Ibsrela (Tenapanor) is a prescription medication used to treat irritable bowel syndrome with constipation (IBS-C) in adults.

What Is Ibsrela?

Ibsrela is the brand name for tenapanor, a medication manufactured by Ardelyx, Inc. It belongs to a drug class called NHE3 inhibitors (sodium/hydrogen exchanger 3 inhibitors) — a first-in-class medication, meaning Ibsrela is the only drug in this category approved for IBS-C.

Ibsrela was approved by the FDA specifically for the treatment of IBS-C in adults. It is not a controlled substance, so no DEA scheduling applies. It's available only by prescription.

What Is Ibsrela Used For?

Ibsrela is FDA-approved to treat irritable bowel syndrome with constipation (IBS-C) in adults. IBS-C is a chronic condition where people experience recurring abdominal pain along with constipation — infrequent bowel movements, hard stools, and straining.

It's important to note that Ibsrela is specifically for IBS-C, not for general constipation or other types of IBS (like IBS-D, which involves diarrhea). If you're not sure which type of IBS you have, your doctor can help with a diagnosis.

Tenapanor is also marketed under a different brand name, Xphozah, for a separate condition — hyperphosphatemia in chronic kidney disease — but that's a distinct product with different dosing.

How Is Ibsrela Taken?

Ibsrela comes as a 50 mg oral tablet. The standard dosing is:

• 50 mg twice daily
• Take the first dose immediately before breakfast (or your first meal of the day)
• Take the second dose immediately before dinner

Important Dosing Instructions

• Take Ibsrela right before eating — timing with meals is important for how the medication works.
• If you miss a dose, skip it and take the next dose at the regular time. Do not double up.
• Store tablets in the original container and keep the desiccant packet inside to protect from moisture.
• Do not remove tablets from the bottle until you're ready to take them.

For details on how the medication works inside your body, read our article on Ibsrela's mechanism of action.

Who Should Not Take Ibsrela?

Ibsrela is not for everyone. You should not take Ibsrela if you:

• Are under 6 years old — Ibsrela is contraindicated due to serious dehydration risk (boxed warning).
• Are 6 to 17 years old — Safety and effectiveness have not been established in pediatric patients. Use should be avoided in children 6 to 12.
• Have a known or suspected mechanical gastrointestinal obstruction — a physical blockage in the intestines.

Talk to your doctor before taking Ibsrela if you are pregnant or breastfeeding. While minimal amounts of the drug are expected to reach the bloodstream, there are no adequate studies in pregnant women.

You should also tell your doctor about all medications you take, including over-the-counter drugs and supplements, to check for drug interactions.

What Are the Side Effects?

The most common side effects of Ibsrela include:

• Diarrhea (16% of patients)
• Abdominal bloating (3%)
• Gas (3%)
• Dizziness (2%)

Serious side effects are rare but can include severe diarrhea leading to dehydration, rectal bleeding, and electrolyte imbalances. Read our full guide on Ibsrela side effects for more details.

How Much Does Ibsrela Cost?

Without insurance, Ibsrela costs approximately $2,000 to $2,500 for a 30-day supply (60 tablets). It is a brand-name medication with no generic alternative currently available. The earliest generic version of tenapanor is estimated to arrive around August 2033.

Insurance Coverage

Most commercial insurance plans cover Ibsrela, but typically require:

• Prior authorization — Your doctor must submit documentation showing medical necessity.
• Step therapy — You may need to try and fail on lower-cost alternatives like Linzess (Linaclotide) or Trulance (Plecanatide) first.

Not all Medicare Part D or Medicaid plans cover Ibsrela.

Savings Programs

The Ibsrela Commercial Copay Program can reduce your cost to as low as $0 per fill with eligible commercial insurance. Ardelyx pays up to $1,786 per 30-day supply. The discount is applied automatically at most pharmacies — no physical copay card needed.

For more options, see our guide on how to save money on Ibsrela.

How to Find Ibsrela

Because Ibsrela is a specialty medication from a single manufacturer, not every pharmacy keeps it in stock. If you're having trouble locating it, Medfinder can help you find a pharmacy near you that has Ibsrela available.

Final Thoughts

Ibsrela is a first-in-class IBS-C treatment that works differently from other available medications. Taken as a 50 mg tablet twice daily before meals, it can help relieve both the constipation and abdominal pain that come with IBS-C. While the cost is high without insurance, savings programs can significantly reduce what you pay.

If you think Ibsrela might be right for you, start by talking to your doctor — or learn how to find a doctor who prescribes Ibsrela near you.