PMID- 20377472
OWN - NLM
STAT- MEDLINE
DCOM- 20100929
LR  - 20181201
IS  - 1744-764X (Electronic)
IS  - 1474-0338 (Linking)
VI  - 9
IP  - 4
DP  - 2010 Jul
TI  - Proton pump inhibitors and clopidogrel: is it a significant drug interaction?
PG  - 593-602
LID - 10.1517/14740331003645609 [doi]
AB  - IMPORTANCE OF THE FIELD: Clopidogrel is indicated as part of a dual antiplatelet 
      therapy (DAT) with aspirin for the prevention of cardiac related events in acute 
      coronary syndromes particularly in patients undergoing percutaneous coronary 
      intervention. Recently, there have been reports of a clinically significant drug 
      interaction between clopidogrel and proton pump inhibitors (PPI), which are 
      frequently co-prescribed to prevent DAT associated gastrointestinal (GI) 
      bleeding. AREAS COVERED IN THIS REVIEW: This review evaluates the risk of GI 
      bleeding associated with DAT and the rationale for the use of PPI. This review 
      also describes the pharmacokinetic and pharmacodynamic basis for the interaction 
      and evaluates its significance on clinical outcomes. An extensive literature 
      search on PubMed from January 1980 to August 2009 was performed. Additionally, 
      abstracts and presentations from key cardiology meetings and press releases were 
      reviewed for relevant studies related to the interaction. WHAT THE READER WILL 
      GAIN: At the end of the review, readers should have a complete understanding of 
      the interaction and steps that can be taken to limit the interaction. TAKE HOME 
      MESSAGE: There is a mechanistic basis and pharmacodynamic data supporting an 
      interaction between PPIs, particularly omeprazole and clopidogrel. The clinical 
      significance of this interaction is, however, still a subject of intense debate 
      and ongoing research.
FAU - Oyetayo, Ola O
AU  - Oyetayo OO
AD  - University of Texas Health Science Center, Pharmacotherapy Education and Research 
      Center, School of Medicine, 7703 Floyd Curl Drive, MC 6220, San Antonio, TX 
      78229, USA. oyetayo@uthscsa.edu
FAU - Talbert, Robert L
AU  - Talbert RL
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Expert Opin Drug Saf
JT  - Expert opinion on drug safety
JID - 101163027
RN  - 0 (Gastrointestinal Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - OM90ZUW7M1 (Ticlopidine)
SB  - IM
MH  - Blood Platelets/drug effects
MH  - Clopidogrel
MH  - Drug Interactions
MH  - Drug Therapy, Combination/adverse effects
MH  - Gastrointestinal Agents/adverse effects
MH  - Gastrointestinal Hemorrhage/chemically induced/prevention & control
MH  - Humans
MH  - Platelet Aggregation Inhibitors/*adverse effects/metabolism/therapeutic use
MH  - Proton Pump Inhibitors/*adverse effects/metabolism/therapeutic use
MH  - Randomized Controlled Trials as Topic
MH  - Ticlopidine/adverse effects/*analogs & derivatives/metabolism/therapeutic use
MH  - Treatment Outcome
RF  - 39
EDAT- 2010/04/10 06:00
MHDA- 2010/09/30 06:00
CRDT- 2010/04/10 06:00
PHST- 2010/04/10 06:00 [entrez]
PHST- 2010/04/10 06:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
AID - 10.1517/14740331003645609 [doi]
PST - ppublish
SO  - Expert Opin Drug Saf. 2010 Jul;9(4):593-602. doi: 10.1517/14740331003645609.