XPHOZAH®: An Exciting New Frontier in Managing Hyperphosphatemia – A Phosphate Absorption Inhibitor for Dialysis Patients

Shree Mulay|April 24, 2024|Hyperphosphatemia, Kidney Basics
The XPHOZAH logo features the medication name in stylized aqua green-blue lettering, highlighting a new treatment option for high phosphate levels in dialysis patients.

At The Kidney Experts, we’re dedicated to providing compassionate, cutting-edge care for our kidney disease patients. Part of that commitment means staying informed about new treatment options. If you’re a dialysis patient, you’re likely familiar with the challenges of managing hyperphosphatemia, or high blood phosphate levels. XPHOZAH® (tenapanor) is a newly approved medication, specifically a phosphate absorption inhibitor, offering a unique approach to this common problem.

Understanding Hyperphosphatemia: Why It Matters

When our kidneys aren’t functioning optimally, they struggle to filter out excess phosphate from our blood. This buildup can lead to serious complications:

  • Bone Disease: High phosphate triggers the release of hormones that pull calcium from bones, weakening them.
  • Cardiovascular Risks: Phosphate can deposit in blood vessels, accelerating hardening and increasing the risk of heart disease.
  • Other Concerns: Itchy skin, joint pain, and nerve problems can occur with chronically elevated phosphate levels.

How XPHOZAH® Works: A Different Approach

Unlike traditional phosphate binders, which work by attaching to phosphate in the digestive tract, XPHOZAH® is a selective phosphate absorption inhibitor that takes a more targeted approach:

  • Selective Action: XPHOZAH® targets a specific protein in the gut called the sodium-hydrogen exchanger 3 (NHE3). This protein plays a role in both sodium and phosphate absorption. By blocking NHE3, XPHOZAH® indirectly reduces phosphate entering the bloodstream through the paracellular pathway (the spaces between cells, which is the primary route for phosphate absorption).
  • Localized Effect: XPHOZAH® focuses its action within the intestines. This minimizes the potential for systemic side effects that can occur with some other phosphate-lowering medications that work throughout the body.
  • Important Note: XPHOZAH® is a valuable tool, but it’s not a replacement for dialysis. Dialysis remains essential for removing a wide range of waste products and toxins, including phosphate, from the blood of patients with kidney disease.

XPHOZAH® in Practice: What You Need to Know

  • Dosing:
    • Typically, we’ll start with 30mg twice a day, taken with meals.
    • If you experience side effects, we may reduce your dose to 30mg once daily or consider alternative management strategies.
    • It’s important to note that taking XPHOZAH twice daily, with meals, is the recommended regimen for optimal phosphate control.
  • Timing: Avoid taking XPHOZAH® immediately before a dialysis session, especially in the first few weeks, as this can increase the risk of diarrhea.
  • Managing Diarrhea: The most common side effect, diarrhea, often lessens over time. We’ll work with you on strategies like hydration and potential dose adjustments.
  • Stop Laxatives: It’s crucial to stop using laxatives and stool softeners while on XPHOZAH® to manage diarrhea effectively.
  • Drug Interactions: Take other oral medications several hours before or after XPHOZAH® to avoid interactions.
  • Monitoring: We’ll regularly check your phosphate levels to ensure XPHOZAH® is working optimally and adjust your dose as needed.

Potential Benefits of XPHOZAH®

  • Novel Mechanism: A different approach for those who struggle with traditional phosphate binders.
  • Reduced Pill Burden: May potentially simplify your medication regimen.
  • Adherence Matters: Taking XPHOZAH® with meals is essential for effectiveness. We’ll support you with strategies to stay on track.

The Kidney Experts: Your Partners in Care

Our goal is to help you live your best life with kidney disease. XPHOZAH® may be a valuable tool for some patients. We’ll discuss if it’s right for you, individualize our treatment plan, and address any concerns you have along the way.

Q: I’m on dialysis and struggle with high phosphate levels. Is XPHOZAH® right for me? A: XPHOZAH® may be a good option for some dialysis patients, but it’s important to discuss your individual situation with your nephrologist at The Kidney Experts. We’ll consider your current medications, side effects you experience, and overall health to determine if it’s a suitable choice.

Q: How does XPHOZAH® compare to traditional phosphate binders? A: XPHOZAH® works differently from traditional phosphate binders. It targets phosphate absorption in the gut, rather than binding to phosphate that’s already been absorbed. This can offer some advantages, but your doctor is the best person to advise if XPHOZAH® would be a better fit than your current regimen.

Q: What are the common side effects of XPHOZAH®? A: Diarrhea is the most common side effect, especially when starting XPHOZAH®. It often improves over time, and we provide strategies to manage it. It’s crucial to stop taking laxatives and stool softeners while on XPHOZAH® to avoid worsening diarrhea.

Q: How do I take XPHOZAH®? A: Take XPHOZAH® with meals – this is essential for it to work properly. We usually start with a twice-daily dose, but it may be adjusted to a once-daily dose if it is not tolerated. Avoid taking it immediately before dialysis, as this can increase the risk of diarrhea.

Q: Are there any medications I shouldn’t take with XPHOZAH®? A: Yes. It’s important to let your doctor at The Kidney Experts know about all medications you take, including over-the-counter ones and supplements. XPHOZAH® can interact with some medications, so we’ll need to space out the timing of your doses.

Q: How will I know if XPHOZAH® is working for me? A: We’ll monitor your phosphate levels regularly while on XPHOZAH®. The goal is to bring your phosphate into a healthy range, and we may adjust your dose to achieve that.

Have more questions? Don’t hesitate to contact The Kidney Experts. We’re committed to helping you manage your kidney health and optimize your treatment plan.

Further Resources

Disclaimer: This blog post is for informational purposes only. Please consult with your own doctor for specific medical advice regarding any medications or health concerns.