Vonoprazan, Clarithromycin, and Amoxicillin
Vonoprazan, clarithromycin and amoxicillin are the medicines in two co-packaged Voquezna treatment kits (Triple Pak and Dual Pak) used to treat Helicobacter pylori (H. pylori) infection 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 →
Voquezna Triple Pak and Dual Pak are 14-day kits for H. pylori, a stomach infection, pairing vonoprazan, a newer acid blocker that lets the antibiotics work better, with amoxicillin (plus clarithromycin in the Triple Pak). On the market since about 2023, they are an alternative to older H. pylori regimens built on omeprazole-type acid reducers. Most people finish without much trouble, though diarrhea is common and the Triple Pak often leaves a bad taste. Watch for allergy (trouble breathing, swelling, a blistering rash), report any past penicillin reaction before starting, and finish every dose even once you feel better; for the Triple Pak, have your pharmacist screen your medicine list first, since clarithromycin clashes with many drugs.
Clinical pearls
- Simvastatin and lovastatin must not be taken with the Triple Pak, so expect your prescriber to pause or switch the statin.
- On warfarin, plan on closer INR checks (a blood clotting test) during the course, since the kit can shift your clotting numbers.
- Diarrhea that is severe or will not stop can be C. difficile, a gut infection that may appear up to two months later.
- Vonoprazan can falsely raise chromogranin A, a blood test for neuroendocrine tumors, so mention the kit if that test is ordered.
Patient information guide A plain-language walkthrough of Vonoprazan, Clarithromycin, and Amoxicillin, written from its FDA label.
What Vonoprazan, Clarithromycin, and Amoxicillin is used for
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These ingredients are sold together in two co-packaged kits for the same condition.
- Voquezna Triple Pak (vonoprazan, amoxicillin, clarithromycin): treats H. pylori infection in adults.
- Voquezna Dual Pak (vonoprazan, amoxicillin): treats H. pylori infection in adults.
How Vonoprazan, Clarithromycin, and Amoxicillin works
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Vonoprazan blocks the acid pumps in the stomach's lining cells, which lowers stomach acid. It does this in a reversible way and does not need acid to activate it.
Less acid helps the antibiotics work better against H. pylori. Amoxicillin and clarithromycin are the antibacterial medicines in the kits.
Vonoprazan, Clarithromycin, and Amoxicillin dosage
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Both kits are taken by mouth for 14 days, with or without food. Always follow your prescriber and the label.
- Voquezna Triple Pak: vonoprazan, amoxicillin and clarithromycin, each twice daily, about 12 hours apart.
- Voquezna Dual Pak: vonoprazan twice daily and amoxicillin three times daily (morning, mid-day, evening).
- Missed dose: take it within 4 hours. After that, skip it and resume your regular schedule.
Dosing details from the FDA-approved label
From the Vonoprazan, Clarithromycin, and Amoxicillin prescribing information (“Dosage and Administration”). Doses are set by your prescriber for your product, condition, kidney function and age — never change a dose on your own.
- VOQUEZNA TRIPLE PAK (adults)
- Vonoprazan 20 mg plus amoxicillin 1,000 mg plus clarithromycin 500 mg, each given twice daily (morning and evening, 12 hours apart), with or without food, for 14 days
- with or without food
- VOQUEZNA DUAL PAK (adults)
- Vonoprazan 20 mg twice daily (morning and evening) plus amoxicillin 1,000 mg three times a day (morning, mid-day, and evening), with or without food, for 14 days
- with or without food
- Renal impairment, estimated GFR 30 mL/minute or greater
- TRIPLE PAK: 20 mg vonoprazan twice daily, 1,000 mg amoxicillin twice daily, 500 mg clarithromycin twice daily
- DUAL PAK: 20 mg vonoprazan twice daily, 1,000 mg amoxicillin three times daily
- Renal impairment, estimated GFR less than 30 mL/minute
- Use is not recommended
- Hepatic impairment, Child-Pugh Class A
- TRIPLE PAK: 20 mg vonoprazan twice daily, 1,000 mg amoxicillin twice daily, 500 mg clarithromycin twice daily
- DUAL PAK: 20 mg vonoprazan twice daily, 1,000 mg amoxicillin three times daily
- Hepatic impairment, Child-Pugh Class B or C
- Use is not recommended
Read the label’s full dosing text
2 DOSAGE AND ADMINISTRATION VOQUEZNA TRIPLE PAK : The recommended dosage is vonoprazan 20 mg plus amoxicillin 1,000 mg plus clarithromycin 500 mg, each given twice daily (morning and evening, 12 hours apart), with or without food, for 14 days. ( 2.1 ) VOQUEZNA DUAL PAK : The recommended dosage is vonoprazan 20 mg twice daily (morning and evening) plus amoxicillin 1,000 mg, three times a day (morning, mid-day, and evening), with or without food, for 14 days. ( 2.2 ) See full prescribing information for the recommended dosage for patients with renal or hepatic impairment. ( 2.3 , 2.4 ) 2.1 Recommended Dosage for VOQUEZNA TRIPLE PAK VOQUEZNA TRIPLE PAK is a co-packaged product containing vonoprazan tablets, amoxicillin capsules, and clarithromycin tablets each given twice daily (in the morning and evening, 12 hours apart) with or without food, for 14 days [see Clinical Pharmacology (12.3) ] . The recommended adult oral dosage of VOQUEZNA TRIPLE PAK is the following: In the morning, take 20 mg of vonoprazan (one oval pale red tablet), 1,000 mg of amoxicillin (two yellow capsules), and 500 mg of clarithromycin (one oval white tablet) In the evening, take 20 mg of vonoprazan (one oval pale red tablet), and 1,000 mg of amoxicillin (two yellow capsules), and 500 mg of clarithromycin (one oval white tablet) 2.2 Recommended Dosage for VOQUEZNA DUAL PAK VOQUEZNA DUAL PAK is a co-packaged product containing vonoprazan tablets and amoxicillin capsules given with or without food, for 14 days [see Clinical Pharmacology (12.3) ] . The recommended adult oral dosage of VOQUEZNA DUAL PAK is the following: In the morning, take 20 mg of vonoprazan (one oval pale red tablet) and 1,000 mg of amoxicillin (two yellow capsules) Mid-day, take 1,000 mg of amoxicillin (two yellow capsules) In the evening, take 20 mg of vonoprazan (one oval pale red tablet) and 1,000 mg of amoxicillin (two yellow capsules) 2.3 Recommended Dosage in Patients with Renal Impairment The recommended dosage of VOQUEZNA TRIPLE PAK and VOQUEZNA DUAL PAK in adult patients with renal impairment is described in Table 1 [see Use in Specific Populations (8.6) and Clinical Pharmacology (12.3) ].
Excerpted — the section continues on the label. Read the full Dosage and Administration section on DailyMed →
Vonoprazan, Clarithromycin, and Amoxicillin side effects
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The most common side effects in studies were:
Common side effects
- Diarrhea
- Abnormal or bad taste (mostly with Triple Pak)
- Vaginal yeast infection
- Stomach pain
- Headache (mostly with Triple Pak)
- High blood pressure (with Triple Pak)
- Stuffy or runny nose or cold-like symptoms (with Dual Pak)
When to get medical help
- Get emergency help for signs of a serious allergic reaction, such as trouble breathing, swelling or severe rash.
- Stop the medicine and call your doctor right away if you get a severe skin reaction, such as blistering or peeling skin.
- Call your doctor if you have repeated vomiting a few hours after a dose, especially with paleness or unusual sleepiness.
- Call your doctor if you have diarrhea that is severe or doesn't go away. This can happen even up to two months after antibiotics.
- With Triple Pak, call your doctor right away for yellow skin or eyes, dark urine, itching, loss of appetite or a tender belly, which may signal liver problems.
- With Triple Pak, get help for a fast or irregular heartbeat or fainting.
- Tell your doctor if you have worsening muscle weakness if you have myasthenia gravis (Triple Pak).
Seek help for allergic reactions, severe skin reactions, severe or lasting diarrhea, signs of liver problems, or heart rhythm symptoms.
Vonoprazan, Clarithromycin, and Amoxicillin warnings and precautions
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- Serious allergic reactions, including anaphylaxis, can be fatal. Stop the medicine and get help.
- Severe skin reactions such as Stevens-Johnson syndrome and toxic epidermal necrolysis.
- Kidney inflammation (acute tubulointerstitial nephritis) has been reported with vonoprazan.
- Drug-induced enterocolitis syndrome (DIES): protracted vomiting 1 to 4 hours after a dose, mostly reported in children.
- C. difficile diarrhea: can range from mild to fatal colitis, even months after treatment.
- Rash with mononucleosis: avoid use.
- Triple Pak only: QT prolongation and heart rhythm problems, liver injury, worsening myasthenia gravis, and pregnancy risk.
Vonoprazan, Clarithromycin, and Amoxicillin interactions
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These kits can interact with many medicines.
- Rilpivirine: must not be combined.
- Pimozide, lomitapide, lovastatin, simvastatin, ergot drugs, lurasidone (Triple Pak): contraindicated because of serious risks.
- Colchicine: dose reduction needed, and not allowed with kidney or liver problems.
- Warfarin and other blood thinners: clotting time can rise, so monitoring is needed.
- CYP3A inducers: may make the kits less effective.
- Clopidogrel: vonoprazan may reduce its effect.
- Medicines that need stomach acid to be absorbed (such as some HIV drugs, iron salts and certain cancer drugs): may work less well.
- Probenecid and allopurinol: may raise amoxicillin levels or rash risk.
- Diabetes medicines and insulin (Triple Pak): can cause low blood sugar.
- Urine glucose tests: amoxicillin can cause false positives with some tests.
Interactions listed in the FDA-approved label
From the Vonoprazan, Clarithromycin, and Amoxicillin prescribing information (“Drug Interactions”): what the manufacturer studied or reported to the FDA.
- Strong or moderate CYP3A inducers: May decrease exposure of vonoprazan and clarithromycin, which may reduce the effectiveness of the pak. Avoid concomitant use.
- Probenecid: May increase amoxicillin exposure by blocking its renal tubular secretion, which may increase the risk of adverse reactions. Closely monitor for signs or symptoms of increased or prolonged adverse reactions associated with amoxicillin.
- Allopurinol: Increase in the incidence of rashes reported in patients receiving both allopurinol and amoxicillin compared to amoxicillin alone. Discontinue allopurinol at the first appearance of skin rash.
- Omeprazole: Clarithromycin concentrations in gastric tissue and mucus were increased by concomitant omeprazole. Avoid concomitant use of VOQUEZNA TRIPLE PAK with omeprazole.
- Itraconazole: Both are CYP3A substrates and inhibitors, potentially causing a bi-directional interaction and increased clarithromycin exposure. Monitor closely for signs or symptoms of increased or prolonged adverse reactions associated with itraconazole and clarithromycin.
- Rilpivirine-containing products: Vonoprazan reduces intragastric acidity, which may alter absorption of antiretrovirals. Concomitant use with VOQUEZNA TRIPLE PAK is contraindicated.
- Atazanavir, nelfinavir: Vonoprazan reduces intragastric acidity, which may alter antiretroviral absorption and affect safety and/or effectiveness. Avoid concomitant use with VOQUEZNA TRIPLE PAK.
- Tacrolimus, cyclosporine (CYP3A substrates): Clarithromycin and vonoprazan may increase exposure of CYP3A4 substrates, increasing risk of related adverse reactions. Frequent monitoring for concentrations and/or adverse reactions; dosage reduction of substrate drugs may be needed.
- Clopidogrel (CYP2C19 substrate): Vonoprazan may reduce plasma concentrations of clopidogrel's active metabolite and may reduce platelet inhibition. Carefully monitor the efficacy of clopidogrel and consider alternative anti-platelet therapy.
- Oral anticoagulants: Abnormal prolongation of prothrombin time (increased INR) has been reported with amoxicillin and oral anticoagulants. Appropriate monitoring; dose adjustments of oral anticoagulants may be necessary.
Read the label’s full interactions text
7 DRUG INTERACTIONS Collated drug interaction information for the individual components in VOQUEZNA TRIPLE PAK and VOQUEZNA DUAL PAK is summarized below. Drug interaction studies with VOQUEZNA TRIPLE PAK or VOQUEZNA DUAL PAK have not been conducted. These recommendations are based on either drug interaction trials or predicted interactions due to the expected magnitude of interaction and potential for serious adverse reactions or loss of efficacy [see Clinical Pharmacology (12.3) ] . Clarithromycin (a component of VOQUEZNA TRIPLE PAK) is a strong CYP3A inhibitor. Concomitant use of VOQUEZNA TRIPLE PAK with a drug(s) primarily metabolized by CYP3A may cause elevations in CYP3A substrate drug's concentrations that could increase or prolong both therapeutic and adverse effects of the concomitant drug. Table 4: Effects of Other Drugs on VOQUEZNA TRIPLE PAK Strong or Moderate CYP3A Inducers Clinical Effect Vonoprazan and clarithromycin are CYP3A substrates. Strong or moderate CYP3A inducers may decrease exposure of vonoprazan and clarithromycin [see Clinical Pharmacology (12.3) ] , which may reduce the effectiveness of VOQUEZNA TRIPLE PAK. Prevention or Management Avoid concomitant use with VOQUEZNA TRIPLE PAK. Probenecid Clinical Effect Amoxicillin undergoes tubular secretion. Probenecid may increase amoxicillin exposure by blocking its renal tubular secretion, which may increase the risk of VOQUEZNA TRIPLE PAK adverse reactions. Prevention or Management Closely monitor for signs or symptoms of increased or prolonged adverse reactions associated with amoxicillin when used with VOQUEZNA TRIPLE PAK. Allopurinol Clinical Effect Increase in the incidence of rashes is reported in patients receiving both allopurinol and amoxicillin together compared to patients receiving amoxicillin alone. It is not known whether this potentiation of amoxicillin rashes is due to allopurinol or the hyperuricemia present in these patients.
Excerpted — the section continues on the label. Read the full Drug Interactions section on DailyMed →
Not a complete list. The label covers the interactions the manufacturer studied or reported, and our own interaction database does not cover every medicine either. Bring your full medication list, including vitamins and herbal products, to your pharmacist.
Before taking Vonoprazan, Clarithromycin, and Amoxicillin
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- Known allergy to vonoprazan, penicillins or other beta-lactams, or (Triple Pak) macrolides.
- Taking rilpivirine-containing medicines.
- Severe kidney impairment or moderate to severe liver impairment: not recommended.
- Pregnancy: Triple Pak is not recommended unless no alternative exists. A pregnancy registry monitors outcomes with both kits.
- Older adults: higher risk of torsades de pointes (a dangerous heart rhythm) with Triple Pak.
- Mononucleosis, heart rhythm problems, low potassium or magnesium, slow heartbeat, or myasthenia gravis (Triple Pak).
Vonoprazan, Clarithromycin, and Amoxicillin overdose
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No information is available on overdose of the kits in humans. Contact a physician, poison control center or emergency room. Amoxicillin overdose may affect the kidneys, and clarithromycin overdose can cause stomach pain, vomiting, nausea and diarrhea.
What Vonoprazan, Clarithromycin, and Amoxicillin does in the body
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A single dose of vonoprazan begins lowering stomach acid within 2 to 3 hours, and the effect lasts over 24 hours. The effect builds with repeat dosing and fades over 24 to 48 hours after stopping. Vonoprazan raises gastrin levels, which return to normal within 4 weeks of stopping, and it can raise chromogranin A, affecting some tumor tests.
How your body processes Vonoprazan, Clarithromycin, and Amoxicillin
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Vonoprazan reaches peak blood levels in about 2.5 to 3 hours and has a half-life of roughly 7 hours. A high-fat meal does not change its absorption in a meaningful way. The body breaks it down into inactive products using several liver enzymes, mainly CYP3A4/5, and clears it through urine and feces. Kidney or liver impairment raises vonoprazan levels in the body.
How to store Vonoprazan, Clarithromycin, and Amoxicillin
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Store between 20°C and 25°C (68°F and 77°F). Protect from light.
Written from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
Vonoprazan, Clarithromycin, and Amoxicillin: pharmacist answers to common questions
Quick, plain-English answers to the questions patients ask most about Vonoprazan, Clarithromycin, and Amoxicillin — the kind of thing our pharmacy team would talk through with you at the counter.
What is this medicine for?
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How do I take it?
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What if I miss a dose?
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What side effects should I expect?
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When should I get urgent help?
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Do I need to tell you about my other medicines?
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Is Vonoprazan, Clarithromycin, and Amoxicillin available over the counter?
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When was Vonoprazan, Clarithromycin, and Amoxicillin first available?
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Answers drafted from the FDA-approved label with AI and reviewed by our pharmacy team. How we use AI →
More about Vonoprazan, Clarithromycin, and Amoxicillin on HelloPharmacist
Vonoprazan, Clarithromycin, and Amoxicillin on the U.S. market: products, makers and brands
How Vonoprazan, Clarithromycin, 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.
1 company lists 1 Vonoprazan, Clarithromycin, and Amoxicillin product record with the FDA; the earliest marketing or approval year on record is 2023. Brand names on the directory include Voquezna Triple Pak, Voquezna Dual Pak; the rest are generics.
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, Clarithromycin, and Amoxicillin is used (Medicaid data)
A general measure of how commonly Vonoprazan, Clarithromycin, and Amoxicillin is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q2 2025 – Q1 2026, summed across every form and brand of the drug.
Think of this as a proxy for how widely Vonoprazan, Clarithromycin, 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, Clarithromycin, and Amoxicillin prescribed? Of the 1,601 medications we measure, Vonoprazan, Clarithromycin, and Amoxicillin ranks #1,397 by Medicaid prescriptions — more than 13% 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, Clarithromycin, 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, Clarithromycin, and Amoxicillin NDCs with Medicaid activity.
Compare Vonoprazan, Clarithromycin, and Amoxicillin products
A representative set of FDA-listed product records for Vonoprazan, Clarithromycin, 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. | NDA | View NDC → |
Showing 1 of 1 products — FDA National Drug Code Directory. See every product, package size and price: browse all 1 Vonoprazan, Clarithromycin, and Amoxicillin NDCs →
Vonoprazan, Clarithromycin, and Amoxicillin side effects reported to the 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, Clarithromycin, 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, Clarithromycin, 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.
Vonoprazan, Clarithromycin, and Amoxicillin FDA approval history
How Vonoprazan, Clarithromycin, and Amoxicillin went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
Vonoprazan, Clarithromycin, and Amoxicillin 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.
The FDA’s enforcement reports list no Vonoprazan, Clarithromycin, and Amoxicillin recalls since July 2021.
✅No Vonoprazan, Clarithromycin, and Amoxicillin recalls on record since July 2021Source: FDA enforcement (recall) reports, via openFDA; our copy was last updated Sep 24, 2026.
Vonoprazan, Clarithromycin, and Amoxicillin supply and shortage status
Whether Vonoprazan, Clarithromycin, 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.
Vonoprazan, Clarithromycin, and Amoxicillin brand names
Vonoprazan, Clarithromycin, and Amoxicillin is sold under 2 brand names in the FDA directory — Voquezna Triple Pak, Voquezna Dual Pak. A brand and its generic contain the same active ingredient; the brand name belongs to one company's product.
Who makes Vonoprazan, Clarithromycin, and Amoxicillin: manufacturers and labelers
One company lists Vonoprazan, Clarithromycin, and Amoxicillin products with the FDA. By number of product records, the largest are Phathom Pharmaceuticals Inc.. Labelers include manufacturers and repackagers; the product in your bottle depends on which one your pharmacy stocks.
Sources for this Vonoprazan, Clarithromycin, and Amoxicillin page
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 this page is built
HelloPharmacist combines public FDA and NLM records and does not author the underlying clinical facts. The plain-language sections are written with AI from the FDA-approved label text and reviewed by our pharmacy team before publication. Phathom Pharmaceuticals Inc. is the representative DailyMed label linked for verification and dates. This is general education, not medical advice: always talk to your doctor or pharmacist about your own medicines. How we build and review drug pages →