Voquezna

Pronunciation: voe-kwez-nah
Generic name: vonoprazan
Dosage form: oral tablet
Drug class: Proton pump inhibitors

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 2, 2023.

What is Voquezna?

Voquezna (vonoprazan) is an oral potassium-competitive, acid blocker that may be used to block acid production in the stomach and is approved for the:

Relief and maintenance treatment of heartburn associated with erosive esophagitis.
Relief of, and to maintain healing of, all grades of erosive esophagitis.
Treatment of Helicobacter pylori (H. pylori) infection in adults in combination with amoxicillin and clarithromycin (Voquezna Triple Pak) or amoxicillin (Voquezna Dual Pak).

Voquezna works by inhibiting the potassium-dependant component of the H+, K+-ATPase enzyme system (also called the acid [proton] pump) within the parietal cell, blocking the final step of acid production. Voquezna does not require acid to activate it, concentrates in parietal cells, and binds reversibly and non-covalently to the pump. It suppresses both basal and stimulated gastric acid secretion.

Voquezna was first FDA approved on May 3, 2022 as Voquezna Triple and Dual Pak.

Warnings

Do not take Voquezna if you are allergic to Voquezna, vonoprazan, or any of the ingredients in the tablets.

Certain medications that are used to treat HIV-1 may interact with Voquezna and they should not be used together. Tell your healthcare provider about all the medications you take.

May mask the symptoms of gastric cancer. Your healthcare provider should consider additional follow-up and diagnostic testing to rule out gastric cancer.

May cause acute tubulointerstitial nephritis, a type of acute kidney injury.

May increase the risk of Clostridioides difficile-Associated Diarrhea (CDAD) and increase the risk of osteoporosis-related fractures. Voquezna should be taken for the shortest duration appropriate to the condition.

Associated with an increased risk of severe skin conditions including severe cutaneous adverse reactions.

Long-term use may lead to malabsorption or deficiency of Vitamin B12 (Cobalamin), low magnesium levels, or fundic gland polyps.

Before taking

Before taking Voquezna, tell your healthcare provider about all of your medical conditions, including if you:

have low magnesium, calcium, or potassium in your blood or you are taking a medicine to increase urine production (such as a diuretic)
have kidney or liver problems
are pregnant, think you may be pregnant, or plan to become pregnant
are breastfeeding or plan to breastfeed.

Pregnancy and breastfeeding

It is not known if Voquezna will harm an unborn baby. Call the Phathom Pharmaceuticals, Inc. Adverse Event reporting line at 1-888- 775-7428 if you inadvertently become pregnant while taking it.

It is not known if Voquezna passes into your breast milk. You and your healthcare provider should decide if you will take it or breastfeed. You should not do both.

How should I take Voquezna?

Take Voquezna exactly as your healthcare provider tells you to take it.

Do not change your dose or stop taking it without talking to your healthcare provider first.
Take with or without food.
Swallow the tablets whole. Do not chew or crush the tablet.

Dosage

Erosive esophagitis

Healing: 20 mg once daily for 8 weeks.
Maintenance: 10 mg once daily for up to 6 months.

Treatment of H. pylori Infection

See full prescribing information.

What happens if I miss a dose?

Erosive esophagitis

If you miss a dose of Voquezna, take it as soon as possible if it is within 12 hours of the missed dose. If more than 12 hours have passed, skip the missed dose and take the next dose at the regularly scheduled time.

H. pylori infection

If you miss a dose of Voquezna, take it as soon as possible if it is within 4 hours of the missed dose. If more than 4 hours have passed, skip the missed dose and take the next dose at the regularly scheduled time. Continue your regular dosing schedule until the treatment is completed.

What happens if I overdose?

Call your healthcare provider or the Poison Help line at 1-800-222-1222.

What are the side effects of Voquezna?

Voquezna may cause serious side effects, including:

A type of kidney problem (acute tubulointerstitial nephritis). Call your healthcare provider right away if you are passing less urine or if you have blood in your urine
Diarrhea, caused by an infection (Clostridioides difficile) in your intestines. Call your healthcare provider right away if you have watery stools, stomach pain, or a fever that does not go away
Bone fractures (hip, wrist, or spine). Bone fractures in the hip, wrist, or spine may happen in people who take multiple daily doses of a related type of medicine that reduces acid in your stomach known as proton pump inhibitors (PPI medicines) for a long period (a year or longer). Tell your healthcare provider if you have a bone fracture, especially in the hip, wrist, or spine
Severe skin reactions. Can cause rare but severe skin reactions that may affect any part of your body. These serious skin reactions may need to be treated in a hospital and may be life-threatening. Stop taking Voquezna and call your healthcare provider right away if you develop:
A skin rash that may include blistering, peeling, or bleeding on any part of your skin (including your lips, eyes, mouth, nose, genital, hands, or feet) or fever, chills, body aches, shortness of breath, or enlarged lymph nodes
Low Vitamin B-12 levels. Voquezna lowers the amount of acid in your stomach and stomach acid is needed to absorb Vitamin B12 properly. Tell your healthcare provider if you have symptoms of low vitamin B12 levels, including irregular heartbeat, shortness of breath, lightheadedness, tingling or numbness in the arms and legs, muscle weakness, pale skin, feeling tired, or mood changes
Low magnesium levels. Tell your healthcare provider right away if you have symptoms of low magnesium levels, including seizures, dizziness, irregular heartbeat, jitteriness, muscle aches or weakness, or spasms of hands, feet, or voice
Stomach growths (fundic gland polyps). Talk with your healthcare provider about the risk of fundic gland polyps if you have been on Voquezna for more than a year.

The most common side effects of Voquezna when used for erosive esophagitis affecting 2% to 3% or more people include:

diarrhea
high blood pressure
indigestion
nausea
stomach bloating
stomach inflammation
stomach pain
urinary tract infection.

The most common side effects of Voquezna when used with antibiotics for treatment of H. pylori infection affecting 2% or more people include:

cold-like symptoms
diarrhea
headache
high blood pressure
stomach pain
temporary changes in sense of taste
vaginal yeast infection.

These are not all the possible side effects of Voquezna. You may report side effects to the FDA at 1-800-FDA-1088.

What other drugs will affect Voquezna?

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Keep a list of them to show your healthcare provider and pharmacist when you get a new medicine.

Voquezna may affect how other medicines work and other medicines may affect how it works. Tell your doctor if you take:

atazanavir
digoxin or other drugs that cause hypomagnesemia
nelfinavir
medicines that contain rilpivirine used to treat HIV-1 (Human Immunodeficiency Virus)
other antiretrovirals or medicines (such as iron, or ketoconazole) dependent on gastric pH for absorption
certain CYP3A substrates with a narrow therapeutic index, such as theophylline
CYP2C19 substrates, such as clopidogrel, or citalopram.

May interfere with investigations for gastrinoma or neuroendocrine tumors. Temporarily stop Voquezna at least 14 days before assessing chromogranin A (CgA) levels or performing a secretin stimulation test.

See the product information for a full list of interactions.

Storage

Store at room temperature between 68°F to 77°F (20°C to 25°C).

Keep out of the reach of children.

Ingredients

Active: vonoprazan

Inactive: ascorbic acid, croscarmellose sodium, ferric oxide red (only in 20 mg tablets), ferric oxide yellow (only in 10 mg tablets), fumaric acid, hydroxypropyl cellulose, hypromellose, magnesium stearate, mannitol, microcrystalline cellulose, polyethylene glycol 8000, and titanium dioxide.

Available in 10mg and 20mg tablets.