Voquezna

Overview

vonoprazan

PPI

• CYP3A4 substrate
• CYP2C19 inhibitor, weak
• CYP3A4 inhibitor, weak
• gastric pH modulator
• hypomagnesemia

Contraindicated

• cisapride
Voquezna (vonoprazan)

+

cisapride

1 interaction

Contraindicated

vonoprazan + cisapride

contraindicated: combo may incr. cisapride levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• eliglustat
Voquezna (vonoprazan)

+

eliglustat

1 interaction

Contraindicated

vonoprazan + eliglustat

CYP2D6 EM: contraindicated if Child-Pugh Class A and if also combined w/ moderate or strong CYP2D6 inhibitor; if also combined w/ moderate or strong CYP2D6 inhibitor, monitor ECG and decr. eliglustat dose to 84 mg qd; otherwise, monitor ECG; CYP2D6 IM: if also combined w/ moderate or strong CYP2D6 inhibitor, monitor ECG and decr. eliglustat dose to 84 mg qd; otherwise, monitor ECG; CYP2D6 PM: avoid combo: combo may incr. eliglustat levels, risk of PR or QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• rilpivirine
Voquezna (vonoprazan)

+

rilpivirine

1 interaction

Contraindicated

vonoprazan + rilpivirine

contraindicated: combo may decr. rilpivirine levels, efficacy (absorption decreased at higher gastric pH)

Avoid/Use Alternative

• alprazolam
Voquezna (vonoprazan)

+

alprazolam

1 interaction

Avoid/Use Alternative

vonoprazan + alprazolam

use alternative or monitor respiratory rate; consider decr. alprazolam dose: combo may incr. alprazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• amphetamine
Voquezna (vonoprazan)

+

amphetamine

1 interaction

Avoid/Use Alternative

vonoprazan + amphetamine

use alternative or monitor BP, HR: combo may incr. amphetamine levels, risk of adverse effects (absorption increased at higher gastric pH)

• apalutamide
Voquezna (vonoprazan)

+

apalutamide

1 interaction

Avoid/Use Alternative

vonoprazan + apalutamide

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• atazanavir
Voquezna (vonoprazan)

+

atazanavir

1 interaction

Avoid/Use Alternative

vonoprazan + atazanavir

avoid combo: combo may decr. atazanavir levels, efficacy (absorption decreased at higher gastric pH)

• bosentan
Voquezna (vonoprazan)

+

bosentan

1 interaction

Avoid/Use Alternative

vonoprazan + bosentan

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• bosutinib
Voquezna (vonoprazan)

+

bosutinib

1 interaction

Avoid/Use Alternative

vonoprazan + bosutinib

consider alternative, incl. H2 blockers or short-acting antacids 2h before or 2h after bosutinib: combo may decr. bosutinib levels, efficacy (absorption decreased at higher gastric pH)

• butalbital
Voquezna (vonoprazan)

+

butalbital

1 interaction

Avoid/Use Alternative

vonoprazan + butalbital

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• carbamazepine
Voquezna (vonoprazan)

+

carbamazepine

1 interaction

Avoid/Use Alternative

vonoprazan + carbamazepine

avoid combo: combo may incr. carbamazepine levels, risk of adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• cefuroxime axetil
Voquezna (vonoprazan)

+

cefuroxime axetil

1 interaction

Avoid/Use Alternative

vonoprazan + cefuroxime axetil

avoid combo: combo may decr. cefuroxime levels, efficacy (absorption decreased at higher gastric pH)

• cenobamate
Voquezna (vonoprazan)

+

cenobamate

1 interaction

Avoid/Use Alternative

vonoprazan + cenobamate

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• clopidogrel
Voquezna (vonoprazan)

+

clopidogrel

1 interaction

Avoid/Use Alternative

vonoprazan + clopidogrel

consider alternative: combo may decr. clopidogrel active metabolite levels, efficacy (hepatic metabolism inhibited, decr. conversion of clopidogrel to active metabolite)

• codeine
Voquezna (vonoprazan)

+

codeine

1 interaction

Avoid/Use Alternative

vonoprazan + codeine

use alternative or monitor respiratory rate, consider decr. codeine dose: combo may incr. codeine and active metabolite morphine levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited, may incr. production of active metabolite morphine)

• colchicine
Voquezna (vonoprazan)

+

colchicine

1 interaction

Avoid/Use Alternative

vonoprazan + colchicine

CV RISK REDUCTION: consider monitoring CK, myopathy s/sx; GOUT or FMF: use alternative or consider decr. colchicine dose during and x14 days after vonoprazan use: combo may incr. colchicine levels, risk of myopathy, rhabdomyolysis, other life-threatening toxicity (hepatic metabolism inhibited)

• dabrafenib
Voquezna (vonoprazan)

+

dabrafenib

1 interaction

Avoid/Use Alternative

vonoprazan + dabrafenib

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• dacomitinib
Voquezna (vonoprazan)

+

dacomitinib

1 interaction

Avoid/Use Alternative

vonoprazan + dacomitinib

use alternative, incl. H2 blockers 10h before or 6h after dacomitinib or short-acting antacids: combo may decr. dacomitinib levels, efficacy (absorption decreased at higher gastric pH)

• dasatinib
Voquezna (vonoprazan)

+

dasatinib

1 interaction

Avoid/Use Alternative

vonoprazan + dasatinib

use alternative, incl. short-acting antacids 2h before or 2h after dasatinib; Phyrago use ok: combo may decr. dasatinib levels, efficacy (absorption decreased at higher gastric pH)

• defactinib
Voquezna (vonoprazan)

+

defactinib

1 interaction

Avoid/Use Alternative

vonoprazan + defactinib

avoid combo: combo may decr. defactinib levels, efficacy (absorption decreased at higher gastric pH)

• dexlansoprazole
Voquezna (vonoprazan)

+

dexlansoprazole

1 interaction

Avoid/Use Alternative

vonoprazan + dexlansoprazole

avoid combo: combo may incr. risk of hypomagnesemia, tetany, seizures, other adverse effects (additive effects, duplicate therapy)

• dextroamphetamine
Voquezna (vonoprazan)

+

dextroamphetamine

1 interaction

Avoid/Use Alternative

vonoprazan + dextroamphetamine

use alternative or monitor BP, HR w/ oral dextroamphetamine: combo may incr. dextroamphetamine levels, risk of adverse effects (absorption increased at higher gastric pH)

• efavirenz
Voquezna (vonoprazan)

+

efavirenz

1 interaction

Avoid/Use Alternative

vonoprazan + efavirenz

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• encorafenib
Voquezna (vonoprazan)

+

encorafenib

1 interaction

Avoid/Use Alternative

vonoprazan + encorafenib

avoid combo: combo may incr. encorafenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• enzalutamide
Voquezna (vonoprazan)

+

enzalutamide

1 interaction

Avoid/Use Alternative

vonoprazan + enzalutamide

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• erlotinib
Voquezna (vonoprazan)

+

erlotinib

1 interaction

Avoid/Use Alternative

vonoprazan + erlotinib

use alternative: combo may decr. erlotinib levels, efficacy (absorption decreased at higher gastric pH)

• esomeprazole
Voquezna (vonoprazan)

+

esomeprazole

1 interaction

Avoid/Use Alternative

vonoprazan + esomeprazole

avoid combo: combo may incr. risk of hypomagnesemia, cardiac arrhythmias, tetany, seizures, other adverse effects (additive effects, duplicate therapy)

• etravirine
Voquezna (vonoprazan)

+

etravirine

1 interaction

Avoid/Use Alternative

vonoprazan + etravirine

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• fexinidazole
Voquezna (vonoprazan)

+

fexinidazole

1 interaction

Avoid/Use Alternative

vonoprazan + fexinidazole

avoid combo: combo may decr. fexinidazole active metabolite levels, efficacy; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited, decr. conversion to active metabolites; hepatic metabolism induced)

• fosphenytoin
Voquezna (vonoprazan)

+

fosphenytoin

1 interaction

Avoid/Use Alternative

vonoprazan + fosphenytoin

avoid combo: combo may incr. phenytoin levels, risk of toxicity; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• gefitinib
Voquezna (vonoprazan)

+

gefitinib

1 interaction

Avoid/Use Alternative

vonoprazan + gefitinib

use alternative or give gefitinib 12h before or after vonoprazan: combo may decr. gefitinib levels, efficacy (absorption decreased at higher gastric pH)

• hydrocodone
Voquezna (vonoprazan)

+

hydrocodone

1 interaction

Avoid/Use Alternative

vonoprazan + hydrocodone

use alternative or monitor respiratory rate, ECG, consider decr. (benz)hydrocodone dose: combo may incr. hydrocodone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• ivosidenib
Voquezna (vonoprazan)

+

ivosidenib

1 interaction

Avoid/Use Alternative

vonoprazan + ivosidenib

avoid combo: combo may incr. ivosidenib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• ketoconazole
Voquezna (vonoprazan)

+

ketoconazole

1 interaction

Avoid/Use Alternative

vonoprazan + ketoconazole

consider alternative or admin. ketoconazole w/ acidic beverage; monitor for breakthrough fungal infection: combo may decr. ketoconazole levels, efficacy (absorption decreased at higher gastric pH)

• lansoprazole
Voquezna (vonoprazan)

+

lansoprazole

1 interaction

Avoid/Use Alternative

vonoprazan + lansoprazole

avoid combo: combo may incr. risk of hypomagnesemia, tetany, seizures, other adverse effects (additive effects, duplicate therapy)

• ledipasvir
Voquezna (vonoprazan)

+

ledipasvir

1 interaction

Avoid/Use Alternative

vonoprazan + ledipasvir

avoid combo: combo may decr. ledipasvir levels, efficacy (absorption decreased at higher gastric pH)

• levoketoconazole
Voquezna (vonoprazan)

+

levoketoconazole

1 interaction

Avoid/Use Alternative

vonoprazan + levoketoconazole

avoid combo: combo may incr. or decr. levoketoconazole levels, incr. risk of QT prolongation, cardiac arrhythmias, other adverse effects or decr. efficacy (hepatic metabolism inhibited; absorption decreased at higher gastric pH)

• lopinavir/ritonavir
Voquezna (vonoprazan)

+

lopinavir/ ritonavir

1 interaction

Avoid/Use Alternative

vonoprazan + lopinavir/ ritonavir

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• lorlatinib
Voquezna (vonoprazan)

+

lorlatinib

1 interaction

Avoid/Use Alternative

vonoprazan + lorlatinib

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• lumacaftor/ivacaftor
Voquezna (vonoprazan)

+

lumacaftor/ ivacaftor

1 interaction

Avoid/Use Alternative

vonoprazan + lumacaftor/ ivacaftor

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• mavacamten
Voquezna (vonoprazan)

+

mavacamten

1 interaction

Avoid/Use Alternative

vonoprazan + mavacamten

avoid combo: combo may incr. mavacamten levels, risk of heart failure, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• mefenamic acid
Voquezna (vonoprazan)

+

mefenamic acid

1 interaction

Avoid/Use Alternative

vonoprazan + mefenamic acid

use alternative: combo may incr. mefenamic acid levels, risk of adverse effects (absorption increased at higher gastric pH)

• meperidine
Voquezna (vonoprazan)

+

meperidine

1 interaction

Avoid/Use Alternative

vonoprazan + meperidine

use alternative or monitor respiratory rate, ECG: combo may incr. meperidine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• mesalamine
Voquezna (vonoprazan)

+

mesalamine

1 interaction

Avoid/Use Alternative

vonoprazan + mesalamine

avoid combo w/ ER mesalamine capsules; other forms okay: combo may decr. mesalamine levels, efficacy (altered dissolution of mesalamine at higher gastric pH)

• methadone
Voquezna (vonoprazan)

+

methadone

1 interaction

Avoid/Use Alternative

vonoprazan + methadone

use alternative or monitor respiratory rate, ECG; consider decr. methadone dose: combo may incr. methadone levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• methamphetamine
Voquezna (vonoprazan)

+

methamphetamine

1 interaction

Avoid/Use Alternative

vonoprazan + methamphetamine

avoid combo: combo may incr. methamphetamine levels, risk of adverse effects (absorption increased at higher gastric pH)

• methylphenidate
Voquezna (vonoprazan)

+

methylphenidate

1 interaction

Avoid/Use Alternative

vonoprazan + methylphenidate

consider alternative w/ some oral methylphenidate ER formulations: combo may alter methylphenidate release, incr. risk of adverse effects or decr. efficacy (altered dissolution of ER methylphenidate at higher gastric pH)

• mitapivat
Voquezna (vonoprazan)

+

mitapivat

1 interaction

Avoid/Use Alternative

vonoprazan + mitapivat

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• mitotane
Voquezna (vonoprazan)

+

mitotane

1 interaction

Avoid/Use Alternative

vonoprazan + mitotane

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• modafinil
Voquezna (vonoprazan)

+

modafinil

1 interaction

Avoid/Use Alternative

vonoprazan + modafinil

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• nafcillin
Voquezna (vonoprazan)

+

nafcillin

1 interaction

Avoid/Use Alternative

vonoprazan + nafcillin

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• nelfinavir
Voquezna (vonoprazan)

+

nelfinavir

1 interaction

Avoid/Use Alternative

vonoprazan + nelfinavir

avoid combo: combo may decr. nelfinavir levels, efficacy (absorption decreased at higher gastric pH)

• neratinib
Voquezna (vonoprazan)

+

neratinib

1 interaction

Avoid/Use Alternative

vonoprazan + neratinib

avoid combo: combo may decr. neratinib levels, efficacy (absorption decreased at higher gastric pH)

• nilotinib
Voquezna (vonoprazan)

+

nilotinib

1 interaction

Avoid/Use Alternative

vonoprazan + nilotinib

use alternative, incl. H2 blockers 10h before or 2h after nilotinib or short-acting antacids 2h before or 2h after nilotinib: combo may decr. nilotinib levels, efficacy (absorption decreased at higher gastric pH)

• nirogacestat
Voquezna (vonoprazan)

+

nirogacestat

1 interaction

Avoid/Use Alternative

vonoprazan + nirogacestat

avoid combo: combo may decr. nirogacestat levels, efficacy (absorption decreased at higher gastric pH)

• omeprazole
Voquezna (vonoprazan)

+

omeprazole

1 interaction

Avoid/Use Alternative

vonoprazan + omeprazole

avoid combo: combo may incr. risk of hypomagnesemia, cardiac arrhythmias, tetany, seizures, other adverse effects (additive effects, duplicate therapy)

• oxycodone
Voquezna (vonoprazan)

+

oxycodone

1 interaction

Avoid/Use Alternative

vonoprazan + oxycodone

use alternative or monitor respiratory rate; consider decr. oxycodone dose: combo may incr. oxycodone levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• pacritinib
Voquezna (vonoprazan)

+

pacritinib

1 interaction

Avoid/Use Alternative

vonoprazan + pacritinib

avoid combo: combo may incr. pacritinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, bleeding (including life-threatening), other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• paltusotine
Voquezna (vonoprazan)

+

paltusotine

1 interaction

Avoid/Use Alternative

vonoprazan + paltusotine

if paltusotine dose 60 mg or more, avoid combo; otherwise, consider paltusotine dose adjustment: combo may decr. paltusotine levels, efficacy (absorption decreased at higher gastric pH)

• pantoprazole
Voquezna (vonoprazan)

+

pantoprazole

1 interaction

Avoid/Use Alternative

vonoprazan + pantoprazole

avoid combo: combo may incr. risk of hypomagnesemia, tetany, seizures, other adverse effects (additive effects, duplicate therapy)

• pazopanib
Voquezna (vonoprazan)

+

pazopanib

1 interaction

Avoid/Use Alternative

vonoprazan + pazopanib

use alternative, incl. short-acting antacids separated from pazopanib by at least several hours: combo may decr. pazopanib levels, efficacy (absorption decreased at higher gastric pH)

• pentobarbital
Voquezna (vonoprazan)

+

pentobarbital

1 interaction

Avoid/Use Alternative

vonoprazan + pentobarbital

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• pexidartinib
Voquezna (vonoprazan)

+

pexidartinib

1 interaction

Avoid/Use Alternative

vonoprazan + pexidartinib

avoid combo: combo may incr. or decr. pexidartinib levels, incr. risk of hepatotoxicity, other adverse effects or decr. efficacy; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited, absorption decreased at higher gastric pH; hepatic metabolism induced)

• phenobarbital
Voquezna (vonoprazan)

+

phenobarbital

1 interaction

Avoid/Use Alternative

vonoprazan + phenobarbital

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• phenytoin
Voquezna (vonoprazan)

+

phenytoin

1 interaction

Avoid/Use Alternative

vonoprazan + phenytoin

avoid combo: combo may incr. phenytoin levels, risk of toxicity; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• pimozide
Voquezna (vonoprazan)

+

pimozide

1 interaction

Avoid/Use Alternative

vonoprazan + pimozide

use alternative or monitor ECG: combo may incr. pimozide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• posaconazole
Voquezna (vonoprazan)

+

posaconazole

1 interaction

Avoid/Use Alternative

vonoprazan + posaconazole

use alternative w/ posaconazole IR oral suspension or monitor for breakthrough fungal infections: combo may decr. posaconazole levels, efficacy (absorption decreased at higher gastric pH)

• pralsetinib
Voquezna (vonoprazan)

+

pralsetinib

1 interaction

Avoid/Use Alternative

vonoprazan + pralsetinib

if also combined w/ P-gp inhibitor, use alternative or consider monitoring ECG, electrolytes and decr. pralsetinib dose as follows: if on pralsetinib 400 mg qd, decr. to 300 mg qd; if on pralsetinib 300 mg qd, decr. to 200 mg qd; if on pralsetinib 200 mg qd, decr. to 100 mg qd; otherwise, consider monitoring ECG, electrolytes: combo may incr. pralsetinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• primidone
Voquezna (vonoprazan)

+

primidone

1 interaction

Avoid/Use Alternative

vonoprazan + primidone

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• propafenone
Voquezna (vonoprazan)

+

propafenone

1 interaction

Avoid/Use Alternative

vonoprazan + propafenone

if CYP2D6 poor metabolizer or if also combined w/ CYP2D6 inhibitor, avoid combo; otherwise, monitor ECG, BP: combo may incr. propafenone levels, risk of QT prolongation, cardiac arrhythmias, hypotension, other adverse effects (hepatic metabolism inhibited)

• rabeprazole
Voquezna (vonoprazan)

+

rabeprazole

1 interaction

Avoid/Use Alternative

vonoprazan + rabeprazole

avoid combo: combo may incr. risk of hypomagnesemia, tetany, seizures, other adverse effects (additive effects, duplicate therapy)

• repotrectinib
Voquezna (vonoprazan)

+

repotrectinib

1 interaction

Avoid/Use Alternative

vonoprazan + repotrectinib

avoid combo: combo may incr. repotrectinib levels, risk of adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• rifabutin
Voquezna (vonoprazan)

+

rifabutin

1 interaction

Avoid/Use Alternative

vonoprazan + rifabutin

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• rifampin
Voquezna (vonoprazan)

+

rifampin

1 interaction

Avoid/Use Alternative

vonoprazan + rifampin

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• rifapentine
Voquezna (vonoprazan)

+

rifapentine

1 interaction

Avoid/Use Alternative

vonoprazan + rifapentine

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• rilzabrutinib
Voquezna (vonoprazan)

+

rilzabrutinib

1 interaction

Avoid/Use Alternative

vonoprazan + rilzabrutinib

avoid combo: combo may incr. rilzabrutinib levels, risk of adverse effects; may decr. rilzabrutinib levels, efficacy (hepatic metabolism inhibited; absorption decreased at higher gastric pH)

• risedronate
Voquezna (vonoprazan)

+

risedronate

1 interaction

Avoid/Use Alternative

vonoprazan + risedronate

DELAYED-RELEASE RISEDRONATE: avoid combo; IMMEDIATE-RELEASE RISEDRONATE: no adjustment: combo may incr. risedronate levels, risk of adverse effects (rapid dissolution of delayed-release risedronate at higher gastric pH)

• selpercatinib
Voquezna (vonoprazan)

+

selpercatinib

1 interaction

Avoid/Use Alternative

vonoprazan + selpercatinib

use alternative or give selpercatinib w/ food; monitor ECG, electrolytes: combo may incr. or decr. selpercatinib levels, incr. risk of QT prolongation, cardiac arrhythmias, other adverse effects or decr. efficacy (hepatic metabolism inhibited, absorption decreased at higher gastric pH)

• simvastatin
Voquezna (vonoprazan)

+

simvastatin

1 interaction

Avoid/Use Alternative

vonoprazan + simvastatin

use alternative or monitor CK, myopathy sx; adjust max simvastatin dose to 20 mg/day: combo may incr. simvastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• sotorasib
Voquezna (vonoprazan)

+

sotorasib

1 interaction

Avoid/Use Alternative

vonoprazan + sotorasib

avoid combo: combo may decr. levels of both drugs, efficacy (hepatic metabolism induced; absorption decreased at higher gastric pH)

• sparsentan
Voquezna (vonoprazan)

+

sparsentan

1 interaction

Avoid/Use Alternative

vonoprazan + sparsentan

avoid combo: combo may decr. sparsentan levels, efficacy (absorption decreased at higher gastric pH)

• St. John's wort
Voquezna (vonoprazan)

+

St. John's wort

1 interaction

Avoid/Use Alternative

vonoprazan + St. John's wort

avoid combo: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• taletrectinib
Voquezna (vonoprazan)

+

taletrectinib

1 interaction

Avoid/Use Alternative

vonoprazan + taletrectinib

avoid combo: combo may incr. taletrectinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. taletrectinib levels, efficacy (hepatic metabolism inhibited; absorption decreased at higher gastric pH)

• velpatasvir
Voquezna (vonoprazan)

+

velpatasvir

1 interaction

Avoid/Use Alternative

vonoprazan + velpatasvir

avoid combo: combo may decr. velpatasvir levels, efficacy (absorption decreased at higher gastric pH)

• vonoprazan
Voquezna (vonoprazan)

+

vonoprazan

1 interaction

Avoid/Use Alternative

vonoprazan + vonoprazan

avoid combo: combo may incr. risk of hypomagnesemia, other adverse effects (additive effects, duplicate therapy)

• ziftomenib
Voquezna (vonoprazan)

+

ziftomenib

1 interaction

Avoid/Use Alternative

vonoprazan + ziftomenib

avoid combo: combo may decr. ziftomenib levels, efficacy (absorption decreased at higher gastric pH)

Monitor/Modify Tx

• abemaciclib
Voquezna (vonoprazan)

+

abemaciclib

1 interaction

Monitor/Modify Tx

vonoprazan + abemaciclib

monitor CBC: combo may incr. abemaciclib levels, risk of serious infection, myelosuppression, thrombosis, other adverse effects (hepatic metabolism inhibited)

• acalabrutinib
Voquezna (vonoprazan)

+

acalabrutinib

1 interaction

Monitor/Modify Tx

vonoprazan + acalabrutinib

monitor CBC: combo may incr. acalabrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• alfentanil
Voquezna (vonoprazan)

+

alfentanil

1 interaction

Monitor/Modify Tx

vonoprazan + alfentanil

monitor respiratory rate; consider decr. alfentanil dose: combo may incr. alfentanil levels, risk of CNS and respiratory depression, psychomotor impairment, delayed recovery from anesthesia, other adverse effects (hepatic metabolism inhibited)

• amiodarone
Voquezna (vonoprazan)

+

amiodarone

1 interaction

Monitor/Modify Tx

vonoprazan + amiodarone

monitor ECG: combo may incr. amiodarone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• amphotericin
Voquezna (vonoprazan)

+

amphotericin

1 interaction

Monitor/Modify Tx

vonoprazan + amphotericin

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• avanafil
Voquezna (vonoprazan)

+

avanafil

1 interaction

Monitor/Modify Tx

vonoprazan + avanafil

monitor BP; consider decr. avanafil dose: combo may incr. avanafil levels, risk of hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• avapritinib
Voquezna (vonoprazan)

+

avapritinib

1 interaction

Monitor/Modify Tx

vonoprazan + avapritinib

monitor bleeding s/sx: combo may incr. avapritinib levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• belumosudil
Voquezna (vonoprazan)

+

belumosudil

1 interaction

Monitor/Modify Tx

vonoprazan + belumosudil

incr. belumosudil dose to 200 mg bid: combo may decr. belumosudil levels, efficacy (absorption decreased at higher gastric pH)

• brigatinib
Voquezna (vonoprazan)

+

brigatinib

1 interaction

Monitor/Modify Tx

vonoprazan + brigatinib

monitor BP, HR: combo may incr. brigatinib levels, risk of HTN, bradycardia, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• bumetanide
Voquezna (vonoprazan)

+

bumetanide

1 interaction

Monitor/Modify Tx

vonoprazan + bumetanide

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• capivasertib
Voquezna (vonoprazan)

+

capivasertib

1 interaction

Monitor/Modify Tx

vonoprazan + capivasertib

monitor glucose: combo may incr. capivasertib levels, risk of severe hyperglycemia, other adverse effects (hepatic metabolism inhibited)

• carboplatin
Voquezna (vonoprazan)

+

carboplatin

1 interaction

Monitor/Modify Tx

vonoprazan + carboplatin

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• cetuximab
Voquezna (vonoprazan)

+

cetuximab

1 interaction

Monitor/Modify Tx

vonoprazan + cetuximab

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• chlorothiazide
Voquezna (vonoprazan)

+

chlorothiazide

1 interaction

Monitor/Modify Tx

vonoprazan + chlorothiazide

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• chlorthalidone
Voquezna (vonoprazan)

+

chlorthalidone

1 interaction

Monitor/Modify Tx

vonoprazan + chlorthalidone

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• cilostazol
Voquezna (vonoprazan)

+

cilostazol

1 interaction

Monitor/Modify Tx

vonoprazan + cilostazol

consider decr. cilostazol dose to 50 mg bid: combo may incr. cilostazol levels, risk of adverse effects (hepatic metabolism inhibited)

• cisplatin
Voquezna (vonoprazan)

+

cisplatin

1 interaction

Monitor/Modify Tx

vonoprazan + cisplatin

monitor magnesium: combo may incr. risk of hypomagnesemia, tetany (additive effects)

• citalopram
Voquezna (vonoprazan)

+

citalopram

1 interaction

Monitor/Modify Tx

vonoprazan + citalopram

monitor ECG; adjust max citalopram dose to 20 mg/day: combo may incr. citalopram levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• clobazam
Voquezna (vonoprazan)

+

clobazam

1 interaction

Monitor/Modify Tx

vonoprazan + clobazam

monitor respiratory rate: combo may incr. clobazam and active metabolite levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• clozapine
Voquezna (vonoprazan)

+

clozapine

1 interaction

Monitor/Modify Tx

vonoprazan + clozapine

monitor ECG, BP, HR; consider decr. clozapine dose: combo may incr. clozapine levels, risk of QT prolongation, cardiac arrhythmias, hypotension, bradycardia, other adverse effects (hepatic metabolism inhibited)

• cyclosporine
Voquezna (vonoprazan)

+

cyclosporine

1 interaction

Monitor/Modify Tx

vonoprazan + cyclosporine

monitor cyclosporine levels, renal fxn, magnesium: combo may incr. cyclosporine levels, risk of serious infection, nephrotoxicity, hypomagnesemia, seizures, other adverse effects (hepatic metabolism inhibited, additive effects)

• cysteamine
Voquezna (vonoprazan)

+

cysteamine

1 interaction

Monitor/Modify Tx

vonoprazan + cysteamine

monitor WBC cystine levels w/ delayed-release cysteamine: combo may decr. cysteamine efficacy, incr. WBC cystine levels (premature dissolution of delayed-release cysteamine at higher gastric pH)

• diazepam
Voquezna (vonoprazan)

+

diazepam

1 interaction

Monitor/Modify Tx

vonoprazan + diazepam

monitor respiratory rate: combo may incr. diazepam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• digoxin
Voquezna (vonoprazan)

+

digoxin

1 interaction

Monitor/Modify Tx

vonoprazan + digoxin

if oral digoxin use, monitor levels, electrolytes: combo may incr. digoxin levels, risk of digoxin toxicity, bradycardia, AV block, cardiac arrhythmias, other adverse effects (absorption possibly increased at higher gastric pH, electrolyte abnormalities may incr. digoxin sensitivity)

• disopyramide
Voquezna (vonoprazan)

+

disopyramide

1 interaction

Monitor/Modify Tx

vonoprazan + disopyramide

monitor disopyramide levels, ECG: combo may incr. disopyramide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• docetaxel
Voquezna (vonoprazan)

+

docetaxel

1 interaction

Monitor/Modify Tx

vonoprazan + docetaxel

monitor CBC: combo may incr. docetaxel levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• dofetilide
Voquezna (vonoprazan)

+

dofetilide

1 interaction

Monitor/Modify Tx

vonoprazan + dofetilide

monitor ECG: combo may incr. dofetilide levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• domperidone
Voquezna (vonoprazan)

+

domperidone

1 interaction

Monitor/Modify Tx

vonoprazan + domperidone

separate admin.; monitor ECG, HR, electrolytes: combo may incr. or decr. domperidone levels, incr. risk of QT prolongation, cardiac arrhythmias, other adverse effects or decr. efficacy (hepatic metabolism inhibited, absorption possibly decreased at higher gastric pH)

• entrectinib
Voquezna (vonoprazan)

+

entrectinib

1 interaction

Monitor/Modify Tx

vonoprazan + entrectinib

monitor ECG, CBC: combo may incr. entrectinib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• eplerenone
Voquezna (vonoprazan)

+

eplerenone

1 interaction

Monitor/Modify Tx

vonoprazan + eplerenone

monitor potassium: combo may incr. eplerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• erythromycin
Voquezna (vonoprazan)

+

erythromycin

1 interaction

Monitor/Modify Tx

vonoprazan + erythromycin

monitor ECG: combo may incr. erythromycin levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• ethacrynic acid
Voquezna (vonoprazan)

+

ethacrynic acid

1 interaction

Monitor/Modify Tx

vonoprazan + ethacrynic acid

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• everolimus
Voquezna (vonoprazan)

+

everolimus

1 interaction

Monitor/Modify Tx

vonoprazan + everolimus

TSC-ASSOC. SEGA, TSC-ASSOC. PARTIAL ONSET SEIZURES, TRANSPLANT: monitor everolimus levels, CBC; OTHER INDICATIONS: monitor CBC: combo may incr. everolimus levels, risk of adverse effects (hepatic metabolism inhibited)

• fedratinib
Voquezna (vonoprazan)

+

fedratinib

1 interaction

Monitor/Modify Tx

vonoprazan + fedratinib

monitor CBC, LFTs: combo may incr. fedratinib levels, risk myelosuppression, hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• felodipine
Voquezna (vonoprazan)

+

felodipine

1 interaction

Monitor/Modify Tx

vonoprazan + felodipine

monitor BP, HR: combo may incr. felodipine levels, risk of hypotension, reflex tachycardia, other adverse effects (hepatic metabolism inhibited)

• fentanyl
Voquezna (vonoprazan)

+

fentanyl

1 interaction

Monitor/Modify Tx

vonoprazan + fentanyl

monitor respiratory rate, consider decr. fentanyl dose: combo may incr. fentanyl levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• finerenone
Voquezna (vonoprazan)

+

finerenone

1 interaction

Monitor/Modify Tx

vonoprazan + finerenone

monitor potassium: combo may incr. finerenone levels, risk of hyperkalemia, other adverse effects (hepatic metabolism inhibited)

• flibanserin
Voquezna (vonoprazan)

+

flibanserin

1 interaction

Monitor/Modify Tx

vonoprazan + flibanserin

monitor BP: combo may incr. flibanserin levels, risk of CNS depression, psychomotor impairment, severe hypotension (including syncope), other adverse effects (hepatic metabolism inhibited)

• foscarnet
Voquezna (vonoprazan)

+

foscarnet

1 interaction

Monitor/Modify Tx

vonoprazan + foscarnet

monitor magnesium, ECG: combo may incr. risk of hypomagnesemia, QT prolongation, cardiac arrhythmias, tetany, seizures (additive effects)

• furosemide
Voquezna (vonoprazan)

+

furosemide

1 interaction

Monitor/Modify Tx

vonoprazan + furosemide

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• gentamicin
Voquezna (vonoprazan)

+

gentamicin

1 interaction

Monitor/Modify Tx

vonoprazan + gentamicin

monitor magnesium: combo may incr. risk of hypomagnesemia, tetany (additive effects)

• gepirone
Voquezna (vonoprazan)

+

gepirone

1 interaction

Monitor/Modify Tx

vonoprazan + gepirone

monitor ECG, electrolytes: combo may incr. gepirone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• glipizide
Voquezna (vonoprazan)

+

glipizide

1 interaction

Monitor/Modify Tx

vonoprazan + glipizide

monitor glucose: combo may incr. glipizide levels, risk of hypoglycemia, other adverse effects (absorption possibly increased at higher gastric pH)

• hydrochlorothiazide
Voquezna (vonoprazan)

+

hydrochlorothiazide

1 interaction

Monitor/Modify Tx

vonoprazan + hydrochlorothiazide

monitor magnesium: combo may incr. risk of hypomagnesemia, cardiac arrhythmias (additive effects)

• ibrutinib
Voquezna (vonoprazan)

+

ibrutinib

1 interaction

Monitor/Modify Tx

vonoprazan + ibrutinib

consider decr. ibrutinib dose: combo may incr. ibrutinib levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• indapamide
Voquezna (vonoprazan)

+

indapamide

1 interaction

Monitor/Modify Tx

vonoprazan + indapamide

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• itraconazole
Voquezna (vonoprazan)

+

itraconazole

1 interaction

Monitor/Modify Tx

vonoprazan + itraconazole

ITRACONAZOLE 100 MG CAP or 200 MG TAB: give itraconazole at least 2h before vonoprazan w/ non-diet cola to incr. GI acidity; ITRACONAZOLE 65 MG CAP: consider decr. itraconazole dose: combo with itraconazole 100 mg CAP or 200 mg TAB may decr. itraconazole levels, efficacy; combo with itraconazole 65 mg CAP may incr. itraconazole levels, risk of adverse effects (absorption altered at higher gastric pH; effect varies with formulation)

• ivabradine
Voquezna (vonoprazan)

+

ivabradine

1 interaction

Monitor/Modify Tx

vonoprazan + ivabradine

monitor HR, ECG: combo may incr. ivabradine levels, risk of bradycardia, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• ixabepilone
Voquezna (vonoprazan)

+

ixabepilone

1 interaction

Monitor/Modify Tx

vonoprazan + ixabepilone

monitor CBC: combo may incr. ixabepilone levels, risk of serious infection, myelosuppression, other toxicity (hepatic metabolism inhibited)

• lemborexant
Voquezna (vonoprazan)

+

lemborexant

1 interaction

Monitor/Modify Tx

vonoprazan + lemborexant

adjust max lemborexant dose to 5 mg/day: combo may incr. lemborexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• levothyroxine
Voquezna (vonoprazan)

+

levothyroxine

1 interaction

Monitor/Modify Tx

vonoprazan + levothyroxine

monitor thyroid fxn w/ levothyroxine tablet; consider other levothyroxine formulations, incl. soft gel capsule, oral solution: combo may decr. thyroid hormone levels, efficacy (absorption decreased at higher gastric pH; dissolution of soft gel capsule, oral solution may be less dependent on gastric pH)

• lomitapide
Voquezna (vonoprazan)

+

lomitapide

1 interaction

Monitor/Modify Tx

vonoprazan + lomitapide

ADULT PATIENTS: if patient on stable vonoprazan dose and starting lomitapide, adjust max lomitapide dose to 30 mg/day; if patient on stable lomitapide dose and starting vonoprazan, decr. lomitapide dose by 50% and adjust max lomitapide dose to 30 mg/day; PEDIATRIC PATIENTS: if patient on stable vonoprazan dose and starting lomitapide, adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo; if patient on stable lomitapide dose and starting vonoprazan, decr. lomitapide dose by 50% and adjust max lomitapide dose to 10 mg/day if 2-10 yo or 20 mg/day if 11-17 yo: combo may incr. lomitapide levels, risk of hepatotoxicity, other adverse effects (hepatic metabolism inhibited)

• lonafarnib
Voquezna (vonoprazan)

+

lonafarnib

1 interaction

Monitor/Modify Tx

vonoprazan + lonafarnib

consider monitoring HR, ECG, electrolytes: combo may incr. lonafarnib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lovastatin
Voquezna (vonoprazan)

+

lovastatin

1 interaction

Monitor/Modify Tx

vonoprazan + lovastatin

monitor CK, myopathy sx: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited)

• lumateperone
Voquezna (vonoprazan)

+

lumateperone

1 interaction

Monitor/Modify Tx

vonoprazan + lumateperone

monitor ECG: combo may incr. lumateperone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lurasidone
Voquezna (vonoprazan)

+

lurasidone

1 interaction

Monitor/Modify Tx

vonoprazan + lurasidone

monitor ECG: combo may incr. lurasidone levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• lurbinectedin
Voquezna (vonoprazan)

+

lurbinectedin

1 interaction

Monitor/Modify Tx

vonoprazan + lurbinectedin

monitor CBC: combo may incr. lurbinectedin levels, risk of myelosuppression, other adverse effects (hepatic metabolism inhibited)

• metolazone
Voquezna (vonoprazan)

+

metolazone

1 interaction

Monitor/Modify Tx

vonoprazan + metolazone

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• midazolam
Voquezna (vonoprazan)

+

midazolam

1 interaction

Monitor/Modify Tx

vonoprazan + midazolam

monitor respiratory rate: combo may incr. midazolam and active metabolite levels, risk of profound CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• mobocertinib
Voquezna (vonoprazan)

+

mobocertinib

1 interaction

Monitor/Modify Tx

vonoprazan + mobocertinib

monitor ECG: combo may incr. mobocertinib levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• necitumumab
Voquezna (vonoprazan)

+

necitumumab

1 interaction

Monitor/Modify Tx

vonoprazan + necitumumab

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• nifedipine
Voquezna (vonoprazan)

+

nifedipine

1 interaction

Monitor/Modify Tx

vonoprazan + nifedipine

monitor BP, consider lowest nifedipine start dose: combo may incr. nifedipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• nimodipine
Voquezna (vonoprazan)

+

nimodipine

1 interaction

Monitor/Modify Tx

vonoprazan + nimodipine

monitor BP: combo may incr. nimodipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• nisoldipine
Voquezna (vonoprazan)

+

nisoldipine

1 interaction

Monitor/Modify Tx

vonoprazan + nisoldipine

monitor BP: combo may incr. nisoldipine levels, risk of hypotension, other adverse effects (hepatic metabolism inhibited)

• octreotide
Voquezna (vonoprazan)

+

octreotide

1 interaction

Monitor/Modify Tx

vonoprazan + octreotide

consider oral octreotide dose adjustment: combo may decr. octreotide levels, efficacy (absorption decreased at higher gastric pH)

• oliceridine
Voquezna (vonoprazan)

+

oliceridine

1 interaction

Monitor/Modify Tx

vonoprazan + oliceridine

monitor respiratory rate, ECG: combo may incr. oliceridine levels, risk of CNS and respiratory depression, psychomotor impairment, QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• pamidronate
Voquezna (vonoprazan)

+

pamidronate

1 interaction

Monitor/Modify Tx

vonoprazan + pamidronate

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• panitumumab
Voquezna (vonoprazan)

+

panitumumab

1 interaction

Monitor/Modify Tx

vonoprazan + panitumumab

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• patiromer
Voquezna (vonoprazan)

+

patiromer

1 interaction

Monitor/Modify Tx

vonoprazan + patiromer

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• pemigatinib
Voquezna (vonoprazan)

+

pemigatinib

1 interaction

Monitor/Modify Tx

vonoprazan + pemigatinib

monitor phosphate: combo may incr. pemigatinib levels, risk of hyperphosphatemia, other adverse effects (hepatic metabolism inhibited)

• peppermint
Voquezna (vonoprazan)

+

peppermint

1 interaction

Monitor/Modify Tx

vonoprazan + peppermint

separate admin. by at least 2h w/ enteric-coated peppermint oil: combo may decr. peppermint oil efficacy, incr. risk of adverse effects (premature dissolution of enteric-coated peppermint at higher gastric pH)

• quinidine (antiarrhythmic)
Voquezna (vonoprazan)

+

quinidine (antiarrhythmic)

1 interaction

Monitor/Modify Tx

vonoprazan + quinidine (antiarrhythmic)

monitor quinidine levels, ECG: combo may incr. quinidine levels, risk of QT prolongation, cardiac arrhythmias, other adverse effects (hepatic metabolism inhibited)

• red yeast rice
Voquezna (vonoprazan)

+

red yeast rice

1 interaction

Monitor/Modify Tx

vonoprazan + red yeast rice

monitor CK, myopathy sx w/ large amounts of red yeast rice: combo may incr. lovastatin levels, risk of myopathy, rhabdomyolysis, other adverse effects (hepatic metabolism inhibited, red yeast rice contains varying amounts of lovastatin)

• ribociclib
Voquezna (vonoprazan)

+

ribociclib

1 interaction

Monitor/Modify Tx

vonoprazan + ribociclib

monitor ECG, electrolytes, CBC: combo may incr. ribociclib levels, risk of QT prolongation, cardiac arrhythmias, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• romidepsin
Voquezna (vonoprazan)

+

romidepsin

1 interaction

Monitor/Modify Tx

vonoprazan + romidepsin

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• sirolimus
Voquezna (vonoprazan)

+

sirolimus

1 interaction

Monitor/Modify Tx

vonoprazan + sirolimus

monitor sirolimus levels: combo may incr. sirolimus levels, risk of serious infection, other adverse effects (hepatic metabolism inhibited)

• sirolimus albumin-bound
Voquezna (vonoprazan)

+

sirolimus albumin-bound

1 interaction

Monitor/Modify Tx

vonoprazan + sirolimus albumin-bound

decr. sirolimus albumin-bound dose to 56 mg/m2; monitor CBC, bleeding s/sx: combo may incr. sirolimus albumin-bound levels, risk of serious infection, myelosuppression, bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• sodium polystyrene sulfonate
Voquezna (vonoprazan)

+

sodium polystyrene sulfonate

1 interaction

Monitor/Modify Tx

vonoprazan + sodium polystyrene sulfonate

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• spironolactone
Voquezna (vonoprazan)

+

spironolactone

1 interaction

Monitor/Modify Tx

vonoprazan + spironolactone

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• sufentanil
Voquezna (vonoprazan)

+

sufentanil

1 interaction

Monitor/Modify Tx

vonoprazan + sufentanil

monitor respiratory rate, consider decr. sufentanil dose or frequency: combo may incr. sufentanil levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• tacrolimus
Voquezna (vonoprazan)

+

tacrolimus

1 interaction

Monitor/Modify Tx

vonoprazan + tacrolimus

monitor tacrolimus levels, ECG, renal fxn, magnesium: combo may incr. tacrolimus levels, risk of QT prolongation, cardiac arrhythmias, nephrotoxicity, hypomagnesemia, other adverse effects (hepatic metabolism inhibited, additive effects)

• tadalafil
Voquezna (vonoprazan)

+

tadalafil

1 interaction

Monitor/Modify Tx

vonoprazan + tadalafil

monitor BP: combo may incr. tadalafil levels, risk of hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• temsirolimus
Voquezna (vonoprazan)

+

temsirolimus

1 interaction

Monitor/Modify Tx

vonoprazan + temsirolimus

monitor CBC: combo may incr. temsirolimus and active metabolite sirolimus levels, risk of serious infection, myelosuppression, other adverse effects (hepatic metabolism inhibited)

• tobramycin
Voquezna (vonoprazan)

+

tobramycin

1 interaction

Monitor/Modify Tx

vonoprazan + tobramycin

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• tolvaptan
Voquezna (vonoprazan)

+

tolvaptan

1 interaction

Monitor/Modify Tx

vonoprazan + tolvaptan

consider decr. tolvaptan dose: combo may incr. tolvaptan levels, risk of adverse effects (hepatic metabolism inhibited)

• torsemide
Voquezna (vonoprazan)

+

torsemide

1 interaction

Monitor/Modify Tx

vonoprazan + torsemide

monitor magnesium: combo may incr. risk of hypomagnesemia (additive effects)

• triazolam
Voquezna (vonoprazan)

+

triazolam

1 interaction

Monitor/Modify Tx

vonoprazan + triazolam

monitor respiratory rate; consider decr. triazolam dose: combo may incr. triazolam levels, risk of CNS and respiratory depression, psychomotor impairment, other adverse effects (absorption increased at higher gastric pH, hepatic metabolism inhibited)

• ubrogepant
Voquezna (vonoprazan)

+

ubrogepant

1 interaction

Monitor/Modify Tx

vonoprazan + ubrogepant

limit ubrogepant dose to 50 mg, may give second 50 mg dose after 2h if needed: combo may incr. ubrogepant levels, risk of adverse effects (hepatic metabolism inhibited)

• vardenafil
Voquezna (vonoprazan)

+

vardenafil

1 interaction

Monitor/Modify Tx

vonoprazan + vardenafil

monitor ECG: combo may incr. vardenafil levels, risk of QT prolongation, cardiac arrhythmias, hypotension, priapism, other adverse effects (hepatic metabolism inhibited)

• venetoclax
Voquezna (vonoprazan)

+

venetoclax

1 interaction

Monitor/Modify Tx

vonoprazan + venetoclax

monitor CBC, tumor lysis syndrome s/sx: combo may incr. venetoclax levels, risk of serious infection, myelosuppression, tumor lysis syndrome, other adverse effects (hepatic metabolism inhibited)

• verapamil
Voquezna (vonoprazan)

+

verapamil

1 interaction

Monitor/Modify Tx

vonoprazan + verapamil

monitor BP, HR: combo may incr. verapamil levels, risk of hypotension, bradycardia, AV block, other adverse effects (hepatic metabolism inhibited)

• vinblastine
Voquezna (vonoprazan)

+

vinblastine

1 interaction

Monitor/Modify Tx

vonoprazan + vinblastine

monitor CBC: combo may incr. vinblastine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

• vincristine
Voquezna (vonoprazan)

+

vincristine

1 interaction

Monitor/Modify Tx

vonoprazan + vincristine

monitor CBC: combo may incr. vincristine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metabolism inhibited)

• vinorelbine
Voquezna (vonoprazan)

+

vinorelbine

1 interaction

Monitor/Modify Tx

vonoprazan + vinorelbine

monitor CBC: combo may incr. vinorelbine levels, risk of serious infection, myelosuppression, autonomic neuropathy, other adverse effects (hepatic metabolism inhibited)

• warfarin
Voquezna (vonoprazan)

+

warfarin

1 interaction

Monitor/Modify Tx

vonoprazan + warfarin

monitor INR, bleeding s/sx, especially during initiation/titration: combo may incr. warfarin levels, risk of bleeding (including life-threatening), other adverse effects (hepatic metabolism inhibited)

• zanubrutinib
Voquezna (vonoprazan)

+

zanubrutinib

1 interaction

Monitor/Modify Tx

vonoprazan + zanubrutinib

monitor CBC: combo may incr. zanubrutinib levels, risk of serious infection, myelosuppression, other adverse effects; may decr. vonoprazan levels, efficacy (hepatic metabolism inhibited; hepatic metabolism induced)

Caution Advised

• abrocitinib
Voquezna (vonoprazan)

+

abrocitinib

1 interaction

Caution Advised

vonoprazan + abrocitinib

caution advised: combo may incr. abrocitinib and active metabolite levels, risk of serious infection, other adverse effects (hepatic metabolism inhibited)

• armodafinil
Voquezna (vonoprazan)

+

armodafinil

1 interaction

Caution Advised

vonoprazan + armodafinil

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• artemether/lumefantrine
Voquezna (vonoprazan)

+

artemether/ lumefantrine

1 interaction

Caution Advised

vonoprazan + artemether/ lumefantrine

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• belzutifan
Voquezna (vonoprazan)

+

belzutifan

1 interaction

Caution Advised

vonoprazan + belzutifan

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• bexarotene
Voquezna (vonoprazan)

+

bexarotene

1 interaction

Caution Advised

vonoprazan + bexarotene

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• bisacodyl
Voquezna (vonoprazan)

+

bisacodyl

1 interaction

Caution Advised

vonoprazan + bisacodyl

caution advised: combo may alter bisacodyl release, incr. risk of GI adverse effects or decr. efficacy (premature dissolution of bisacodyl at higher gastric pH)

• cariprazine
Voquezna (vonoprazan)

+

cariprazine

1 interaction

Caution Advised

vonoprazan + cariprazine

caution advised: combo may incr. cariprazine and active metabolite levels, risk of adverse effects (hepatic metabolism inhibited)

• carisoprodol
Voquezna (vonoprazan)

+

carisoprodol

1 interaction

Caution Advised

vonoprazan + carisoprodol

caution advised: combo may incr. carisoprodol levels, decr. active metabolite meprobamate levels, alter risk of adverse effects and efficacy (hepatic metabolism inhibited, decr. conversion to active metabolite)

• cefpodoxime
Voquezna (vonoprazan)

+

cefpodoxime

1 interaction

Caution Advised

vonoprazan + cefpodoxime

caution advised: combo may decrease cefpodoxime levels, efficacy (absorption decreased at higher gastric pH)

• cobimetinib
Voquezna (vonoprazan)

+

cobimetinib

1 interaction

Caution Advised

vonoprazan + cobimetinib

caution advised: combo may incr. cobimetinib levels, risk of adverse effects (hepatic metabolism inhibited)

• conivaptan
Voquezna (vonoprazan)

+

conivaptan

1 interaction

Caution Advised

vonoprazan + conivaptan

caution advised: combo may incr. conivaptan levels, risk of overly rapid serum sodium correction, neurologic sequelae, other adverse effects (hepatic metabolism inhibited)

• cyclophosphamide
Voquezna (vonoprazan)

+

cyclophosphamide

1 interaction

Caution Advised

vonoprazan + cyclophosphamide

caution advised: combo may decr. cyclophosphamide active metabolite levels, efficacy (hepatic metabolism possibly inhibited, decr. conversion to active metabolite)

• danshen
Voquezna (vonoprazan)

+

danshen

1 interaction

Caution Advised

vonoprazan + danshen

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• daridorexant
Voquezna (vonoprazan)

+

daridorexant

1 interaction

Caution Advised

vonoprazan + daridorexant

caution advised: combo may incr. daridorexant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• darolutamide
Voquezna (vonoprazan)

+

darolutamide

1 interaction

Caution Advised

vonoprazan + darolutamide

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• dexamethasone
Voquezna (vonoprazan)

+

dexamethasone

1 interaction

Caution Advised

vonoprazan + dexamethasone

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• dicloxacillin
Voquezna (vonoprazan)

+

dicloxacillin

1 interaction

Caution Advised

vonoprazan + dicloxacillin

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• dihydroergotamine
Voquezna (vonoprazan)

+

dihydroergotamine

1 interaction

Caution Advised

vonoprazan + dihydroergotamine

caution advised: combo may incr. dihydroergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• echinacea
Voquezna (vonoprazan)

+

echinacea

1 interaction

Caution Advised

vonoprazan + echinacea

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• elafibranor
Voquezna (vonoprazan)

+

elafibranor

1 interaction

Caution Advised

vonoprazan + elafibranor

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• elagolix
Voquezna (vonoprazan)

+

elagolix

1 interaction

Caution Advised

vonoprazan + elagolix

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• elinzanetant
Voquezna (vonoprazan)

+

elinzanetant

1 interaction

Caution Advised

vonoprazan + elinzanetant

caution advised: combo may incr. elinzanetant levels, risk of CNS depression, psychomotor impairment, other adverse effects (hepatic metabolism inhibited)

• enasidenib
Voquezna (vonoprazan)

+

enasidenib

1 interaction

Caution Advised

vonoprazan + enasidenib

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• ergotamine
Voquezna (vonoprazan)

+

ergotamine

1 interaction

Caution Advised

vonoprazan + ergotamine

caution advised: combo may incr. ergotamine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• eslicarbazepine acetate
Voquezna (vonoprazan)

+

eslicarbazepine acetate

1 interaction

Caution Advised

vonoprazan + eslicarbazepine acetate

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• felbamate
Voquezna (vonoprazan)

+

felbamate

1 interaction

Caution Advised

vonoprazan + felbamate

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• ferrous fumarate
Voquezna (vonoprazan)

+

ferrous fumarate

1 interaction

Caution Advised

vonoprazan + ferrous fumarate

caution advised: combo may decr. iron levels, efficacy (absorption decreased at higher gastric pH)

• ferrous gluconate
Voquezna (vonoprazan)

+

ferrous gluconate

1 interaction

Caution Advised

vonoprazan + ferrous gluconate

caution advised: combo may decr. iron levels, efficacy (absorption decreased at higher gastric pH)

• ferrous sulfate
Voquezna (vonoprazan)

+

ferrous sulfate

1 interaction

Caution Advised

vonoprazan + ferrous sulfate

caution advised: combo may decr. iron levels, efficacy (absorption decreased at higher gastric pH)

• fosamprenavir
Voquezna (vonoprazan)

+

fosamprenavir

1 interaction

Caution Advised

vonoprazan + fosamprenavir

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• fosinopril
Voquezna (vonoprazan)

+

fosinopril

1 interaction

Caution Advised

vonoprazan + fosinopril

caution advised: combo may decr. fosinopril levels, efficacy (absorption decreased at higher gastric pH)

• garlic
Voquezna (vonoprazan)

+

garlic

1 interaction

Caution Advised

vonoprazan + garlic

caution advised w/ supplemental garlic; dietary intake OK: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• ginkgo
Voquezna (vonoprazan)

+

ginkgo

1 interaction

Caution Advised

vonoprazan + ginkgo

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• ginseng, Asian
Voquezna (vonoprazan)

+

ginseng, Asian

1 interaction

Caution Advised

vonoprazan + ginseng, Asian

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• glycerol phenylbutyrate
Voquezna (vonoprazan)

+

glycerol phenylbutyrate

1 interaction

Caution Advised

vonoprazan + glycerol phenylbutyrate

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• griseofulvin
Voquezna (vonoprazan)

+

griseofulvin

1 interaction

Caution Advised

vonoprazan + griseofulvin

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• levodopa
Voquezna (vonoprazan)

+

levodopa

1 interaction

Caution Advised

vonoprazan + levodopa

caution advised w/ oral levodopa: combo may decr. levodopa levels, efficacy (absorption decreased at higher gastric pH)

• meropenem
Voquezna (vonoprazan)

+

meropenem

1 interaction

Caution Advised

vonoprazan + meropenem

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism possibly induced)

• methylergonovine
Voquezna (vonoprazan)

+

methylergonovine

1 interaction

Caution Advised

vonoprazan + methylergonovine

caution advised: combo may incr. methylergonovine levels, risk of ergot toxicity, severe vasospasm, ischemia, other adverse effects (hepatic metabolism inhibited)

• mycophenolate mofetil
Voquezna (vonoprazan)

+

mycophenolate mofetil

1 interaction

Caution Advised

vonoprazan + mycophenolate mofetil

caution advised w/ oral mycophenolate mofetil: combo may decr. mycophenolic acid levels, efficacy (absorption decreased at higher gastric pH)

• nevirapine
Voquezna (vonoprazan)

+

nevirapine

1 interaction

Caution Advised

vonoprazan + nevirapine

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• odevixibat
Voquezna (vonoprazan)

+

odevixibat

1 interaction

Caution Advised

vonoprazan + odevixibat

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• olutasidenib
Voquezna (vonoprazan)

+

olutasidenib

1 interaction

Caution Advised

vonoprazan + olutasidenib

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism possibly induced)

• omaveloxolone
Voquezna (vonoprazan)

+

omaveloxolone

1 interaction

Caution Advised

vonoprazan + omaveloxolone

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• oxcarbazepine
Voquezna (vonoprazan)

+

oxcarbazepine

1 interaction

Caution Advised

vonoprazan + oxcarbazepine

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• palovarotene
Voquezna (vonoprazan)

+

palovarotene

1 interaction

Caution Advised

vonoprazan + palovarotene

caution advised: combo may incr. palovarotene levels, risk of adverse effects (hepatic metabolism inhibited)

• perampanel
Voquezna (vonoprazan)

+

perampanel

1 interaction

Caution Advised

vonoprazan + perampanel

caution advised if on perampanel 12 mg/day: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• pioglitazone
Voquezna (vonoprazan)

+

pioglitazone

1 interaction

Caution Advised

vonoprazan + pioglitazone

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• prednisone
Voquezna (vonoprazan)

+

prednisone

1 interaction

Caution Advised

vonoprazan + prednisone

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• proguanil
Voquezna (vonoprazan)

+

proguanil

1 interaction

Caution Advised

vonoprazan + proguanil

caution advised: combo may incr. proguanil levels, risk of adverse effects; may decr. proguanil active metabolite levels, efficacy (hepatic metabolism inhibited, decr. conversion to active metabolite)

• ritonavir
Voquezna (vonoprazan)

+

ritonavir

1 interaction

Caution Advised

vonoprazan + ritonavir

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• roflumilast
Voquezna (vonoprazan)

+

roflumilast

1 interaction

Caution Advised

vonoprazan + roflumilast

caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• roflumilast topical
Voquezna (vonoprazan)

+

roflumilast topical

1 interaction

Caution Advised

vonoprazan + roflumilast topical

caution advised: combo may incr. roflumilast levels, risk of adverse effects (hepatic metabolism inhibited)

• rufinamide
Voquezna (vonoprazan)

+

rufinamide

1 interaction

Caution Advised

vonoprazan + rufinamide

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• sarilumab
Voquezna (vonoprazan)

+

sarilumab

1 interaction

Caution Advised

vonoprazan + sarilumab

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism altered; sarilumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes upon tx start and downregulation upon D/C)

• sirolimus topical
Voquezna (vonoprazan)

+

sirolimus topical

1 interaction

Caution Advised

vonoprazan + sirolimus topical

caution advised: combo may incr. sirolimus levels, risk of adverse effects (hepatic metabolism inhibited)

• stiripentol
Voquezna (vonoprazan)

+

stiripentol

1 interaction

Caution Advised

vonoprazan + stiripentol

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism possibly induced)

• sunvozertinib
Voquezna (vonoprazan)

+

sunvozertinib

1 interaction

Caution Advised

vonoprazan + sunvozertinib

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• suzetrigine
Voquezna (vonoprazan)

+

suzetrigine

1 interaction

Caution Advised

vonoprazan + suzetrigine

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• tazemetostat
Voquezna (vonoprazan)

+

tazemetostat

1 interaction

Caution Advised

vonoprazan + tazemetostat

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• tecovirimat
Voquezna (vonoprazan)

+

tecovirimat

1 interaction

Caution Advised

vonoprazan + tecovirimat

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• telotristat ethyl
Voquezna (vonoprazan)

+

telotristat ethyl

1 interaction

Caution Advised

vonoprazan + telotristat ethyl

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• tocilizumab
Voquezna (vonoprazan)

+

tocilizumab

1 interaction

Caution Advised

vonoprazan + tocilizumab

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism altered; tocilizumab may reverse inflammatory cytokine-induced downregulation of CYP450 enzymes resulting in relative induction of enzymes)

• topiramate
Voquezna (vonoprazan)

+

topiramate

1 interaction

Caution Advised

vonoprazan + topiramate

caution advised especially w/ topiramate doses >200 mg/day: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• tovorafenib
Voquezna (vonoprazan)

+

tovorafenib

1 interaction

Caution Advised

vonoprazan + tovorafenib

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• vaborbactam
Voquezna (vonoprazan)

+

vaborbactam

1 interaction

Caution Advised

vonoprazan + vaborbactam

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism possibly induced)

• vamorolone
Voquezna (vonoprazan)

+

vamorolone

1 interaction

Caution Advised

vonoprazan + vamorolone

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism possibly induced)

• vemurafenib
Voquezna (vonoprazan)

+

vemurafenib

1 interaction

Caution Advised

vonoprazan + vemurafenib

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism induced)

• vorasidenib
Voquezna (vonoprazan)

+

vorasidenib

1 interaction

Caution Advised

vonoprazan + vorasidenib

caution advised: combo may decr. vonoprazan levels, efficacy (hepatic metabolism possibly induced)