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.
Helicobacter pylori (H. pylori) stomach infection in adults
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.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
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
Contains clarithromycin, which can interact with many other medications
Need to take 4 pills twice daily
Not available as a lower-cost generic
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.
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 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.
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.
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.
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.
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.
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.
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.
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.
Dosage | Quantity | Price as low as | Price per unit |
---|---|---|---|
20mg/500mg/500mg | 1 carton | $786.00 | $786.00 |
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.
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
Helicobacter pylori (H. pylori) stomach infection in adults
Helicobacter pylori (H. pylori) stomach infection in adults
Helicobacter pylori (H. pylori) stomach infection in adults
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Andersen, J. T., et al. (2013). Clarithromycin in early pregnancy and the risk of miscarriage and malformation: A register based nationwide cohort study. Public Library of Science One.
Chey, W. D., et al. (2022). Vonoprazan triple and dual therapy for Helicobacter pylori infection in the United States and Europe: Randomized clinical trial. Gastroenterology.
Phathom Pharmaceuticals. (n.d.). Voquezna works differently.
Phathom Pharmaceuticals Inc. (2024). Voquezna Dual Pak- vonoprazan fumarate and amoxicillin kit; Voquezna Triple Pak- vonoprazan fumarate, amoxicillin and clarithromycin kit [package insert]. DailyMed.
Shah, R., et al. (2023). Cholestatic jaundice.
U.S. Food and Drug Administration. (2023). Drug Trials Snapshots: Voquezna Triple Pak, Voquezna Dual Pak.
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