Voquezna Triple Pak
Voquezna Triple Pak (vonoprazan / amoxicillin/ clarithromycin) is taken to treat H. pylori infections in adults. It's made up of 3 separate medications packaged together in a blister pack: vonoprazan to lower stomach acid, and antibiotics amoxicillin and clarithromycin to fight the infection. All medications in Voquezna Triple Pak are taken by mouth twice per day for 2 weeks. Some common side effects include diarrhea, changes in taste, and yeast infections.
What is Voquezna Triple Pak?
What is Voquezna Triple Pak used for?
- Helicobacter pylori (H. pylori) stomach infection in adults
How Voquezna Triple Pak works
Voquezna Triple Pak is a combination of three medications that treat stomach infections caused by the bacteria Helicobacter pylori (H. pylori).
- Vonoprazan is a potassium-competitive acid blocker (PCAB). It blocks a protein to stop stomach acid from being made and released into your stomach. This prevents stomach acid from irritating your stomach.
- Amoxicillin is a penicillin antibiotic. It kills bacteria by preventing them from making their own protective covering in your body.
- Clarithromycin is a macrolide antibiotic. It stops bacteria from making proteins which they need to grow and survive.
Drug facts
Side effects of Voquezna Triple Pak
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Change in taste (5%)
- Diarrhea (4%)
- Vaginal yeast infection (3%)
- Headache (3%)
- Stomach pain (2%)
Less Common Side Effects
- Runny nose and sore throat
- Bloating
- Vomiting
- Feeling tired
- Low appetite
- Dry mouth
- Rash
Voquezna Triple Pak serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reaction: difficulty breathing, hives, itching, fast heartbeat, tightness in the throat, nausea, stomach pain, dizziness, lightheadedness, swelling in the face or tongue
- Severe skin reaction: red or purple skin rash, blisters on skin, peeling skin, fever
- Severe, frequent diarrhea (C. difficile infection): loose and watery stools, severe stomach pain or cramps, fever, nausea
- Abnormal heart rhythm (QT prolongation): chest pounding, short of breath, chest pain, feeling faint or lightheaded
- Serious liver problems: swelling or pain in your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
The following Voquezna Triple Pak side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Rash, fever, and swollen lymph nodes
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Severe diarrhea, fever
- Severe or prolonged vomiting or diarrhea
- Unusual vaginal discharge, itching, or odor
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
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Pros and cons of Voquezna Triple Pak
Pros
- Works well to treat H. pylori infections, including infections caused by certain resistant bacteria
- Conveniently packaged as 2-week treatment packs
- Can be taken with or without food
Cons
- Contains clarithromycin, which can interact with many other medications
- Need to take 4 pills twice daily
- Not available as a lower-cost generic
Pharmacist tips for Voquezna Triple Pak
- You can take Voquezna Triple Pak with or without food. But since antibiotics typically cause stomach side effects (e.g., nausea, stomach upset, diarrhea), taking your pills with food can help prevent or ease stomach upset.
- It's best to avoid drinking alcohol because it can worsen stomach side effects of Voquezna Triple Pak.
- It's possible for clarithromycin in Voquezna Triple Pak to cause dizziness, confusion, and vertigo. Don't drive or operate heavy machinery until you know how this medication affects you.
- Diarrhea is a common side effect of Voquezna Triple Pak and can lead symptoms of dehydration, like dry mouth and feeling light-headed. Stay hydrated with fluids and eat a healthy, balanced diet that's easy to digest.
- Ask your provider if it's appropriate for you to take a probiotic to help prevent or ease diarrhea. If you do, separate the probiotic from Voquezna Triple Pak by at least 2 hours to prevent the antibiotics from killing the "good" bacteria in the probiotic.
- Contact your provider you develop severe diarrhea with symptoms such as stomach cramps, fever, and tiredness. This might be a symptom of infectious diarrhea – a rare, but serious side effect of Voquezna Triple Pak that needs immediate medical attention. Rarely, infectious diarrhea have developed 2 months after the end of treatment.
- Make sure to finish all of the medication in the 2-week course, even if you start to feel better before then. This is to make sure Voquezna Triple Pak gets rid of the infection so you don't get sick again. Stopping treatment earlier than prescribed can make your infection come back and become resistant (harder to treat).
- Voquezna Triple Pak interacts with many medications. For example, because vonoprazan makes your stomach less acidic, it can affect how well your body absorbs certain antiviral medications. Tell your provider about all of the medications you're taking before starting Voquezna Triple Pak.
- If you miss your dose of Voquezna Triple Pak, take it as soon as you remember if it's within 4 hours of the missed dose. If more than 4 hours has passed, skip the dose and continue the next dose at the regularly scheduled time. Never double-up the dose to make up for the missed dose.
Common questions about Voquezna Triple Pak
Yes. Voquezna Triple Pak contains two antibiotics, amoxicillin and clarithromycin. These antibiotics work together to kill off the H. pylori bacteria.
Voquezna Triple Pak starts to work soon after your first dose. Vonoprazan begins to lower the amount of acid in your stomach 2 to 3 hours after you take it. And it might take 2 to 3 days before you start to feel better from the antibiotics. Regardless of how quickly your condition improve after starting Voquezna Triple Pak, it's important you finish the entire prescribed treatment course. Stopping the medication too early can make your infection come back and become harder to treat.
It's best to avoid alcohol with antibiotics because this can worsen stomach side effects (e.g., nausea, vomiting, diarrhea). Additionally, alcohol can make it harder for you to recover from an infection. If avoiding alcohol isn't a possible option for you, talk to your provider about what's a safer amount to drink.
Yes, Voquezna Triple Pak received FDA-approval in May of 2022 for the treatment of H. pylori in adults.
If you're pregnant and diagnosed with a H. pylori infection, discuss with your provider about possible treatment options. While amoxicillin is considered safe during pregnancy, clarithromycin can raise the risk for miscarriage. In addition, vonoprazan hasn't been well-studied during pregnancy, but animal studies suggest it might harm developing babies.
Probably not. Animal studies show that vonoprazan can pass into breast milk, but it's unclear how this might affect a nursing baby. To be safe, don't breastfeed while taking and for 2 days after completing Voquezna Triple Pak. In the meantime, consider feeding your baby previously stored breast milk or formula. If you’re breastfeeding, talk to your provider about the risks and benefits of taking Voquezna Triple Pak.
In clinical studies, Voquezna Triple Pak worked just as well to treat H.pylori infection compared to people who used standard therapy with lansoprazole/clarithromycin/amoxicillin (former brand name Prevpac). Also, Voquezna Triple Pak worked even better to treat people with a resistant (difficult-to-treat bacteria) strain of H. pylori compared to people taking Prevpac.
Both Voquezna Triple Pak and Voquezna Dual Pak contain vonoprazan as the medication that lowers stomach acid. The main difference between them is Voquezna Triple Pak contains two antibiotics (amoxicillin and clarithromycin), whereas Voquezna Dual Pak contains just amoxicillin. Another difference is that Voquezna Dual Pak is taken by mouth 3 times daily, whereas Voquezna Triple Pak is taken twice daily. Your provider will determine which medication is appropriate for your infection.
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Risks and warnings for Voquezna Triple Pak
Voquezna Triple Pak can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Severe allergic and skin reactions
Severe allergic reactions to Voquezna Triple Pak are possible, including life-threatening reactions like facial swelling, hives, and anaphylaxis (e.g., closing of the throat).
Voquezna Triple Pak can also cause serious skin reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). These reactions typically start off as aching, headaches, fever, or a burning sensation in the eyes. You could also get blisters, redness, or a red or purple rash on your skin. If you notice any signs of a severe allergic or skin reaction after taking Voquezna Triple Pak, get medical attention right away.
Infectious diarrhea
Voquezna Triple Pak can put you at a higher risk for getting Clostridioides difficile (C. difficile)-associated diarrhea (CDAD), a dangerous side effect. Like many other bacteria, C. difficile naturally lives in your gut and normally don’t cause any problems. But taking antibiotics, like amoxicillin, can cause C. difficile to grow out of control. This can lead to infectious diarrhea which can cause rapid heart rate, foul-smelling diarrhea, fever, nausea, frequent bowel movements (even up to 15 times per day) and is an emergency. If you have any of these symptoms, get medical attention right away so your provider can test you for infectious diarrhea. Your provider might ask you to stop Voquezna Triple Pak.
Life-threatening heart rhythm problems (QT prolongation)
- Risk factors: Heart rhythm problems | Taking other medications that affect your heart rhythm | Older adults | Electrolyte problems
The clarithromycin in Voquezna Triple Pak raises your risk for a serious heart rhythm condition called QT prolongation. The risk is higher for people taking other medications that can affect your heart rhythm, such as amiodarone (Pacerone) or certain antipsychotic medications. Make sure to tell your provider about all the medications you're taking before you start Voquezna Triple Pak. If you feel symptoms of heart problems, such as a pounding chest, trouble breathing, feeling faint or lightheaded, or chest pain while taking Voquezna Triple Pak, call 911 right away.
Liver damage
Voquezna Triple Pak can cause liver damage, which can be serious and even dangerous. Your provider might recommend that you get blood tests before and during treatment with Voquezna Triple Pak to make sure your liver is healthy. Let your provider know if you experience symptoms of liver problems such as feeling tired, nausea, dark urine, pale stool, and yellowing of the whites of the eyes and skin.
Interactions with other medications
The clarithromycin antibiotic in Voquezna Triple Pak interacts with many commonly-used prescription and over-the-counter medications, including clopidogrel (Plavix), citalopram (Celexa), colchicine (Colcrys), amlodipine (Norvasc), warfarin (Coumadin), and statin medications. This isn't a complete list. Some doses of these medications might need to be adjusted while others might need to be stopped while you take Voquezna Triple Pak. Make sure to tell your provider about all of the medications you're taking before starting Voquezna Triple Pak. Don't start any new medications without talking to your provider first.
Harm to unborn baby
Clarithromycin (one of the medications in Voquezna Triple Pak) is known to harm unborn babies. Voquezna Triple Pak isn't recommended for use in pregnancy. If you or your partner is able to become pregnant, make sure you use effective birth control during treatment with Voquezna Triple Pak.
Worsening of myasthenia gravis
If you have myasthenia gravis, taking clarithromycin can worsen symptoms like muscle weakness and difficulty breathing. Ask your healthcare provider if you're concerned about this problem.
Difficult-to-treat infections
Only take Voquezna Triple Pak if your provider confirmed you have H. pylori stomach infection and prescribed this medication for you. Don't share this medication with anyone else. Taking Voquezna Triple Pak when it's not needed can raise the risk of developing infections that can be more difficult to treat in the future.
Voquezna Triple Pak dosage
Carton| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 20mg/500mg/500mg | 1 carton | $849.31 | $849.31 |
Typical dosage for Voquezna Triple Pak
Each pack contains vonoprazan 20 mg tablets, amoxicillin 500 mg capsules, and clarithromycin 500 mg tablets.
The typical dose is 1 tablet of vonoprazan, 2 capsules of amoxicillin, and 1 tablet of clarithromycin, all taken by mouth two times a day (12 hours apart) for a total of 14 days.
How much does Voquezna Triple Pak cost?
$849.31
Voquezna Triple Pak contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Voquezna Triple Pak will not be safe for you to take.
- Severe allergy to vonoprazan, amoxicillin (or other penicillin antibiotic), or clarithromycin (or other macrolide antibiotic)
- Taking a product with rilpivirine (Edurant)
- Also taking pimozide, lomitapide (Juxtapid), simvastatin (Zocor), lovastatin (Altoprev), or ergot alkaloids, lurasidone (Latuda), or colchicine (Colcrys) (in people with kidney or liver problems)
- History of cholestatic jaundice or liver problems with clarithromycin
What are alternatives to Voquezna Triple Pak?
Voquezna Triple Pak images
