Drug & supplement interaction

Bael + Tenapanor Hydrochloride

Tenapanor Hydrochloride brand name: Ibsrela.

Minor Interaction
Medically reviewed by · Updated September 2026
The bottom line Minor

Bael has a minor interaction with Tenapanor Hydrochloride. Bael and its constituents marmelosin and marmesinin inhibited cytochrome P450 3A4 (CYP3A4) activity in vitro.

Read the full interaction report
SeverityMinor
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Bael and Tenapanor Hydrochloride

Here is the interaction we found between these two, with the evidence behind it.

Minor

CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES

Why this applies to Tenapanor Hydrochloride

Tenapanor Hydrochloride falls under CYTOCHROME P450 3A4 (CYP3A4) SUBSTRATES — the group Bael interacts with.

Bael and its constituents marmelosin and marmesinin inhibited cytochrome P450 3A4 (CYP3A4) activity in vitro. So far, this interaction has not been reported in humans. Theoretically, bael might increase levels of drugs metabolized by CYP3A4.
Some drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and numerous others. Use bael cautiously or avoid in patients taking these drugs.
Severity Minor Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the good news about tenapanor (Ibsrela): it works right in your gut, blocking a sodium transporter in the intestine, and very little of it actually gets absorbed into your bloodstream. Because so little gets inside the body, the usual liver enzyme story (CYP3A4) doesn't play much of a role for this particular medicine.

The interaction on file is only theoretical, based on lab-dish studies showing bael may slow CYP3A4. It has never been reported in people, and tenapanor's main effect (loosening stools to treat constipation) doesn't really depend on that pathway. The bigger practical thing to watch is that bael's tannins are traditionally used to firm up stools, which could work against what tenapanor is trying to do. If you take both, mention it to your pharmacist or doctor.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Manda VK, Avula B, Chittiboyina AG, Khan IA, Walker LA, Khan SI. Inhibition of CYP3A4 and CYP1A2 by Aegle marmelos and its constituents. Xenobiotica. 2016;46(2):117-25.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Bael Also Interacts With Other Medications

Bael has 111 moderate, 707 minor known drug interactions in our database — the Tenapanor Hydrochloride one above is one of them. If you take anything else, check it against the full list below.

Moderate 111 Minor 707 No known interaction 2,012 (incl. Tenapanor Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Bael

Covers the 2,830 medications we’ve checked against Bael. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Tenapanor Hydrochloride

This page covers Bael only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Tenapanor Hydrochloride page lists 138 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Grapefruit (major), St. John's Wort (major), Acacia Rigidula (moderate) and Adrafinil (moderate).

By severity: 3 major · 94 moderate · 41 minor.

From our pharmacist’s overview on the Tenapanor Hydrochloride page

“Tenapanor hydrochloride (Ibsrela) works in the gut to relieve irritable bowel syndrome with constipation, and its supplement interaction list deserves genuine care rather than a quick skim. Three of the 138 ingredients on file rate major: grapefruit, St.”

Reviewed by 2 · Jul 18, 2026

Open the Tenapanor Hydrochloride interaction page

One more smart check

Taking Bael as Part of a Dietary Supplement Product? Check It for Interactions

We hold 94 real supplement products containing Bael, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Bael. Your product may carry other ingredients that interact with Tenapanor Hydrochloride too, on top of Bael — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Bael and Tenapanor Hydrochloride Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Bael
Top half

#592 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tenapanor Hydrochloride
Top 5%

#83 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Bael

What is Bael?

Bael
  • Diarrhea and dysentery
  • Indigestion and other digestive complaints
  • Constipation
  • Blood sugar support
  • General wellness in traditional medicine

Bael is a fruit-bearing tree long used in traditional Indian (Ayurvedic) medicine, mostly for digestive problems like diarrhea and indigestion. Modern human evidence for its medicinal benefits is very limited, so it should be viewed mainly as a food and traditional remedy rather than a proven treatment. Talk to your pharmacist or doctor before using bael as a supplement, especially if you are pregnant, breastfeeding, or have a health condition.

Read the full Bael monograph & all interactions
Medication

About Tenapanor

What Is Tenapanor Used For?

Brand name: Ibsrela

Tenapanor is approved for two distinct conditions, each under a separate brand. Ibsrela is used to treat irritable bowel syndrome with constipation (IBS-C) in adults. XPHOZAH is used to reduce high phosphorus levels (hyperphosphatemia) in adults with chronic kidney disease (CKD) who are on dialysis — specifically as an add-on when phosphate binders haven't worked well enough or aren't tolerated.

See full Tenapanor drug information
Keep checking

Other Drugs & Bael

Browse every other medication we’ve checked against Bael — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
111Moderate
707Minor
2,011No known interaction
111 Moderate 707 Minor 2,011 No interaction
Moderate

111 interactions

Showing 60 of 111 moderate interactions — see all 111 on the Bael page.

Minor

707 interactions

Showing 60 of 707 minor interactions — see all 707 on the Bael page.

No interaction 2,011 drugs checked — show the list

We also checked Bael against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,011 medications checked with no known interaction — see the full Bael list.

See the full Bael interactions page
See every supplement checked against Tenapanor Hydrochloride, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Bael monograph › Uses, safety, and every drug interaction in one place Tenapanor Hydrochloride supplement interactions › Every supplement checked against Tenapanor Hydrochloride, ranked by severity Tenapanor drug information › The full plain-English guide to this medication Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Bael and Tenapanor Hydrochloride Together: Common Questions

Can you take Bael with Tenapanor Hydrochloride?
There is only a minor interaction, which is usually not serious. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Bael and Tenapanor Hydrochloride interaction?
We rate it Minor. This interaction is generally not clinically significant, but it remains worth noting and discussing with your pharmacist.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Tenapanor Hydrochloride and Bael?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.