The most common adverse reaction is diarrhea, which occurred in 43-53% of patients. The majority of diarrhea was reported to be mild-to-moderate; severe diarrhea was reported in 5% of patients.​ If diarrhea occurred, it tended to be reported soon after initiation and resolve over time or with dose reduction, but could occur at any time during treatment with XPHOZAH.​ In the phase 3 clinical trials, the majority of patients who discontinued due to diarrhea did so during the randomized treatment period. 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.