For preventing peptic ulcers and gastrointestinal reflux disease (GERD) you can prescribe these popular drugs, which include omeprazole (Prilosec), esomeprazole (Nexium), lansoprazole (Prevacid), dexlansoprazole (Dexilant, Kapidex), and pantoprazole (sold under many names). It was said that omeprazole interfere with clopidogrel activity but Harvard university recently have published an article. Here it is. Recently, a study led by Harvard researchers found no evidence that concurrent use of clopidogrel and omeprazole causes an increase in heart attacks, strokes, or death. Dr. Deepak L. Bhatt, chief of cardiology at the VA Boston Health System and associate professor of medicine at Harvard Medical School, hopes this puts concerns to rest. "In a test tube, there is a drug-drug interaction, but no randomized clinical trial has shown that it matters clinically," he says. "PPIs like Prilosec may be taking the blame for a complex problem. Multiple factors affect the risk of a future cardiac event in patients with stents, including genetics, smoking, diabetes, being overweight, a heart attack versus stable coronary artery disease—and PPIs," he explains. If the drug-drug interaction were a major problem, doctors would expect to see blood clots in the stents of patients taking PPIs. But they don't. "I would not tell a patient to stop taking PPIs. We see more problems when patients don't fill their clopidogrel prescription," says Dr. Bhatt. Ease your mind If you are worried about taking clopidogrel together with a PPI, you can: Verify your need for a PPI with the doctor who prescribed it. You may be able to stop taking it. If you have diagnosed yourself with GERD or heartburn and are buying your PPI over the counter, see a gastroenterologist to confirm your diagnosis. Switch PPIs. Another recent study conducted by Dr. Bhatt and colleagues found that clopidogrel was affected less by dexlansoprazole and lansoprazole than by omeprazole or esomeprazole. Talk with your cardiologist about your concerns. Never stop taking clopidogrel without checking with your doctor first.
