7 Voquezna Side Effects You Should Know About

Voquezna (vonoprazan) is a potassium-competitive acid blocker (PCAB) medication. It works by decreasing the amount of acid in your stomach.

Voquezna works faster and may be more effective in some cases than other common acid reflux medications, such as proton pump inhibitors (PPIs). It is FDA approved to relieve heartburn symptoms caused by erosive esophagitis or gastroesophageal reflux disease (GERD) in adults. It is also used in combination with certain antibiotics to treat Helicobacter pylori (H. pylori) infections. H. pylori infections can cause inflammation and ulcers in the stomach.  

Voquezna is generally well tolerated. But there are some side effects you should be aware of before taking it. Knowing about Voquezna side effects in advance can help you manage them if they happen to you.

Voquezna side effects at a glance

During clinical trials, Voquezna side effects were rare overall. Below is a list of mild side effects and a list of rare, but serious, side effects that may occur. Keep in mind that these lists do not include all possible Voquezna side effects. Don’t hesitate to speak to your healthcare team about any side effects you experience while taking Voquezna, even if they aren’t named here.

Mild Voquezna side effects include:

• Stomach pain

• Nausea

• Bloating

• Diarrhea

• Indigestion

• Belching

• Increased risk of urinary tract infections (UTIs)

• Increased risk of upper respiratory tract infections (URTIs)

• Increased risk of vaginal yeast infections

• Headaches

• High blood pressure

• Constipation

• Temporary changes in sense of taste

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Rare but serious Voquezna side effects include:

• Very low vitamin B12 levels

• Very low magnesium levels

• Increased risk of bone fractures

• Clostridioides difficile-associated diarrhea

• Kidney damage

• Severe skin reactions

• Stomach polyps

Here, we will discuss seven notable Voquezna side effects in more detail, along with what to do if they occur.

Good to know: When Voquezna is taken for H. pylori, it’s combined with other medications that have additional side effects to consider. If you’re taking it for this purpose, talk to your pharmacist or prescriber about other side effects you should be aware of.

1. Upset stomach

Stomach upset is one of the most common Voquezna side effects. Symptoms can include stomach pain, nausea, and bloating. These symptoms may be due to Voquezna itself or due to the condition that it’s treating. For example, GERD can cause an upset stomach.

Upset stomach symptoms related to Voquezna are usually mild and often improve over time. If they occur, see if taking Voquezna with food helps. You can also talk to your healthcare team about starting an over-the-counter (OTC) medication, such as Emetrol (phosphorated carbohydrate), to help with this side effect. But don’t combine Voquezna with an OTC heartburn medication unless your prescriber tells you to.

2. Diarrhea

Another common Voquezna side effect is diarrhea. This side effect is typically mild and usually resolves on its own. If you have diarrhea, avoid eating foods that can make diarrhea worse, such as spicy or fried foods. You can also talk to your prescriber about starting an OTC antidiarrheal medication, such as loperamide (Imodium A-D), if needed. But if you need OTC diarrhea medication for more than 2 days in a row, let your prescriber know.

EXPERT PICKS: WHAT TO READ NEXT

• Other acid reflux medications: Learn about other medications that relieve heartburn symptoms to see which may be the best option for you.

• Foods and drinks that affect heartburn: There are certain foods and drinks that can make heartburn symptoms worse. Learn more about the best foods and drinks for heartburn.

• Probiotics for acid reflux and heartburn: Certain probiotics may improve acid reflux and heartburn symptoms. Find out which probiotics are most helpful for these conditions.

In rare cases, Voquezna can lead to a serious form of diarrhea known as Clostridioides difficile-associated diarrhea. This happens when low stomach acid levels allow C.diff bacteria to overgrow, leading to severe diarrhea. It can be life-threatening if it isn’t treated quickly. So it’s important to seek medical attention right away if you develop severe diarrhea along with a fever or stomach pain.

3. Urinary tract infections

Voquezna may increase the risk of urinary tract infections (UTIs). UTIs occur when germs such as bacteria grow in the urinary tract. We don’t know exactly why Voquezna increases the risk of UTIs. 

To decrease your risk of UTIs, make sure that you drink plenty of water while taking Voquezna. This can help flush out your urinary tract and prevent infections.

Typical UTI symptoms include pain when you pee and needing to pee more often. Most UTIs are mild, but you’ll need an antibiotic to treat them. If left untreated, a UTI can lead to complications, such as a kidney infection. So if you develop symptoms of a UTI, let your healthcare team know.

4. Upper respiratory tract infections

Upper respiratory tract infections (URTIs) are another possible Voquezna side effect. URTIs include the common cold and sinus infections. They can occur because Voquezna decreases the amount of acid in your stomach. When there’s less stomach acid, bacteria can overgrow and cause infections in the respiratory tract.

URTI symptoms include a runny nose, sore throat, and cough. These infections typically go away on their own after a few days. But OTC cough and cold medications can help, if needed. Drinking hot tea and using a humidifier are also good nonmedication options. But if you have difficulty breathing or a fever that won't go away, you should seek medical care.

5. Low vitamin B12 levels

Vitamin B12 protects your nerves, makes DNA, and makes red blood cells. Taking Voquezna may decrease your vitamin B12 levels. This can happen because Voquezna reduces the amount of acid in your stomach. This can lower your body’s absorption of vitamin B12.

You may have an increased risk of low vitamin B12 levels if you’re over age 75 or if you’re vegan or vegetarian. This side effect is also more likely if you take Voquezna every day for long periods of time. It’s best to take Voquezna for the shortest time needed to lower your risk.

In many cases, having low vitamin B12 levels doesn’t cause any symptoms. But if your vitamin B12 levels become very low, you may feel more tired than usual or notice numbness in your hands and feet. Let your prescriber know if you experience either of these symptoms. They may check your vitamin B12 levels and recommend a vitamin B12 supplement, if needed.

6. Low magnesium levels

Magnesium is a mineral that helps your muscles work and keeps your heartbeat steady. Taking Voquezna can decrease magnesium absorption, which can lead to low magnesium levels. Low magnesium is more likely if you take other medications that decrease your magnesium levels or if you’re living with kidney problems.

Having low magnesium levels may not cause any symptoms. But if your magnesium levels are very low, you may experience muscle cramps or heart rhythm changes. 

Let your healthcare team know if you experience either of these symptoms. They can check your magnesium levels and recommend a magnesium supplement, if needed. But you shouldn't take extra magnesium on your own unless your prescriber tells you to. Too much magnesium can be harmful for your health.

7. Increased risk of bone fractures

Taking Voquezna may increase your risk of bone fractures. Medications that decrease stomach acid, such as Voquezna and PPIs, can lower your calcium absorption. This can weaken your bones and make fractures more likely.

Bone fractures are a rare Voquezna side effect. They’re more likely with long-term treatment. They’re also more likely if you’re living with osteoporosis or are at risk of developing it. But Voquezna doesn’t cause osteoporosis on its own.

To decrease your risk of bone fractures, take Voquezna for the shortest amount of time possible to treat your condition. Eating foods that help make your bones stronger, such as yogurt and tuna, and exercising can also help decrease your risk. Your prescriber may recommend a calcium or vitamin D supplement to help strengthen your bones. But you shouldn’t start taking a calcium or vitamin D supplement unless your prescriber tells you to.

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Written by:

Emma Scholes, PharmD Candidate

Emma Scholes has experience as a pharmacy intern at Walgreens and as a pharmacy technician at both CVS and a long-term care facility. During pharmacy school, she served as the vice president of professional affairs and development for the Student College of Clinical Pharmacy (SCCP) student chapter and was a project coordinator for Project Brown Bag and Project Safe Medication Disposal.

Reviewed by:

Kathryn Cannaday, PharmD Candidate

Kathryn Cannaday is currently a pharmacy intern with Ascension St. Vincent Hospital in Indianapolis. She is also currently involved in a year-long experience with Butler University Community Outreach Pharmacy, serving as a medication therapy consultant for the underserved local community.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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