⚕️Dissection of Vonoprazan🧑⚕️
Vonoprazan is gaining popularity in the treatment of hyperacid secretion or acidity, gastroesophageal reflux disease and in the treatment H.pylori associated ulcer. Some regimes have replaced it for proton pump inhibitors but are they really safer and efficacious than proton pump inhibitors or PPIs?
So, in order to know about the superiority existence of vonoprazan let’s dissect it out!
Vonoprazan | Clinical Characteristics |
Drug category of Vonoprazan | potassium-competitive acid blocker |
Therapeutic Class of Vonoprazan | Acid suppressant agents |
Mechanism of action of Vonoprazan | As it is a potassium-competitive acid blocker so it blocks the proton pump that is involved in secreting H+ ion in the stomach which reacts with chlorine to make HCL. This proton pump requires potassium (K⁺) to function, as it exchanges intracellular H⁺ for extracellular K⁺ to secrete acid. Vonoprazan competes with K⁺ at the binding site of the pump. This prevents the pump from exchanging H⁺ and K⁺, thereby inhibiting acid secretion. Unlike PPIs, vonoprazan does not require acid activation and can act in both resting and active proton pumps. ● Have high affinity ● Fastest action ● Longer duration |
Indication of Vonoprazan | Treatment or healing of erosive esophagitis and relief of heartburn associated with erosive esophagitis in adults Also used in combination with amoxicillin and clarithromycin for the treatment of Helicobacter pylori (H. pylori) infection in adults. Also used in combination with amoxicillin for the treatment of H. pylori infection in adults |
Dosage forms availability of Vonoprazan | Tablets (10 mg and 20 mg ) |
Dosage and administration guidelines of Vonoprazan | For the Healing of Erosive Esophagitis: 20 mg OD (once daily) for 8 weeks ∙ Maintenance of Healed Erosive Esophagitis: 10 mg once daily for up to 6 months. ∙ Treatment of H. pylori Infection: depends upon the prescribed regime. Dose adjustment is required in patient with renal or hepatic impairment. |
Precautions and Warnings of Vonoprazan | Acute Tubulointerstitial Nephritis, Clostridioides difficile-Associated Diarrhea (CDAD) as it is also common with PPIs, Bone Fracture, including Osteoporosis-related Fracture as with PPIs, Severe Cutaneous Adverse Reactions, Vitamin B12 (Cobalamin) Deficiency associated with Long-term use as occurs with PPIs, Hypomagnesemia and Mineral Metabolism like PPIs, Interactions with Investigations for Neuroendocrine Tumours, and Fundic Gland Polyps associated with long-term use. |
Contraindications of Vonoprazan | Known hypersensitivity to vonoprazan |
Adverse drug reactions of Vonoprazan | Gastritis, diarrhea, abdominal distension, abdominal pain, and nausea, and when using it in triple therapy, a risk of vulvovaginal candidiasis also develops. Also all the conditions mentioned in the precaution section |
Interactions of Vonoprazan | ● Diuretics (as the risk of hypomagnesemia increases) ● Antiretroviral and other Drugs like iron salts, erlotinib, dasatinib, nilotinib, mycophenolate mofetil, ketoconazole/itraconazole (as their absorption is affected due to changes in gastric pH) ● Vonoprazan is a strong inhibitor of CYP2C19 and weak inhibitor of CYP3A4 thus all the drugs that are metabolized by these enzymes should be adjusted accordingly especially clopidogrel citalopram, cilostazol, that are metabolized by the CYP2C19. |
Facts about Vonoprazan | ● Don’t significantly Crosses BBB. ● FDA approved |
Common Brands of Vonoprazan | ● Voniza 10 and 20mg ● Vonozan 10 and 20mg ● Vonnp 10 and 20mg ● VOQUEZNA
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Reference:
U.S. Food and Drug Administration. (n.d.). Drugs@FDA: FDA-Approved drug products. U.S. Department of Health and Human Services. https://www.accessdata.fda.gov/scripts/cder/daf/index.cfm?event=BasicSearch.process
Disclaimer: The information provided in this table is for informational purposes only and is not intended as a substitute for professional advice, diagnosis, or treatment. Always consult a qualified professional or expert before making decisions based on this data.
