title: The interaction between proton pump inhibitors and clopidogrel and upper gastrointestinal bleeding.
abstract: There is increasing concern regarding a possible adverse interaction between proton pump inhibitors (PPIs) and clopidogrel that could lead to reduced cardiovascular protection by clopidogrel. We performed a literature search for relevant original studies and systematic reviews. PPIs likely affect the antiplatelet activity of clopidogrel as measured in vitro, and this may be a class effect. We conclude that the pharmacodynamic effect has not been translated into any clinically meaningful adverse effect. PPI cotherapy reduces the incidence of recurrent peptic ulcer and of upper gastrointestinal bleeding among patients on clopidogrel.
authors.affiliation: Division of Gastroenterology, Health Sciences Centre, McMaster University, Hamilton, ON, Canada. leontia@mcmaster.ca
authors.forename: Grigorios I
authors.initials: GI
authors.lastname: Leontiadis
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Yuan
authors.forename: Colin W
authors.initials: CW
authors.lastname: Howden
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control; D000077144:Clopidogrel; D004347:Drug Interactions; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced*; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D054328:Proton Pump Inhibitors / Q000009:adverse effects / Q000494:pharmacology; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology; D041742:Upper Gastrointestinal Tract / Q000187:drug effects*
chemical_list: D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine