Vontac 20

✔️ How Vontac Works

Vonoprazan is a potassium-competitive acid blocker (P-CAB). It reversibly and competitively inhibits the H⁺/K⁺-ATPase proton pump in gastric parietal cells.

By blocking this final step in stomach acid production, Vontac strongly and persistently reduces gastric acid secretion. This helps relieve acid-related symptoms and supports healing and prevention of damage to the upper gastrointestinal tract.

✔️ Side Effects

• Diarrhea
• Constipation
• Nausea
• Abdominal bloating or distension
• Rash
• Urticaria (hives)
• Drug eruption
• Increased liver enzymes
• Abnormal liver function tests
• Elevated AST, ALT, ALP, GGT or LDH
• Eosinophilia
• Edema

✔️ Vontac should not be used in patients with:

• Known hypersensitivity to vonoprazan or any component of the formulation
• Concomitant use of atazanavir, nelfinavir, or rilpivirine, as reduced absorption or effectiveness of these medicines may occur

✔️ Use in Special Populations

Children:
The safety and effectiveness of vonoprazan have not been adequately established in patients below 18 years of age. Use in children and adolescents is therefore not generally recommended.

Elderly:
Older patients may have reduced kidney or liver function and should be monitored carefully during treatment.

Kidney impairment:
No dose adjustment is generally required for mild to moderate renal impairment (eGFR 30–89 mL/min). Use should be avoided in severe renal impairment (eGFR below 30 mL/min) unless specifically directed by a specialist.

Liver impairment:
No adjustment is generally required in mild hepatic impairment. Vonoprazan should be avoided in patients with moderate to severe hepatic impairment unless specifically recommended by a healthcare professional.

✔️ Dosage and Administration

Vontac may be taken with or without food.

Gastric ulcer:
20 mg once daily for 8 weeks.

Duodenal ulcer:
20 mg once daily for 6 weeks.

Reflux esophagitis:
20 mg once daily for 4 weeks. If healing is inadequate, treatment may be extended, but generally not beyond 8 weeks.

Maintenance treatment for recurrent reflux esophagitis:
10 mg once daily. If the response is inadequate, the dose may be increased to 20 mg once daily.

Prevention of ulcer recurrence with low-dose aspirin:
10 mg once daily.

Prevention of ulcer recurrence with NSAIDs:
10 mg once daily.

✔️ H. pylori Eradication Therapy

When used as part of H. pylori eradication treatment, the following regimen may be prescribed for 7 days:

First-line triple therapy:

• Vonoprazan 20 mg twice daily
• Amoxicillin 750 mg twice daily
• Clarithromycin 200 mg twice daily

In certain circumstances, the clarithromycin dose may be increased by the physician, but it should not exceed the recommended maximum.

Alternative therapy when previous PPI-based triple therapy has failed:

• Vonoprazan 20 mg twice daily
• Amoxicillin 750 mg twice daily
• Metronidazole 250 mg twice daily

These antibiotic combinations should only be taken under medical supervision.

✔️ Pregnancy and Breastfeeding

Vonoprazan should be used during pregnancy only when the expected benefits clearly outweigh the potential risks.

There is limited information regarding its use during breastfeeding. If treatment is considered essential, the doctor may recommend discontinuing breastfeeding during therapy.

✔️ Precautions and Warnings

• The underlying condition should be regularly evaluated during treatment.
• Use the lowest effective dose for the shortest appropriate duration.
• Long-term treatment should involve appropriate medical monitoring.
• For maintenance treatment of reflux esophagitis, vonoprazan should generally be reserved for patients with recurrent symptoms or disease.
• If healing remains stable and the risk of recurrence becomes low, the doctor may consider reducing the dose from 20 mg to 10 mg or stopping treatment.
• Patients with liver or kidney problems should inform their doctor before treatment.
• Tell your doctor about all prescription medicines, over-the-counter medicines, and supplements you are taking.

✔️ Storage:

• Store below 30°C.
• Keep in a cool, dry place.
• Protect from light.
• Keep out of reach of children.