vonopran is a pcab used in gerd git.pptx

vonopran is a pcab used in gerd git.pptx
pharmacology mechanism of action

1. VONOPRAN ( Vonoprazan ) Clinical Pharmacology

2. What is GERD? Gastroesophageal reflux disease or gastro- oesophageal reflux disease is a chronic upper gastrointestinal disease in which stomach content persistently and regularly flows up into the esophagus, resulting in symptoms and/or complications

3. Clinical Presentation of GERD Clinically, GERD typically manifests with symptoms of heartburn and regurgitation. It can also present in an atypical fashion with extra-esophageal symptoms such as chest pain, dental erosions, chronic cough, laryngitis, or asthma

4. Management Non-pharmacological Measures Life style modification Pharmacological Measures Pcabs , Antacids, PPIs, H2Bs, Prokinetics, Alginate, Sucralfate etc.

5. Why we need Vonopran ( Vonoprazan ) PPIs have been used for more than a quarter-century as a first-line treatment for these diseases, it has become clear that there are some issues in need of improvement. It takes several days to show maximal effect. Reflux symptoms of GERD are not sufficiently relieved after the first dose of PPI in 2/3 patients due to slow onset of the action, 1/3 of patients still have symptoms even after 3 days of treatment. Effects of PPI are influenced by cytochrome p450 (CYP) 2C19 polymorphism. Unsatisfactory effects at night • Requires an acidic environment for activation, PPI are unstable in acidic conditions

6. Clinical pharmacology Potassium-Competitive Acid Blocker Suppresses gastric acid secretion by inhibiting H+, K+-ATPase enzyme. Vonoprazan does not require activation by acid. Vonoprazan may selectively concentrate in the parietal cells in both the resting and stimulated states. It binds to the active pumps in a noncovalent and reversible manner

7. Indications and usage VONOPRAN is a potassium-competitive acid blocker indicated: for healing of all grades of erosive esophagitis and relief of heartburn associated with erosive esophagitis in adults. to maintain healing of all grades of erosive esophagitis and relief of heartburn associated with erosive esophagitis in adults. in combination with amoxicillin and clarithromycin for the treatment of Helicobacter pylori (H. pylori) infection in adults. in combination with amoxicillin for the treatment of H. pylori infection in adults.

8. Dosage and Administration Recommended Dosage Healing of Erosive Esophagitis and Relief of Heartburn The recommended adult oral dosage is VONOPRAN 20 mg once daily for 8 weeks. Maintenance of Healed Erosive Esophagitis and Relief of Heartburn. The recommended adult oral dosage is VONOPRAN 10 mg once daily for up to 6 months. Treatment of H. pylori Infection Triple Therapy: The recommended adult oral dosage is VONOPRAN 20 mg plus amoxicillin 1,000 mg plus clarithromycin 500 mg, each given twice daily (in the morning and evening, 12 hours apart) for 14 days. Dual Therapy: The recommended adult oral dose is VONOPRAN 20 mg given twice daily (in the morning and evening) plus amoxicillin 1,000 mg three times daily (in the morning, mid-day, and evening) for 14 days.

9. CONTRAINDICATIONS Hypersensitivity to vonoprazan or any component Rilpivirine -containing products Presence of Gastric Malignancy Acute Tubulointerstitial Nephritis Clostridioides difficile-Associated Diarrhea Bone Fracture Vitamin B12 (Cobalamin) Deficiency Hypomagnesemia and Mineral Metabolism WARNINGS AND PRECAUTIONS

10. Drug Interactions • Antiretrovirals (e.g., rilpivirine) • CYP3A substrates • Drugs affecting gastric pH (e.g., iron salts, ketoconazole)

11. Summary Rapid Onset of action Potent Acid control Can be taken with or without food Better safety profile

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