Q. I suffer from GERD, and the many meds I have tried do not offer adequate relief. I’ve seen ads for Voquezna. Can you share information on its efficacy, please?

A. Vonoprazan (Voquezna) is the first in a new class of acid-suppressing drugs to be marketed in the U.S. The Food and Drug Administration approved it for sale in 2024.

Usually, gastroesophageal reflux disorder (GERD) is treated with a proton pump inhibitor (PPI) such as omeprazole, esomeprazole or lansoprazole. These powerful acid-suppressing medications are known by the brand names Prilosec, Nexium and Prevacid.

Voquezna is a “potassium-competitive acid blocker” (PCAB). Some studies indicate that it is at least as effective as a PPI, and it may even be a bit better. A recent review suggests that for someone like you, who has not gotten relief with a PPI, this new acid-blocking drug might be a viable alternative (Cureus, May 17, 2025).

Side effects mentioned in the TV commercial for Voquezna include allergic reactions that may cause “trouble breathing, rash, itching and swelling of face, lips, tongue or throat.”

Other serious reactions include “kidney problems, intestinal infections, fractures, life-threatening skin reactions, low B12 or magnesium levels and stomach growths.” Other potential side effects include stomachache, high blood pressure, urinary tract infection, and either diarrhea or constipation.

One other possible obstacle is the price. If insurance does not cover this prescription medication, the coupon price could be as much as $700 for a month’s supply.

You can find more information about this and many other ways to tame heartburn in our “eGuide to Overcoming Digestive Disorders.” This online resource can be found under the Health eGuides tab at www.PeoplesPharmacy.com.

Q. I had quadruple bypass heart surgery 25 years ago. Following the procedure, my cardiologist put me on the higher dose (325 milligrams) aspirin. I have stayed on this dose all these years with no problems.

I recently went to a cardiology nurse practitioner who suggested I should get off this dose and go to the baby aspirin dose. I am leery to do this.

Should I get back in touch with my cardiologist before changing the dose?

A. For decades, Americans were told to take a standard dose aspirin pill (325 milligrams) to prevent a heart attack. Then, that advice was modified, and the recommended dose was lowered to 81 milligrams. That is a so-called baby aspirin, although pediatricians do not recommend giving children aspirin. The dosage reduction for adults was to reduce the risk of stomach irritation or bleeding.

In recent years, most cardiologists have determined that otherwise healthy people do not need to take aspirin. Their fear is that bleeding episodes could counterbalance any benefit such individuals might gain from even a small aspirin dose. People like you, however, are at higher risk for heart problems because you had bypass surgery.

Doctors usually advise them to continue taking aspirin.

While you certainly could check with your cardiologist, the cardiology nurse practitioner seems to be up to date on the prescribing guidelines. The American Heart Association and the American College of Cardiology both recommend that people take aspirin indefinitely following bypass surgery, with 81 milligrams considered an acceptable dose for many individuals.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 300 W. 57th Street, 41st Floor, New York, NY 10019, or email them via their website: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”