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Overview: Voquezna Triple Pak is used to treat an infection in the stomach caused by bacteria called Helicobacter pylori (H. pylori). It contains three different medicines that work together to kill this bacteria. Common side effects include diarrhea, stomach pain, and a change in how things taste. Serious side effects are rare but may include allergic reactions and severe diarrhea. If you develop a rash, stop the medicine and call your health care provider right away.

Uses

What is Voquezna Triple Pak used for?

Voquezna Triple Pak (vonoprazan, amoxicillin, and clarithromycin) is commonly used to treat Helicobacter pylori (H. pylori) infections, which occur in the stomach. Infection with H. pylori can lead to stomach ulcers and other problems.

Voquezna Triple Pak contains three medicines that are used together to fight a specific type of bacteria, H. pylori, that infects the stomach. Some bacteria may have developed resistance to the antibiotics in Voquezna Triple Pak. This may make the antibiotics not work as well. 

These antibiotics will not work for infections caused by viruses, such as the common cold, the flu, or coronavirus. They will also not work for any other infections that are not caused by bacteria. Taking any antibiotic when it is not needed may cause the antibiotic to not work for bacterial infections in the future.

Voquezna Triple Pak may also be used for other conditions as determined by your health care provider.

See also: Voquezna Dual Pak

How does Voquezna Triple Pak work (mechanism of action)?

Helicobacter pylori (H. pylori) is a type of bacteria that grows well in acidic places, like the stomach. Voquezna Triple Pak contains three different medicines called vonoprazan, amoxicillin, and clarithromycin. These medicines are used together to help get rid of an H. pylori infection. They each work in different ways. 

Vonoprazan helps to fight H. pylori infection by decreasing the amount of acid that the stomach makes. Amoxicillin is an antibiotic that kills H. pylori by preventing it from creating a cell wall. Clarithromycin is an antibiotic that stops H. pylori from making proteins that it needs to grow and multiply. 

How is Voquezna Triple Pak supplied (dosage forms)?

Brands and other names

  • Voquezna Triple Pak

Dosage forms and strengths

  • Vonoprazan 20 mg oral tablets co-packaged with amoxicillin 500 mg oral capsules and clarithromycin 500 mg oral tablets

How should I store Voquezna Triple Pak?

Voquezna Triple Pak should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place and protect it from light.

Side Effects

What are the most common side effects of Voquezna Triple Pak?

The most common side effects of Voquezna Triple Pak are listed below. Tell your health care provider if you have any of these side effects that bother you.

There may be other side effects of Voquezna Triple Pak that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Voquezna Triple Pak?

While less common, the most serious side effects of Voquezna Triple Pak are described below, along with what to do if they happen.

Severe Allergic Reactions. Voquezna Triple Pak may cause allergic reactions, including a specific type of allergic reaction called DRESS. DRESS stands for Drug Reaction with Eosinophilia and Systemic Symptoms. It is also sometimes called multiorgan hypersensitivity. This is a reaction that can affect multiple parts of the body, including your liver, kidneys, and heart. Stop taking the medicine and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Severe Skin Reactions. Voquezna Triple Pak can cause severe skin reactions, such as Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP). These can lead to death if not treated. If you develop a rash, stop the medicine and call your health care provider right away. Get emergency help if you have any of the following symptoms of a severe skin reaction.

  • Painful red or purple skin that looks burned and peels off
  • Red skin covered with pus-filled bumps (pustules)
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Antibiotic-Associated Diarrhea. An overgrowth of germs called Clostridioides difficile, or “C. diff,” can happen in your gut with many types of antibiotics, including amoxicillin and clarithromycin, two of the medicines in Voquezna Triple Pak. This can cause a condition known as antibiotic-associated diarrhea and can happen even up to two months after stopping the antibiotic. Call your health care provider right away if you have any of the following symptoms of this condition.

  • Watery diarrhea
  • Diarrhea that does not go away
  • Blood in your stool (poop)
  • Severe stomach cramps
  • Fever that starts after you start or finish the medicine

Drug-Induced Enterocolitis Syndrome (DIES). Amoxicillin, one of the medicines in Voquezna Triple Pak, may rarely cause a severe reaction in the gastrointestinal (GI) tract called drug-induced enterocolitis syndrome (DIES). This reaction can be life-threatening and usually occurs within a day of taking the medicine. Stop taking Voquezna Triple Pak and get emergency help if you have any of the following symptoms.  

  • Severe vomiting that happens within a couple hours of taking the medicine
  • Severe diarrhea
  • Extreme tiredness or weakness
  • Unusually pale skin
  • Low blood pressure
  • Dizziness or lightheadedness
  • Confusion
  • Unsteadiness

Heart Rhythm Changes. Clarithromycin, one of the medicines in Voquezna Triple Pak, may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or take other medicines that can prolong the QT interval. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking clarithromycin, one of the medicines in Voquezna Triple Pak. Stop taking Voquezna Triple Pak and call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Kidney Problems. A type of kidney problem called acute tubulointerstitial nephritis has happened in some people taking vonoprazan, one of the medicines in Voquezna Triple Pak. If you notice a change in the amount of your urine (pee) or see blood in your urine, call your health care provider right away.

Warnings & Precautions

Who should not use Voquezna Triple Pak?

Allergies to Ingredients. People who are allergic to any of the following should not take Voquezna Triple Pak.

  • Amoxicillin
  • Clarithromycin
  • Vonoprazan
  • Voquezna Triple Pak
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Voquezna Triple Pak.

Allergies to Certain Antibiotics. Some people who have an allergy to certain other antibiotics may also be allergic to amoxicillin or clarithromycin, two of the medicines in Voquezna Triple Pak. Let your health care provider know if you have ever had a severe allergic reaction to an antibiotic.

Drug Interactions. Voquezna Triple Pak should not be taken while you are using certain other medicines. Before taking Voquezna Triple Pak, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Liver Damage from Clarithromycin. In rare cases, clarithromycin, one of the medicines in Voquezna Triple Pak, can cause liver damage. If this has happened to you in the past, you should not use clarithromycin again.

What should I know about Voquezna Triple Pak before using it?

Do not take Voquezna Triple Pak unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share Voquezna Triple Pak with other people, even if they have the same condition as you. It may harm them.

Keep Voquezna Triple Pak out of the reach of children.

Each dose of Voquezna Triple Pak comes in a “daily treatment pack.” Follow the instructions on the blister card and ask your pharmacist or other health care provider if you have any questions. All three medicines should be taken together twice every day, in the morning and evening. At the end of each day after all doses have been taken, the empty card may be thrown away.

People who are over the age of 65 can be at greater risk for some side effects from Voquezna Triple Pak. Talk to your health care provider about the risks if you are in this age group.

Clarithromycin, one of the medicines in Voquezna Triple Pak, can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how the medicine affects you.

Voquezna Triple Pak may affect the results of certain lab tests. Tell all of your health care providers that you are taking this medicine before any lab tests or bloodwork. 

Voquezna Triple Pak may make it difficult for you to get your partner pregnant. If you have concerns, talk to your health care provider.

What should I tell my health care provider before using Voquezna Triple Pak?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Voquezna Triple Pak is right for you.

In particular, make sure that you discuss any of the following.

Heart Rhythm Problems. Tell your health care provider if you or anyone in your family has a history of heart attack or an irregular heartbeat (arrhythmia), especially a condition called “QT prolongation” or “long QT syndrome.”

Myasthenia Gravis. Clarithromycin, one of the medicines in Voquezna Triple Pak, may worsen a condition called myasthenia gravis. Tell your health care provider if you have this condition. 

Other Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • An allergy to any other medicines
  • History of antibiotic-associated diarrhea
  • Kidney problems
  • Liver problems
  • Low levels of potassium or magnesium
  • Mononucleosis, also called “mono” or the kissing disease

Pregnancy. Clarithromycin, one of the medicines in Voquezna Triple Pak, may cause harm to an unborn baby. It is not known if or how the other medicines in Voquezna Triple Pak could affect pregnancy or harm an unborn baby. Tell your health care provider if you are or plan to become pregnant. If you become pregnant, contact your health care provider right away. You can also notify the company that makes this medicine by calling 888-775-7428. The company is collecting safety information about the use of Voquezna Triple Pak during pregnancy.

Breastfeeding. Voquezna Triple Pak passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. You and your health care provider may decide that you should pump your breastmilk and throw it away while you are taking this medicine and for two days after you finish taking it. During this time, you may feed your baby previously stored breastmilk or infant formula.

How can I get more information about Voquezna Triple Pak?

For more information about Voquezna Triple Pak, you can visit the manufacturer’s website at www.voquezna.com/hp or call them at 877-742-8466.

Interactions

Does Voquezna Triple Pak interact with foods or drinks?

There are no known interactions between Voquezna Triple Pak and foods or drinks.

It is unknown if drinking alcohol will affect Voquezna Triple Pak, but heavy drinking can make it harder for your body to fight infection and increase your risk of developing stomach ulcers.

Does Voquezna Triple Pak interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking Voquezna Triple Pak.

  • A blood thinner, which is a medicine used to treat or prevent blood clots
  • A medicine for diabetes
  • A medicine for HIV or AIDS
  • A medicine used to control your heart rate or rhythm (antiarrhythmic), such as amiodarone, quinidine, or sotalol
  • A medicine to lower cholesterol, such as atorvastatin (Lipitor and others), fluvastatin, lomitapide (Juxtapid), lovastatin, rosuvastatin (Crestor), or simvastatin 
  • An ergot, such as dihydroergotamine (Migranal or Trudhesa) or ergotamine (Ergomar), which is a medicine used to treat migraine
  • Allopurinol, colchicine, or probenecid, which are medicines commonly used for gout
  • An antifungal medicine, such as itraconazole (Sporanox, Tolsura) or ketoconazole, which is a medicine used for fungal infections
  • An antiplatelet medicine, such as cilostazol or clopidogrel (Plavix), which is a medicine used to prevent blood clots
  • Digoxin (Lanoxin), which is a medicine used to treat irregular heartbeat and some types of heart failure
  • A calcium channel blocker, such as amlodipine, diltiazem (Cardizem CD and others), nifedipine, or verapamil (Verelan, Verelan PM), which is a medicine used for high blood pressure or other conditions
  • Iron, which is a supplement used to improve the iron levels in your blood
  • Citalopram (Celexa), lurasidone (Latuda), or quetiapine (Seroquel), which are medicines used to treat certain mental health conditions
  • Any medicine that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as pimozide
  • Mycophenolate (Cellcept and others), which is a medicine that suppresses your immune system
  • Omeprazole (Prilosec), which is a proton pump inhibitor (PPI) that may be used to treat certain stomach conditions
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis
  • St. John’s wort, which is a supplement that may be used for depression
  • Theophylline (Elixophyllin, Theo-24), which is a medicine for asthma or certain other breathing problems
  • Cyclosporine (Gengraf, Neoral, Sandimmune, and others) or tacrolimus, which are medicines that suppresses your immune system
  • A tyrosine kinase inhibitor, such as dasatinib (Sprycel), erlotinib (Tarceva), or nilotinib (Tasigna), which is a medicine used to treat certain types of cancer
  • A benzodiazepine, such as alprazolam or triazolam, which is a medicine used for anxiety, muscle spasms, or seizure
  • A phosphodiesterase-5 (PDE-5) inhibitor, such as sildenafil (Revatio, Viagra, and others), tadalafil (Cialis and others), or vardenafil (Levitra, Staxyn), which is a medicine used for erectile dysfunction or pulmonary arterial hypertension (PAH)

Many other medicines may alter the blood levels of Voquezna Triple Pak, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This is not a complete list of medicines that can interact with Voquezna Triple Pak. Always check with your health care provider.

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Overdose/Missed Dose

What should I do if I accidentally use too much Voquezna Triple Pak?

If you or someone else has used too much Voquezna Triple Pak, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Voquezna Triple Pak?

If you miss a dose, take it as soon as you remember. If it has been more than four hours since the missed dose, skip the missed dose and only take the next dose at the regular time. Do not take double or extra doses.

It is important to complete your prescribed course of Voquezna Triple Pak, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to these or other similar medicines.

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