Vonocab 10

Indications

Vonocab is utilized for the effective management of:

• Gastric Ulcers: Treatment of gastric ulcers and duodenal ulcers.
• Reflux Esophagitis: Relief from symptoms of reflux esophagitis and prevention of ulcer recurrence during low-dose aspirin or NSAID use.
• Helicobacter pylori Eradication: As an adjunct in the treatment of gastric and duodenal ulcers, MALT lymphoma, idiopathic thrombocytopenic purpura, and post-endoscopic resection of early-stage gastric cancer or H. pylori gastritis.

Pharmacology

Vonoprazan is a potent potassium-competitive acid blocker (P-CAB) that inhibits gastric acid production by binding competitively and reversibly to the H+, K+-ATPase enzyme. Unlike traditional acid reducers, Vonoprazan maintains strong activity without requiring acid activation, offering extended acid suppression and effective protection against mucosal damage in the upper gastrointestinal tract.

Dosage

• Gastric and Duodenal Ulcers: 20 mg once daily for 8 weeks (gastric ulcers) or 6 weeks (duodenal ulcers).
• Reflux Esophagitis: 20 mg once daily for 4 to 8 weeks. For maintenance, 10 mg daily, adjustable to 20 mg if needed.
• Recurrence Prevention: 10 mg daily during low-dose aspirin or NSAID use.
• Helicobacter pylori Eradication: 20 mg twice daily combined with 750 mg amoxicillin and 200 mg clarithromycin for 7 days. Alternatively, 20 mg Vonoprazan with 750 mg amoxicillin and 250 mg metronidazole.

Administration

Vonoprazan can be taken with or without food.

Contraindications

• Hypersensitivity: Avoid use in patients allergic to Vonoprazan or any of its excipients.
• Drug Interactions: Contraindicated with atazanavir, nelfinavir, or rilpivirine.

Side Effects

Possible side effects include diarrhea, constipation, hypersensitivity reactions (e.g., anaphylactic shock), rash, jaundice, nausea, and elevated liver enzymes. These are generally comparable in frequency to placebo.

Pregnancy & Lactation

• Pregnancy: Use only if the benefits outweigh risks.
• Lactation: Avoid use during breastfeeding unless absolutely necessary.

Precautions & Warnings

• Monitoring: Regular monitoring is advised during long-term use. For reflux esophagitis maintenance, only administer to patients with recurrent symptoms.
• Special Populations: Use with caution in elderly patients and those with renal or hepatic impairment. Avoid in severe renal or hepatic impairment.

Overdose Effects

No specific overdose data is available. Treatment should be symptomatic and supportive as Vonoprazan is not removed by hemodialysis.

Therapeutic Class

Potassium-Competitive Acid Blocker

Storage Conditions

Store below 30°C, in a dry place, away from light, and keep out of reach of children.