The Medical Letter on Drugs and Therapeutics
Drug Interaction: Clopidogrel and PPIs
February 27, 2017 (Issue: 1515)The antiplatelet drug clopidogrel (Plavix, and others) reduces major cardiovascular events, but can cause bleeding. Proton pump inhibitors (PPIs) are often used with clopidogrel to prevent gastrointestinal bleeding, however, some evidence...more
- NS Abraham et al. ACCF/ACG/AHA 2010 expert consensus document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. J Am Coll Cardiol 2010; 56:2051.
- JL Mega et al. Cytochrome P-450 polymorphisms and response to clopidogrel. N Engl J Med 2009; 360:354.
- T Zvyaga et al. Evaluation of six proton pump inhibitors as inhibitors of various human cytochromes P450: focus on cytochrome P450 2C19. Drug Metab Dispos 2012; 40:1698.
- RS Wedemeyer and H Blume. Pharmacokinetic drug interaction profiles of proton pump inhibitors: an update. Drug Saf 2014; 37:201.
- AL Frelinger 3rd et al. A randomized, 2-period, crossover design study to assess the effects of dexlansoprazole, lansoprazole, esomeprazole, and omeprazole on the steady-state pharmacokinetics and pharmacodynamics of clopidogrel in healthy volunteers. J Am Coll Cardiol 2012; 59:1304.
- JM Siller-Matula et al. Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel. Am Heart J 2009;157:148.e1.
- DJ Angiolillo et al. Differential effects of omeprazole and pantoprazole on the pharmacodynamics and pharmacokinetics of clopidogrel in healthy subjects: randomized, placebo-controlled, crossover comparison studies. Clin Pharmacol Ther 2011; 89:65.
- N Simon et al. Omeprazole, pantoprazole, and CYP2C19 effects on clopidogrel pharmacokinetic-pharmacodynamic relationships in stable coronary artery disease patients. Eur J Clin Pharmacol 2015; 71:1059.
- SA Scott et al. Antiplatelet drug interactions with proton pump inhibitors. Expert Opin Drug Metab Toxicol 2014; 10:175.
- SD Bouziana and K Tziomalos. Clinical relevance of clopidogrel-proton pump inhibitors interaction. World J Gastrointest Pharmacol Ther 2015; 6:17.
- DN Juurlink et al. A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ 2009; 180:713.
- PM Ho et al. Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome. JAMA 2009; 301:937.
- WA Ray et al. Outcomes with concurrent use of clopidogrel and proton pump inhibitors: a cohort study. Ann Intern Med 2010; 152:337.
- DL Bhatt et al. Clopidogrel with or without omeprazole in coronary artery disease. N Engl J Med 2010; 363:1909.
- MR Southworth and R Temple. Interaction of clopidogrel and omeprazole. N Engl J Med 2010; 363:1977.
- DN Juurlink. Comment on: Clopidogrel with or without omeprazole in coronary artery disease. N Engl J Med 2011; 364:681.
- SP Dunn et al. Impact of proton pump inhibitor therapy on the efficacy of clopidogrel in the CAPRIE and CREDO trials. J Am Heart Assoc 2013; 2:e004564.
- SG Goodman et al. Association of proton pump inhibitor use on cardiovascular outcomes with clopidogrel and ticagrelor. Circulation 2012; 125:978.
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