Clopidogrel
Clopidogrel
ATC Code: B01AC04
Warning
Until further information is available FDA recommends the following:
* Healthcare providers should continue to prescribe and patients should continue to take clopidogrel as directed, because clopidogrel has demonstrated benefits in preventing blood clots that could lead to a heart attack or stroke.
* Healthcare providers should re-evaluate the need for starting or continuing treatment with a PPI, including Prilosec OTC, in patients taking clopidogrel.
* Patients taking clopidogrel should consult with their healthcare provider if they are currently taking or considering taking a PPI, including Prilosec OTC.
Evidence
Good
Reference
2 comments so far
John Y.
Sunday 08 March 2009 - 16:46 PM
Pantaloc and Nexium have not shown to produce reduction in efficacy of Plavix. Plavix is a pro-drug, requiring enzymatic activation, something that is suppressed by most PPI's. In BC, the cardiologist are pushing hard for Special Authority to recognize this, and allow the use of these selected PPI's with concurrent Plavix is required. An alternative, as suggested by Dr. Victor Huckell, cardiologist, is to take the Plavix and PPI 12 hours apart.
Susan D.
Tuesday 31 March 2009 - 08:45 AM
The April 2009 issue of Prescriber's Letter suggests not to rely on taking the two drugs twelve hours apart, as the metabolites of the PPI may inhibit the CYP2C19 enzyme as well. It looks like omeprazole is the worst offender, pantoloc the least.