Pharmacy Times – February 2010


Drug Interactions: Insights and Observations


Clopidogrel – Proton Pump Inhibitor Interaction: An Update


John R. Horn, PharmD, FCCP and Philip D. Hansten, PharmD





  1. Kazui M, et al. Identification of the human cytochrome P45o enzymes involved in the two oxidative steps in the bioactivation of clopidogrel to its pharmacologically active metabolite. Drug Metab Disp. 2010;38:92-99.
  2. Gilard M, et al. Influence of omeprazole on the antiplatelet action of clopidogrel associated with aspirin. J Am Coll Cardiol. 2008;51:256-60.
  3. Ho PM, et al. Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome. JAMA. 2009;301:937–944.
  4. Juurlink DN, et al. A population-based study of the drug interaction between proton pump inhibitors and clopidogrel. CMAJ.2009;180(7):713-8.
  5. Pezella E, et al. Initial assessment of clopidogrel impact of a drug interaction between clopidogrel and proton pump inhibitors. JACC. 2008;52:1038–1039.
  6. Stanek EJ, et al. Abstract O-11: A national study of the effect of individual proton pump inhibitors on cardiovascular outcomes in patients treated with clopidogrel following coronary stenting: The Clopidogrel Medco Outcomes Study. Presented at: The Society for Cardiovascular Angiography and Interventions, 2009; Las Vegas, NV.
  7. O’Donoghue ML, et al. Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomized trials. Lancet. 2009;347:989-97.
  8. Rassen JA, et al. Cardiovascular outcomes and mortality in patients using clopidogrel with proton pump inhibitors after percutaneous coronary intervention or acute coronary syndrome. Circulation.2009;120:2322-39.
  9. Bhatt DL, et al. The COGENT Trial. Presented at Transcatheter Cardiovascular Therapeutics, 2009; San Francisco, CA. Available at:
  10. Information for Healthcare Professionals: Update to the labeling of Clopidogrel Bisulfate (marketed as Plavix) to alert healthcare professionals about a drug interaction with omeprazole (marketed as Prilosec and Prilosec OTC). Food and Drug Administration. Available online at: