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.
- © 2010 The Cleveland Clinic Foundation. All Rights Reserved.
- Department of Internal Medicine, Medicine Institute, Cleveland Clinic
- Chief of Cardiology, VA Boston Healthcare System; Director, Integrated Interventional Cardiovascular Program, Brigham and Women’s Hospital; Associate Professor of Medicine, Harvard Medical School; Senior Investigator, TIMI Study Group; Boston, MA
- ADDRESS:
Deepak L. Bhatt, MD, MPH, VA Boston Healthcare System, 1400 VFW Parkway, Boston, MA 02132; e-mail dlbhattmd{at}post.harvard.edu.
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.
- © 2010 The Cleveland Clinic Foundation. All Rights Reserved.