From the Guidelines
Voquezna (vonoprazan) should be used as a first-line treatment for H. pylori infections due to its superior eradication rates compared to traditional proton pump inhibitors (PPIs), particularly in patients with clarithromycin-resistant strains, as evidenced by a systematic review of 7 Asian randomized trials showing significantly higher pooled eradication rates for vonoprazan vs PPI (92% vs 80%) 1.
Key Points
- Voquezna is a potassium-competitive acid blocker (P-CAB) that provides more rapid and consistent acid suppression than PPIs, making it effective regardless of meal timing 1.
- The typical dose for H. pylori eradication is 20 mg once daily for 14 days in combination with amoxicillin and clarithromycin (Voquezna Triple Pak) or with amoxicillin alone (Voquezna Dual Pak) 1.
- Voquezna has been shown to be superior to PPIs in eradicating H. pylori infections, particularly in patients with clarithromycin-resistant strains, with eradication rates approaching 95% and 90% in first- and second-line dual therapy, respectively 1.
- Common side effects of Voquezna include diarrhea, nausea, and abdominal pain, and patients should inform their healthcare provider about all medications they take, as Voquezna may interact with certain drugs like clopidogrel.
Treatment Recommendations
- For patients with H. pylori infections, Voquezna should be used as a first-line treatment due to its superior eradication rates compared to PPIs 1.
- For patients with erosive esophagitis, Voquezna may be used as a therapeutic option for healing and maintenance of healing, particularly in patients with more severe disease (LA grade C/D EE) 1.
- The duration of treatment for H. pylori eradication is typically 14 days, but shorter treatment durations may be effective, as shown in a Japanese trial with 335 patients that found similar eradication rates with 7 days of vonoprazan dual therapy compared to 14 days of PPI-based triple therapy 1.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Voquezna Overview
- Voquezna, also known as vonoprazan, is a potassium-competitive acid blocker used for the treatment of Helicobacter pylori infection 2, 3, 4, 5, 6.
- It has been shown to provide potent and sustained acid suppression, making it a valuable alternative to standard proton-pump inhibitor (PPI)-based triple therapy in the treatment of H. pylori infection 2, 3, 4.
Efficacy and Safety
- Vonoprazan-based dual and triple therapy regimens have been found to be generally well tolerated and effective in eradicating H. pylori infection 2, 3, 4, 6.
- Studies have demonstrated that vonoprazan-based therapies are at least as effective as PPI-based therapies, with some showing superior eradication rates in clarithromycin-resistant infections 3, 4.
- Common adverse effects associated with vonoprazan include nasopharyngitis, diarrhea, constipation, flatulence, dyspepsia, headache, and abdominal pain 5.
Treatment Regimens
- Vonoprazan can be used in combination with amoxicillin (dual therapy) or amoxicillin and clarithromycin (triple therapy) for the treatment of H. pylori infection 2, 3, 4, 6.
- Dual therapy with vonoprazan and amoxicillin has been shown to be as effective as triple therapy with vonoprazan, amoxicillin, and clarithromycin for eradication of H. pylori 6.