The occurrence of diarrhea and softer stool is an expected pharmacodynamic effect based on the mechanism of action of XPHOZAH. NHE3 inhibition in the intestine results in luminal sodium and water retention, resulting in softer and more frequent stool. INDICATION XPHOZAH (tenapanor) 30 mg BID is indicated to reduce serum phosphorus in adults with chronic kidney disease (CKD) on dialysis as add-on therapy in patients who have an inadequate response to phosphate binders or who are intolerant of any dose of phosphate binder therapy. IMPORTANT SAFETY INFORMATION CONTRAINDICATIONS XPHOZAH is contraindicated in: Pediatric patients under 6 years of age Patients with known or suspected mechanical gastrointestinal obstruction WARNINGS AND PRECAUTIONS Diarrhea Patients may experience severe diarrhea. Treatment with XPHOZAH should be discontinued in patients who develop severe diarrhea. MOST COMMON ADVERSE REACTIONS Diarrhea, which occurred in 43-53% of patients, was the only adverse reaction reported in at least 5% of XPHOZAH-treated patients with CKD on dialysis across trials. The majority of diarrhea events in XPHOZAH-treated patients were reported to be mild-to-moderate in severity and resolved over time, or with dose reduction. Diarrhea was typically reported soon after initiation but could occur at any time during treatment with XPHOZAH. Severe diarrhea was reported in 5% of XPHOZAH-treated patients in these trials.