Vonaprazan 20 dosage
Reading File
Searching the Web
vonaprazan 20mg dosage indications prescribing information 2024
Finding Sources
Reading File
Reading File
Here is a complete dosing reference for Vonoprazan (Voquezna) 20 mg:
Vonoprazan (Voquezna) - Dosing Reference
What It Is
Vonoprazan is a potassium-competitive acid blocker (P-CAB) - a pyrrole derivative that blocks the H+/K+-ATPase pump by competing with potassium at the binding site. Unlike PPIs, it does not require acid activation, works from the first dose, and maintains effect for 24 hours regardless of meals. - Goodman & Gilman's Pharmacological Basis of Therapeutics
Standard Dosing (FDA-Approved, USA)
GERD / Erosive Esophagitis (Voquezna tablets)
| Indication | Dose | Duration |
|---|---|---|
| Healing of erosive esophagitis (all grades) + heartburn relief | 20 mg once daily | 8 weeks |
| Maintenance of healed erosive esophagitis + heartburn relief | 10 mg once daily | Up to 6 months |
| Non-erosive GERD heartburn relief | 10 mg once daily | 4 weeks |
H. pylori Eradication (Voquezna Triple Pak / Dual Pak)
| Regimen | Vonoprazan Dose | Antibiotics |
|---|---|---|
| Triple Pak | 20 mg twice daily x 14 days | + Amoxicillin 1,000 mg BID + Clarithromycin 500 mg BID |
| Dual Pak | 20 mg twice daily x 14 days | + Amoxicillin 1,000 mg TID |
Administration: Take with or without food.
Dose Adjustments
Renal Impairment (Erosive Esophagitis tablets)
| eGFR | Healing Dose | Maintenance Dose |
|---|---|---|
| ≥ 30 mL/min | 20 mg once daily | No change |
| < 30 mL/min | Reduce to 10 mg once daily | No change |
Hepatic Impairment (Erosive Esophagitis tablets)
| Child-Pugh Class | Healing Dose | Maintenance Dose |
|---|---|---|
| A | 20 mg once daily | No change |
| B or C | Reduce to 10 mg once daily | No change |
H. pylori Paks - Hepatic Impairment
| Child-Pugh Class | Recommendation |
|---|---|
| A | 20 mg BID (full dose) |
| B or C | Not recommended |
H. pylori Paks - Renal Impairment
| eGFR | Recommendation |
|---|---|
| ≥ 30 mL/min | Full dose |
| < 30 mL/min | Not recommended |
Missed Dose
Take as soon as possible within 4 hours of the missed dose. If more than 4 hours have passed, skip it and resume the next scheduled dose.
Pharmacokinetics (Voquezna 20 mg)
- Onset: Near-maximal acid suppression from Day 1 (vs. 3-5 days for PPIs)
- Tmax: 0.5 - 2 hours
- Elimination t1/2: 2 - 9 hours
- Metabolism: Liver via CYP3A4/5 (not CYP2C19 - less inter-individual variability than PPIs)
- Food effect: None - can take with or without food
Common Adverse Effects
Diarrhea, nasopharyngitis, dyspepsia, headache, abdominal pain. - Goodman & Gilman's
Key Clinical Notes
- Peptic ulcers (Japan approved): 10-20 mg daily for gastric/duodenal ulcers, NSAID/aspirin gastroprotection
- Superiority over PPIs: Clinical trials show vonoprazan 20 mg once daily is non-inferior (and in some studies superior) to lansoprazole 30 mg for erosive esophagitis healing and H. pylori eradication - Sleisenger & Fordtran's GI and Liver Disease
- FDA approval: November 2023 (erosive esophagitis); earlier approval (May 2022) for H. pylori paks
- Classified as "restricted" or requiring prior authorization in many formularies due to cost vs. PPI availability
This is a shared conversation. Sign in to Orris to start your own chat.