PMID- 24023447
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20130911
LR  - 20211021
IS  - 0975-1483 (Print)
IS  - 0975-1505 (Electronic)
IS  - 0975-1483 (Linking)
VI  - 5
IP  - 1
DP  - 2013 Mar
TI  - Clopidogrel and the possibility of drug-drug interaction in primary health care.
PG  - 18-21
LID - 10.1016/j.jyp.2013.01.002 [doi]
AB  - INTRODUCTION: Clopidogrel ineffectiveness is a serious problem in antiplatelet 
      therapy. Many factors may contribute to this phenomenon. One of them is 
      clopidogrel drug-drug interaction with CYP2C19 and CYP3A4 enzyme inhibitors. The 
      main goal of this descriptive study was to assess the prevalence of cases of 
      clopidogrel-drug interactions in the primary health care physicians' practices. 
      MATERIALS AND METHODS: During 2010-2011, 80 patients receiving clopidogrel 
      antiplatelet therapy from primary care physicians' clinical practices were 
      involved in this study. By using questionnaires and case histories, the following 
      information was collected: Age, gender, clinical diagnoses, and medications used. 
      RESULTS: IN THE CURRENT STUDY, DRUGS WERE USED THAT COULD POTENTIALLY INFLUENCE 
      THE EFFECT OF CLOPIDOGREL: Omeprazole, lipophilic statins, calcium channel 
      blockers (CCB). There was a different use of the above-mentioned drugs before and 
      after the initiation of the clopidogrel therapy, e.g., 12 (15.0%) and 44 (55.0%) 
      patients used proton pump inhibitors (PPI) before and after the clopidogrel 
      therapy accordingly (P = 0.16; chi (2) = 1.91). However, pantoprazole was 
      recommended more often than other PPI. The use of the potential CYP3A4 inhibitors 
      - lipophilic statins and CCB - was increased after the prescription of 
      clopidogrel too. Concomitant use of statins (mainly atorvastatin) with 
      clopidogrel was observed in 75 (93.8%) patients and the use of CCB (mainly 
      amlodipine) - in 33 (41.3%) patients. CONCLUSION: In the primary health care 
      practices, it is revealed that there is co-medication of clopidogrel with weak 
      CYP3A4 inhibitors, such as lipophilic statins and amlodipine, and with the 
      moderate CYP2C19 inhibitor - omeprazole. The latter co-medication is potentially 
      harmful and it is very important to inform the first care professionals about the 
      opportunity to change omeprazole to pantoprazole, which does not influence 
      clopidogrel biotransformation.
FAU - Urtane, Inga
AU  - Urtane I
AD  - Department of Pharmacy, Riga Stradins University, Latvia.
FAU - Aitullina, Aleksandra
AU  - Aitullina A
FAU - Pukite, Katrina
AU  - Pukite K
LA  - eng
PT  - Journal Article
DEP - 20130307
PL  - India
TA  - J Young Pharm
JT  - Journal of young pharmacists : JYP
JID - 101537066
PMC - PMC3758091
OTO - NOTNLM
OT  - Amlodipine
OT  - Atorvastatin
OT  - Clopidogrel
OT  - Drug-drug interaction
OT  - Omeprazole
EDAT- 2013/09/12 06:00
MHDA- 2013/09/12 06:01
PMCR- 2014/03/01
CRDT- 2013/09/12 06:00
PHST- 2012/10/20 00:00 [received]
PHST- 2012/12/13 00:00 [accepted]
PHST- 2013/09/12 06:00 [entrez]
PHST- 2013/09/12 06:00 [pubmed]
PHST- 2013/09/12 06:01 [medline]
PHST- 2014/03/01 00:00 [pmc-release]
AID - S0975-1483(13)00003-4 [pii]
AID - 10.1016/j.jyp.2013.01.002 [doi]
PST - ppublish
SO  - J Young Pharm. 2013 Mar;5(1):18-21. doi: 10.1016/j.jyp.2013.01.002. Epub 2013 Mar 
      7.