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 Jul 22, 2024.

What is Voquezna?

Voquezna (vonoprazan) is an oral potassium-competitive acid blocker that reduces the amount of acid in your stomach and may be used in adults:

For 8 weeks to heal acid-related damage to the lining of the esophagus (called erosive esophagitis) and for relief of heartburn related to erosive esophagitis
For up to 6 months to maintain healing of erosive esophagitis and for relief of heartburn related to erosive esophagitis
For 4 weeks for relief of heartburn related to gastroesophageal reflux disease
For 14 days with the antibiotics amoxicillin and clarithromycin to treat an infection caused by bacteria called Helicobacter pylori (H. pylori)
For 14 days with the antibiotic amoxicillin to treat an infection caused by H. pylori.

Voquezna's mechanism of action is to inhibit the potassium-dependant component of the acid-proton pump within cells in the gastric glands lining the stomach (these are called parietal cells) whose function is to secrete hydrochloride acid. Voquezna blocks the final step of acid production and reduces both baseline and stimulated gastric acid secretion. It does not require acid to activate it. Voquezna works like a proton pump inhibitor (PPIs) but blocks a different part of the proton pump and is called a potassium-competitive acid blocker (PCAB).

Voquezna was first FDA approved on May 3, 2022 as Voquezna Triple and Dual Pak. It was FDA-approved as a stand-alone tablet on November 1, 2023.

Voquezna side effects

The most common side effects of Voquezna when used for acidic stomach conditions 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 the treatment of H. pylori infection include:

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

Serious side effects and warnings

Voquezna may cause the following serious side effects.

Acute tubulointerstitial nephritis (a type of kidney problem). Call your healthcare provider right away if you are passing less urine or if you have blood in your urine

Diarrhea caused by infection with a bacteria called 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). Observational studies have suggested an increased risk of bone fractures of the hip, wrist, or spine, particularly in people who receive high doses (multiple daily doses), and long-term therapy (a year or longer). Use Voquezna for the shortest duration possible. Tell your healthcare provider who prescribes Voquezna if you fracture a bone.

Severe skin reactions. Voquezna 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, which 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. Voquezna also lowers magnesium levels which may lead to low calcium or low potassium levels. Your healthcare provider should monitor your laboratory levels of these minerals but 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). Voquezna is associated with an increased risk of fundic gland polyps that increases with long-term use, especially beyond one year. Talk with your healthcare provider about the risk of fundic gland polyps if you have been on Voquezna for more than a year.

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

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

Before taking

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

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
take any medications
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.

Voquezna is usually taken 1 time a day, usually for a set period depending on the condition being treated (see Voquezna dosage below).
May be taken with or without food.
Swallow the tablets whole. Do not chew or crush the tablet.

Dosage

The dosage of Voquezna needs to be adjusted in people with liver or kidney disease.

Voquezna dosage for erosive esophagitis

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

Voquezna dosage for relief of heartburn associated with non-erosive gastroesophageal reflux disease

Voquezna 10 mg once daily for 4 weeks.

Voquezna dosage for H. pylori Infection

Triple therapy: Voquezna 20 mg plus amoxicillin 1000 mg plus clarithromycin 500 mg, each given twice daily (in the morning and evening, 12 hours apart) for 14 days.
Dual therapy: Voquezna 20 mg given twice daily (in the morning and evening) plus amoxicillin 1000 mg three times daily (in the morning, mid-day, and evening) for 14 days.

What happens if I miss a dose?

Erosive esophagitis or heartburn relief

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 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.

Voquezna 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.