Voquezna or Talicia?
I will try to keep this brief, I am wondering if anyone has any input regarding the efficacy of or suggestions when choosing a treatment between Voquezna and Talicia.
In December of last year, after nearly a month of antibiotics I developed intense epigastric pain and insane burping. I was on bactrim for 24 days (10 days on, 1 week off, 14 days on) and then doxycycline (10 days off bactrim) for 2 days (I had to stop due to possible intracranial hypertension) for recurrent epididymitis. A few days after stopping doxy my symptoms started. I know doxy can irritate the stomach pretty well.
Over the next 5 months while I waited on my GI referral appointment, my symptoms largely improved but never disappeared. The epigastric pain and pressure significantly lessened to what I would consider a constant but mild annoyance. My burping went from possibly 200 times a day to maybe 30. Day to day I am lucky to say my symptoms are probably only a 2-3/10.
An endoscopy was done and revealed "focal mild superficial chronic inflammation"/gastritis and immunohistochemical assay was positive for "rare H. pylori like organism".
The GI doctors gave me the option between taking Voquezna (Vonoprazan + Amoxicillin) or Talicia (Omeprazole + Amoxicillin + Rifabutin).
It's been about a week and I still have yet to decide which one to take. I am leaning towards Voquezna due to my recent extended use of antibiotics, less chances of negative side effects with one antibiotic (I am prone to side effects from medications), as well as the greater acid reducing potential of vonoprazan. Additionally, I believe this leaves Talicia as a second line treatment in the case that Voquezna fails to eradicate. More than anything I'd like to treat this in one round to avoid even more exposure to antibiotics as my gut has just now FINALLY started to heal after taking so many antibiotics at the end of last year.
I should note that in addition to the antibiotics at the time, I was under a great deal of stress. I believe these two factors played a major role in my H. pylori going for asymptomatic to pathogenic.
Does anyone have any thoughts regarding these two medications? The GI docs wanted to avoid starting with BQT due to my previous sensitive to doxycycline.
Lastly, would it be wise to supplement either of these medications with bismuth subsalicylate (in the form of Pepto Bismol) to help with eradication like in bismuth quad therapy? If so, what dosage would you recommend in this case?
Thanks so much
Posted Jun 11, 2025, 7:49 PM UTC