Vonoprazan Disease Interactions

Various published observational studies have reported that PPI therapy may be associated with an increased risk for osteoporosis related fractures of the hip, wrist or spine. The risk was increased in patients who received high doses (multiple daily doses), and long term treatment (a year or longer). Patients should use the lowest dose and shortest duration of PPI therapy appropriate to the condition being treated. Caution should be used in patients at risk for osteoporosis related fractures and should be managed according to established treatment guidelines.

Postmarketing cases of hypomagnesemia have been reported with vonoprazan. Hypomagnesemia may lead to hypocalcemia and/or hypokalemia and may exacerbate underlying hypocalcemia in at-risk patients. Monitor magnesium and calcium levels regularly in patients with a preexisting risk of hypocalcemia (e.g., hypoparathyroidism). Monitor magnesium levels prior to initiating therapy with vonoprazan in all patients, and then periodically while on treatment. Monitor magnesium levels closely in patients taking drugs that may have increased toxicity in the presence of hypomagnesemia (e.g., digoxin), or drugs that may cause hypomagnesemia (e.g., diuretics).