An antiplatelet drug, clopidogrel is commonly used to prevent clotting events in patients at high risk for heart attacks or strokes. Proton pump inhibitors belong to a class of medications aimed at lowering stomach acid production. People with gastrointestinal ulcers or gastroesophageal reflux disease (GERD) may benefit from the use of proton pump inhibitors. Antiplatelet drugs can cause gastrointestinal side-effects and, to prevent this, patients may be instructed to take medications like clopidogrel and proton pump inhibitors together. Concomitant use of the two significantly reduces the efficacy of clopidogrel, however, and is thus not advised.
Antiplatelet medications typically inhibit the formation of arterial blood clots. People with atherosclerosis commonly take clopidogrel as part of a treatment plan to prevent clot formation. The drug may also be used to prevent further clotting events in patients who have already suffered a heart attack or stroke. Like all medications, clopidogrel has some side effects, including allergic reactions and fatigue. Taking clopidogrel may also cause gastrointestinal issues like diarrhea, stomach pain, ulcers, and bleeding.
Proton pump inhibitors have a direct effect on the acid-producing cells that make up the stomach lining. The use of such drugs generally decreases the production of acid in the stomach. This usually promotes the healing of existing stomach ulcers. A decrease in stomach acid production can also help improve symptoms for patients with GERD. Taking a combination of clopidogrel and proton pump inhibitors can decrease the gastrointestinal side effects associated with antiplatelet drugs.
Clopidogrel is inactive when taken and is converted to its active form by an enzyme in the body. Proton pump inhibitors can disrupt this process by partially blocking the conversion of clopidogrel to its active form. Concomitant use of clopidogrel and proton pump inhibitors may result in a blood concentration of clopidogrel that is well below therapeutic levels. This can have serious consequences. Reducing the drug’s action may result in breakthrough clotting events.
Medical studies indicate that concurrent use of clopidogrel and proton pump inhibitors is not safe. People should avoid taking the two medications together in order to get the full therapeutic effect of clopidogrel therapy. Concomitant intake may result in serious complications due to reduced clopidogrel efficacy.
