Voquezna
Voquezna (vonoprazan) is a potassium-competitive acid blocker (PCAB). It relieves heartburn from erosive esophagitis and non-erosive gastroesophageal reflux disease (GERD). It can also treat H. pylori infections, in combination with certain antibiotics. Voquezna (vonoprazan) received FDA approval in late 2023 for adults and is available as a tablet that's taken by mouth once per day. Side effects aren't common, but can include stomach pain and indigestion. Voquezna (vonoprazan) is typically taken short-term to prevent more serious side effects, like bone fractures and infectious diarrhea.
What is Voquezna (vonoprazan)?
What is Voquezna (vonoprazan) used for?
- Heartburn relief from erosive esophagitis
- Healing from erosive esophagitis
- Heartburn relief from non-erosive gastroesophageal reflux disease (GERD)
- Treatment of Helicobacter pylori (H. pylori) stomach infection (together with amoxicillin and/or clarithromycin)
How Voquezna (vonoprazan) works
Voquezna (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.
Drug facts
More on Voquezna (vonoprazan) essentials
Side effects of Voquezna (vonoprazan)
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
- Stomach inflammation (up to 6%)
- Stomach pain (up to 4%)
- Indigestion (up to 4%)
Less Common Side Effects
- Urinary tract infection
- Nausea
- Bloating
Voquezna (vonoprazan) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious kidney problems: bloody urine, fever, sleepiness, confusion, rash, nausea, vomiting, fluid build-up
- Infectious (C. difficile-related) diarrhea: rapid heart rate, foul-smelling diarrhea, fever, nausea, frequent bowel movements (even up to 15 times per day)
- Severe skin reaction: painful rash, blisters, peeling skin, fever, flu-like symptoms
The following Voquezna (vonoprazan) 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
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Low magnesium level—muscle pain or cramps, unusual weakness or fatigue, fast or irregular heartbeat, tremors
- Low vitamin B12 level—pain, tingling, or numbness in the hands or feet, muscle weakness, dizziness, confusion, trouble concentrating
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Severe diarrhea, fever
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 (vonoprazan)
Pros
- Taken by mouth
- Starts to work within 2-3 hours
- Can take with or without food
Cons
- Not available as a generic
- No liquid version available for those who can't swallow pills
- Available by prescription only
Pharmacist tips for Voquezna (vonoprazan)
- Voquezna (vonoprazan) can be taken with or without food. If it's upsetting your stomach, try taking it with food to help.
- Let your provider know if your heartburn symptoms aren't getting better or worsen after taking Voquezna (vonoprazan). They might ask you to get tested for a more serious stomach problem.
- Voquezna (vonoprazan) can interact with a lot of medications, especially those that need an acidic environment in your stomach for better absorption into your body. Make sure to tell you provider about all of the medications you're taking before starting Voquezna (vonoprazan).
- If you're taking Voquezna (vonoprazan) once daily for erosive esophagitis and miss a dose, take it as soon as you remember if it's within 12 hours of the missed dose. If more than 12 hours have passed, skip the missed dose and take your next dose at the regularly scheduled time. Never double-up the dose to make up for the missed dose.
- If you're taking Voquezna (vonoprazan) twice daily for H.pylori infection and miss a dose, take it as soon as you remember if it's within 4 hours of the missed dose. If more than 4 hours have passed, skip the missed dose and take your next dose at the regularly scheduled time.
Common questions about Voquezna (vonoprazan)
It takes about 2 to 3 hours for Voquezna (vonoprazan) to lower the amount of acid in your stomach. The effects of Voquezna (vonoprazan) tend to last all day.
Yes, Voquezna (vonoprazan) is approved by the FDA and available in the US. But because it was approved fairly recently, not all pharmacies have it in stock. It's best to call your local pharmacy and ask if they have or can help you order Voquezna (vonoprazan).
Yes, the FDA approved Voquezna (vonoprazan) in November 2023 for the treatment heartburn relief from erosive esophagitis and treatment of H. pylori. In July 2024, Voquezna (vonoprazan) received FDA-approval to help with heartburn from non-erosive GERD.
No, Voquezna (vonoprazan) isn't an antibiotic; it's a potassium-competitive acid blocker (PCAB) that lowers the amount of acid in your stomach. But sometimes providers prescribe Voquezna (vonoprazan) with certain antibiotics (e.g., amoxicillin, clarithromycin) to treat a stomach infection caused by the bacteria H. pylori. The combination treatment also comes as easy-to-use dosing packs (e.g., Voquezna Dual Pak, Voquezna Triple Pak).
Voquezna (vonoprazan) is taken by mouth with or without food. But if it's hurting your stomach, taking it with food could help. Swallow Voquezna (vonoprazan) tablets whole; don't chew or crush the tablet.
Voquezna (vonoprazan) might not be appropriate for everyone. For example, it should be avoided by people who previously had an allergic reaction to it. It also must be avoided by people who are taking an antiviral medication called rilpivirine (Edurant) that needs stomach acid to become activated and work. Ask your provider if you're not sure whether Voquezna (vonoprazan) is a good option for you.
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Risks and warnings for Voquezna (vonoprazan)
Voquezna (vonoprazan) 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.
Possible risk of cancer
In some rare cases, heartburn can be warning signs of a more serious stomach problem or cancer. Sometimes, taking heartburn medications, like Voquezna (vonoprazan), can mask these warning signs. If your heartburn symptoms don't go away after you've completed treatment with Voquezna (vonoprazan), contact your provider. You might need to undergo testing to see if you have a more serious problem like stomach cancer.
Kidney problems
Some people reported inflammation in the kidneys after starting Voquezna (vonoprazan). Let your provider know if you notice changes to how much or how often you urinate, if you have blood in your urine, or are feeling unwell.
Infectious diarrhea
Risk factor: Taking Voquezna (vonoprazan) for a long time | Recent or current hospital stays | Taking antibiotics at the same time
Voquezna (vonoprazan) might raise your risk of infectious diarrhea from a bacteria called Clostridioides difficile (C. diff), which can be serious. It's important to recognize the difference between diarrhea as a side effect of Voquezna (vonoprazan) and this type of infectious diarrhea. Let your provider know if you experience diarrhea that doesn't get better over time, or is accompanied by fever, stomach cramps, and tiredness.
Weakened bones
- Risk factors: Taking Voquezna (vonoprazan) for a long time
Voquezna (vonoprazan) might weaken your bones and raise your risk of getting bone fractures. Your risk might be higher if you take Voquezna (vonoprazan) for a long time. Use Voquezna (vonoprazan) at the lowest dose and for the shortest amount of time possible for your condition.
Severe skin reactions
Some people have reported severe skin reactions, such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), after starting Voquezna (vonoprazan). These reactions can be life-threatening, but occur very rarely with Voquezna (vonoprazan). If you experience flu-like symptoms or a painful rash, get medical help as soon as possible.
Low magnesium and vitamin B12 levels
- Risk factors: Taking Voquezna (vonoprazan) for a long time | Taking other medications that lower vitamin B12 or magnesium
Taking Voquezna (vonoprazan) for a long time can cause low vitamin B12 levels. Your risk is higher if you're taking other medications that can do the same, such as metformin (Glucophage). Let your provider know if you feel symptoms of low vitamin B12 include low energy, headaches, and tiredness.
Voquezna (vonoprazan) can also lower magnesium levels, especially if you're taking other medication that can do the same, such as water pills or digoxin (Lanoxin). Talk to your provider if you notice any signs or symptoms of low magnesium (e.g., weakness or fatigue, muscle cramps, numbness).
Risk of false positive in lab test
Let your provider know you're taking Voquezna (vonoprazan) before you receive lab tests that tests for neuroendocrine tumors. This medication can cause a rise in serum chromogranin A (CgA) level, which suggests you have a certain type of tumor when you don't. If you need to take a test for CgA level, you must wait at least 2 weeks after you're finished with Voquezna (vonoprazan) treatment.
Voquezna (vonoprazan) dosage
Typical dosage for Voquezna (vonoprazan)
- Healing of erosive esophagitis and heartburn relief: The typical dose is 20 mg by mouth once per day for 2 months.
- Maintenance of healed erosive esophagitis: The typical dose is 10 mg by mouth once a day for 6 months.
- Heartburn relief from non-erosive GERD: The typical dose is 10 mg by mouth once a day for 4 weeks.
- Treatment of H. pylori (used with antibiotics): The typical dose is 20 mg by mouth twice a day in combination with antibiotics for 14 days.
Your dose will differ if you have kidney or liver problems.
How much does Voquezna (vonoprazan) cost?
$25.00
Voquezna (vonoprazan) 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 (vonoprazan) will not be safe for you to take.
Taking rilpivirine (Edurant)
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