Vonoprazan Vs Omeprazole – Which is Right for You?

Vonoprazan Vs Omeprazole is a comparison of the two highly effective anti-ulcer drugs. Both these drugs lower acid secretion in a slightly different way.

Omeprazole is a time-tested drug and is being used worldwide for various stomach disorders including GERD, erosive esophagitis, peptic ulcer disease, and Helicobacter pylori infection.

The FDA has recently cleared Vonoprazan for the treatment of erosive and non-erosive GERD.

Here is a brief review of the two drugs:

Vonoprazan Vs Omeprazole

• Vonoprazan (Voquezna):

This is actually a new addition to a wide edition of meds used to treat acid-related issues. It was introduced in 2015 by Takeda Pharmaceuticals, and it has been approved by the FDA to treat the non-erosive form of GERD.

Voquezna has not been around for decades as omeprazole has and because of that, we have less clinical data on it.

But the FDA approval is enough to show its effectiveness and it helped us understand the mechanism of action as well.

However, early studies suggest potassium-competitive acid blockers like Vonoprazan might offer faster and more potent acid reduction, potentially leading to quicker symptom relief [ref].

• Omeprazole:

Omeprazole, the first drug of its kind, was created in 1979 by the Swedish company AB Hässle, which later became part of AstraZeneca.

It was the 1st proton pump inhibitor (PPI) which is a type of medicine known for greatly reducing stomach acid.

It was originally sold as Losec but then it became very popular and is now made by many companies around the world as a generic drug.

Omeprazole is mainly used to treat problems caused by too much stomach acid, like peptic ulcers, gastroesophageal reflux disease (GERD), and Zollinger-Ellison syndrome.

Its long history and effectiveness have made it a key treatment for acid-related issues.

Side effects of Vonoprazan Vs Omeprazole:

• Voquezna:

Common side effects of Voquezna include:

• Diarrhea
• Headache
• Abdominal pain
• Nausea
• Indigestion
• Gastritis (inflammation of the stomach lining)

Less common side effects can include:

• High blood pressure
• Urinary tract infections
• Cold-like symptoms

• Omeprazole:

Common side effects of Omeprazole include:

• Headache
• Diarrhea
• Abdominal pain
• Nausea
• Constipation
• Gas

Less common side effects can include:

• Dizziness
• Rash
• Joint pain
• Muscle aches

Mechanism of action of Vonoprazan Vs Omeprazole:

• Vonoprazan (Voquezna)

Vonoprazan is a drug known as a potassium-competitive acid blocker (PCAB). It works by blocking an enzyme system called H+, K+-ATPase in a way that competes with potassium.

This action reduces both the normal and triggered production of stomach acid on the surface of certain stomach cells called parietal cells.

Although Vonoprazan and another class of drugs called proton-pump inhibitors (PPIs) both block the H+, K+-ATPase enzyme, they do so in different ways.

PPIs attach to a specific part of the enzyme and inactivate it by forming a chemical bond. In contrast, PCABs like Vonoprazan prevent potassium from binding to the enzyme, thus stopping it from working.

• Omeprazole:

This drug functions by reducing the amount of acid your stomach makes, and it belongs to a group of meds called proton pump inhibitors (PPIs).

These medicines target the proton pumps in your stomach lining, which produce stomach acid. When these pumps are blocked, acid production stops.

After you take omeprazole, it goes straight to your bloodstream, reaches the stomach cells, and gets converted into their active forms.

This form then binds to the proton pumps and inhibits them. Moving forward, a reduction in stomach acid occurs which helps to heal acid-related conditions like gastroesophageal reflux disease (GERD), stomach ulcers, and Zollinger-Ellison syndrome.

This process also relieves symptoms like heartburn and indigestion by preventing the acid from causing damage to the esophagus, stomach, or intestines.

Vonoprazan Vs Omeprazole Dosage and administration

• Voquezna:

The dosage varies depending on the specific condition being treated. It is typically administered orally in tablet form. [ref]

• Healing of erosive esophagitis and relief of associated heartburn: 20 mg once daily for 8 weeks.
• Maintenance of healed erosive esophagitis and relief of associated heartburn: 10 mg once daily for up to 6 months.
• Relief of heartburn associated with non-erosive gastroesophageal reflux disease: 10 mg once daily for 4 weeks.
• Treatment of H. pylori infection:
  • Triple therapy: 20 mg plus amoxicillin 1000 mg plus clarithromycin 500 mg, each given twice daily for 14 days.
  • Dual therapy: 20 mg given twice daily plus amoxicillin 1000 mg three times daily for 14 days.

• Omeprazole:

Dosage varies depending on the specific condition being treated. It is generally taken orally in tablet or capsule form [ref].

• Erosive esophagitis: 20 mg once daily for 4 to 8 weeks.
• Gastroesophageal reflux disease (GERD): 20 mg once daily.
• Helicobacter pylori infection: 20 mg twice daily for 10 to 14 days, in combination with antibiotics.
• Zollinger-Ellison syndrome: Dosage varies widely and is determined by the individual patient’s needs.

Comparing Vonoparazan vs other PPIs:

In clinical trials, results are variable. However, most studies indicate that Vonoprazan is superior to most PPIs in terms of its rapid onset of action and faster healing rates.

Here is a summary of one systemic review comparing Vonoprazan vs other PPIs. The authors of this review selected 43 studies out of 4001 clinical trials.