Why the study?
Does omeprazole given with clopidogrel affect cardiovascular outcomes in patients receiving dual antiplatelet therapy?
Does omeprazole given with clopidogrel affect cardiovascular outcomes in patients receiving dual antiplatelet therapy?
Physicians should continue to prescribe proton pump inhibitors for patients on dual antiplatelet therapy at risk of GI bleeding, as preliminary RCT data show no adverse effect on cardiovascular outcomes despite FDA warnings.
The US Food and Drug Administration has issued a warning that omeprazole (Prilosec) reduces the antiplatelet activity of clopidogrel (Plavix) by about 50%. However, the warning is based largely on ex vivo data. Preliminary results from a randomized clinical trial revealed no effect on cardiovascular outcomes when omeprazole was given with clopidogrel. We recommend that physicians continue to prescribe a proton pump inhibitor for patients receiving dual antiplatelet therapy who are at risk of gastrointestinal bleeding or have an indication for use of a proton pump inhibitor.
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Depta et al. (2010) studied this question.
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