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Omeprazole and clopidogrel: Should clinicians be worried?
Jeremiah P Depta1, Deepak L Bhatt
1Department of Internal Medicine, Medicine Institute, Cleveland Clinic, USA.
Abstract:
The US Food and Drug Administration has issued a warning that omeprazole (Prilosec) reduces the antiplatelet activity of clopidogrel (Plavix) by about 50%. However, the warning is based largely on ex vivo data. Preliminary results from a randomized clinical trial revealed no effect on cardiovascular outcomes when omeprazole was given with clopidogrel. We recommend that physicians continue to prescribe a proton pump inhibitor for patients receiving dual antiplatelet therapy who are at risk of gastrointestinal bleeding or have an indication for use of a proton pump inhibitor.
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