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FDA Reminds Patients to Avoid Using Plavix and Omeprazole at the Same Time
An FDA reminder warns patients and health care providers that concomitant use of Plavix® (clopidogrel) and omeprazole should be avoided due to significant reductions in clopidogrel's effectiveness when the drugs are taken at the same time. FDA also provides additional facts for health care providers. As reported by FDA in November 2009, concomitant use of clopidogrel and omeprazole can result in significant reductions in clopidogrel's active metabolite levels and antiplatelet activity. Patients prescribed Plavix will not get the full anti-clotting effect if they also take omeprazole which is found in prescription products (Prilosec®, Zegerid®, and generic products) and over-the-counter products (Prilosec OTCTM, Zegerid OTCTM, and generic products). In the reminder notice, FDA emphasizes to health care providers that this recommendation applies only to omeprazole and not to all proton pump inhibitors (PPIs), as not all PPIs have the same inhibitory effect on the CYP 2C19 enzyme that is needed for Plavix to convert into its active form. FDA also notes that providers may consider pantoprazole (Protonix®) as an alternative PPI because it is a weak inhibitor of CYP2C19 and has less effect on the pharmacological activity of Plavix than omeprazole.
