Tenapanor (Xphozah)

Tenapanor is used to reduce phosphorus levels in patients with chronic kidney disease (CKD) on dialysis who have not responded to or have not tolerated other therapies. Tenapanor is in a class of medications called sodium/hydrogen exchanger (NHE3) inhibitors. It works by increasing the movement of food and waste through the stomach and intestines, thereby reducing phosphate absorption.

Tenapanor comes as a tablet to take by mouth. It is usually taken twice daily before the first and last meals of the day. Do not take tenapanor right before a dialysis session. Instead, wait and take tenapanor with the meal following dialysis. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take tenapanor exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Continue to take tenapanor even if you feel well. Do not stop taking tenapanor without talking to your doctor.

Ask your pharmacist or doctor for a copy of the manufacturer's information for the patient.

Tenapanor is also sometimes used to treat irritable bowel syndrome. Talk to your doctor about the risks of using this medication for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before taking tenapanor,

• tell your doctor and pharmacist if you are allergic to tenapanor, any other medications, or any of the ingredients in tenapanor tablets. Ask your pharmacist for a list of the ingredients.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take while taking tenapanor. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• if you are taking sodium polystyrene sulfonate, take it at least 3 hours before or after you take tenapanor.
• tell your doctor if you have had or currently have any type of blockage in your stomach or bowels. Your doctor may tell you not to take tenapanor.
• tell your doctor if you have or have ever had other medical conditions.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking tenapanor, call your doctor.

Unless your doctor tells you otherwise, continue your normal diet.

Skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

Tenapanor may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• diarrhea

Some side effects can be serious. If you experience any of these symptoms, call your doctor immediately:

• severe diarrhea

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (https://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org

Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include:

• diarrhea
• extreme thirst, dry mouth and/or skin, decreased urination, sunken eyes, or fast heartbeat

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.

• Xphozah^®