Controversy of proton pump inhibitor and clopidogrel interaction: A review
Journal of Digestive Diseases, 10/18/2010
Tan HJ – Proton pump inhibitor is often co–prescribed with clopidogrel to reduce the gastrointestinal risk of bleeding ulcer in patients following acute coronary syndrome or stent implant. However, the safety issue of such practice has been scrutinised after some studies reporting an increase incidence of cardiovascular events and mortality, although there were also researchers reporting otherwise. This has lead to the warning statement from the US Food and Drug Administration FDA cautioning the concomitant use of proton pump inhibitor and clopidogrel. This review examines the evidence of proton pump inhibitor as gastroprotective agent, H2RA as an alternative therapy, the influence of proton pump inhibitor on the antiplatelet effect of clopidogrel, and the controversies of various studies.