Vonoprazan

vonoprazan

يعد دواء Vonaspire المثيل المصري للدواء الياباني vocinti ،و مادته الفعالة هي vonoprazan ,و التي تعتبر rapid, strong and long-lasting gastric acid inhibitor و الذي يستخدم لعالج ال GERD and ulcer peptic أيضا يستخدم في علاج helicobacter pylori

vonoprazan

Mechanism of Action

Potassium-competitive acid blocker (PCAB)

Suppresses basal and stimulated gastric acid secretion at secretory surface of gastric parietal cell through inhibition of the H+, K+-ATPase enzyme system in a potassium competitive manner

Because this enzyme is regarded as the acid (proton) pump within the parietal cell, vonoprazan has been characterized as a type of gastric proton-pump inhibitor, as it blocks the final step of acid production

Does not require activation by acid.; may selectively concentrate in parietal cells in both resting and stimulated states

Binds to active proton pumps in noncovalent and reversible manner

Vonoprazan indications

GERD treatment

For adults 20 mg once daily for a month و يمكن أن يتبعها 4 أسابيع أخرى إذا لزم الامر

peptic ulcer treatment

For gastric ulcer adults 20 mg once daily for 2 months OR for 6 weeks for duodenal ulcer

prevention of peptic ulcer from NSAIDs:

10mg once daily

H.Pylori Combined Therapy

in combination with amoxiclillin, clarithromycycin in triple therapy

Contraindications

Lactaion ️
التزامن مع الأدوية التي تعتمد على acidic pH for absorption مثل atazanavir, rilpivirine and nelfinavir
Hypersensitivity Renal Impairment, hepatic impairment
pregnancy safety still unclear

Side effects

▪️pseudomembranous colitis, increased intragastric pH, benign gastric
polyps (prolonged use)

️▪اضطرابات الجهاز الهضمي
▪️ hepatic function abnormalities, including liver injury. Rarely
️▪اضطرابات الجهاز المناعي ك hypersensitivity
️▪ من األضرار التي تحت البحث: زيادة إنزيم ALT ،AST “ ،glutamyl-gamma
،”transferase
️▪ طفح جلدي .
️▪زيادة تركيز الدم مع مثبطات CYP3A4( مثل clarithromycin )ومع amoxicillin في
العالج الثالثي للقضاء على جرثومة المعدة.

قد يقلل من آثار itraconazole و ”inhibitors kinase tyrosine( ”مثل ”gefitinib ”
.)”nilotinib“
قد يزيد vonaspireمن آثارmethyldigoxin and digoxin.