title: Inconsistencies surrounding the risk of adverse outcomes with concomitant use of clopidogrel and proton pump inhibitors.
abstract: BACKGROUND
  There is considerable debate surrounding the clinical relevance of an adverse interaction between clopidogrel and proton pump inhibitors (PPIs). Some studies have indicated that PPIs may attenuate the antiplatelet efficacy of clopidogrel, thus leading to increased risk of thrombotic cardiovascular events.
  
  
  METHODS
  From a literature search of MEDLINE and EMBASE, the authors critically appraised data from systematic reviews, randomised controlled trials and observational studies that evaluated platelet function and clinical outcomes in patients receiving concomitant clopidogrel and PPIs.
  
  
  CONCLUSIONS
  The evidence from platelet function and cardiovascular outcome studies is highly inconsistent. Higher quality data from randomised trials indicate that use of PPI therapy for up to 6 months is unlikely to cause any adverse interaction with clopidogrel, and there are gastrointestinal benefits with PPI use.
authors.affiliation: University of East Anglia, Norwich Medical School, Norwich, NR4 7TJ, UK.
authors.forename: Chun Shing
authors.initials: CS
authors.lastname: Kwok
authors.forename: Yoon Kong
authors.initials: YK
authors.lastname: Loke
mesh_terms: D000818:Animals; D001792:Blood Platelets / Q000187:drug effects; D000077144:Clopidogrel; D004347:Drug Interactions; D019317:Evidence-Based Medicine; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000517:prevention & control; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000493:pharmacokinetics; D054328:Proton Pump Inhibitors / Q000009:adverse effects* / Q000493:pharmacokinetics; D018570:Risk Assessment; D012307:Risk Factors; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000493:pharmacokinetics
chemical_list: D010975:Platelet Aggregation Inhibitors; D054328:Proton Pump Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine