We conducted a systematic review comparing the safety
The clopidogrel-PPI interaction does not seem to be a PPI class effect
Both aspirin plus PPIs (OR: 2
Moderate
Recently, concerns have been raised about the potential for PPIs to blunt
compared to clopidogrel
Keywords: a PPI such as lansoprazole has been found to reduce the rates of ulcer complications for those taking aspirin
1 Available in the European Union under the trade names Plavix and Iscover, and as generic medicines
In summary an interaction between clopidogrel and PPIs seems to exist for omeprazole and esomeprazole, whereas there are only limited data for rabeprazole
Applies to: lansoprazole and Plavix (clopidogrel) Talk to your doctor before using clopidogrel together with lansoprazole
Clopidogrel: Lansoprazole Omeprazole, Rabeprazole: 16: 37: 89: 65: 30: No PPI: 284: 66
Biological Plausibility of the Clopidogrel–PPI Interaction? PPIs may reduce the availability of the biologically active metabolite of clopidogrel by competitively inhibiting cytochrome P450 2C19 (CYP2C19), one of the isozymes responsible for the step-wise hepatic oxidation and subsequent hydroxylation of the thienopyridine prodrug
We conducted a systematic review comparing the safe increased risk for adverse cardiovascular events for those taking pantoprazole (hazard ratio 1
In healthy individuals, dexlansoprazole, lansoprazole, or pantoprazole had less effect on clopidogrel's antiplatelet activity than did omeprazole or esomeprazole; of these proton Accordingly, proton pump inhibitors are frequently administered in combination with clopidogrel to reduce the risk for GI bleeding
Ahlström M, Weidolf L
Retrospective analyses of randomized trials of clopidogrel in patients with acute coronary syndromes revealed less benefit of the antiplatelet agent when esomeprazole was coadministered
Review need for PPI in the elderly + adequate calcium and Vit D intake