Tenapanor

Tenapanor, sold under the brand name Ibsrela among others, is a medication used for the treatment of adults with a disease of the gut called irritable bowel syndrome with constipation commonly referred to as IBS-C.^[3][5] It is used in form of tenapanor hydrochloride.^[3] It is also used in the treatment of hyperphosphatemia associated with chronic kidney disease.^[4] Tenapanor is a sodium hydrogen exchanger 3 (NHE3) inhibitor.^[4]

Tenapanor

Clinical data
Trade names	Ibsrela, Xphozah, others
Other names	Tenapanor hydrochloride
AHFS/Drugs.com	Monograph
License data	US DailyMed: Tenapanor
Routes of administration	By mouth
Drug class	NHE3 inhibitors
ATC code	A06AX08 (WHO)
Legal status
Legal status	CA: ℞-only[1][2] US: ℞-only[3][4]
Identifiers
IUPAC name N,N'-(10,17,-dioxo-3,6,21,24-tetraoxa-9,11,16,18-tetraazahexacosane-1,26-diyl)bis([(4S)-6,8-dichloro-2-methyl-1,2,3,4-tetrahydroisoquinolin-4-yl]benzenesulfonamide)
CAS Number	1234423-95-0
PubChem CID	71587953
DrugBank	DB11761
ChemSpider	32056950
UNII	WYD79216A6 50605O2ZNS
KEGG	D11652 D11653
ChEMBL	ChEMBL3304485
CompTox Dashboard (EPA)	DTXSID40154016
ECHA InfoCard	100.243.471
Chemical and physical data
Formula	C50H66Cl4N8O10S2
Molar mass	1145.04 g·mol−1
3D model (JSmol)	Interactive image
SMILES CN1C[C@H](C2=C(C1)C(=CC(=C2)Cl)Cl)C3=CC(=CC=C3)S(=O)(=O)NCCOCCOCCNC(=O)NCCCCNC(=O)NCCOCCOCCNS(=O)(=O)C4=CC=CC(=C4)[C@@H]5CN(CC6=C5C=C(C=C6Cl)Cl)C
InChI InChI=1S/C50H66Cl4N8O10S2/c1-61-31-43(41-27-37(51)29-47(53)45(41)33-61)35-7-5-9-39(25-35)73(65,66)59-15-19-71-23-21-69-17-13-57-49(63)55-11-3-4-12-56-50(64)58-14-18-70-22-24-72-20-16-60-74(67,68)40-10-6-8-36(26-40)44-32-62(2)34-46-42(44)28-38(52)30-48(46)54/h5-10,25-30,43-44,59-60H,3-4,11-24,31-34H2,1-2H3,(H2,55,57,63)(H2,56,58,64)/t43-,44-/m0/s1 Key:DNHPDWGIXIMXSA-CXNSMIOJSA-N

Tenapanor is a drug developed by Ardelyx, which acts as an inhibitor of the sodium-proton exchanger NHE3. This antiporter protein is found in the kidney and intestines, and normally acts to regulate the levels of sodium absorbed and secreted by the body. When administered orally, tenapanor selectively inhibits sodium uptake in the intestines, limiting the amount absorbed from food, and thereby reduces levels of sodium in the body.^[6] This may make it useful in the treatment of chronic kidney disease and hypertension, both of which are exacerbated by excess sodium in the diet.^[7]

It was approved for medical use in the United States in September 2019.^[3][8][5][9] The U.S. Food and Drug Administration (FDA) considers it to be a first-in-class medication.^[10] In October 2023, tenapanor was approved by the FDA for the treatment of hyperphosphatemia.^[11]