This product is used to treat an infection caused by the bacteria H. pylori. This bacteria can cause stomach/intestinal ulcers and irritation/swelling of the lining of the stomach. It may also increase the risk of stomach cancer. Treating the infection will help the ulcers get better and reduces the risk of serious damage to the lining of the stomach/intestines (such as bleeding, tearing).
Vonoprazan is an acid blocker. It works by blocking acid production in the stomach. Decreasing excess stomach acid can help ulcers heal. Amoxicillin and clarithromycin are antibiotics used to treat a wide variety of bacterial infections (including H. pylori). Treating the infection helps the ulcers heal and reduces the risk of ulcers returning. Amoxicillin is a penicillin-type antibiotic and clarithromycin is a macrolide-type antibiotic. They work by stopping the growth of bacteria. The antibiotics in this product treat only bacterial infections. Antibiotics do not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
This product comes as a package with 14 separate dosing cards. Each card contains the morning and evening doses of this medication (a 1-day supply). Consult your doctor or pharmacist for instructions on the proper use of this product.
Take this medication by mouth with or without food as directed by your doctor, usually 1 dose (4 pills) twice daily (once in the morning and once in the evening, about 12 hours apart).
For the best effect, take this product at evenly spaced times. To help you remember, take this product at the same times every day. Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.
Tell your doctor if your condition lasts or gets worse.
Diarrhea, headache, nausea, vomiting, or abnormal taste in your mouth may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.
Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
Tell your doctor right away if you have any serious side effects, including: muscle weakness, dark urine, yellowing eyes/skin, easy bruising/bleeding, signs of kidney problems (such as change in the amount of urine, bloody urine), mental/mood changes (such as agitation, confusion).
Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, fast/irregular heartbeat.
This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.
If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.
This medication may sometimes cause oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.
A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: fever, swollen lymph nodes, rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.
Amoxicillin can commonly cause a mild rash that is usually not serious. However, you may not be able to tell it apart from a rare rash that could be a sign of a severe allergic reaction. Get medical help right away if you develop any rash.
This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.
In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.
In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Before taking this product, tell your doctor or pharmacist if you are allergic to vonoprazan, amoxicillin, or clarithromycin; or to penicillins (such as ampicillin), cephalosporins (such as cephalexin), or macrolide antibiotics (such as erythromycin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.
Before using this medication, tell your doctor or pharmacist your medical history, especially of: liver disease (including liver problems with past clarithromycin use), kidney disease, heart disease (coronary artery disease, heart attack), a certain type of muscle disease (myasthenia gravis), a certain type of viral infection (infectious mononucleosis).
Some symptoms may actually be signs of a more serious condition. Get medical help right away if you have: heartburn with lightheadedness/sweating/dizziness, chest/jaw/left arm pain (especially with shortness of breath, unusual sweating), unexplained weight loss.
Clarithromycin may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.
The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using this product, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).
Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using this product safely.
Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
This medication may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using this medication before having any immunizations/vaccinations.
Older adults may be more sensitive to the side effects of this drug, especially QT prolongation (see above) and C. difficile infection (see Side Effects section).
During pregnancy, this product should be used only when clearly needed. Discuss the risks and benefits with your doctor.
Amoxicillin and clarithromycin pass into breast milk. It is unknown if vonoprazan passes into breast milk. Because of the possible risk to the infant, breastfeeding is not recommended while using this medication and for 2 days after the last dose. Consult your doctor before breastfeeding.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
A product that may interact with this drug is: methotrexate (especially high-dose treatment).
Many drugs besides clarithromycin may affect the heart rhythm (QT prolongation), including amiodarone, disopyramide, dofetilide, pacritinib, pimozide, procainamide, quinidine, sotalol, among others.
Other medications can affect the removal of clarithromycin and vonoprazan from your body, which may affect how these medications work. Examples include efavirenz, nevirapine, rifamycins (such as rifabutin), saquinavir, among others.
Clarithromycin can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include colchicine, digoxin, some drugs used to treat erectile dysfunction-ED/pulmonary hypertension (such as sildenafil, tadalafil), ergot alkaloids (such as ergotamine, dihydroergotamine), flibanserin, lomitapide, mavacamten, some statin drugs (such as lovastatin, simvastatin), tamsulosin, tolvaptan, ticagrelor, among others.
Some products need stomach acid so that the body can absorb them properly. Vonoprazan decreases stomach acid, so it may change how well these products work. Some affected products include atazanavir, erlotinib, levoketoconazole, nelfinavir, pazopanib, rilpivirine, certain azole antifungals (itraconazole, ketoconazole, posaconazole), among others.
This medication may interfere with certain lab tests (such as urine glucose test), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: change in the amount of urine.
Do not share this medication with others.
This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.
Lab and/or medical tests may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
If you miss a dose, take it as soon as you remember. If it is more than 4 hours after the missed dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.
Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.