Abstract
The European Medicines Agency (EMEA) recently issued a public statement on a possible interaction between clopidogrel and proton pump inhibitors (PPIs) and recommended that the product information for all medicines containing clopidogrel be amended to discourage concomitant use of PPIs unless absolutely necessary. This follows a prior alert issued by the United States Food and Drug Administration (FDA) earlier this year, stating that PPIs might interfere with the effectiveness of clopidogrel and that clinicians should reevaluate starting or continuing treatment with a PPI in patients taking clopidogrel. However, several experts have voiced their concern that the clopidogrel-PPI interaction has been given undue importance, given that all clinical studies suggesting this problem are observational. In this review, we critically analyze the available data and make practical suggestions for the clinician regarding appropriate use of PPIs in patients receiving clopidogrel. Based on currently available evidence, we suggest that the decision to prescribe a PPI to a patient on clopidogrel must be made on an individual patient basis balancing the gastrointestinal risk with the possible thrombotic risk and that PPIs should only be used for truly appropriate indications.
Keywords: Clopidogrel, Proton pump inhibitor, Drug interactions, Platelet inhibition, Gastroprotection
Cardiovascular & Hematological Disorders-Drug Targets
Title: Clopidogrel-Proton Pump Inhibitor Interaction: A Primer for Clinicians
Volume: 10 Issue: 1
Author(s): Christopher Allen, Steven P. Dunn, Tracy E. Macaulay and Debabrata Mukherjee
Affiliation:
Keywords: Clopidogrel, Proton pump inhibitor, Drug interactions, Platelet inhibition, Gastroprotection
Abstract: The European Medicines Agency (EMEA) recently issued a public statement on a possible interaction between clopidogrel and proton pump inhibitors (PPIs) and recommended that the product information for all medicines containing clopidogrel be amended to discourage concomitant use of PPIs unless absolutely necessary. This follows a prior alert issued by the United States Food and Drug Administration (FDA) earlier this year, stating that PPIs might interfere with the effectiveness of clopidogrel and that clinicians should reevaluate starting or continuing treatment with a PPI in patients taking clopidogrel. However, several experts have voiced their concern that the clopidogrel-PPI interaction has been given undue importance, given that all clinical studies suggesting this problem are observational. In this review, we critically analyze the available data and make practical suggestions for the clinician regarding appropriate use of PPIs in patients receiving clopidogrel. Based on currently available evidence, we suggest that the decision to prescribe a PPI to a patient on clopidogrel must be made on an individual patient basis balancing the gastrointestinal risk with the possible thrombotic risk and that PPIs should only be used for truly appropriate indications.
Export Options
About this article
Cite this article as:
Allen Christopher, Dunn P. Steven, Macaulay E. Tracy and Mukherjee Debabrata, Clopidogrel-Proton Pump Inhibitor Interaction: A Primer for Clinicians, Cardiovascular & Hematological Disorders-Drug Targets 2010; 10 (1) . https://dx.doi.org/10.2174/187152910790780078
DOI https://dx.doi.org/10.2174/187152910790780078 |
Print ISSN 1871-529X |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-4063 |
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Cardiovascular Disease in Systemic Lupus Erythematosus: The Role of Traditional and Lupus Related Risk Factors
Current Cardiology Reviews Cardiovascular Diseases and the Nitric Oxide Pathway
Current Vascular Pharmacology Drug-Induced Phototoxicity; An Early In Vitro Identification of Phototoxic Potential of New Drug Entities in Drug Discovery and Development
Current Drug Safety Physiological Roles for K posative Channels and Gap Junctions in Urogenital Smooth Muscle Implications for Improved Understanding of Urogenital Function, Disease and Therapy
Current Drug Targets The Pharmacology of Cyclic Nucleotide-Gated Channels: Emerging from the Darkness
Current Pharmaceutical Design Combined Therapies for Lysosomal Storage Diseases
Current Molecular Medicine How to Achieve Near Zero Fluoroscopy During Radiofrequency Ablation of Atrial Fibrillation: A Strategy Used at Two Centers
Current Cardiology Reviews Adverse Drug Reactions Amongst Adult Patients Admitted in Lagos State University Teaching Hospital Lagos, Nigeria
Current Drug Safety Treatment Possibilities for Psychosis in Parkinson's Disease with An Emphasis on the Newly Approved Drug: Pimavanserin
CNS & Neurological Disorders - Drug Targets Cardiovascular Complications in Inflammatory Bowel Disease
Current Drug Targets The Role of Calcium Stores in Apoptosis and Autophagy
Current Molecular Medicine Left Ventricular Hypertrophy in Isolated Aortic Stenosis: Primetime for the Ventricle
Current Pharmaceutical Biotechnology Impact of Cardiovascular Factors on Pulse Wave Velocity and Total Vascular Resistance in Different Age Group Patients with Cardiovascular Disorders
Current Aging Science Gene Expression Analysis Approach to Establish Possible Links Between Parkinson's Disease, Cancer and Cardiovascular Diseases
CNS & Neurological Disorders - Drug Targets Editorial (Thematic Issue: Modifying Cardiovascular Risk Factors: Current Opinion and Future Trends)
Current Pharmaceutical Design Research Toward Potassium Channels on Tumor Progression
Current Topics in Medicinal Chemistry Recent Developments of Metal and Metal Oxide Nanocatalysts in Organic Synthesis
Mini-Reviews in Medicinal Chemistry The Fetal Cardiac Function
Current Cardiology Reviews New Chemotherapy and Immunotherapy for Tuberculosis
Current Respiratory Medicine Reviews Heterogeneity Amongst 5-HT3 Receptor Subunits: Is this Significant?
Current Molecular Medicine