Proton pump inhibitor and clopidogrel interaction: the case for watchful waiting.

CONTINUING EDuCAtiON Review of the Clopidogrel - Proton Pump inhibitor interaction

OBjECTiVES 1. Describe the proposed mechanism of the interaction between clopidogrel and proton pump inhibitors. 2. Summarize the pharmacologic/pharmacodynamic evidence for the interaction between clopidogrel and proton pump inhibitors. 3. Summarize the clinical evidence for the interaction between clopidogrel and proton pump inhibitors. 4. Describe the food and Drug Administration’s updated wa...

Clopidogrel and interaction with proton pump inhibitors: comparison between cohort and within person study designs

OBJECTIVE To measure the association between use of proton pump inhibitors and a range of harmful outcomes in patients using clopidogrel and aspirin. DESIGN Observational cohort study and self controlled case series. SETTING United Kingdom General Practice Research Database with linked data from the Myocardial Ischaemia National Audit Project (MINAP) and the Office for National Statistics (...

Revisiting the Clopidogrel-Proton Pump Inhibitor Interaction: From Bench to Bedside.

Treatment with clopidogrel and proton pump inhibitors in combination: a review of emerging evidence

Proton pump inhibitors often are prescribed in combination with clopidogrel to decrease risk of gastrointestinal bleeding after acute coronary syndrome. Clopidogrel is a prodrug that has to be metabolized in the liver to generate the active metabolite. Both medications are metabolized largely by the CYP2C19 enzyme; therefore, concerns exist that a drug-drug interaction during concomitant treatm...

Antiplatelet agents and proton pump inhibitors – personalizing treatment

INTRODUCTION Antiplatelet therapy remains one of the cornerstones in the management of non-cardioembolic ischemic stroke. However, a significant percentage of patients have concomitant gastroesophageal reflux or peptic ulcer disease that requires acid-reducing medications, the most powerful and effective being the proton pump inhibitors (PPIs). Antiplatelet efficacy, at least in vivo, and parti...