Drug & supplement interaction

Calabar Bean + Tenapanor Hydrochloride

Tenapanor Hydrochloride brand name: Ibsrela.

No Known Interaction
Medically reviewed by · Updated July 2026 · Pair last verified Sep 13, 2026
The bottom line No known interaction

We found no known interaction between Calabar Bean and Tenapanor Hydrochloride in our sources. Absence of a documented interaction is not the same as proven safety, and does not guarantee one does not exist. Do not start, stop, or change a medication or supplement based on this page; confirm with your pharmacist or doctor first. Additionally, although there is no interaction, the two are separately associated with some of the same side effects, which would make a new symptom harder to attribute to one or the other.

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Interaction report

Calabar Bean and Tenapanor Hydrochloride

We checked these two against our interaction database. Here is what we found.

No Known Interaction Found

We did not find a documented interaction between Tenapanor Hydrochloride and Calabar Bean in our sources. This does not guarantee that the combination is completely free of risk — there is often limited research on supplements and herbal products, especially around drug interactions.

If you decide to take both, the practical routine is simple: add one new thing at a time and note the date you started it. If the combination is going to disagree with you, it usually shows in the first days to a couple of weeks — and a start date turns “I’ve been feeling off” into something a pharmacist can actually work with. Do not stop a prescribed medicine on your own.

Always talk with your pharmacist or doctor before making changes to your medications or supplements, particularly if you take several medications or have an ongoing health condition.

Calabar Bean safety at a glance

Calabar Bean overall Avoid The raw bean is poisonous and can cause severe, even fatal, poisoning.
Pregnancy Unsafe When used orally; avoid using. Read the full pregnancy detail
Breastfeeding Unsafe When used orally; avoid using. Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center) — the full detail is in the Special populations card below. Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

Still wondering about combining Tenapanor Hydrochloride and Calabar Bean? Ask Dr. Brian Staiger, PharmD, BCPS directly ›
How we checked

Why No Interaction Is Listed for Tenapanor Hydrochloride

Interactions in our licensed database are recorded against drug classes, not just single drug names. Tenapanor Hydrochloride is filed under 2 classifications — cytochrome p450 3a4 (cyp3a4) substrates, oral drugs. Calabar Bean has documented interactions with 1 drug class — the most serious being anticholinergic drugs (minor) — and none of Tenapanor Hydrochloride’s classifications are among them.

Classification data comes from our licensed Natural Medicines dataset. A medication can belong to classes beyond those recorded there, so this describes how the check was run — it is not a safety guarantee.

Keep it in perspective

Calabar Bean Does Interact With Other Medications

Calabar Bean has 195 minor known drug interactions in our database — Tenapanor Hydrochloride isn’t one of them. If you take anything else, check it against the full list below.

Minor 195 No known interaction 2,635 (incl. Tenapanor Hydrochloride)
Taking anything else?

Check Another of Your Medications Against Calabar Bean

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

What to actually watch for

No Interaction Found — But Data Suggests Calabar Bean and Tenapanor Hydrochloride May Share a Side Effect

This is not an interaction. Neither one changes how your body handles the other, and nothing here says they react together. What our sources do show is that each has separately been linked to the effects below — so taking both can make those effects more likely to turn up, and harder to pin on one or the other if they do.

  • Diarrhea reported in 31.1% of FDA reports for Tenapanor Hydrochloride Additional detail

    Calabar Bean

    “Orally, physostigmine, a constituent of calabar bean, can cause cholinergic crisis, including paralysis, coma, and death. Other symptoms of cholinergic crisis may include bradycardia, confusion, diarrhea, miosis, muscle weakness, salivation, sweating, and vomiting (15).”

    Calabar Bean · Natural Medicines adverse-effect record, reported in diarrhea.

    1 source cited
    1. 15. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

    Tenapanor Hydrochloride

    Listed in the ADVERSE REACTIONS section of the FDA label for Tenapanor Hydrochloride, and in voluntary FDA adverse-event reports. Read the label on DailyMed ›

Reported for Calabar Bean but not commonly for Tenapanor Hydrochloride: muscle weakness, raised blood pressure, a fast or pounding heartbeat and a slow heartbeat.

Effects for Tenapanor Hydrochloride come from the ADVERSE REACTIONS section of its FDA label; effects for Calabar Bean come from the Natural Medicines adverse-effect record, quoted above. Where a percentage is shown, it is the share of 1,216 voluntary FDA FAERS reports for Tenapanor Hydrochloride that mention that effect — a reporting proportion, not an incidence rate and not evidence the drug caused it. Wording is matched across sources by our own clinical vocabulary, so treat this as a prompt to pay attention, not a diagnosis.

Special populations

Calabar Bean in Pregnancy & Breastfeeding

Pregnancy And Lactation Unsafe

When used orally; avoid using.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.© 2026 Therapeutic Research Center

Overlapping uses

What Tenapanor Hydrochloride Is Prescribed For, and What Calabar Bean Has Been Studied For

These two come up together because they touch the same health topic — not because they do the same job. Tenapanor Hydrochloride is a prescription medicine with approved uses on its FDA label. Calabar Bean is a supplement: what follows is what researchers have looked at it for, and how strong that evidence is.

Tenapanor Hydrochloride is prescribed for: 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.

Calabar Bean has been studied for:

  • Constipation studied, not established Calabar Bean has been studied for this. Natural Medicines rates the evidence: Insufficient Reliable Evidence To Rate Read what the research shows

    Calabar Bean for constipation

    Although there has been interest in using oral calabar bean for constipation, there is insufficient reliable information about the clinical effects of calabar bean for this purpose.

Effectiveness ratings and the research summaries above are the verbatim record from the Natural Medicines database, which grades evidence from “Effective” down to “Insufficient Reliable Evidence To Rate”. A rating below the top of that scale means researchers have looked at it — not that it works, and never that it can stand in for a prescribed medicine. Do not stop or replace Tenapanor Hydrochloride on your own; if you are taking Calabar Bean for the same health topic, tell your prescriber, especially if the medicine is being adjusted to a target.

Everything else you take

See Every Supplement That Interacts With Tenapanor Hydrochloride

This page covers Calabar Bean 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

How much people look this up

Where Calabar Bean 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 Calabar Bean
Steady interest

#1,223 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Tenapanor Hydrochloride
Top 10%

#143 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.

Where does our data come from?
  • Source: the Natural Medicines (TRC Healthcare) clinical database — the evidence-graded professional reference for herb & supplement interactions.
  • Citation library: 103,510 references behind our interaction content, 65,311 of them resolved to verified PubMed/DOI sources. See every Calabar Bean reference on this page ↓
  • Freshness: we automatically re-check this combination every week — this pair was last verified September 13, 2026. The Calabar Bean and Tenapanor Hydrochloride records this page draws on were last updated July 10, 2026.
  • What “no known interaction” means: no documented interaction in the sources above — not a guarantee of safety. Supplements are studied far less than prescription drugs, so we say exactly what the evidence supports, and nothing more.
Data structure & sourcing designed and verified by .
Supplement

About Calabar Bean

What is Calabar Bean?

Calabar Bean
  • Source of physostigmine (a prescription drug ingredient)
  • Historically used in 'trial by ordeal' rituals
  • Traditional pain relief and anti-inflammatory uses
  • Historically used for eye conditions (glaucoma)
  • Historically used as a poison

Calabar bean is a highly poisonous West African seed that contains physostigmine, a powerful cholinesterase inhibitor. It is not a safe dietary supplement, and eating the bean can cause serious poisoning or death. Only the purified, regulated drug physostigmine has a legitimate medical use, and that must be prescribed and monitored by a doctor.

Physostigma venenosum · Fabaceae · Seeds (beans) · Not available as a safe consumer supplement; historically the seed and its extracts were used, and the alkaloid physostigmine is used in prescription medicines

An interaction check asks whether these two react with each other — it does not ask whether Calabar Bean is a good idea for someone in your situation. Here is what our Calabar Bean record says about it on its own.

Calabar Bean: dosing

There is no safe or established dose of Calabar bean for self-care, and it should not be taken as a supplement. The bean is poisonous, and the amount of physostigmine it contains can vary, making any home use extremely risky.The only proper medical use of this plant's active compound is the regulated prescription drug physostigmine, which a doctor doses precisely and monitors closely. Never attempt to use the bean yourself.

From our Calabar Bean monograph — the full record covers uses, side effects and every documented interaction.

Read the full Calabar Bean 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.

Most-Reported Side Effects for Tenapanor Hydrochloride

From FAERS, the FDA’s public side-effect reporting system (0 reports, all brands). Reports are voluntary and are not proof the drug caused the effect.

Diarrhea 1,239 reports
Therapy interrupted 292 reports
Abdominal distension 234 reports
Insurance issue 184 reports
Intentional underdose 167 reports
See full Tenapanor drug information
Keep checking

Other Drugs & Calabar Bean

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

0Major
0Moderate
195Minor
2,634No known interaction
195 Minor 2,634 No interaction
Minor

195 interactions

Showing 60 of 195 minor interactions — see all 195 on the Calabar Bean page.

No interaction 2,634 drugs checked — show the list

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

Showing the 60 most looked-up of 2,634 medications checked with no known interaction — see the full Calabar Bean list.

See the full Calabar Bean interactions page
See every supplement checked against Tenapanor Hydrochloride, ranked by severity
Evidence & sources

Calabar Bean References

The 2 references that drive our Calabar Bean monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

  1. The Review of Natural Products by Facts and Comparisons. St. Louis, MO: Wolters Kluwer Co., 1999.
  2. McEvoy GK, ed. AHFS Drug Information. Bethesda, MD: American Society of Health-System Pharmacists, 1998.

Medication overviews come from MedlinePlus (NIH); supplement label data from the NIH Dietary Supplement Label Database. Content is written and reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

Pharmacist Counseling Corner

Taking Calabar Bean and Tenapanor Hydrochloride Together: Common Questions

Is it safe to take Calabar Bean with Tenapanor Hydrochloride?
We do not list a known interaction between Calabar Bean and Tenapanor Hydrochloride. That does not guarantee the combination is risk-free, so confirm with your pharmacist or doctor — especially if you take other medications or have a health condition.
Do Calabar Bean and Tenapanor Hydrochloride have any of the same side effects?
Yes — our sources link each of them separately to one of the same effects. That is not an interaction: neither changes how your body handles the other. It does mean that if one of those effects turns up, it can be harder to tell which one is behind it. They are listed on this page with the source behind each.
Are Calabar Bean and Tenapanor Hydrochloride used for the same thing?
They overlap in purpose, which usually means the real question is whether you need both rather than whether they are safe together. This page lists the shared uses and how strong the evidence is for Calabar Bean in each. That is a conversation for your prescriber, especially if Tenapanor Hydrochloride is being adjusted to a target.
How was the Calabar Bean and Tenapanor Hydrochloride combination checked?
Interactions in our licensed database are recorded against drug classes. Tenapanor Hydrochloride is filed under 2 classifications, and Calabar Bean has documented interactions with 1 drug class — none of Tenapanor Hydrochloride's classifications are among them. A medication can belong to classes beyond those recorded in our dataset, so this describes how the check was run rather than guaranteeing safety.
Does Calabar Bean interact with any other medications?
Yes. Calabar Bean has 195 documented drug interactions in our database — Tenapanor Hydrochloride is simply not one of them. If you take anything else, it is worth checking each one; they are all listed on this page.
Does Tenapanor Hydrochloride interact with any supplements?
Yes. Tenapanor Hydrochloride has documented interactions with 138 supplements in our database — Calabar Bean is not one of them. The Tenapanor Hydrochloride interaction page linked on this page lists every one, ranked by severity.

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

Where next

Keep Exploring

Calabar Bean monograph Uses, safety profile, and every drug interaction in one place Tenapanor drug information The full plain-English guide to this medication Tenapanor Hydrochloride supplement interactions Every supplement checked against Tenapanor Hydrochloride, ranked by severity Supplement interaction checker Check any supplement or product against your medications Browse medications A–Z Every drug we’ve checked against herbs & supplements References The 2 citations behind this page Ask a pharmacist Free, personal answer from our licensed team

Still Have a Question About Tenapanor Hydrochloride and Calabar Bean?

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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.