Drug Interactions Corner

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Proton pump inhibitors and clopidogrel: Not a good combination?

KEY POINT

A 12-month retrospective cohort study of 16,690 patients who underwent stent placement concluded that patients taking a proton pump inhibitor (PPI) with clopidogrel (Plavix—Bristol-Myers Squibb/ sanofi-aventis) had a significantly increased risk of major cardiovascular events compared with those on clopidogrel alone.

SOURCES

Aubert RE et al. Proton pump inhibitors effect on clopidogrel effectiveness : the clopidogrel Medco outcomes study (abstract 3998). Circulation. 2008;118:S815. 

Dunn SP et al. Baseline proton pump inhibitor use is associated with increased cardiovacular events with and without use of clopidogrel in the CREDO trial (abstract 3999). Circulation. 2008;118:S815. 

American Heart Association. American College of Cardiology (ACC)/American College of Gastroenterology (ACG)/American Heart Association (AHA) joint comment on studies regarding possible interaction of clopidogrel and proton pump inhibitors.