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Vonoprazan
Clinical data
Trade names	Voquezna, others
AHFS/Drugs.com	Voquezna
MedlinePlus	a624006
License data	US DailyMed: Vonoprazan;
Routes of; administration	By mouth
Drug class	Potassium-competitive acid blocker
ATC code	A02BC08 (WHO) ;
Legal status
Legal status	US: ℞-only; In general: ℞ (Prescription only);
Pharmacokinetic data
Bioavailability	Unknown
Protein binding	80%
Metabolism	Liver, by cytochrome P450 (3A4, 2B6, 2C19, 2D6)
Elimination half-life	7.7 h
Duration of action	> 24 h
Excretion	Kidney
Identifiers
CAS Number	881681-00-1; as fumarate: 1260141-27-2;
PubChem CID	15981397; as fumarate: 45375887;
DrugBank	DB11739;
ChemSpider	13112797;
UNII	1R5L3J156G; as fumarate: 4QW3X4AMLB;
KEGG	D11784; as fumarate: D10466;
ChEBI	CHEBI:136048;
ChEMBL	ChEMBL2079130; as fumarate: ChEMBL2064032;
PDB ligand	HKT (PDBe, RCSB PDB);
CompTox Dashboard (EPA)	DTXSID20236869 ;
Chemical and physical data
Formula	C17H16FN3O2S
Molar mass	345.39 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES Fc1ccccc1-c2cc(CNC)cn2S(=O)(=O)c3cccnc3;
	InChI InChI=InChI=1S/C17H16FN3O2S/c1-19-10-13-9-17(15-6-2-3-7-16(15)18)21(12-13)24(22,23)14-5-4-8-20-11-14/h2-9,11-12,19H,10H2,1H3; Key:BFDBKMOZYNOTPK-UHFFFAOYSA-N;

Vonoprazan, sold under the brand name Voquezna among others, is a first-in-class potassium-competitive acid blocker medication.^[2]^[1] Vonoprazan is used in form of the fumarate for the treatment of gastroduodenal ulcer (including some drug-induced peptic ulcers) and reflux esophagitis, and can be combined with antibiotics for the eradication of Helicobacter pylori.^[2]

It was approved in Japan in February 2015,^[3]^[4] and in Russia in April 2021.^[5] Vonoprazan was approved for medical use in the United States in November 2023.^[1]^[6] Co-packaged combinations of vonoprazan with amoxicillin and vonoprazan with amoxicillin and clarithromycin are available.^[7]^[8]

Medical uses

Vonoprazan is indicated for healing of all grades of erosive esophagitis and relief of heartburn associated with erosive esophagitis in adults; to maintain healing of all grades of erosive esophagitis and relief of heartburn associated with erosive esophagitis in adults; in combination with amoxicillin and clarithromycin for the treatment of Helicobacter pylori (H. pylori) infection in adults; in combination with amoxicillin for the treatment of H. pylori infection in adults.^[1]^[7]^[9]

In July 2024, the indication was expanded in the US to include non-erosive gastroesophageal reflux disease.^[10]

Adverse effects

The most common side effects are constipation, diarrhea, enlarged feeling of abdomen, nausea, rash, and edema.^[1]^[11]

Long-term use may lead to vitamin B12 deficiency, hypomagnesemia, and fundic gland polyps.^[11]

Society and culture

Names

Vonoprazan is the international nonproprietary name (INN).^[12]

References

^ ^a ^b ^c ^d ^e "Voquezna- vonoprazan fumarate tablet". DailyMed. 8 November 2023. Retrieved 20 November 2023.
^ ^a ^b Echizen H (April 2016). "The First-in-Class Potassium-Competitive Acid Blocker, Vonoprazan Fumarate: Pharmacokinetic and Pharmacodynamic Considerations". Clinical Pharmacokinetics. 55 (4): 409–418. doi:10.1007/s40262-015-0326-7. PMID 26369775. S2CID 5984975.
^ Garnock-Jones KP (2015). "Vonoprazan: first global approval". Drugs. 75 (4): 439–43. doi:10.1007/s40265-015-0368-z. PMID 25744862. S2CID 43293048.
^ "Takecab Now Available for the Treatment of Acid-related Diseases in Japan". Takeda Pharmaceuticals (Press release). 26 February 2015. Archived from the original on 26 October 2023. Retrieved 20 November 2023.
^ "Russian State Register of Medicines. Vocinti (vonoprazan) Film-Coated Tablets. Full Prescribing Information". grls.rosminzdrav.ru (in Russian). Takeda Pharmaceutical Company Limited. Archived from the original on 18 February 2023. Retrieved 18 February 2023.
^ "Phathom Pharmaceuticals Announces Commercial Availability of Voquezna (vonoprazan) Tablets, a Powerful First-In-Class PCAB for the Treatment of Erosive GERD and Relief of Associated Heartburn". GlobeNewswire (Press release). Phathom Pharmaceuticals. 28 November 2023. Retrieved 26 January 2024.
^ ^a ^b "Voquezna Dual Pak- vonoprazan fumarate and amoxicillin kit; Voquezna Triple Pak- vonoprazan fumarate, amoxicillin and clarithromycin kit". DailyMed. 21 June 2022. Archived from the original on 3 July 2022. Retrieved 3 July 2022.
^ "Phathom Pharmaceuticals Announces FDA Approval of Voquezna Triple Pak (vonoprazan, amoxicillin, clarithromycin) and Voquezna Dual Pak (vonoprazan, amoxicillin) for the Treatment of H. pylori Infection in Adults" (Press release). Phathom Pharmaceuticals. 3 May 2022. Archived from the original on 10 May 2022. Retrieved 9 May 2022 – via GlobeNewswire.
^ "Drug Approval Package: Voquezna". U.S. Food and Drug Administration (FDA). 8 June 2022. Retrieved 3 February 2024.
^ "Phathom Pharmaceuticals Announces FDA Approval of Voquezna (vonoprazan) Tablets for the Relief of Heartburn Associated with Non-Erosive GERD in Adults" (Press release). Phathom Pharmaceuticals. 18 July 2024. Retrieved 19 July 2024 – via GlobeNewswire.
^ ^a ^b FDA Professional Drug Information
^ World Health Organization (2012). "International nonproprietary names for pharmaceutical substances (INN): recommended INN: list 68". WHO Drug Information. 26 (3). hdl:10665/109813.

External links

Clinical trial number NCT04124926 for "Efficacy and Safety of Vonoprazan Compared to Lansoprazole in Participants With Erosive Esophagitis" at ClinicalTrials.gov
Clinical trial number NCT04167670 for "Efficacy and Safety of Vonoprazan Compared to Lansoprazole in Participants With Helicobacter Pylori Infection" at ClinicalTrials.gov