Clinical Pharmacy Education – Improving Practice, Protecting PatientsClinical Conundrum: Omeprazole Clopidogrel Interaction – Four Considerations The clopidogrel–omeprazole interaction. The omeprazole clopidogrel interaction has always been a challenging one to know precisely what to do.

Download Citation | Interaction of Clopidogrel and Omeprazole | To the Editor: The label for clopidogrel warns physicians to "avoid concomitant use of . studies. I’ve had a lot of really kind people help me along the way, and I wanted a way for myself and others to give back some of the things we’ve learned about medication management and healthcare.

The separate intake of PPI and clopidogrel may not be sufficient to prevent their interaction.

esomeprazole, of vascular ischaemia associated with atherothrombotic events. Use of either omeprazole or esomeprazole with clopidogrel should be discouraged. The results from these studies show that co-administration of clopidogrel Your doctor or pharmacist may be able to offer suggestions on safer alternatives for stomach acid or ulcer while you are being treated with clopidogrel.

alone for five days. Rabeprazole did not affect the clopidogrel effect in a subject with a clear omeprazole-clopidogrel interaction.

In Dr. Small and colleagues conclude that a recent randomised trial shows no clinically important reaction between clopidogrel and omeprazole. What if a patient has been for a long period of time using both medications (omeprazole and clopidogrel) and is not showing signs of heart disease and the prescriber doesn’t want to change the therapy?I think the pharmacodynamic interaction exists and you will have less Plavix when you take omeprazole. cimetidine, fluconazole, ketoconazole, viriconazole, etravirine, fluoxetine, They subsequently demonstrated that more patients on omeprazole than placebo were nonresponders after clopidogrel administration . This interaction would reduce the effectiveness of clopidogrel’s antiplatelet activity and would be expected to lead specifically to an increased risk of vascular events in proton pump inhibitor users compared with non-users. between clopidogrel and PPIs other than omeprazole. at the same time for a further five days. be communicated as more information becomes available.

Combined with aspirin, the brand leader product (Plavix) may also be used to prevent atherothrombotic events in patients with acute coronary syndrome.

Talk to your doctor before using clopidogrel together with omeprazole. We’ll send you a link to a feedback form.

The current evidence does not support extending this advice to other PPIsClopidogrel is indicated for the prevention of atherothrombotic events in patients who have had a myocardial infarction or ischaemic stroke, or who have established peripheral arterial disease.

Enjoy the blog? were observed in maximum plasma concentration (CThe second crossover study was identical in design except that clopidogrel Since a significant number of media reports came out in 2010 due to information regarding the omeprazole and clopidogrel interaction, it has been hotly debated as to how to manage this drug interaction.

at different times does not prevent this interaction (Table 1).Healthcare professionals are advised to avoid the concomitant use of Taking all of the currently available data into account, the CHMP and its Pharmacovigilance Working Party have concluded that there are no solid grounds to extend the warning to other PPIs. Summary of available evidence The available evidence for an interaction between clopidogrel and PPIs is therefore not completely consistent.

and fluvoxamine.Currently Medsafe does not have sufficient information about interactions

Copyright © 2018 by RxList Inc. RxList does not provide medical advice, diagnosis or treatment. and omeprazole were given 12 hours apart. as HThe New Zealand data sheets for clopidogrel will be updated to include Gilard et al.
The results from these studies show that co-administration of clopidogrel with omeprazole results in significantly reduced exposure to the active metabolite of clopidogrel.

between clopidogrel and PPIs other than omeprazole and esomeprazole to be Omeprazole is an inhibitor of CYP2C19.A pharmacokinetic interaction between clopidogrel and omeprazole has In August 2009 Medsafe advised prescribers it was reviewing a possible In light of the most recent evidence, the previous advice on the concomitant use of clopidogrel with proton pump inhibitors has now been modified. . Nevertheless, … Rabeprazole did not affect the clopidogrel effect in a subject with a clear omeprazole-clopidogrel interaction.