Vonoprazan and Amoxicillin
Vonoprazan and amoxicillin are an acid blocker and antibiotic combination used together — in two different co-packaged products, Voquezna Dual Pak and Voquezna Triple Pak — to treat H. pylori (Helicobacter pylori) bacterial infections in adults.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Vonoprazan and Amoxicillin: Patient Information Guide
A plain-language walkthrough of Vonoprazan and Amoxicillin — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Vonoprazan and amoxicillin are used together as part of two co-packaged prescription products to treat bacterial infection.
- Voquezna Dual Pak (vonoprazan + amoxicillin) is indicated to treat Helicobacter pylori (H. pylori) infection in adults.
- Voquezna Triple Pak (vonoprazan + amoxicillin + clarithromycin) is also indicated to treat H. pylori infection in adults.
- Both products should only be used when H. pylori infection is confirmed or strongly suspected, to reduce the risk of antibiotic resistance.
⚙️How it works▾
Vonoprazan is a potassium-competitive acid blocker (PCAB) — it shuts down the stomach's acid-producing proton pump by blocking the enzyme that generates acid. Unlike older acid blockers, vonoprazan does not need stomach acid to become active, so it works quickly and consistently. A less acidic stomach environment helps H. pylori bacteria replicate more actively, and also helps amoxicillin (and clarithromycin in the Triple Pak) stay stable and effective in the stomach — making the antibiotics more likely to fully clear the infection.
Amoxicillin is a penicillin-type antibiotic that kills H. pylori bacteria directly by disrupting their cell walls.
💊How it's taken▾
Both paks are taken by mouth with or without food for a full 14 days. Voquezna Triple Pak is taken twice daily — morning and evening, roughly 12 hours apart. Voquezna Dual Pak involves vonoprazan twice daily (morning and evening) and amoxicillin three times daily (morning, midday, and evening). Follow your prescriber's instructions exactly for each product.
- If you miss a dose, take it as soon as you realize — but only if it has been less than 4 hours since the missed dose.
- If more than 4 hours have passed, skip the missed dose and continue your normal schedule. Do not double up.
- Dosage adjustments may be needed for kidney or liver problems — your prescriber will determine what is appropriate for you.
🤒Side effects — in detail▾
The most commonly reported side effects differ slightly between the two paks.
- Voquezna Dual Pak: diarrhea, abdominal pain, vulvovaginal yeast infection, nasopharyngitis (cold-like symptoms)
- Voquezna Triple Pak: altered taste (dysgeusia), diarrhea, vulvovaginal yeast infection, headache, abdominal pain, high blood pressure
Seek medical attention right away for severe or bloody diarrhea (possible C. diff infection), any blistering or peeling skin rash, signs of a severe allergic reaction (throat swelling, difficulty breathing), or symptoms of liver problems such as yellowing of the skin or eyes, dark urine, or severe stomach pain.
⚠️Warnings & precautions▾
- Serious allergic reactions: Anaphylaxis and severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis) have been reported. Stop the medication immediately and get emergency help if you develop widespread rash, blistering, facial swelling, or trouble breathing.
- C. difficile diarrhea: Antibiotics can allow C. diff bacteria to overgrow in the gut, causing severe diarrhea that may occur up to 2 months after finishing treatment. Report persistent or severe diarrhea to your doctor.
- Kidney inflammation (acute tubulointerstitial nephritis): A type of kidney injury has been reported with vonoprazan. Tell your doctor if you notice reduced urination or signs of kidney problems.
- Heart rhythm problems (Voquezna Triple Pak): Clarithromycin can prolong the QT interval, potentially causing dangerous arrhythmias. Avoid Voquezna Triple Pak if you have a heart rhythm disorder or take other QT-prolonging drugs.
- Liver injury (Voquezna Triple Pak): Clarithromycin has been linked to serious liver damage. Stop the Triple Pak and contact your doctor if you develop jaundice, dark urine, or abdominal pain.
- Pregnancy (Voquezna Triple Pak): Not recommended in pregnancy unless no other option exists — clarithromycin has been associated with miscarriage and possible fetal abnormalities.
- Mononucleosis: Amoxicillin is very likely to cause a skin rash in people who have mono — avoid these paks if you have mononucleosis.
- False lab test results: Vonoprazan can raise chromogranin A (CgA) levels, which may produce a false-positive result on tests for neuroendocrine tumors. Wait at least 4 weeks after finishing treatment before this test.
🔀What it interacts with▾
These combination paks interact with a wide range of medications — some interactions are serious enough to be life-threatening. Key ones to know:
- Rilpivirine (HIV medication): Contraindicated with both paks — vonoprazan reduces stomach acid, which lowers rilpivirine absorption.
- Pimozide, lomitapide, lovastatin, simvastatin, ergotamine, lurasidone: Contraindicated with Voquezna Triple Pak due to dangerous drug interactions with clarithromycin.
- Warfarin (blood thinner): Clarithromycin can significantly increase bleeding risk — INR must be monitored closely.
- Clopidogrel (anti-platelet drug): Vonoprazan may reduce its effectiveness — your doctor may consider an alternative.
- Colchicine (gout medication): Life-threatening toxicity possible with Voquezna Triple Pak, especially if you have kidney or liver problems.
- Diabetes medications or insulin: Clarithromycin (Triple Pak) can increase the risk of low blood sugar — glucose monitoring is recommended.
- Immunosuppressants (tacrolimus, cyclosporine): Drug levels may rise dangerously with Voquezna Triple Pak — frequent monitoring required.
- Benzodiazepines (triazolam, midazolam): Clarithromycin may increase sedation — use with caution.
- Strong CYP3A inducers (certain seizure or HIV drugs): May reduce vonoprazan and clarithromycin levels, making the treatment less effective — avoid if possible.
- Allopurinol: Higher rate of skin rash when combined with amoxicillin.
- Probenecid (gout medication): Can increase amoxicillin levels — monitor for increased side effects.
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Penicillin or antibiotic allergy: Do not take if you are allergic to penicillins, cephalosporins, or (for Triple Pak) macrolide antibiotics like erythromycin.
- Kidney problems: Both paks are not recommended if your kidney function is severely reduced (estimated GFR below 30 mL/min). Dosage adjustments may be needed for mild to moderate kidney impairment.
- Liver problems: Both paks are not recommended in moderate or severe liver impairment (Child-Pugh Class B or C). Mild liver impairment may still be manageable with standard dosing.
- Pregnancy: Voquezna Triple Pak is not recommended during pregnancy due to risks from clarithromycin. A pregnancy registry exists — ask your doctor about registering. The safety of Voquezna Dual Pak in pregnancy has not been well established.
- Breastfeeding: Discuss the risks and benefits with your doctor before breastfeeding while taking either pak.
- Older adults: May have a higher risk of QT prolongation (heart rhythm changes) with Voquezna Triple Pak.
- Mononucleosis (mono): Avoid amoxicillin-containing paks — a skin rash is very likely.
- Myasthenia gravis (muscle-weakness condition): Clarithromycin in the Triple Pak may worsen symptoms.
- Heart rhythm disorders or electrolyte imbalances: Avoid Voquezna Triple Pak if you have QT prolongation, low potassium, or low magnesium, or take antiarrhythmic drugs.
🚑If you take too much▾
There are no reports of overdose with vonoprazan in humans, and a high single test dose did not cause serious reactions in studies. Amoxicillin overdose may cause gastrointestinal symptoms and, in rare cases, kidney injury from crystal formation in the urine — staying well hydrated is important. Clarithromycin overdose can cause nausea, vomiting, abdominal pain, and diarrhea. If you suspect an overdose, contact a poison control center, your doctor, or an emergency room immediately.
📡Pharmacodynamics — effects in the body▾
Vonoprazan begins raising stomach pH (reducing acid) within 2 to 3 hours of a single dose, and acid suppression lasts more than 24 hours. With repeated daily dosing, the acid-lowering effect increases and reaches a stable level by around day 4. After stopping the medication, acid suppression gradually fades but stomach pH remains elevated for 24 to 48 hours. Vonoprazan also raises gastrin levels (a hormone that stimulates acid production) during treatment, which return to normal within about 4 weeks of stopping — and these elevated levels can temporarily affect certain diagnostic lab tests.
🔬Pharmacokinetics — how your body processes it▾
Vonoprazan is absorbed quickly by mouth, reaching peak blood levels in about 2.5 to 3 hours, and its levels in the body build up to a stable state within 3 to 4 days of regular dosing. It is broken down by liver enzymes (mainly CYP3A4/5, CYP2C19, and CYP2D6) into inactive forms, then mostly cleared through the urine. Food does not meaningfully affect absorption. People with significant kidney or liver impairment have higher vonoprazan exposure, which is why dose adjustments or avoiding these paks altogether may be necessary in those groups.
📦How to store it▾
Store between 20°C and 25°C (68°F and 77°F). Protect from light.
📄 Written from Vonoprazan and Amoxicillin’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Vonoprazan and Amoxicillin — the kind of thing our pharmacy team would talk through with you at the counter.
What exactly is H. pylori, and why do I need two or three medications to treat it? ▾
Does it matter which pak I was prescribed — Dual or Triple? ▾
Can I eat normally while I'm taking this? ▾
What side effects are most likely, and which ones should make me call my doctor? ▾
I take several other medications. Should I be worried about interactions? ▾
I might be pregnant — is it safe to take this? ▾
Is Vonoprazan and Amoxicillin available over the counter? ▾
When was Vonoprazan and Amoxicillin first available? ▾
💬 Answers drafted from Vonoprazan and Amoxicillin’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
📊 Vonoprazan and Amoxicillin across the U.S. market
How Vonoprazan and Amoxicillin appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
Also listed with the FDA, not a patient dose form: Kit (4) — bulk drug substance sold to compounders/manufacturers and multi-item kits. These aren’t counted in the dose-form total above.
📈 How widely Vonoprazan and Amoxicillin is used
A general measure of how commonly Vonoprazan and Amoxicillin is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Vonoprazan and Amoxicillin is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Vonoprazan and Amoxicillin prescribed? Of the 1,596 medications we measure, Vonoprazan and Amoxicillin ranks #1,429 by Medicaid prescriptions — more than 10% of them.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Vonoprazan and Amoxicillin, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 1 of 1 listed Vonoprazan and Amoxicillin NDCs with Medicaid activity.
🔍 Compare Vonoprazan and Amoxicillin products
A representative set of FDA-listed product records for Vonoprazan and Amoxicillin — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|
| 💊Kits | ||
| Phathom Pharmaceuticals Inc. × 4 listings | NDA | View NDC → |
Showing 4 of 4 products — FDA National Drug Code Directory. See every product, package size and price: browse all 4 Vonoprazan and Amoxicillin NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Vonoprazan and Amoxicillin — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Vonoprazan and Amoxicillin in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Vonoprazan and Amoxicillin went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
📦 Supply & shortage status
Whether Vonoprazan and Amoxicillin is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
For canonical ingredient pages, bounded product-attributed indication and administration excerpts may be added to the AI evidence, and the generator is instructed to preserve available product, brand, route, and form qualifiers instead of treating one label as universal. Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Phathom Pharmaceuticals Inc. is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.