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Xphozah 10mg, 20mg or 30mg Tablet
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Indications & Clinical Uses
- Xphozah (tenapanor) is a film-coated tablet taken by mouth to lower high phosphorus levels in the blood (hyperphosphataemia).
- It is approved in the US, as add-on therapy, for adults with chronic kidney disease (CKD) who are on dialysis and who have an inadequate response to phosphate binders or cannot tolerate phosphate binders.
- The recommended dose is 30 mg twice daily, taken just before the morning and evening meals, with adjustment based on blood phosphorus and tolerability.
- Tenapanor is minimally absorbed into the blood.
- Xphozah is available in 10 mg, 20 mg and 30 mg tablets, and no 200 mg tablet exists.
- It is prescribed for use at home by adults on dialysis and is not approved for children.
Side Effects
- Diarrhoea is the main side effect of Xphozah and was the only adverse reaction reported in at least 5% of patients; it occurred in roughly 43% to 53% of patients and was severe in about 5%.
- It is usually mild to moderate, and often settles over time or with a dose reduction.
- Severe diarrhoea can lead to dehydration and low blood sodium (hyponatraemia), reported in fewer than 1% of patients, so stop Xphozah and contact your healthcare provider if diarrhoea becomes severe.
- Avoid stool softeners and laxatives while taking it.
- The label carries no boxed warning.
- Seek help promptly if you feel faint, very thirsty, unusually weak or cannot keep fluids down.
Precautions & Warnings
- Xphozah is contraindicated in children under 6 years of age, because of the risk of serious dehydration and low sodium, and in anyone with known or suspected mechanical gastrointestinal (bowel) obstruction.
- It must not be taken right before haemodialysis: skip that dose and resume with your next meal after dialysis.
- Take each dose just before the first and last meals of the day.
- Your dose may be adjusted according to serum phosphorus levels.
- Tenapanor is minimally absorbed and was not detected in breast milk, and animal studies showed no harm to the foetus, so it can be used in pregnancy or breastfeeding if clinically needed.
- If you miss a dose, skip it and take the next dose at the usual time.
- Keep tablets in the original bottle with the desiccant, tightly closed and away from moisture, at 20°C to 25°C.
Avoid Interactions
- Medicines that may reduce efficacy or need monitoring: Xphozah can lower the absorption of medicines carried by the OATP2B1 transporter; for example, enalapril peak levels fell by about 70%, so your healthcare provider may monitor how well those medicines work and adjust doses.
- Sodium polystyrene sulfonate should be taken at least 3 hours apart from Xphozah.
- Avoid stool softeners and laxatives, which can add to diarrhoea and dehydration risk.
- Xphozah is used as add-on treatment alongside phosphate binders, so keep taking any binder your healthcare provider has prescribed.
- Tell your healthcare provider about all prescription medicines, over-the-counter products and supplements you take.
References
Frequently Asked Questions
Xphozah (tenapanor) lowers high phosphorus levels in the blood of adults with chronic kidney disease who are on dialysis. It is added to phosphate binder treatment when a binder alone has not worked well enough, or when binders cannot be tolerated.
The usual dose of Xphozah (tenapanor) is 30 mg by mouth twice a day, just before your morning and evening meals. Your dose may be adjusted based on your blood phosphorus and how well you tolerate it. Do not take a dose right before dialysis; wait until your next meal after dialysis.
Diarrhoea is the main side effect of Xphozah (tenapanor), affecting about 43% to 53% of people and severe in about 5%. It is usually mild to moderate and often eases with time or a lower dose. Stop the tablets and call your healthcare provider if diarrhoea becomes severe, and watch for dehydration.
Do not use Xphozah (tenapanor) if you have a blocked bowel, and avoid stool softeners or laxatives, which can worsen diarrhoea. Take sodium polystyrene sulfonate at least 3 hours apart. Xphozah can lower levels of OATP2B1 drugs such as enalapril, so your prescriber may adjust doses.
If you miss a dose of Xphozah (tenapanor), skip it and take your next dose at the regular time. Do not take two doses together. Keep the tablets in the original bottle with the desiccant, tightly closed, at 20°C to 25°C, away from moisture.
No. Xphozah (tenapanor) must not be given to children under 6 years because of the risk of serious dehydration and low sodium. It is approved only for adults with chronic kidney disease on dialysis. It is also contraindicated in anyone with a known or suspected blocked bowel.
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