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Topics in Evidence-Based Pharmacy Practice
1/14/2011: Clopidogrel with or without Omeprazole in Coronary Artery Disease
Michelle Tyra
Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
Gabriel Aguilar
Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
Amy P. Witte
Feik School of Pharmacy, University of the Incarnate Word, San Antonio, Texas
Excerpt:"Clopidogrel is an antiplatelet agent indicated for the treatment of patients with recent MI, recent stroke, established peripheral arterial disease, acute coronary syndromes, or post-percutaneous coronary interventions.1 Clopidogrel prevents platelet aggregation that may lead to a blockage and a subsequent cardiovascular events. Therefore clopidogrel is a useful agent in primary and secondary prevention of cardiovascular events.2 Due to clopidogrel's efficacy in these patients, it has become the second most prescribed drug in the world.3 However, the risk for gastrointestinal (GI) bleeding is increased with use of an antiplatelet agent. Thus, a proton pump inhibitor (PPI) such as omeprazole is indicated in patients at high risk for GI bleeding taking clopidogrel alone or with aspirin therapy. Recent observational studies suggest that concomitant use of clopidogrel and a PPI leads to an increased risk of CV events.1..."
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