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NHE3 Inhibitor — Intestinal Phosphate Absorption Reducer

Tenapanor

Brand names: Xphozah

Tenapanor is an oral, minimally absorbed agent used to control hyperphosphataemia in patients with chronic kidney disease on dialysis, often when phosphate binders are inadequate or not tolerated.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It inhibits the gastrointestinal sodium-hydrogen exchanger NHE3, reducing intestinal phosphate absorption through the paracellular pathway.

Prescribing in practice

  • Diarrhoea is very common and can be severe, potentially causing dehydration and electrolyte disturbance, so it is contraindicated in known or suspected bowel obstruction.
  • Take as directed in relation to meals to optimise the reduction in phosphate absorption.
  • It may be used alone or with phosphate binders; review fluid and electrolyte status, particularly in those prone to volume depletion.

Monitoring

Monitor serum phosphate to guide dosing, and watch for the effects of diarrhoea on hydration and electrolytes.

Counselling the patient

  • Loose stools are common, especially at first; report severe or persistent diarrhoea.
  • Take this medicine as instructed in relation to your meals.

Evidence & guidelines

Tenapanor lowered serum phosphate in randomised controlled trials in dialysis patients, supporting its use in hyperphosphataemia.

Reference: Block et al. NEJM 2019 (AMPLIFY trial); MHRA SPC Xphozah; KDIGO CKD-MBD Guidelines 2017; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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