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Drug - Ibsrela® (tenapanor) [Ardelyx, Inc.]

October 2022

Therapeutic area - GI Motility, Chronic

Approval criteria

  • Patient must be 18 years of age and older AND 
  • Patient has a diagnosis of irritable bowel syndrome with constipation (IBS-C) AND
  • Patients does not have known or suspected mechanical gastrointestinal obstruction AND
  • Prescriber attests that constipation-causing therapies for other diseases have been reviewed and therapies avoided if possible AND 
  • Patient has tried and failed at least 4 of the following medical therapies: psyllium, methlycellulose, polycarbophil, wheat dexdrin, magnesium hydoxide, magnesium citrate, sodium phosphate, lactulose, PEG electrolyte solution, docusate, mineral oil, senna, bisacodyl, phosphate enema, mineral oil retention, tap-water enema, glycerin suppository, glycerin-bisacodyl suppository AND
  • Patient has tried and failed Linzess, unless contraindicated

Quantity limits

  • 60 tablets per 30 days


MHCP Provider Resource Center 651-431-2700 or 800-366-5411

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