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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. May 6, 2015; 6(2): 17-21
Published online May 6, 2015. doi: 10.4292/wjgpt.v6.i2.17
Clinical relevance of clopidogrel-proton pump inhibitors interaction
Stella D Bouziana, Konstantinos Tziomalos
Stella D Bouziana, Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, 54636 Thessaloniki, Greece
Author contributions: Bouziana SD drafted the paper; Tziomalos K revised the draft critically for important intellectual content.
Conflict-of-interest: We have no conflict of interest to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Konstantinos Tziomalos, MD, PhD, Assistant Professor of Internal Medicine, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Kiriakidi 1, 54636 Thessaloniki, Greece. ktziomalos@yahoo.com
Telephone: +30-2310-994621 Fax: +30-2310-994773
Received: January 13, 2015
Peer-review started: January 15, 2015
First decision: March 6, 2015
Revised: March 24, 2015
Accepted: April 16, 2015
Article in press: April 20, 2015
Published online: May 6, 2015
Core Tip

Core tip: Even though pharmacodynamic studies suggest that omeprazole can attenuate the antiplatelet effect of clopidogrel, this interaction does not appear to translate into increased cardiovascular risk in patients treated with this combination in observational studies. In the only randomized, double-blind, placebo-controlled study that assessed the cardiovascular implications of combining clopidogrel and omeprazole, patients treated with clopidogrel/omeprazole combination had reduced risk for gastrointestinal events and similar risk for cardiovascular events. Other proton pump inhibitors also do not appear to interact with clopidogrel. However, given the limitations of existing studies, the decision to administer proton pump inhibitors to patients treated with clopidogrel should be individualized based on the patient’s bleeding and cardiovascular risk.