II. Mechanism
- Potassium Competitive Acid Blocker (PCAB) blocks both active and resting proton pumps
- Activity onset within hours regardless of timing with meals
- Contrast with Proton Pump Inhibitors
- Block only active proton pumps
- Full action is delayed up to 7 days
- Best taken 30 to 60 minutes before a meal
III. Preparations
- Vonoprazan Fumarate (Takecab)
- High Dose: 20 mg orally twice daily
- Helicobacter Pylori Management
- Moderate Dose: 20 mg orally daily
- Low Dose: 10 mg orally daily
- Reflux Esophagitis prevention
- Aspirin or NSAID induced Peptic Ulcer prevention
- High Dose: 20 mg orally twice daily
IV. Preparations: Helicobacter Pylori Management
- Background
- Lower efficacy than quadruple therapy
- At $800 in 2022, the cost is four fold higher than standard quadruple therapy
- Voquezna Dual Pak (Vonoprazan, Amoxicillin)
- Voquezna Triple Pak (Vonoprazan, Amoxicillin, Clarithromycin)