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.
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)
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.
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):
Taken by mouth
Starts to work within 2-3 hours
Can take with or without food
Not available as a generic
No liquid version available for those who can't swallow pills
Available by prescription only
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
Taking rilpivirine (Edurant)
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)
Prevention and treatment of heartburn (gastroesophageal reflux disease or GERD)
Gastric ulcer (open sore in the stomach)
Duodenal ulcer (open sore in the first part of the small intestine)
Heartburn (GERD)
Erosive esophagitis due to GERD (inflammation of the esophagus)
Other conditions that cause too much stomach acid secretion (i.e., Zollinger-Ellison syndrome)
Heartburn — OTC only
Lower the risk of duodenal ulcer caused by Helicobacter pylori (H. pylori) infection
Other medical conditions that cause too much stomach acid (e.g., Zollinger-Ellison syndrome)
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Aggarwal, N., et al. (2023). S1905: Vonoprazan may increase the risk of fractures. American Journal of Gastroenterology.
Brooks, A. (2024). Vonoprazan (Voquezna) Receives FDA Approval for Heartburn Associated with Non-Erosive GERD. HCP Live.
Grossi, G., et al. (2023). FDA approves erosive GERD therapy Vonoprazan. American Journal of Managed Care.
Neuroendocrine Tumor Research Foundation. (n.d.). Blood tests for neuroendocrine tumors.
O’Brien, F., et al. (2023). Tubulointerstitial nephritis. Merck Manual Consumer Version.
Phathom Pharmaceuticals. (n.d.). Voquezna works differently.
Phathom Pharmaceuticals Inc. (2023). Voquezna- vonoprazan fumarate tablet [package insert]. DailyMed.
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