least 25% of bowel movements
They typically recommend it when other treatments, such as stimulant laxatives, osmotic laxatives, or saline laxatives, haven’t improved symptoms.
Tenapanor isn’t a supplemental medication, meaning doctors do not recommend it for use if you’re using other IBS-C treatment options, such as linaclotide (Linzess).
Additionally, it’s not recommended if you show an indication of mechanical bowel obstruction. Researchers still have not yet established the safety of tenapanor (Ibsrela) for pregnant people.
What medication is used for IBS-C?
Medications for IBS-C include laxatives as well as prescription medications, including linaclotide (Linzess) and tenapanor (Ibsrela).
What is the best remedy for IBS-C?
Some people can manage IBS-C by eating more fiber, staying hydrated, reducing stress, and avoiding dietary triggers, such as gluten and FODMAPs. Doctors may also recommend peppermint oil capsules, which can stimulate the digestive tract.
What is the first-line treatment for IBS-C?
First-line treatments for IBS-C typically include management strategies, including changes to your diet and taking laxatives when needed. If you still have symptoms, doctors may recommend a medication, such as linaclotide (Linzess), tenapanor (Ibsrela), lubiprostone (Amitiza), or plecanatide (Trulance).
What is the best antidepressant for IBS-C?
Doctors may recommend tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) for some people with IBS-C if other treatments haven’t worked. However, antidepressants are not a first-line treatment for IBS-C as they can sometimes worsen constipation.
If you’re considering tenapanor (Ibsrela) for IBS-C that’s not responding to other treatments, reach out to your doctor.
Though there’s currently no cure for IBS-C, new research is producing innovative medications, such as tenapanor (Ibsrela), that may help manage your symptoms.
For many with IBS-C, medication with lifestyle changes means lasting relief is on the horizon.