Clopidogrel and PPI Interaction: Clinically Relevant or Not?
Summary of "Clopidogrel and PPI Interaction: Clinically Relevant or Not?"
Proton pump inhibitors and clopidogrel are commonly prescribed medications, both alone and in combination. In January of 2009 the US Food and Drug Administration and the European Medicines Agency issued warnings with regard to the concomitant use of clopidogrel and proton pump inhibitors. Later that year, these warnings were limited to the proton pump inhibitor omeprazole. These warnings were largely based on in-vitro studies and observational analyses suggesting decreased efficacy of clopidogrel in the presence of proton pump inhibitors. Recent literature has suggested there may not be a clinically meaningful interaction.
Affiliation
Duke Clinical Research Institute, 2400 Pratt Street, Durham, NC, 27715, USA, Robert.w.harrison@duke.edu.
Journal Details
This article was published in the following journal.
Name: Current cardiology reports
ISSN: 1534-3170
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22090195
- DOI: http://dx.doi.org/10.1007/s11886-011-0233-y
Medical and Biotech [MESH] Definitions
Asperger Syndrome
A childhood disorder predominately affecting boys and similar to autism (AUTISTIC DISORDER). It is characterized by severe, sustained, clinically significant impairment of social interaction, and restricted repetitive and stereotyped patterns of behavior. In contrast to autism, there are no clinically significant delays in language or cognitive development. (From DSM-IV)
Aminacrine
A highly fluorescent anti-infective dye used clinically as a topical antiseptic and experimentally as a mutagen, due to its interaction with DNA. It is also used as an intracellular pH indicator.
Protein Interaction Mapping
Methods for determining interaction between proteins.
Rod-cone Interaction
Reciprocal action of two vertebrate photoreceptor cells (RODS AND CONES). Rod-cone interaction occurs during MESOPIC VISION in which both rods and cones are active in light transduction to the VISUAL CORTEX. Such interaction can influence visual sensitivity and luminous efficiency.
Spectroscopy, Mossbauer
A spectroscopic technique which uses the Mossbauer effect (inelastic scattering of gamma radiation resulting from interaction with heavy nuclei) to monitor the small variations in the interaction between an atomic nucleus and its environment. Such variations may be induced by changes in temperature, pressure, chemical state, molecular conformation, molecular interaction, or physical site. It is particularly useful for studies of structure-activity relationship in metalloproteins, mobility of heavy metals, and the state of whole tissue and cell membranes.
PubMed Articles
Interaction of clopidogrel and omeprazole.
To the Editor: The label for clopidogrel warns physicians to "avoid concomitant use of . . . strong or moderate CYP2C19 inhibitors." Such inhibitors (e.g., omeprazole) decrease the formation of the...
Four randomized, placebo-controlled, crossover studies were conducted among 282 healthy subjects to investigate whether an interaction exists between clopidogrel (300-mg loading dose/75-mg/day mainten...
Antiplatelet therapy in secondary stroke prevention - state of the art.
Abstract Objective: To provide the reader with an overview as well as an update on current antiplatelet therapy for secondary stroke prevention. Methods: Relevant journals were hand-searched by the au...
In this study, we investigated pharmacokinetic drug interactions of clopidogrel with P-gp inhibitors in rats and dogs. Following the oral administration of clopidogrel with or without the P-gp inhibit...
Clopidogrel-drug interactions.
Multidrug therapy increases the risk for drug-drug interactions. Clopidogrel, a prodrug, requires hepatic cytochrome P450 (CYP) metabolic activation to produce the active metabolite that inhibits the...
Clinical Trials
Clopidogrel/Aspirin Interaction Study
This study will explore the effect of different doses of aspirin on the effects of double-dose or standard dose clopidogrel.
Primary objective: - Assess the effects of clopidogrel (300 mg loading dose followed by 4 days 75 mg/day) on Adenosine diphosphate (ADP)-induced platelet aggregation when given co...
Primary objective: - Assess the effects of clopidogrel (600 mg loading dose followed by 4 days 150 mg/day) on Adenosine diphosphate (ADP)-induced platelet aggregation when given c...
Clopidogrel Reloading in Clopidogrel Resistant Patients With ACS
Laboratory clopidogrel resistance is associated with adverse atherothrombotic events in patients with coronary artery disease. In the proposed study we wish to prospectively assess the eff...
This study will establish the optimal therapeutic strategy for patients with a coronary artery disease (CAD) and chronically treated with clopidogrel 75 mg/day requiring co-administration...