Xphozah (Tenapanor) is an FDA-approved sodium-hydrogen exchanger 3 (NHE3) inhibitor specifically indicated for the treatment of hyperphosphatemia in patients with chronic kidney disease (CKD) undergoing dialysis. By inhibiting intestinal absorption of sodium and phosphate, it provides a new treatment option for patients with inadequate response to or intolerance of phosphate binders.

Dosage and Administration of Xphozah (Tenapanor)

Recommended Dosage Regimen

The regular recommended dosage of Xphozah is 30mg orally, twice daily, taken before breakfast and dinner respectively.

Dosage should be adjusted based on serum phosphorus levels and the patient’s gastrointestinal tolerance.

Administration Timing Requirements

Take immediately before the first and last meal of the day.

Avoid taking immediately before hemodialysis; administer before the next meal after dialysis.

If a dose is missed, skip the missed dose and take the next dose at the regular time.

Dosage Form and Specification Information

10mg Xphozah: Yellow, oval, biconvex tablets; engraved with "" on one side and "T10" on the other.

20mg Xphozah: Brown, oval, biconvex tablets; engraved with "" on one side and "T20" on the other.

30mg Xphozah: Red, oval, biconvex tablets; engraved with "" on one side and "T30" on the other.

Use in Special Populations for Xphozah (Tenapanor)

Pediatric Patients

Contraindicated in children under 6 years old due to the risk of diarrhea and severe dehydration.

Efficacy in patients aged 6-18 years has not been established; use is not recommended.

Geriatric Patients

In clinical studies of Xphozah, 28% of patients were ≥65 years old.

Available data show similar efficacy between elderly and younger patients; no special dosage adjustment is required.

Pregnant Women

Xphozah is minimally systemically absorbed after oral administration, with plasma concentrations below the quantitation limit (<0.5ng/mL).

Maternal use is not expected to result in fetal exposure to the drug.

Limited available data have not identified risks of major birth defects, miscarriage, or adverse maternal/fetal outcomes associated with the drug.

Important Precautions for Xphozah (Tenapanor)

Contraindications

Patients under 6 years old.

Patients with known or suspected mechanical gastrointestinal obstruction.

Drug Interactions

OATP2B1 substrates: Xphozah is an inhibitor of the intestinal uptake transporter OATP2B1, which may reduce the exposure of co-administered OATP2B1 substrate drugs.

Sodium polystyrene sulfonate (SPS): Administration of Xphozah and SPS should be separated by at least 3 hours.