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Warning over clopidogrel and PPI use

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PPIs should be avoided in patients taking the antiplatelet drug clopidogrel (Plavix), the European Medicines Agency has warned.

The need for PPI therapy in patients who are also taking clopidogrel (Plavix) should be reviewed at their next appointment, it warned, as use of these drugs together should be avoided unless considered essential.

It follows a review of evidence, carried out by the agency’s Committee for Medicinal Products for Human Use, which concluded that PPIs reduced the effectiveness of clopidogrel in preventing the recurrence of adverse cardiac events such as myocardial infarction and coronary artery restenosis.

‘Taken together, these studies suggest that a significant interaction might occur between clopidogrel and members of the PPI class of medicines, making clopidogrel less effective when given with these medicines,’ the agency said.

Other acid-lowering medicines, such as H2 blockers or antacids, would not be expected to interact with clopidogrel, the agency said, but cautioned that there are currently no substantial data from clinical outcome studies to support this.

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