Can we use PPI with clopidogrel?

Can we use PPI with clopidogrel?

Proton pump inhibitors (PPIs) are often used with clopidogrel to prevent gastrointestinal bleeding, however, some evidence suggests that PPIs may interfere with the activation of clopidogrel and diminish its antiplatelet effect.

Which proton pump inhibitor should be avoided in a patient taking clopidogrel?

On the other hand, the United States Food and Drug Administration and the European Medicines Agency revised the labelling of clopidogrel, which now mentions that omeprazole and esomeprazole should be avoided in patients treated with clopidogrel, that other acid-lowering agents with minimal or no inhibitory effects on …

Which PPI can be taken with clopidogrel?

So, which PPIs are safe to use with Plavix? Currently, the manufacturer of Plavix recommends using pantoprazole (Protonix), lansoprazole (Prevacid), or Dexilant (dexlansoprazole). In their research, these three PPIs had the least effect on the effectiveness of Plavix.

Can clopidogrel and pantoprazole be taken together?

clopidogrel pantoprazole Combining these medications may reduce the effectiveness of clopidogrel in preventing heart attack or stroke. The interaction is most likely to occur if you are using a higher dosage of pantoprazole than recommended or if you are using it too frequently.

Do proton pump inhibitors reduce the clinical efficacy of clopidogrel?

All PPIs are also metabolised via the cytochrome P450 system, particularly CYP2C19 and CYP3A4. All PPIs inhibit these isoenzymes to different degrees and therefore could affect the clinical efficacy of clopidogrel.

What should you not take with clopidogrel?

Clopidogrel may interact with other medications

• Diabetes drug. In most cases, repaglinide should not be taken with clopidogrel.
• Stomach acid drugs (proton pump inhibitors)
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Blood thinners.
• Drugs used to treat depression.
• Salicylates (aspirin)
• Opioids.

Which PPI is contraindicated with clopidogrel?

Healthcare professionals are advised to avoid the concomitant use of clopidogrel with omeprazole and other CYP2C19 inhibitors e.g. esomeprazole, cimetidine, fluconazole, ketoconazole, viriconazole, etravirine, fluoxetine, and fluvoxamine.

What is the best antacid to take with clopidogrel?

The FDA advises that if you are experiencing heartburn or acid reflux while taking Plavix, you should try using antacids ( Maalox, Mylanta, Rolaids, Tums and generics) and most H2 blockers such as famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac), but not cimetidine (Tagamet, Tagamet HB, and generics).

Why clopidogrel is contraindicated when co administered with PPIs?

This review followed the publication of studies suggesting concomitant use of proton pump inhibitors can reduce the efficacy of clopidogrel. Clopidogrel inhibits platelet aggregation and is indicated for the prevention of vascular ischaemia associated with atherothrombotic events.

What medications interact with clopidogrel?

Can you take omeprazole with clopidogrel?

Concomitant use of clopidogrel and omeprazole or esomeprazole is to be discouraged unless considered essential. Doctors should check whether patients who are taking clopidogrel are also buying over-the-counter omeprazole and consider whether other gastrointestinal therapies would be more suitable.

Why PPI decrease the effect of clopidogrel?

Proton pump inhibitors are inhibitors of CYP2C19 with varying degrees of potency. Therefore, PPIs may inhibit activation of clopidogrel to its active metabolite via CYP2C19 leading to decreased serum concentrations of the active metabolite and potentially reducing the antiplatelet effect of clopidogrel.

What drug brand names are proton pump inhibitors?

List of Proton Pump Inhibitors Omeprazole. The first proton pump inhibitor, omeprazole, was introduced in 1989. Lansoprazole. Lansoprazole comes in 15 and 30 mg doses. Rabeprazole. Rabeprazole is available as the brand name drug Aciphex or in generic versions. Pantoprazole. Pantoprazole is available by the brand name Protonix or in a generic drug. Esomeprazole. Dexlansoprazole.

Which drugs reaact with proton pump inhibitors?

Proton pump inhibitor drug interactions can happen with medicines ranging from aspirin to cancer drugs . People should be aware of how proton pump inhibitors interact with other drugs they take. PPIs alter the pH of the stomach. The pH is a measure of stomach acidity. An altered pH can change the way certain drugs work within the body.

What are the most common clopidogrel interactions?

The most common clopidogrel interactions are seen in patients who use any type of proton pump inhibitor medications together with clopidogrel. The intake of proton pump inhibitors within 12 hours of taking clopidogrel greatly reduces platelet inhibition. This increases the risk of clot formation.

What drugs interact with Plavix?

Plavix may interact with other blood thinners, aspirin, or nonsteroidal anti-inflammatory drugs ( NSAIDs ). Plavix may also interact with armodafinil, modafinil , fluoxetine , fluvoxamine, gemfibrozil , isoniazid , cancer medications, stomach acid reducers, antifungals, HIV medications, or seizure medications.