Is there a drug-drug interaction between clopidogrel and omeprazole?
Background Clopidogrel (Plavix) is a thienopyridine that inhibits adenosine diphosphate (ADP)-induced platelet activation through the formation of an inactivating disulfide bond within the platelet P2Y12 ADP receptor’s active site. The blockade of ADP-induced platelet activation leads to a reduction in platelet aggregation and arterial thrombus formation. Clopidogrel, as monotherapy or when used concomitantly with aspirin, has proven to be effective in treatment of acute coronary syndromes and in the reduction of stent thrombosis. Clopidogrel is a prodrug activated in the liver to an active metabolite via cytochrome P450 isoenzymes. Variations in polymorphic expression of CYP2C19 specifically seem to be associated with differences in pharmacodynamic response to clopidogrel. Omeprazole (Prilosec) is a proton-pump inhibitor (PPI), available over-the-counter. It is often used to prevent gastrointestinal bleeding in patients on chronic aspirin-clopidogrel antiplatelet dual therapy. Omepraz
