Omeprazole and clopidogrel: Should clinicians be worried?
The US Food and Drug Administration has issued a warning that omeprazole (Prilosec) reduces the antiplatelet activity of clopidogrel (Plavix) by about 50%. However, the warning is based largely on ex vivo data. Preliminary results from a randomized clinical trial revealed no effect on cardiovascular outcomes when omeprazole was given with clopidogrel. We recommend that physicians continue to prescribe a proton pump inhibitor for patients receiving dual antiplatelet therapy who are at risk of gastrointestinal bleeding or have an indication for use of a proton pump inhibitor.
Depta
Jeremiah P
JP
Department of Internal Medicine, Medicine Institute, Cleveland Clinic, USA.
Bhatt
Deepak L
DL
D000897:Anti-Ulcer Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000077144:Clopidogrel; D004347:Drug Interactions; D004359:Drug Therapy, Combination / Q000009:adverse effects; D006801:Humans; D009853:Omeprazole / Q000008:administration & dosage / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D000897:Anti-Ulcer Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D009853:Omeprazole; D013988:Ticlopidine