
Am Fam Physician. 2022;105(6):656-658
Author disclosure: No relevant financial relationships.
Tenapanor (Ibsrela) is labeled for the treatment of irritable bowel syndrome with constipation (IBS-C) in adults.1 It is a sodium/hydrogen exchanger 3 inhibitor that acts on the surface of the small intestine and colon to block the absorption of dietary sodium, resulting in increased water secretion. This leads to more frequent and softer bowel movements. Tenapanor also decreases visceral hypersensitivity, leading to reduced abdominal pain.

Drug | Dosage | Dose form | Cost of full course |
---|---|---|---|
Tenapanor (Ibsrela) | 50 mg twice daily, taken immediately before first meal of the day and before dinner | 50-mg tablets | Price not yet available |
Safety
Tolerability
Effectiveness
Tenapanor was evaluated in two randomized, double-blind, placebo-controlled studies involving a total of 1,199 patients who had irritable bowel syndrome (based on the ROME III criteria) with the IBS-C subtype (based on a mean abdominal pain score of at least 3 out of 10, fewer than five spontaneous bowel movements per week, and fewer than three complete spontaneous bowel movements per week). Each study evaluated the response to treatment over 12 weeks, with one study following patients for an additional 14 weeks. Clinical improvement, defined as at least a 30% reduction in abdominal pain and at least one additional complete spontaneous bowel movement per week for at least six out of 12 weeks, occurred in 27% to 37% of patients receiving tenapanor and 19% to 24% of those receiving placebo (number needed to treat = 8 to 12; 95% CI, 5 to 50).2,3
Price
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