Vonomax Duo
Generic Name
Vonoprazan + Mosapride
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| vonomax duo 40 mg tablet | ৳ 55.00 | N/A |
Description
Overview of the medicine
Vonomax Duo 40 mg Tablet is a combination medication containing Vonoprazan and Mosapride. Vonoprazan is a potassium-competitive acid blocker (P-CAB) that effectively reduces stomach acid secretion, used for conditions like GERD and peptic ulcers. Mosapride is a prokinetic agent that enhances gastrointestinal motility, helping to relieve symptoms like heartburn, bloating, and nausea associated with dyspepsia and reflux. This combination aims to provide comprehensive relief for acid-related disorders complicated by impaired gastric motility.
Uses & Indications
Dosage
Adults
Usually 1 tablet once daily before breakfast. Dosage and duration may vary based on condition and physician's advice.
Elderly
No specific dose adjustment is generally required, but caution is advised in elderly patients, especially those with impaired hepatic or renal function.
Renal_impairment
No dosage adjustment is generally required for Vonoprazan in mild to moderate renal impairment, but caution is advised in severe cases. For Mosapride, dose adjustment may be necessary in severe renal impairment.
How to Take
Oral administration. Take the tablet whole with water. It is generally recommended to take it once daily before breakfast for optimal acid suppression. For specific motility issues, your doctor may advise different timing.
Mechanism of Action
Vonoprazan inhibits H+, K+-ATPase (the proton pump) in gastric parietal cells, thereby suppressing gastric acid secretion. Its mechanism is distinct from proton pump inhibitors (PPIs) as it reversibly binds to the proton pump, providing a rapid and sustained acid suppression. Mosapride is a selective 5-HT4 receptor agonist that increases acetylcholine release from enteric neurons, leading to enhanced gastrointestinal motility and accelerated gastric emptying.
Pharmacokinetics
Onset
Acid suppression for Vonoprazan within hours. Prokinetic effect for Mosapride within 30-60 minutes.
Excretion
Vonoprazan and its metabolites are mainly excreted renally and fecally. Mosapride and its metabolites are primarily excreted renally.
Half life
Vonoprazan: Approximately 7-9 hours. Mosapride: Approximately 1.5-2 hours.
Absorption
Vonoprazan is rapidly absorbed after oral administration, reaching peak plasma concentrations within 1.5-2 hours. Mosapride is also rapidly absorbed, reaching peak plasma levels within 1 hour.
Metabolism
Vonoprazan is primarily metabolized by CYP3A4 and to a lesser extent by CYP2B6, CYP2C19, and CYP2D6. Mosapride is extensively metabolized in the liver, primarily by CYP3A4, to its active metabolite.
Side Effects
Contraindications
- Hypersensitivity to Vonoprazan, Mosapride, or any component of the formulation
- Severe hepatic impairment (for Mosapride component)
Drug Interactions
Anticholinergics
May antagonize the prokinetic effect of Mosapride.
CYP3A4 Inducers (e.g., Rifampicin)
May decrease plasma concentration of Vonoprazan.
CYP3A4 Inhibitors (e.g., Ketoconazole)
May increase plasma concentration of Vonoprazan.
Drugs requiring gastric pH for absorption (e.g., Atazanavir, Nelfinavir)
Reduced absorption due to elevated gastric pH.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote. Monitor vital signs and manage any adverse reactions.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies the potential risk to the fetus. It is unknown if Vonoprazan or Mosapride are excreted in human milk; use with caution in nursing mothers.
Side Effects
Contraindications
- Hypersensitivity to Vonoprazan, Mosapride, or any component of the formulation
- Severe hepatic impairment (for Mosapride component)
Drug Interactions
Anticholinergics
May antagonize the prokinetic effect of Mosapride.
CYP3A4 Inducers (e.g., Rifampicin)
May decrease plasma concentration of Vonoprazan.
CYP3A4 Inhibitors (e.g., Ketoconazole)
May increase plasma concentration of Vonoprazan.
Drugs requiring gastric pH for absorption (e.g., Atazanavir, Nelfinavir)
Reduced absorption due to elevated gastric pH.
Storage
Store in a cool, dry place, below 30°C. Protect from light and moisture. Keep out of reach of children.
Overdose
In case of overdose, symptomatic and supportive treatment should be initiated. There is no specific antidote. Monitor vital signs and manage any adverse reactions.
Pregnancy & Lactation
Pregnancy Category C. Use only if potential benefit justifies the potential risk to the fetus. It is unknown if Vonoprazan or Mosapride are excreted in human milk; use with caution in nursing mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date
Availability
Pharmacies, hospitals
Approval Status
Approved by regulatory authorities in several countries (e.g., DGDA in Bangladesh)
Patent Status
Patent expired for generic components, brand formulation may be patented
Clinical Trials
Both Vonoprazan and Mosapride have undergone extensive clinical trials demonstrating their efficacy and safety individually and in combination for various GI disorders.
Lab Monitoring
- Liver function tests (especially with long-term use)
- Renal function tests (in patients with impairment)
Doctor Notes
- Counsel patients on lifestyle modifications for GERD/dyspepsia.
- Monitor for signs of hypomagnesemia and bone mineral density with prolonged use.
- Be aware of potential drug interactions, especially with CYP3A4 substrates/inhibitors.
Patient Guidelines
- Take as directed by your doctor, usually once daily before breakfast.
- Do not crush or chew the tablet; swallow it whole.
- Inform your doctor about all other medications you are taking.
- Report any unusual or severe side effects to your doctor.
- Do not stop the medication without consulting your doctor, even if symptoms improve.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
This medicine may cause dizziness or visual disturbances in some individuals. If you experience these effects, avoid driving or operating machinery.
Lifestyle Advice
- Avoid spicy, fatty, and acidic foods.
- Eat smaller, more frequent meals.
- Avoid lying down immediately after meals.
- Elevate the head of your bed if experiencing nighttime reflux.
- Limit alcohol and caffeine intake.
- Quit smoking.
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