Comprehensive medication guide to Voquezna including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$25–$50 copay for commercially insured patients with prior authorization approved; the Voquezna Savings Card can further reduce cost to as little as $25 per fill. Medicare Part D coverage varies by plan; savings card not available for government program enrollees.
Estimated Cash Pricing
$829–$1,013 retail for a 30-day supply (brand only, no generic available); as low as $199 with a GoodRx coupon or $583 with SingleCare for a 30-day supply.
Medfinder Findability Score
60/100
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Voquezna is the brand name for vonoprazan, a first-in-class potassium-competitive acid blocker (PCAB) developed by Phathom Pharmaceuticals. It is the first medication of its class approved in the United States, representing the most significant innovation in acid-suppression therapy in over 30 years. It is available as 10 mg and 20 mg oral tablets, as well as in combination packs (Voquezna Triple Pak and Voquezna Dual Pak) for H. pylori eradication.
The FDA approved the standalone Voquezna tablet in November 2023 for adults with erosive esophagitis and, in July 2024, expanded approval to include non-erosive GERD. The Voquezna Triple Pak and Dual Pak for H. pylori infection were first approved in May 2022.
Unlike traditional proton pump inhibitors (PPIs), Voquezna does not require food timing for activation, takes effect within 2–3 hours of the first dose, and is not significantly affected by CYP2C19 genetic variation. Clinical trials demonstrated Voquezna's superiority over lansoprazole for healing and maintaining healing of severe erosive esophagitis (LA Grade C/D).
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Voquezna (vonoprazan) works by blocking the proton pump — the molecular machine in stomach parietal cells that produces hydrochloric acid. The proton pump, or H+/K+-ATPase, works by exchanging hydrogen ions (acid) for potassium ions across the stomach lining. Vonoprazan is a potassium-competitive acid blocker (PCAB): it competes with potassium ions at the pump, blocking acid production without requiring activation by stomach acid.
This mechanism differs from proton pump inhibitors (PPIs) like omeprazole, which bind the pump irreversibly and require an active, acid-secreting pump (stimulated by food) to work. Voquezna binds reversibly and does not need meal timing, providing faster onset and more consistent acid suppression throughout the day and night.
Vonoprazan is also acid-stable — it doesn't degrade in the stomach before reaching its target — and its activity is not substantially affected by the CYP2C19 enzyme polymorphisms that reduce PPI effectiveness in some patients. Clinical studies show it begins working within 2–3 hours of the first dose.
10 mg — tablet
Pale yellow film-coated tablet for non-erosive GERD (4 weeks) and maintenance of healed erosive esophagitis (up to 6 months)
20 mg — tablet
Pale red film-coated tablet for healing of erosive esophagitis (8 weeks) and H. pylori eradication (20 mg BID x 14 days with antibiotics)
20 mg/1000 mg/500 mg — Triple Pak
Vonoprazan 20 mg + amoxicillin 1000 mg + clarithromycin 500 mg — each given twice daily for 14 days for H. pylori
20 mg/1000 mg — Dual Pak
Vonoprazan 20 mg + amoxicillin 1000 mg — given twice daily for 14 days for H. pylori (amoxicillin taken 3x/day in some regimens)
Voquezna is not on the FDA's official drug shortage list, but many patients report difficulty finding it at retail pharmacies. As a newer, brand-name-only drug with a high cash price (~$829–$1,013/month), many pharmacies have not built it into standard inventory. Smaller independent pharmacies are least likely to stock it; larger chains (CVS, Walgreens) and hospital pharmacies have better availability.
The most reliable path to getting Voquezna is through BlinkRx (Phathom's delivery partner) for home delivery, or by using medfinder to locate nearby pharmacies that have it in stock. medfinder calls pharmacies in your area and texts you the results, saving significant time.
Availability is gradually improving as Voquezna has been added to major PBM formularies including CVS Caremark (covering 26+ million commercially insured members) and Express Scripts. Insurance prior authorization is commonly required and can create additional delays.
Voquezna (vonoprazan) is not a controlled substance, so any licensed prescriber in the U.S. can prescribe it without special DEA authorization. Prescribers typically include:
Gastroenterologists: Most experienced with Voquezna, especially for erosive esophagitis and H. pylori
Primary Care Physicians (PCPs) and Internists: Commonly prescribe for GERD and H. pylori treatment
Nurse Practitioners (NPs) and Physician Assistants (PAs): Qualified to prescribe in most states, including via telehealth
Urgent Care Physicians: May prescribe for straightforward GERD or confirmed H. pylori
Telehealth is appropriate for non-erosive GERD, which can be diagnosed and treated based on symptoms alone. Erosive esophagitis requires endoscopic confirmation (in-person). H. pylori treatment requires a positive test result. Many telehealth platforms including Teladoc, MDLive, and Amazon Clinic can prescribe Voquezna for non-erosive GERD.
No. Voquezna (vonoprazan) is not a controlled substance and is not scheduled by the DEA. It has no abuse potential and does not require special prescribing authority. Any licensed prescriber — physicians, nurse practitioners, physician assistants, and other qualified providers — can prescribe it for FDA-approved indications without a DEA registration number.
Voquezna is a prescription-only medication (Rx required) and is not available over the counter. This means you need a healthcare provider to evaluate your condition and write a prescription. It can be obtained via telehealth for non-erosive GERD, or in-person for conditions requiring endoscopy such as erosive esophagitis.
Most patients tolerate Voquezna well. The most commonly reported side effects in clinical trials include:
Stomach inflammation (gastritis)
Diarrhea
Nausea
Abdominal pain
Indigestion (dyspepsia)
Constipation
Rare but serious side effects require immediate medical attention:
Severe allergic reaction (anaphylaxis): Difficulty breathing, swelling of face/lips/throat — stop and call 911
Acute tubulointerstitial nephritis (kidney inflammation): Decreased urination, blood in urine, fever
C. difficile-associated diarrhea: Persistent watery diarrhea with fever and severe abdominal pain
Severe skin reactions (Stevens-Johnson Syndrome/TEN): Blistering, peeling, or bleeding skin with fever
Hypomagnesemia (low magnesium): Muscle spasms, irregular heartbeat, tremors
Vitamin B12 deficiency (long-term use): Fatigue, numbness, weakness, irregular heartbeat
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Omeprazole (Prilosec)
Generic PPI available OTC and Rx. First-line for most GERD. Effective for mild-moderate erosive esophagitis. Costs $5–$15/month as generic — dramatically less than Voquezna.
Esomeprazole (Nexium)
Generic PPI, among the more potent. Available OTC at 20 mg; Rx at 40 mg. Generic costs ~$10–$30/month. Strong evidence for erosive esophagitis healing.
Lansoprazole (Prevacid)
Generic PPI used as the comparator drug in Voquezna's pivotal trial. Voquezna showed superiority for Grade C/D EE. Available OTC and Rx; generic ~$5–$15/month.
Pantoprazole (Protonix)
Prescription-only generic PPI widely used in hospital and outpatient settings. Costs ~$10–$25/month generic. No significant drug interactions via CYP2C19.
Dexlansoprazole (Dexilant)
Dual-release PPI with extended acid suppression. May be better for nighttime GERD. Brand name; some generics available. Higher cost than basic generics but lower than Voquezna.
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Rilpivirine (Edurant, Complera, Juluca, Odefsey)
majorContraindicated. Voquezna reduces stomach acid, dramatically reducing rilpivirine absorption and risking HIV treatment failure.
Strong CYP3A inducers (rifampin, carbamazepine, St. John's Wort)
majorAvoid. These drugs accelerate vonoprazan metabolism, significantly reducing its blood levels and effectiveness.
Clopidogrel (Plavix)
moderateVonoprazan inhibits CYP2C19, potentially reducing clopidogrel's conversion to its active antiplatelet metabolite. Monitor cardiovascular outcomes.
Ketoconazole, itraconazole
moderateVoquezna raises gastric pH, significantly reducing absorption of these antifungals. Consider alternative antifungals or alternate timing.
Iron salts
moderateReduced absorption with elevated gastric pH. Separate iron supplementation from Voquezna when possible.
Erlotinib, dasatinib, nilotinib (cancer drugs)
moderatepH-dependent absorption may be reduced. Consult oncologist before combining with Voquezna.
QT-prolonging antiarrhythmics (with Triple Pak only)
majorClarithromycin in Voquezna Triple Pak can cause dangerous QT prolongation. Avoid Triple Pak with amiodarone, sotalol, quinidine, Class IA/III antiarrhythmics.
Statins — simvastatin, lovastatin (with Triple Pak only)
majorClarithromycin inhibits statin metabolism, risking rhabdomyolysis. Hold or switch statins during 14-day Triple Pak treatment.
Voquezna (vonoprazan) represents the most significant advance in acid-blocking therapy in over three decades. For patients with severe erosive esophagitis (LA Grade C/D), PPI-refractory GERD, or clarithromycin-resistant H. pylori, it offers clinically meaningful advantages over generic PPIs. For milder conditions, the cost-benefit tradeoff is more nuanced — especially for patients without commercial insurance.
Access challenges are real but solvable. The Voquezna Savings Card reduces cost to as little as $25/month for eligible commercially insured patients. BlinkRx home delivery bypasses pharmacy stocking issues entirely. Availability at retail pharmacies is improving as Voquezna gains wider formulary coverage.
If you're struggling to find Voquezna at your pharmacy, medfinder can call pharmacies in your area and report which ones have it in stock — saving you the time of calling around yourself.
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