CONTINUING EDuCAtiON Review of the Clopidogrel - Proton Pump inhibitor interaction

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...

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

Clopidogrel is an integral part of the management of several important vascular diseases. However the medium to long term clinical outcomes are poorer for these patients if they experience gastro-intestinal bleeding, hence patients with risk factors for gastro-intestinal bleeding are frequently prescribed proton pump inhibitors. Conflicting evidence exists as to the existence of an adverse inte...

Circulation: Cardiovascular Interventions Topic Review Circulation: Cardiovascular Interventions Editors’ Picks: Most Important Papers in Antiplatelet Therapy

A growing body of evidence has shown a broad variability in interindividual pharmacodynamic response profiles to the platelet inhibitor clopidogrel, and patients with reduced platelet inhibition have an increased risk of recurrent atherothrombotic events. Numerous factors may contribute to poor clopidogrel response. Among these, that secondary to a drug interaction with the proton pump inhibito...