Vonoprazan

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]

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[1] 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

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]