There has been a lot of discussion lately about the interaction between clopidogrel and the proton pump inhibitors (eg omperazole).
Clopidogrel is an antiplatelet drug. Well it is not really a drug. It is a prodrug and needs to be converted to an active metabolite in the liver. If you can get something to reduce Cytochrome CYP2C19 then clopidogrel is not metabolised and so no antiplatelet action occurs.
Yes you got it. The proton pump inhibitors can inhibit CYP2C19.
This bulletin from the Repatriation General Hospital in Adelaide sums up the latest evidence. Click on the picture below to download the small pdf.
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Hi,
Well written article amd I subscribe and enjoy all of these.
However, in this article (Clopidogrel and PPIs), the last summary sentence reads “..ppis… may attenuate the anti-platelet benefits of clopidogrel.”
I thought that PPIs (except pantoprazole) reduce the anti-platelet activity of clopidogrel via inhibition of the CYP2C19 enzyme…
I hope you can verify this via e-mail.
Regards,
Lidia, NPS facilitator at Southcity GP Services
G’day Lidia,
I don’t write these great articles. merely assist distribute them. I have passed your comment on
Hi Lidia,
Thanks for your interest! The statment regarding attenuation of effect is consistent with your interpretation and the rest of the material presented in the E-Bulletin. So I’m not sure whether there is another problem here which I am missing.
Regards,
Karin Nyfort-Hansen
Acting Editor RGH Pharmacy E-Bulletin
thanks, the artciel is correct after all.
Thanks
Lidia