Ibsrela (tenapanor) is a prescription drug used to treat irritable bowel syndrome. Ibsrela can cause side effects that range from mild to serious. Examples include abdominal bloating, gas, diarrhea, and dizziness.

Specifically, Ibsrela is used in adults to treat irritable bowel syndrome with constipation (IBS-C), a chronic (long-term) gastrointestinal (GI) disorder.

Ibsrela comes as an oral tablet and contains the active ingredient tenapanor. (An active ingredient is what makes a drug work.)

Keep reading to learn about the common, mild, and serious side effects Ibsrela can cause. For a general overview of the drug, including details about its uses, see this article.

Some people may experience mild to serious side effects during Ibsrela treatment. Examples of the drug’s commonly reported side effects include:

Mild side effects have been reported with Ibsrela. These include:

In most cases, these side effects should be temporary. And some may be easily managed with diet changes, over-the-counter medications, or home remedies. But if you have ongoing or bothersome symptoms, talk with your doctor or pharmacist. And do not stop taking Ibsrela unless your doctor recommends it.

Ibsrela may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Ibsrela, but this side effect wasn’t reported in studies.

Serious side effects have been reported with Ibsrela. These include:

If you develop serious side effects while taking Ibsrela, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after taking Ibsrela, but this side effect wasn’t reported in studies.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Ibsrela, visit MedWatch.

Get answers to some frequently asked questions about Ibsrela’s side effects.

Can Ibsrela cause weight gain or weight loss?

Weight gain and weight loss were not side effects reported in studies of Ibsrela. However, fluid gain or loss caused by Ibsrela or irritable bowel syndrome may cause weight to temporarily increase or decrease.

If you notice a significant change in your weight, talk with your pharmacist or doctor right away.

How do side effects of Ibsrela compare with those of Trulance?

Ibsrela and Trulance (plecanatide) both treat IBS-C but work differently. Side effects they have in common include diarrhea, dizziness, bloating, and gas.

Other side effects differ by drug. For example, Ibsrela can cause rectal bleeding. And Trulance can cause nausea, cold symptoms, upper respiratory tract infection, and urinary tract infection (UTI). Elevated liver enzymes were also a rare side effect reported in studies of Trulance.

For more information on how the side effects of Ibsrela and Trulance compare, talk with your doctor or pharmacist.

Does Ibsrela cause long-term side effects?

Long-term side effects weren’t reported in studies of Ibsrela. However, studies were only conducted for 26 weeks.

If you’re concerned about possible long-term side effects from Ibsrela, talk with your doctor or pharmacist.

Learn more about some of the side effects Ibsrela may cause.

Risk of serious dehydration in certain children

Ibsrela has a boxed warning for the risk of serious dehydration in certain children. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Ibsrela is not approved for use in children of any age. The safety and effectiveness of Ibsrela use in children under 18 years old haven’t been confirmed in studies. And because of the risk of life threatening diarrhea and dehydration, children less than 6 years old should not take this medication.

Severe diarrhea and dehydration in children may cause symptoms such as:

What might help

If a child accidentally takes Ibsrela, immediately call a pediatrician and get urgent medical care. Giving them fluids by mouth may not be enough to prevent life threatening dehydration.

If you think they’re having a medical emergency, immediately call 911 or your local emergency number.

Severe diarrhea

Severe diarrhea was a common side effect reported in studies of Ibsrela. It may cause symptoms such as:

  • cramping
  • nausea
  • abdominal pain and bloating
  • loose, watery stool
  • excessive bowel movements

Diarrhea can quickly lead to fluid loss and increase the risk of dehydration. Left untreated, diarrhea can cause serious side effects. Symptoms of dehydration include:

  • dry mouth and increased thirst
  • dizziness
  • increased heartbeat
  • headache
  • little to no urine output
  • confusion
  • lethargy or unresponsiveness

People with low kidney function have an increased risk of severe diarrhea and dehydration. Additional factors that can increase the risk of diarrhea when taking this drug include:

  • food sensitivities
  • eating or drinking sugary items
  • taking magnesium supplements or laxatives
  • intestinal infection

What might help

If you have diarrhea during Ibsrela treatment, consider using the BRAT diet to help temporarily relieve your symptoms. Make sure to drink plenty of water and supplement it with low sugar electrolyte drinks. If your diarrhea continues or worsens, talk with your doctor. They’ll likely recommend a medical evaluation.

Allergic reaction

Like most drugs, Ibsrela can cause an allergic reaction in some people. But this side effect wasn’t reported in studies. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an oral antihistamine, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Ibsrela, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Ibsrela, they may have you switch to a different treatment.

Keeping track of side effects

During your Ibsrela treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Ibsrela affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before taking Ibsrela.

Boxed warning: Risk of serious dehydration in some children

Ibsrela has a boxed warning for the risk of serious dehydration in some children. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Ibsrela is not approved for use in children of any age. Studies have not confirmed the safety and effectiveness of Ibsrela in children under 18 years old. And because of the potential danger of life threatening diarrhea and dehydration, Ibsrela should not be given to children under 6 years old.

To learn more, see the “Side effects explained” section above.

Other warnings

Ibsrela can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Ibsrela is a good treatment option for you.

Talk with your doctor about your health history before starting this medication. Be sure to tell them if any of the following factors apply to you:

Alcohol and Ibsrela

There are no known interactions between alcohol and Ibsrela. If you have questions about consuming alcohol while taking this drug, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Ibsrela

Before starting Ibsrela treatment, talk with your doctor if you’re pregnant, breastfeeding, or planning to be either.

Pregnancy

Ibsrela is generally considered safe to take during pregnancy as it is minimally absorbed into the bloodstream. But if you’re pregnant or planning a pregnancy, you should still talk with your doctor before starting treatment with this medication.

Breastfeeding

Ibsrela is generally considered safe to take while breastfeeding. But if you’re breastfeeding or planning to do so, you should still talk with your doctor before starting Ibsrela treatment.

Like most drugs, Ibsrela can cause a number of side effects that range from mild to serious. But most are temporary and go away after a few days to weeks. If you have questions about side effects Ibsrela can cause, talk with your doctor. Examples to help get you started include:

  • Can I take Imodium (loperamide) to treat diarrhea caused by Ibsrela?
  • When should I contact you regarding the severity of diarrhea with Ibsrela?
  • How long will it take for diarrhea to go away once I’ve stopped taking this medication?

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.