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Updated: May 27, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Published on: March 15, 2022

Clopidogrel and PPI interaction: clinically relevant or not?

Robert W Harrison1, Kenneth W Mahaffey

  • 1Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC 27715, USA. Robert.w.harrison@duke.edu

Current Cardiology Reports
|November 18, 2011
PubMed
Summary
This summary is machine-generated.

Proton pump inhibitors (PPIs) and clopidogrel are common drugs. Recent studies suggest that combining PPIs with clopidogrel may not significantly reduce the drug

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Area of Science:

  • Pharmacology
  • Drug Interactions
  • Cardiovascular Medicine

Background:

  • Proton pump inhibitors (PPIs) and clopidogrel are frequently prescribed, individually and concurrently.
  • Regulatory agencies issued warnings in 2009 regarding the combined use of PPIs and clopidogrel, later restricting these warnings to omeprazole.
  • Initial concerns were based on in-vitro and observational data suggesting reduced clopidogrel efficacy when used with PPIs.

Purpose of the Study:

  • To evaluate the clinical significance of the interaction between proton pump inhibitors and clopidogrel.
  • To review recent literature addressing the efficacy of clopidogrel in patients using PPIs.

Main Methods:

  • Review of recent scientific literature.
  • Analysis of in-vitro studies and observational data.
  • Assessment of clinical trial outcomes regarding drug efficacy.

Main Results:

  • Early concerns about reduced clopidogrel efficacy with PPIs were primarily derived from in-vitro and observational studies.
  • More recent research indicates that the interaction between most PPIs and clopidogrel may not be clinically significant.
  • Specific warnings were initially issued by FDA and EMA but later narrowed to omeprazole.

Conclusions:

  • The clinical impact of combining proton pump inhibitors with clopidogrel may be less significant than previously thought.
  • Further research and clinical evaluation are warranted to fully understand the nuances of this drug interaction.
  • Healthcare providers should consider individual patient factors when prescribing these medications concurrently.