This New Drug for GERD Works Better Than Proton Pump Inhibitors …C0NTINUE READING HERE >>>
Key Takeaways
The FDA recently approved Voquezna, the first potassium-competitive acid blocker drug for treating erosive and non-erosive gastroesophageal reflux.Voquezna works faster and lasts longer than proton pump inhibitors, the most common drug treatment for GERD.In addition to medication, you can relieve GERD symptoms with diet and lifestyle modifications.
Phathom Pharmaceuticals recently announced that the FDA had approved its new drug, Voquezna (vonoprazan), to treat heartburn associated with the most common type of gastroesophageal reflux (GERD) in adults.
Voquezna is intended to offer faster, longer-lasting relief from non-erosive GERD symptoms than proton pump inhibitors (PPIs), a mainstay for treating acid reflux. Last year, the drug was approved to treat pain from erosions in the esophagus caused by acid reflux.
“There’s no need for a patient to suffer or have symptoms,” Martin Gilligan, Chief Commercial Officer for Phathom Pharmaceuticals, told Verywell. “For 30 years, patients have had the same treatments. Voquezna is different because it works fast and lasts longer, providing all-day symptom relief with one pill.”
What Happens If You Don’t Treat GERD?
Your stomach constantly produces hydrochloric acid to help it digest food. If that acid refluxes out of your stomach back up into your esophagus, it gives you the sensation of heartburn.
Over time, that acid backup isn’t just painful—it can also do some serious damage. Untreated GERD can cause erosions in the esophagus that can lead to upper gastrointestinal bleeding, Barrett’s esophagus, esophageal cancer, and chronic cough due to breathing in (aspirating) stomach contents.
What It’s Like to Take Voquezna
Voquezna is a pill that reduces stomach acid production. It’s only available by prescription and comes in two strengths: 10 milligrams (mg) and 20 mg. It’s taken once a day, at any time of the day, and with or without food. One dose provides 24-hour relief from heartburn.
For patients with GERD and the bacteria Helicobacter pylori in their stomach (a condition that’s linked to stomach irritation, ulcers, and even cancer), Voquezna is also available as Voquezna Dual Pak or Voquezna Triple Pak. These formulations combine vonoprazan and antibiotics that treat H. pylori.
If you have erosions in the esophagus due to acid reflux, you can take Voquezna for eight weeks to heal them and for up to six months to maintain the esophageal lining after healing. Voquezna is also FDA-approved to treat heartburn without erosions for up to four weeks, based on data from clinical trials. However, some providers say the drug can be taken long-term if necessary.
“The FDA can only give guidance on what data shows, but Voquezna has been used in Japan for 10 years and is more popular there than PPIs are,” Larry E. Clark, Jr., MD, a gastroenterologist who also experiences GERD, told Verywell. Clark, who takes Voquezna to manage his symptoms, was also an investigator in the vonoprazan clinical trials.
Phathom Pharmaceuticals is doing more extensive research to test the safety and efficacy of long-term Voquezna use.
“The FDA requested we do an extension to six months to look at long-term safety. There were no signals of concern there,” said Gilligan. “GERD is a chronic disease, and when you stop taking the medication, the symptoms return.”
Why Voquezna Is Different From Other Acid Reflux Medications
Your stomach needs an enzyme called H+/K+ ATPase (or hydrogen/potassium ATPase) to make gastric acid. Proton pump inhibitors (PPIs), such as Prevacid (lansoprazole), Prilosec (omeprazole), and Nexium (esomeprazole), block this enzyme from converting hydrogen to hydrochloric acid.
Voquezna is different; it’s a potassium-competitive acid blocker (PCAB) that binds to the potassium channel of the H+/K+ ATPase enzyme and inactivates it.
Whether you take a PPI or a PCAB for GERD, the result is the same: Your stomach will make less acid.
PPIs have been a mainstay of GERD treatment for 30 years, and they’re effective for many patients. But to work well, PPIs have to be taken 30 minutes before eating or drinking. It can also take several days to notice the full effect of these treatments. Clark added that some patients experience a “significant rebound effect” when they stop taking a PPI.
Clinical trials showed that Voquezna relieved symptoms faster than PPIs and provided a full 24 hours of relief. It can also be taken any time of day, regardless of meal timing or food intake. When tested against lansoprazole (a common PPI), a phase 3 clinical trial showed that vonoprazan was superior at maintaining the healing of an esophageal erosion.
How Much Does Voquezna Cost?
Voquezna is a new drug, so some health insurers may not cover it or may require prior authorization. However, Clark said he’s been able to prescribe it to patients who need it and has “been impressed with my ability to get patients this medication.”
CVS Caremark, the largest pharmacy benefits manager in the United States, recently added Voquezna to its national formulary, making it accessible to over 26 million members. Over 116 million Americans (about three-quarters of whom have commercial health insurance) now have coverage to help cover the cost of Voquezna.
For patients whose health insurance plans don’t cover Voquezna, there’s a Voquezna savings card they can sign up for to help lower their out-of-pocket costs.
Is Voquezna Safe?
The side effects of Voquezna include:
Stomach pain, bloating, and inflammationDiarrhea or constipationNauseaHigh blood pressureUrinary tract infection
There are also some rare but potentially serious complications of Voquezna:
Acute tubulointerstitial nephritis (a kidney condition that decreases urine production)
Diarrhea due to an overgrowth of the bacteria Clostridioides difficile (C. diff)
Increased risk of bone fractures of the hip, wrist, or spine
Allergic skin reactions
Low vitamin B12 or magnesium levels
Benign stomach growths (fundic gland polyps)
If you’re talking to your provider about trying Voquenza, let them know if you have low magnesium, calcium, or potassium levels, take a diuretic, or have liver or kidney disease. If you’re taking rilpivirine, an antiviral drug for HIV, you won’t be able to take Voquezna.
Researchers don’t know if Voquezna is safe for people who are pregnant or breastfeeding.
Lifestyle Strategies to Help With Reflux
In addition to medication, Clark recommends making the following dietary and lifestyle modifications if you have reflux:
Limit caffeine, chocolate, and spicy meals. These foods relax the lower esophageal sphincter and make it easier for acid to back up into the esophagus.
Stick to smaller portions. Eating large portions increases the pressure inside the stomach. Having lighter meals more frequently may also help.
Try to finish eating about four hours before lying down or heading to bed. This will give your stomach time to digest your food while you are still upright and gravity can pull food down your digestive tract. Some people who get night-time heartburn benefit from sleeping with the head of their bed elevated.
What This Means for You
Voquezna is a newly FDA-approved drug that may help if you have GERD symptoms that are not controlled by PPIs and heal erosions in the esophagus caused by GERD. Making lifestyle changes in addition to medication may help you manage your symptoms better.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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