The clinical relevance of the clopidogrel-proton pump inhibitor interaction

J Cardiovasc Transl Res. 2012 Aug;5(4):547-52. doi: 10.1007/s12265-011-9334-7. Epub 2012 Feb 14.

Abstract

Proton pump inhibitors are often prescribed concomitantly with clopidogrel and aspirin to patients post-percutaneous coronary interventions and/or an acute coronary syndrome to mitigate the risk of potential gastrointestinal bleeding, associated primarily with clopidogrel use. Over the last several years, there have been data both supporting and refuting a clopidogrel-proton pump inhibitor interaction. This review critically considers the current evidence and provides practical recommendations to healthcare providers.

Publication types

  • Review

MeSH terms

  • Animals
  • Biotransformation / genetics
  • Clopidogrel
  • Cytochrome P-450 Enzyme System / genetics
  • Cytochrome P-450 Enzyme System / metabolism
  • Drug Interactions
  • Evidence-Based Medicine
  • Gastrointestinal Hemorrhage / chemically induced
  • Gastrointestinal Hemorrhage / prevention & control*
  • Genotype
  • Humans
  • Phenotype
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / pharmacokinetics
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Polymorphism, Genetic
  • Practice Guidelines as Topic
  • Proton Pump Inhibitors / adverse effects
  • Proton Pump Inhibitors / pharmacokinetics
  • Proton Pump Inhibitors / therapeutic use*
  • Risk Assessment
  • Risk Factors
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives*
  • Ticlopidine / pharmacokinetics
  • Ticlopidine / therapeutic use

Substances

  • Platelet Aggregation Inhibitors
  • Proton Pump Inhibitors
  • Cytochrome P-450 Enzyme System
  • Clopidogrel
  • Ticlopidine