PMID- 20979006
OWN - NLM
STAT- MEDLINE
DCOM- 20101130
LR  - 20181201
IS  - 1439-4413 (Electronic)
IS  - 0012-0472 (Linking)
VI  - 135
IP  - 44
DP  - 2010 Nov
TI  - [Dilemma between gastroprotection and cardiovascular prevention].
PG  - 2193-8
LID - 10.1055/s-0030-1267498 [doi]
AB  - Long-term low-dose aspirin intake leads to a 2 - 4-fold risk of risk for upper 
      gastrointestinal bleeding. The additional intake of clopidogrel further increases 
      the risk of upper GI bleeding (OR 7.4). Because of the potential interaction 
      between proton pump inhibitors (PPI) and clopidogrel that compromises the 
      efficacy of clopidogrel on platelet aggregation, there has been a warning in the 
      product information by health authorities in the US and in Europe who discourage 
      the concomitant use of PPI and clopidogrel. In the present study we performed a 
      selected review of the published literature on the indications for gastric 
      protection with PPI in patients on mono- or dual antiplatelet therapy focussing 
      on the possible interaction between clopidogrel and PPI. In ex vivo analyses of 
      platelet function, a reduced efficacy of clopidogrel was observed in patients on 
      comedication with omeprazole. This was not the case with the comedication of 
      other PPIs. To date, clear evidence is missing to state that comedication with 
      PPI reduces the efficacy of clopidogrel IN VIVO. If both Clopidogrel and PPI need 
      to be prescribed, a split dosage regimen of PPI in the morning and clopidogrel in 
      the evening can be recommended. The short half-life of both medications explains 
      the rationale of this recommendation.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Venerito, M
AU  - Venerito M
AD  - Klinik fur Gastroenterologie, Hepatologie und Infektiologie, Otto-von-Guericke 
      Universitat, Magdeburg.
FAU - Kandulski, A
AU  - Kandulski A
FAU - Malfertheiner, P
AU  - Malfertheiner P
LA  - ger
PT  - Journal Article
PT  - Review
TT  - Dilemma zwischen Magenschutz und Kardioprotektion.
DEP - 20101026
PL  - Germany
TA  - Dtsch Med Wochenschr
JT  - Deutsche medizinische Wochenschrift (1946)
JID - 0006723
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Anti-Ulcer Agents)
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - A74586SNO7 (Clopidogrel)
RN  - EC 1.14.14.1 (Aryl Hydrocarbon Hydroxylases)
RN  - EC 1.14.14.1 (CYP2C19 protein, human)
RN  - EC 1.14.14.1 (Cytochrome P-450 CYP2C19)
RN  - KG60484QX9 (Omeprazole)
RN  - OM90ZUW7M1 (Ticlopidine)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Alleles
MH  - Anti-Inflammatory Agents, Non-Steroidal/*administration & dosage/therapeutic use
MH  - Anti-Ulcer Agents/*administration & dosage/*adverse effects
MH  - Aryl Hydrocarbon Hydroxylases/genetics
MH  - Aspirin/*adverse effects/therapeutic use
MH  - Clopidogrel
MH  - Coronary Artery Disease/genetics/mortality/*prevention & control/therapy
MH  - Coronary Restenosis/prevention & control
MH  - Cytochrome P-450 CYP2C19
MH  - Dose-Response Relationship, Drug
MH  - Drug Interactions
MH  - Drug Therapy, Combination
MH  - Drug-Eluting Stents
MH  - Humans
MH  - Long-Term Care
MH  - Mutation
MH  - Omeprazole/*administration & dosage/*adverse 
      effects/pharmacokinetics/*therapeutic use
MH  - Peptic Ulcer Hemorrhage/*chemically induced/genetics/mortality/*prevention & 
      control
MH  - Platelet Aggregation/*drug effects
MH  - Platelet Aggregation Inhibitors/*adverse effects/therapeutic use
MH  - Polymorphism, Genetic
MH  - Proton Pump Inhibitors/*administration & dosage/*adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - Recurrence
MH  - Risk Factors
MH  - Survival Analysis
MH  - Ticlopidine/adverse effects/*analogs & derivatives/pharmacokinetics/therapeutic 
      use
MH  - Treatment Outcome
EDAT- 2010/10/28 06:00
MHDA- 2010/12/14 06:00
CRDT- 2010/10/28 06:00
PHST- 2010/10/28 06:00 [entrez]
PHST- 2010/10/28 06:00 [pubmed]
PHST- 2010/12/14 06:00 [medline]
AID - 10.1055/s-0030-1267498 [doi]
PST - ppublish
SO  - Dtsch Med Wochenschr. 2010 Nov;135(44):2193-8. doi: 10.1055/s-0030-1267498. Epub 
      2010 Oct 26.