Vonoprazan

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Overview[edit | edit source]

Chemical structure of Vonoprazan

Vonoprazan is a medication that belongs to a class of drugs known as potassium-competitive acid blockers (P-CABs). It is primarily used for the treatment of gastroesophageal reflux disease (GERD) and peptic ulcer disease. Unlike traditional proton pump inhibitors (PPIs), vonoprazan works by competitively blocking the potassium-binding site of the H+/K+ ATPase enzyme in the stomach lining, leading to a reduction in gastric acid secretion.

Mechanism of Action[edit | edit source]

Vonoprazan acts by inhibiting the H+/K+ ATPase enzyme, which is responsible for the final step in the production of gastric acid in the stomach. By blocking the potassium-binding site of this enzyme, vonoprazan effectively reduces the secretion of gastric acid, providing relief from acid-related disorders.

Clinical Uses[edit | edit source]

Vonoprazan is used in the management of several acid-related gastrointestinal conditions, including:

Advantages over Proton Pump Inhibitors[edit | edit source]

Vonoprazan offers rapid onset of action compared to PPIs

One of the main advantages of vonoprazan over traditional PPIs is its rapid onset of action. Vonoprazan begins to reduce gastric acid secretion more quickly than PPIs, which require activation in the acidic environment of the stomach. This rapid action can lead to faster symptom relief for patients.

Additionally, vonoprazan is less affected by genetic variations in CYP2C19, an enzyme that metabolizes many PPIs, leading to more consistent therapeutic effects across different patient populations.

Side Effects[edit | edit source]

Common side effects of vonoprazan may include:

Serious side effects are rare but can include hypomagnesemia and Clostridium difficile infection.

Pharmacokinetics[edit | edit source]

Vonoprazan is well absorbed after oral administration and has a long half-life, allowing for once-daily dosing. It is metabolized in the liver and excreted primarily in the urine.

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Contributors: Prab R. Tumpati, MD