Key result
Concomitant use of proton pump inhibitors for up to 6 months is unlikely to cause adverse interactions with clopidogrel and offers gastrointestinal benefits.
Why the study?
Does concomitant use of proton pump inhibitors reduce the antiplatelet efficacy of clopidogrel and increase the risk of thrombotic cardiovascular events in patients receiving clopidogrel?
Does concomitant use of proton pump inhibitors reduce the antiplatelet efficacy of clopidogrel and increase the risk of thrombotic cardiovascular events in patients receiving clopidogrel?
Concomitant use of PPIs with clopidogrel for up to 6 months appears safe and provides gastrointestinal benefits, challenging concerns of adverse interactions.
Supports short-term PPI-clopidogrel co-use for GI protection; challenges interaction concerns yet leaves open need for prospective confirmation.
INTRODUCTION: There is considerable debate surrounding the clinical relevance of an adverse interaction between clopidogrel and proton pump inhibitors (PPIs). Some studies have indicated that PPIs may attenuate the antiplatelet efficacy of clopidogrel, thus leading to increased risk of thrombotic cardiovascular events. AREAS COVERED: From a literature search of MEDLINE and EMBASE, the authors critically appraised data from systematic reviews, randomised controlled trials and observational studies that evaluated platelet function and clinical outcomes in patients receiving concomitant clopidogrel and PPIs. EXPERT OPINION: The evidence from platelet function and cardiovascular outcome studies is highly inconsistent. Higher quality data from randomised trials indicate that use of PPI therapy for up to 6 months is unlikely to cause any adverse interaction with clopidogrel, and there are gastrointestinal benefits with PPI use.
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Kwok et al. (2012) conducted a review in Patients receiving concomitant clopidogrel and proton pump inhibitors. Concomitant clopidogrel and proton pump inhibitors (PPIs) was evaluated on Platelet function and thrombotic cardiovascular events. Concomitant use of proton pump inhibitors for up to 6 months is unlikely to cause adverse interactions with clopidogrel and offers gastrointestinal benefits.
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